Participation of the mouse implanting trophoblast in nitric oxide production during pregnancy.
While considerable progress has been made in elucidating nitric oxide (NO) regulatory mechanisms in the later stages of gestation, much less is known about its synthesis and role during embryo implantation. Thus, to evaluate the participation of the trophoblast in the production of NO during this phase, this study focused on NADPH-diaphorase activity and the distribution of NO synthase isoforms (NOS) using immunohistochemistry in pre- and postimplantation mouse embryos in situ and in vitro, as well as on NO production itself, measured as total nitrite, in trophoblast culture supernatants (Griess reaction). No NADPH-diaphorase activity was found in preimplanting embryos except after culturing for at least 48 h, when a few trophoblastic giant cells were positive. Conversely, postimplantation trophoblast cells either lodged into the implantation chamber (in situ) or after culturing (in vitro) showed intense NADPH-diaphorase activity. Also in the postimplantation trophoblast, the endothelial and inducible NOS (eNOS and iNOS) isoforms were immunodetected, under both in situ and in vitro conditions, although in different patterns. Extracts of ectoplacental cone also revealed bands of 135 and 130 kDa on SDS-PAGE that reacted with anti-eNOS and anti-iNOS, respectively, on Western blot. Analysis of the culture supernatant demonstrated that the nitrite concentration was 1) proportional to the number of cultured trophoblast cells, 2) almost completely abolished in the presence of N(omega)-nitro-L-arginine methyl ester, and 3) increased 2-fold in cultures stimulated with gamma-interferon. These results strongly suggest the production of NO from constitutive and inducible isoforms of NOS by the implanting mouse trophoblast. They also emphasize the possibility of the participation of these cells in vasodilatation and angiogenesis, and in cytotoxic mechanisms involved in the intense phagocytosis of injured maternal cells, which occur during the implantation process.


Tuberculin sensitivity and HIV-1 status of patients attending a sexually transmitted diseases clinic in Lusaka, Zambia: a cross-sectional study.
A cross-sectional study to estimate the prevalence of latent tuberculosis (TB) in a group of Zambians at high risk of human immunodeficiency virus type 1 (HIV-1) infection and to examine the effect of HIV-1 infection on the tuberculin response was conducted in the University Teaching Hospital in Lusaka, Zambia during July to September 1990. Patients were selected from those presenting to the out-patient clinic for first referral with either sexually transmitted or skin disease. 268 adults were included in the study; 158 (59%; 95% confidence interval [CI] = 53-65%) were HIV-1 antibody positive. Of 82 HIV-1 negative participants who returned for Mantoux skin test reading, 51 (62%; 95% CI = 57-67%) had a positive test reaction (diameter > or = 10 mm) after receiving 2 units of RT-23 tuberculin. Of 106 HIV-1 positive participants who returned, only 32 (30%; 95% CI = 26-34%) had a diameter > or = 10 mm. Nine (28%) of the HIV-1 positive and Mantoux positive participants had large reactions > or = 30 mm, compared to 4 (8%) of the HIV-1 negative, Mantoux positive participants (P = 0.03). Results in the HIV-1 negative group indicated a prevalence of latent TB of 62% in this population. HIV-1 infection was associated with a much higher frequency of negative response to tuberculin and with a few large skin test responses. Thus, in populations where HIV seropositivity is high, Mantoux skin tests cannot be used to assess those with latent TB who might benefit from chemoprophylaxis.


Anti-Inflammatory and Osteoprotective Effects of Cannabinoid-2 Receptor Agonist HU-308 in a Rat Model of Lipopolysaccharide-Induced Periodontitis.
Anti-inflammatory and immunologic properties of cannabinoids have been reported in several tissues. Expression of cannabinoid receptor Type 2 was reported in osteoblasts and osteoclasts, suggesting a key role in bone metabolism. The aim of this study is to assess the effect of treatment with cannabinoid-2 receptor agonist HU-308 in the oral health of rats subjected to lipopolysaccharide (LPS)-induced periodontitis. Twenty-four rats were distributed in four groups (six rats per group): 1) control rats; 2) sham rats; 3) rats submitted to experimental periodontitis (LPS); and 4) rats submitted to experimental periodontitis and treated with HU-308 (LPS+HU). In groups LPS and LPS+HU, periodontitis was induced by LPS (1 mg/mL) injected into the gingival tissue (GT) of maxillary and mandibular first molars and into the interdental space between the first and second molars, 3 days per week for 6 weeks. In group LPS+HU, HU-308 (500 ng/mL) was applied topically to the GT daily. Alveolar bone loss resulting from LPS-induced periodontitis was significantly attenuated with HU-308 treatment (LPS+HU), measured by macroscopic and histologic examination. Treatment also reduced gingival production of inflammatory mediators augmented in LPS-injected rats, such as: 1) inducible nitric oxide (iNOS) activity (LPS: 90.18 ± 36.51 pmol/minute/mg protein versus LPS+HU: 16.37 ± 4.73 pmol/minute/mg protein; P <0.05); 2) tumor necrosis factor alpha (LPS: 185.70 ± 25.63 pg/mg protein versus LPS+HU: 95.89 ± 17.47 pg/mg protein; P <0.05); and 3) prostaglandin E2 (PGE2) (LPS: 159.20 ± 38.70 pg/mg wet weight versus LPS+HU: 71.25 ± 17.75 pg/mg wet weight; P <0.05). Additionally, HU-308 treatment prevented the inhibitory effect of LPS-induced periodontitis on the salivary secretory response to pilocarpine. Moreover, iNOS activity and PGE2 content, which were increased by LPS-induced periodontitis in the submandibular gland, returned to control values after HU-308 treatment. This study demonstrates anti-inflammatory, osteoprotective, and prohomeostatic effects of HU-308 in oral tissues of rats with LPS-induced periodontitis.


The transcriptional corepressor SMRTER influences both Notch and ecdysone signaling during Drosophila development.
SMRTER (SMRT-related and ecdysone receptor interacting factor) is the Drosophila homologue of the vertebrate proteins SMRT and N-CoR, and forms with them a well-conserved family of transcriptional corepressors. Molecular characterization of SMRT-family proteins in cultured cells has implicated them in a wide range of transcriptional regulatory pathways. However, little is currently known about how this conserved class of transcriptional corepressors regulates the development of particular tissues via specific pathways. In this study, through our characterization of multiple Smrter (Smr) mutant lines, mosaic analysis of a loss-of-function Smr allele, and studies of two independent Smr RNAi fly lines, we report that SMRTER is required for the development of both ovarian follicle cells and the wing. In these two tissues, SMRTER inhibits not only the ecdysone pathway, but also the Notch pathway. We differentiate SMRTER's influence on these two signaling pathways by showing that SMRTER inhibits the Notch pathway, but not the ecdysone pathway, in a spatiotemporally restricted manner. We further confirm the likely involvement of SMRTER in the Notch pathway by demonstrating a direct interaction between SMRTER and Suppressor of Hairless [Su(H)], a DNA-binding transcription factor pivotal in the Notch pathway, and the colocalization of both proteins at many chromosomal regions in salivary glands. Based on our results, we propose that SMRTER regulates the Notch pathway through its association with Su(H), and that overcoming a SMRTER-mediated transcriptional repression barrier may represent a key mechanism used by the Notch pathway to control the precise timing of events and the formation of sharp boundaries between cells in multiple tissues during development.


Mogamulizumab-kpkc: A Novel Therapy for the Treatment of Cutaneous T-Cell Lymphoma.
Mogamulizumab-kpkc provides a novel mechanism of action for the treatment of mycosis fungoides and Sézary syndrome. The efficacy and safety of mogamulizumab-kpkc for the treatment of relapsed or refractory mycosis fungoides and Sézary syndrome were demonstrated in a multicenter, open-label, randomized phase III trial comparing mogamulizumab-kpkc with vorinostat. Patients treated with mogamulizumab-kpkc showed a statistically significant increased progression-free survival (PFS; 7.7 months) compared with vorinostat (3.1 months). Overall response rates were higher with mogamulizumab-kpkc compared with vorinostat (28% vs. 5%; p < .0001). The most common adverse events (> 20%) associated with mogamulizumab-kpkc include rash, infusion-related reaction, fatigue, diarrhea, musculoskeletal pain, and upper respiratory tract infection. The use of mogamulizumab-kpkc up to 50 days prior to allogeneic hematopoietic stem cell transplantation has been associated with an increased risk of severe acute graft-vs.-host disease, steroid-refractory graft-vs.-host disease, and mortality. Additional labeled warnings include dermatologic toxicity, infection, and autoimmune complications. The overall benefit to risk assessment of mogamulizumab-kpkc is acceptable, but its use is constrained by the high cost of treatment and the short-term benefit.


Impact of HLA-B*52:01-Driven Escape Mutations on Viral Replicative Capacity.
HLA-B*52:01 is strongly associated with protection against HIV disease progression. However, the mechanisms of HLA-B*52:01-mediated immune control have not been well studied. We here describe a cohort with a majority of HIV C-clade-infected individuals from Delhi, India, where HLA-B*52:01 is highly prevalent (phenotypic frequency, 22.5%). Consistent with studies of other cohorts, expression of HLA-B*52:01 was associated with high absolute CD4 counts and therefore a lack of HIV disease progression. We here examined the impact of HLA-B*52:01-associated viral polymorphisms within the immunodominant C clade Gag epitope RMTSPVSI (here, RI8; Gag residues 275 to 282) on viral replicative capacity (VRC) since HLA-mediated reduction in VRC is a central mechanism implicated in HLA-associated control of HIV. We observed in HLA-B*52:01-positive individuals a higher frequency of V280T, V280S, and V280A variants within RI8 (P = 0.0001). Each of these variants reduced viral replicative capacity in C clade viruses, particularly the V280A variant (P < 0.0001 in both the C clade consensus and in the Indian study cohort consensus p24 Gag backbone), which was also associated with significantly higher absolute CD4 counts in the donors (median, 941.5 cells/mm3; P = 0.004). A second HLA-B*52:01-associated mutation, K286R, flanking HLA-B*52:01-RI8, was also analyzed. Although selected in HLA-B*52:01-positive subjects often in combination with the V280X variants, this mutation did not act as a compensatory mutant but, indeed, further reduced VRC. These data are therefore consistent with previous work showing that HLA-B molecules that are associated with immune control of HIV principally target conserved epitopes within the capsid protein, escape from which results in a significant reduction in VRC.IMPORTANCE Few studies have addressed the mechanisms of immune control in HIV-infected subjects in India, where an estimated 2.7 million people are living with HIV. We focus here on a study cohort in Delhi on one of the most prevalent HLA-B alleles, HLA-B*52:01, present in 22.5% of infected individuals. HLA-B*52:01 has consistently been shown in other cohorts to be associated with protection against HIV disease progression, but studies have been limited by the low prevalence of this allele in North America and Europe. Among the C-clade-infected individuals, we show that HLA-B*52:01 is the most protective of all the HLA-B alleles expressed in the Indian cohort and is associated with the highest absolute CD4 counts. Further, we show that the mechanism by which HLA-B*52:01 mediates immune protection is, at least in part, related to the inability of HIV to evade the HLA-B*52:01-restricted p24 Gag-specific CD8+ T-cell response without incurring a significant loss to viral replicative capacity.


Tooth loss and caries prevalence in very old Swedish people: the relationship to cognitive function and functional ability.
To analyse whether cognitive function and functional ability are related to oral health among community-dwelling older people over the age of 80 years. This cross-sectional study is based on the Kungsholmen Elders Oral Health Survey (KEOHS). The study included oral examinations carried out in two local clinics by standardised examiners and interviews using structured questionnaires. Altogether 159 individuals were included in this study. Coronal caries and root caries were assessed using the National Institute of Dental and Craniofacial Research (NIDCR) diagnostic criteria. Cognitive function was assessed by the Mini-Mental State Examination (MMSE) index and functional ability was assessed by a global measure of self-reported changes. Older adults with a low MMSE score (< or = 23) tended to have a higher risk of coronal caries than those with higher scores. Participants with mild cognitive decline (MMSE = 24-26) and with a decrease in functional ability had a significantly higher risk of root caries. These associations changed little when adjusted by the covariates. In addition, people with a low MMSE (0-23) had a four times higher risk of not using dental services regularly. This result was unchanged after adjusting for the variables studied. This study revealed associations between the cognitive and functional status of the individual and aspects of oral health, that may contribute to a deeper understanding of the background of oral health status in older adults.


Psychophysiological whole-brain network clustering based on connectivity dynamics analysis in naturalistic conditions.
We introduce a novel method for delineating context-dependent functional brain networks whose connectivity dynamics are synchronized with the occurrence of a specific psychophysiological process of interest. In this method of context-related network dynamics analysis (CRNDA), a continuous psychophysiological index serves as a reference for clustering the whole-brain into functional networks. We applied CRNDA to fMRI data recorded during the viewing of a sadness-inducing film clip. The method reliably demarcated networks in which temporal patterns of connectivity related to the time series of reported emotional intensity. Our work successfully replicated the link between network connectivity and emotion rating in an independent sample group for seven of the networks. The demarcated networks have clear common functional denominators. Three of these networks overlap with distinct empathy-related networks, previously identified in distinct sets of studies. The other networks are related to sensorimotor processing, language, attention, and working memory. The results indicate that CRNDA, a data-driven method for network clustering that is sensitive to transient connectivity patterns, can productively and reliably demarcate networks that follow psychologically meaningful processes. Hum Brain Mapp 37:4654-4672, 2016. © 2016 Wiley Periodicals, Inc.


Recruitment and retention of primary care physicians at community health centers: a survey of Massachusetts physicians.
As the backbone of the safety-net system, community health centers (CHCs) provide access to essential services, yet contend with high provider turnover. Using an online survey, primary care physicians (PCPs) at 62 Massachusetts League of Community Health Centers member sites were queried about recruitment and retention factors. Nearly 300 (n=294) PCPs representing 46 CHCs completed the survey. Female physicians, those practicing in the greater Boston area, and those in practice for 10 or more years reported a higher likelihood of remaining in a CHC. Additional factors included: residency preparedness to practice in CHCs; the interview process; and satisfaction with the CHC's mission, patient diversity and current compensation. With the expansion of CHCs, attention must be paid to the PCP workforce. These survey results can inform advocates, leaders, policymakers, and educators regarding workforce initiatives and practice redesign. Once a commitment is made to caring for CHC patients, if this commitment is sustained, retention is good.


The association of perceived stress and verbal memory is greater in HIV-infected versus HIV-uninfected women.
In contrast to findings from cohorts comprised primarily of HIV-infected men, verbal memory deficits are the largest cognitive deficit found in HIV-infected women from the Women's Interagency HIV Study (WIHS), and this deficit is not explained by depressive symptoms or substance abuse. HIV-infected women may be at greater risk for verbal memory deficits due to a higher prevalence of cognitive risk factors such as high psychosocial stress and lower socioeconomic status. Here, we investigate the association between perceived stress using the Perceived Stress Scale (PSS-10) and verbal memory performance using the Hopkins Verbal Learning Test (HVLT) in 1009 HIV-infected and 496 at-risk HIV-uninfected WIHS participants. Participants completed a comprehensive neuropsychological test battery which yielded seven cognitive domain scores, including a primary outcome of verbal memory. HIV infection was not associated with a higher prevalence of high perceived stress (i.e., PSS-10 score in the top tertile) but was associated with worse performance on verbal learning (p < 0.01) and memory (p < 0.001), as well as attention (p = 0.02). Regardless of HIV status, high stress was associated with poorer performance in those cognitive domains (p's < 0.05) as well as processing speed (p = 0.01) and executive function (p < 0.01). A significant HIV by stress interaction was found only for the verbal memory domain (p = 0.02); among HIV-infected women only, high stress was associated with lower performance (p's < 0.001). That association was driven by the delayed verbal memory measure in particular. These findings suggest that high levels of perceived stress contribute to the deficits in verbal memory observed in WIHS women.


Glial fibrillary acidic protein elevations relate to neuroimaging abnormalities after mild TBI.
To determine whether a panel of blood-based biomarkers can discriminate between patients with suspected mild traumatic brain injury (mTBI) with and without neuroimaging findings (CT and MRI). Study participants presented to the emergency department with suspected mTBI (n = 277) with a CT and MRI scan and healthy controls (n = 49). Plasma concentrations of tau, glial fibrillary acidic protein (GFAP), ubiquitin carboxyl-terminal hydrolase L1, and neurofilament light chain (NFL) were measured using the single-molecule array technology. Concentrations of GFAP, tau, and NFL were higher in patients with mTBI, compared with those of controls (p's < 0.01). GFAP yielded an area under the curve (AUC) of 0.93 (95% confidence interval [CI] 0.90-0.96), confirming its discriminatory power for distinguishing mTBI from controls. Levels of GFAP, tau, and NFL were higher in patients with trauma-related intracranial findings on CT compared with those with normal CT, with the only significant predictor being GFAP (AUC 0.77, 95% CI 0.70-0.84). Among patients with mTBI, tau, NFL, and GFAP differentiated subjects with and without MRI abnormalities with an AUC of 0.83, with GFAP being the strongest predictor. Combining tau, NFL, and GFAP showed a good discriminatory power (AUC 0.80, 95% CI 0.69-0.90) for detecting MRI abnormalities, even in patients with mTBI with a normal CT. Our study confirms GFAP as a promising marker of brain injury in patients with acute mTBI. A combination of various biomarkers linked to different pathophysiologic mechanisms increases diagnostic subgroup accuracy. This multimarker strategy may guide medical decision making, facilitate the use of MRI scanning, and prove valuable in the stratification of patients with brain injuries in future clinical trials. Class I evidence that blood concentrations of GFAP, tau, and NFL discriminate patients with mTBI with and without neuroimaging findings.


Psychometric properties of the Cognitive Emotion Regulation Questionnaire (CERQ) in Spanish older adults.
The Cognitive Emotion Regulation Questionnaire (CERQ) assesses nine cognitive strategies used to cope with negative events. The aim of this study was to generate validity evidences of this instrument in an older Spanish population. The Spanish version of the CERQ (CERQ-S) and self-report scales, measuring psychological well-being, depression and resilience, were administered to 305 older adults aged 65-90 (70.0 ± 4.7) residents in the Autonomous Community of Madrid, Spain. 150 participants completed the 6-month follow-up in April 2020 (during the COVID-19 pandemic). Confirmatory factor analyses supported 9-strategy structure, with an improved fit 27-item version (CERQ-S-27). Generally adequate composite reliability (CR between 0.63 and 0.84) and temporal stability (ICC between 0.38 and 0.71; p < 0.001) were found. Subscales correlated coherently with measures of depression, well-being and resilience, and T-tests indicated different use between older adults who did or did not have depressive symptoms. Multiple linear regression analysis indicated that subscales predicted depressive symptoms (R2 = 0.17; p < 0.001) and psychological well-being after six months (R2 = 0.21; p < 0.001). Results provided evidences of concurrent, predictive and criterion validity, suggesting that the CERQ-S-27 could be useful for studying use of cognitive emotion regulation strategies among older adults and understanding their influence in ageing and mental health.


Chronic exposure to heavy metals and risk of oral cancer in Taiwanese males.
The incidence of oral cancer has increased rapidly over the past 20years in Taiwan. Cigarette smoking and betel quid chewing are considered as the most important risk factors. However, we found that Changhua, a county in Taiwan, had the highest oral cancer incidence, but a modest prevalence of smoking and betel quid chewing. Our previous study found that the incidence of oral cancer in Taiwan has a strong spatial correlation with the heavy metal concentrations in farm soils of patients' residential areas. A high content of heavy metals in farm soil is likely the result of industrial activities. If exposure to heavy metals is a risk factor for oral cancer, we would expect to find evidence from epidemiologic trends. The age-period-cohort model was used to analyze chart records from the Taiwan Cancer Registry of 21,135 male patients diagnosed with oral cancer from 1983 to 2002. Although the incidence increased in both Changhua and Taiwan overall, Changhua had a similar incidence to that in Taiwan as a whole until 1990, when the incidence in Changhua began to speed up, leaving a marked difference with that in Taiwan. Exposure to the heavy metal pollution for a period of more than 10years has an impact on the incidence of oral cancer. This novel factor can explain the extremely high incidence in Changhua.


Multiple endocrine neoplasia type 1 (MEN1) and type 4 (MEN4).
Multiple endocrine neoplasia (MEN) is characterized by the occurrence of tumors involving two or more endocrine glands within a single patient. Four major forms of MEN, which are autosomal dominant disorders, are recognized and referred to as: MEN type 1 (MEN1), due to menin mutations; MEN2 (previously MEN2A) due to mutations of a tyrosine kinase receptor encoded by the rearranged during transfection (RET) protoncogene; MEN3 (previously MEN2B) due to RET mutations; and MEN4 due to cyclin-dependent kinase inhibitor (CDNK1B) mutations. Each MEN type is associated with the occurrence of specific tumors. Thus, MEN1 is characterized by the occurrence of parathyroid, pancreatic islet and anterior pituitary tumors; MEN2 is characterized by the occurrence of medullary thyroid carcinoma (MTC) in association with phaeochromocytoma and parathyroid tumors; MEN3 is characterized by the occurrence of MTC and phaeochromocytoma in association with a marfanoid habitus, mucosal neuromas, medullated corneal fibers and intestinal autonomic ganglion dysfunction, leading to megacolon; and MEN4, which is also referred to as MENX, is characterized by the occurrence of parathyroid and anterior pituitary tumors in possible association with tumors of the adrenals, kidneys, and reproductive organs. This review will focus on the clinical and molecular details of the MEN1 and MEN4 syndromes. The gene causing MEN1 is located on chromosome 11q13, and encodes a 610 amino-acid protein, menin, which has functions in cell division, genome stability, and transcription regulation. Menin, which acts as scaffold protein, may increase or decrease gene expression by epigenetic regulation of gene expression via histone methylation. Thus, menin by forming a subunit of the mixed lineage leukemia (MLL) complexes that trimethylate histone H3 at lysine 4 (H3K4), facilitates activation of transcriptional activity in target genes such as cyclin-dependent kinase (CDK) inhibitors; and by interacting with the suppressor of variegation 3-9 homolog family protein (SUV39H1) to mediate H3K methylation, thereby silencing transcriptional activity of target genes. MEN1-associated tumors harbor germline and somatic mutations, consistent with Knudson's two-hit hypothesis. Genetic diagnosis to identify individuals with germline MEN1 mutations has facilitated appropriate targeting of clinical, biochemical and radiological screening for this high risk group of patients for whom earlier implementation of treatments can then be considered. MEN4 is caused by heterozygous mutations of CDNK1B which encodes the 196 amino-acid CDK1 p27Kip1, which is activated by H3K4 methylation.


Refinement and psychometric reevaluation of the instrument: Families' Importance In Nursing Care--Nurses' Attitudes.
The instrument Families' Importance in Nursing Care--Nurses' Attitudes (FINC-NA) was developed to measure nurses' attitudes toward the importance of families in nursing care. The low variations in item responses, which affect the discrimination ability and unstable internal consistency, have been considered as limitations. The aim of this study was to refine and revalidate FINC-NA regarding score distribution, homogeneity, dimensionality, differential item functioning for gender, stability, and internal consistency. There were 246 registered nurses studying at advanced levels who answered the revised FINC-NA. The FINC-NA had five response alternatives. The findings showed that although some subscales still deviated from a normal distribution, the variability of the scores and the homogeneity was improved. In addition, the dimensionality was reproduced and minor problems with differential item functioning for gender were detected. All FINC-NA scales showed good reliability. The results allow the use of the revised FINC-NA in studies where an assessment of nurses' attitudes toward families' importance in nursing care is desired.


Determination of benzimidazole fungicides in water samples by on-line MISPE-HPLC.
An analytical methodology based on an on-line sample enrichment of water samples by means of an imprinted polymer, and the separation of benzimidazole compounds within a C(18) column by ion-pair reversed-phase liquid chromatography, has been developed. The molecularly imprinted polymer has been synthesized by precipitation polymerization using thiabendazole as template molecule, methacrylic acid as functional monomer, and divinylbenzene as cross-linker. Initial experiments carried out by solid-phase extraction on cartridges demonstrated a clear imprint effect for thiabendazole, as well as the ability of the imprinted polymer to selectively rebind several benzimidazole compounds. The developed methodology has been applied to the quantification of thiabendazole, carbendazim, and benomyl in river, tap, and well water samples within a single analytical run at concentration levels below the legislated maximum concentration levels. In this sense, detection limits of 2.3-5.7 ng.L(-1) have been obtained for the analysis of benzimidazole fungicides in different water matrices. Recoveries obtained for the determination of benzimidazole fungicides in spiked samples ranged from 87% to 95%, with RSD below 5% in all cases.


Effect of net surface charge on particle sizing and material recognition by using phase Doppler anemometry.
By taking net surface charge into consideration, the scattering field of particles illuminated by dual laser beams of phase Doppler anemometry (PDA) is computed based on Mie's theory, and the effect of net surface charge on the phase-diameter relationship and the phase ratio is studied. It is found that the phase-diameter relationship and the relationship between the phase ratio and the refractive index of charged particles could be significantly different from those of uncharged particles, which would lead to errors in particle sizing and the measurement of refractive indices. A method of recognizing charged particles and determining the value of their surface conductivity, which is related to net surface charge, is proposed by utilizing the effect of net surface charge on the measurement of refractive indices using PDA.


Plastid phylogenomic analysis of green plants: A billion years of evolutionary history.
For the past one billion years, green plants (Viridiplantae) have dominated global ecosystems, yet many key branches in their evolutionary history remain poorly resolved. Using the largest analysis of Viridiplantae based on plastid genome sequences to date, we examined the phylogeny and implications for morphological evolution at key nodes. We analyzed amino acid sequences from protein-coding genes from complete (or nearly complete) plastomes for 1879 taxa, including representatives across all major clades of Viridiplantae. Much of the data used was derived from transcriptomes from the One Thousand Plants Project (1KP); other data were taken from GenBank. Our results largely agree with previous plastid-based analyses. Noteworthy results include (1) the position of Zygnematophyceae as sister to land plants (Embryophyta), (2) a bryophyte clade (hornworts, mosses + liverworts), (3) Equisetum + Psilotaceae as sister to Marattiales + leptosporangiate ferns, (4) cycads + Ginkgo as sister to the remaining extant gymnosperms, within which Gnetophyta are placed within conifers as sister to non-Pinaceae (Gne-Cup hypothesis), and (5) Amborella, followed by water lilies (Nymphaeales), as successive sisters to all other extant angiosperms. Within angiosperms, there is support for Mesangiospermae, a clade that comprises magnoliids, Chloranthales, monocots, Ceratophyllum, and eudicots. The placements of Ceratophyllum and Dilleniaceae remain problematic. Within Pentapetalae, two major clades (superasterids and superrosids) are recovered. This plastid data set provides an important resource for elucidating morphological evolution, dating divergence times in Viridiplantae, comparisons with emerging nuclear phylogenies, and analyses of molecular evolutionary patterns and dynamics of the plastid genome.


Multidrug resistant Gram-negative bacilli in lower respiratory tract infections.
Lower respiratory tract infections are among important causes of morbidity and mortality for all age groups. The emergence of multidrug resistant Gram-negative bacilli is an issue of increasing concern. A retrospective study including respiratory specimens (sputum and BAL) was conducted in our tertiary care centre. Samples were processed for microscopy, culture and susceptibility testing following standard methods. Multidrug resistant Gram-negative bacilli causing lower respiratory tract infections were studied for their causation of disease. The effect of appropriate treatment on clinical outcome was observed. A total of 472 Gram-negative pathogens were isolated from sputum and broncho-alveolar lavage fluid specimens during the study period. Among these Gram-negative pathogens 175 (37%) were found to be multidrug resistant. Klebsiella pneumoniae 85 (48.6%) and Acinetobacter spp. 59 (33.7%) were the predominant multidrug resistant Gram-negative bacilli isolated. Based on clinico-microbiological correlation, 138 (78.9%) multidrug resistant isolates were found to be pathogenic and the rest 37 (21.1%) were considered as colonizers. After initiating appropriate antibiotic therapy, clinical improvement was seen in 110 (79.7%) patients. In the patients who showed improvement, amikacin (34.3%) and cefoperazone-sulbactum (21.8%) were found to be the most effective drugs. A large majority of the isolated multidrug resistant Gram-negative bacilli were found to be pathogenic. Regular surveillance which directs appropriate empirical therapy; and good clinic-microbiological workup of each case of lower respiratory tract infection can reduce the morbidity and mortality associated with multidrug resistant organisms.


Retinoid receptors in gastric cancer: expression and influence on prognosis.
Gastric cancer is frequently lethal despite aggressive multimodal therapies, and new treatment approaches are therefore needed. Retinoids are potential candidate drugs: they prevent cell differentiation, proliferation and malignant transformation in gastric cancer cell lines. They interact with nuclear retinoid receptors (the retinoic acid receptors [RARs] and retinoid X receptors [RXRs]), which function as transcription factors, each with three subclasses, α, β and γ. At present, little is known about retinoid expression and influence on prognosis in gastric cancers. We retrospectively analyzed the expression of the subtypes RARα, RARβ, RARγ, RXRα, RXRβ, RXRγ by immunohistochemistry in 147 gastric cancers and 51 normal gastric epithelium tissues for whom clinical follow-up data were available and correlated the results with clinical characteristics. In addition, we quantified the expression of retinoid receptor mRNA using real- time PCR (RT-PCR) in another 6 gastric adenocarcinoma and 3 normal gastric tissues. From 2008 to 2010, 80 patients with gastric cancers were enrolled onto therapy with all-trans-retinoic acid (ATRA). RARα, RARβ, RARγ and RXRγ positively correlated with each other (p<0.001) and demonstrated significantly lower levels in the carcinoma tissue sections (p<0.01), with lower RARβ, RARγ and RXRα expression significantly related to advanced stages (p<=0.01). Tumors with poor histopathologic grade had lower levels of RARα and RARβ in different histological types of gastric carcinoma (p<0.01). Patients whose tumors exhibited low levels of RARa expression had significantly lower overall survival compared with patients who had higher expression levels of this receptor (p<0.001, HR=0.42, 95.0% CI 0.24-0.73), and patients undergoing ATRA treatment had significantly longer median survival times (p=0.007, HR=0.41, 95.0% CI 0.21-0.80). Retinoic acid receptors are frequently expressed in epithelial gastric cancer with a decreased tendency of expression and RARa may be an indicator of a positive prognosis. This study provides a molecular basis for the therapeutic use of retinoids against gastric cancer.


Cultivable Microbial Diversity Associated With Cellular Phones.
A substantial majority of global population owns cellular phones independently to demographic factors like age, economic status, and educational attainment. In this study, we investigated the diversity of microorganisms associated with cellular phones of 27 individuals using cultivation-based methods. Cellular phones were sampled using cotton swabs and a total of 554 isolates representing different morphotypes were obtained on four growth media. Matrix-assisted laser desorption ionization time of flight (MALDI-TOF) mass spectrometry could generate protein profiles for 527 isolates and species-level identification was obtained for 415 isolates. A dendrogram was constructed based on the protein profiles of the remaining isolates, to group 112 isolates under 39 different proteotypes. The representative strains of each group were selected for 16S rRNA gene and ITS region sequencing based identification. Staphylococcus, Bacillus, Micrococcus, and Pseudomonas were the most frequently encountered bacteria, and Candida, Aspergillus, Aureobasidium, and Cryptococcus were in case of fungi. At species-level the prevalence of Micrococcus luteus, Staphylococcus hominis, Staphylococcus epidermidis, Staphylococcus arlettae, Bacillus subtilis, and Candida parapsilosis was observed, most of these species are commensal microorganisms of human skin. UPGMA dendrogram and PCoA biplot generated based on the microbial communities associated with all cellular phones exhibited build-up of specific communities on cellular phones and the prevalence of objectionable microorganisms in some of the cellular phones can be attributed to the poor hygiene and sanitary practices. The study also revealed the impact of MALDI-TOF MS spectral quality on the identification results. Overall MALDI-TOF appears a powerful tool for routine microbial identification and de-replication of microorganisms. Quality filtering of MALDI-TOF MS spectrum, development of better sample processing methods and enriching the spectral database will improve the role of MALDI-TOF MS in microbial identifications.


Enzymatic synthesis of lipid A molecules with four amide-linked acyl chains. LpxA acyltransferases selective for an analog of UDP-N-acetylglucosamine in which an amine replaces the 3"-hydroxyl group.
LpxA of Escherichia coli catalyzes the acylation of the glucosamine 3-OH group of UDP-GlcNAc, using R-3-hydroxymyristoyl-acyl carrier protein (ACP) as the donor substrate. We now demonstrate that LpxA in cell extracts of Mesorhizobium loti and Leptospira interrogans, which synthesize lipid A molecules containing 2,3-diamino-2,3-dideoxy-d-glucopyranose (GlcN3N) units in place of glucosamine, do not acylate UDP-GlcNAc. Instead, these LpxA acyltransferases require a UDP-Glc-NAc derivative (designated UDP 2-acetamido-3-amino-2,3-dideoxy-alpha-d-glucopyranose or UDP-GlcNAc3N), characterized in the preceding paper, in which an amine replaces the glucosamine 3-OH group. L. interrogans LpxA furthermore displays absolute selectivity for 3-hydroxylauroyl-ACP as the donor, whereas M. loti LpxA functions almost equally well with 10-, 12-, and 14-carbon 3-hydroxyacyl-ACPs. The substrate selectivity of L. interrogans LpxA is consistent with the structure of L. interrogans lipid A. The mechanism of L. interrogans LpxA appears to be similar to that of E. coli LpxA, given that the essential His(125) residue of E. coli LpxA is conserved and is also required for acyltransferase activity in L. interrogans. Acidithiobacillus ferrooxidans (an organism that makes lipid A molecules containing both GlcN and GlcN3N) has an ortholog of LpxA that is selective for UDP-GlcNAc3N, but the enzyme also catalyzes the acylation of UDP-GlcNAc at a slow rate. E. coli LpxA acylates UDP-GlcNAc and UDP-GlcNAc3N at comparable rates in vitro. However, UDP-GlcNAc3N is not synthesized in vivo, because E. coli lacks gnnA and gnnB. When the latter are supplied together with A. ferrooxidans lpxA, E. coli incorporates a significant amount of GlcN3N into its lipid A.


Trends in Hospitalization for Pediatric Pulmonary Hypertension.
Pulmonary hypertension (PH) has been associated with substantial morbidity and mortality in children, but existing analyses of inpatient care are limited to small single-institution series or focused registries representative of selected patient subgroups. We examined US national data on pediatric PH hospitalizations to determine trends in volume, demographics, procedures performed during admission, and resource utilization. Retrospective cohort study using a national administrative database of pediatric hospital discharges: the Kids' Inpatient Database. Children with PH accounted for 0.13% of the 43 million pediatric hospitalizations in the United States between 1997 and 2012, and discharges demonstrated an increasing trend over the study period (P < .0001). Cumulative, inflation-adjusted national hospital charges for PH hospitalizations rose (P = .0003) from $926 million in 1997 to $3.12 billion in 2012. Patients with PH without associated congenital heart disease (CHD) comprised an increasing and majority (56.4%) proportion over the study period (P < .0001), children without associated CHD admitted at urban teaching hospitals comprised the fastest-growing subgroup. In-hospital, all-cause mortality was high (5.9%) in children with PH, but demonstrated a decreasing trend (P < .0001). Morbidity and mortality of pediatric PH continue to represent substantial and growing health care burdens. Shifts in case mix toward PH not associated with CHD, toward noncardiac procedures, and toward care in urban teaching hospitals will increase pressure to manage resource utilization in this small but growing patient group and to improve expertise and define excellence in PH care across a wide range of clinical settings.


R-Ras1 and R-Ras2 Are Essential for Oligodendrocyte Differentiation and Survival for Correct Myelination in the Central Nervous System.
Rapid and effective neural transmission of information requires correct axonal myelination. Modifications in myelination alter axonal capacity to transmit electric impulses and enable pathological conditions. In the CNS, oligodendrocytes (OLs) myelinate axons, a complex process involving various cellular interactions. However, we know little about the mechanisms that orchestrate correct myelination. Here, we demonstrate that OLs express R-Ras1 and R-Ras2. Using female and male mutant mice to delete these proteins, we found that activation of the PI3K/Akt and Erk1/2-MAPK pathways was weaker in mice lacking one or both of these GTPases, suggesting that both proteins coordinate the activity of these two pathways. Loss of R-Ras1 and/or R-Ras2 diminishes the number of OLs in major myelinated CNS tracts and increases the proportion of immature OLs. In R-Ras1-/- and R-Ras2-/--null mice, OLs show aberrant morphologies and fail to differentiate correctly into myelin-forming phenotypes. The smaller OL population and abnormal OL maturation induce severe hypomyelination, with shorter nodes of Ranvier in R-Ras1-/- and/or R-Ras2-/- mice. These defects explain the slower conduction velocity of myelinated axons that we observed in the absence of R-Ras1 and R-Ras2. Together, these results suggest that R-Ras1 and R-Ras2 are upstream elements that regulate the survival and differentiation of progenitors into OLs through the PI3K/Akt and Erk1/2-MAPK pathways for proper myelination.SIGNIFICANCE STATEMENT In this study, we show that R-Ras1 and R-Ras2 play essential roles in regulating myelination in vivo and control fundamental aspects of oligodendrocyte (OL) survival and differentiation through synergistic activation of PI3K/Akt and Erk1/2-MAPK signaling. Mice lacking R-Ras1 and/or R-Ras2 show a diminished OL population with a higher proportion of immature OLs, explaining the observed hypomyelination in main CNS tracts. In vivo electrophysiology recordings demonstrate a slower conduction velocity of nerve impulses in the absence of R-Ras1 and R-Ras2. Therefore, R-Ras1 and R-Ras2 are essential for proper axonal myelination and accurate neural transmission.


A hydride transfer complex reprograms NAD metabolism and bypasses senescence.
Metabolic rewiring and redox balance play pivotal roles in cancer. Cellular senescence is a barrier for tumorigenesis circumvented in cancer cells by poorly understood mechanisms. We report a multi-enzymatic complex that reprograms NAD metabolism by transferring reducing equivalents from NADH to NADP+. This hydride transfer complex (HTC) is assembled by malate dehydrogenase 1, malic enzyme 1, and cytosolic pyruvate carboxylase. HTC is found in phase-separated bodies in the cytosol of cancer or hypoxic cells and can be assembled in vitro with recombinant proteins. HTC is repressed in senescent cells but induced by p53 inactivation. HTC enzymes are highly expressed in mouse and human prostate cancer models, and their inactivation triggers senescence. Exogenous expression of HTC is sufficient to bypass senescence, rescue cells from complex I inhibitors, and cooperate with oncogenic RAS to transform primary cells. Altogether, we provide evidence for a new multi-enzymatic complex that reprograms metabolism and overcomes cellular senescence.


N(epsilon)-carboxymethyllysine-modified proteins are unable to bind to RAGE and activate an inflammatory response.
Advanced glycation endproducts (AGEs) containing carboxymethyllysine (CML) modifications are generally thought to be ligands of the receptor for AGEs, RAGEs. It has been argued that this results in the activation of pro-inflammatory pathways and diseases. However, it has not been shown conclusively that a CML-modified protein can interact directly with RAGE. Here, we have analyzed whether beta-lactoglobulin (bLG) or human serum albumin (HSA) modified chemically to contain only CML (10-40% lysine modification) can (i) interact with RAGE in vitro and (ii) interact with and activate RAGE in lung epithelial cells. Our results show that CML-modified bLG or HSA are unable to bind to RAGE in a cell-free assay system (Biacore). Furthermore, they are unable to activate pro-inflammatory signaling in the cellular system. Thus, CML probably does not form the necessary structure(s) to interact with RAGE and activate an inflammatory signaling cascade in RAGE-expressing cells.


A multiscale approach to detect selection in nonmodel tree species: Widespread adaptation despite population decline in Taxus baccata L.
Detecting the molecular basis of local adaptation and identifying selective drivers is still challenging in nonmodel species. The use of purely population genetic approaches is limited by some characteristics of genetic systems, such as pleiotropy and polygenic control, and parallel evidence from phenotypic-based experimental comparisons is required. In long-lived organisms, the detection of selective pressures might also be precluded by evolutionary lag times in response to the environment. Here, we used the English yew to showcase an example of a multiscale integrative approach in a nonmodel species with limited plant and genomic resources. We combined information from two independent sources, phenotypes in a common environment and genomic data in natural populations, to investigate the signature of selection. Growth differences among populations in a common environment, and phenological patterns of both shoot elongation and male strobili maturation, were associated with climate clines, providing evidence for local adaptation and guiding us in the selection of populations for genomic analyses. We used information on over 25,000 SNPs from c. 1,200 genes to infer the demographic history and to test for molecular signatures of selection at different levels: SNP, gene, and biological pathway. Our results confirmed an overall demographic history of population decline, but we also found evidence for putative local adaptation at the molecular level. We identified or confirmed several candidate genes for positive and negative selection in forest trees, including the pseudo-response regulator 7 (PRR7), an essential component of the circadian clock in plants. In addition, we successfully tested an approach to detect polygenic adaptation in biological pathways, allowing us to identify the flavonoid biosynthesis pathway as a candidate stress-response pathway that deserves further attention in other plants. Finally, our study contributes to the emerging view that explaining contemporary standing genetic variation requires considering adaptation to past climates, especially for long-lived trees.


Experimental study on modulation of Stokes parameters on propagation of a Gaussian Schell model beam in free space.
The effect on the Stokes parameters of a Gaussian Schell model beam on propagation in free space is studied experimentally and results are matched with the theory [X. H. Zhao, et al. Opt. Express 17, 17888 (2009)] that in general the degree of polarization of a Gaussian Schell model beam doesn't change on propagation if the three spectral correlation widths δ xx, δ yy, δ xy are equal and the beam width parameters σ x =σ y. It is experimentally shown that all the four Stokes parameters at the center of the beam decrease on propagation while the magnitudes of the normalized Stokes parameters and the spectral degree of polarization at the center of the beam remain constant for different propagation distances.


Experiences and own management regarding residual symptoms among people with coeliac disease.
Between 7% and 30% of people with treated coeliac disease suffer from residual symptoms, and there is a knowledge gap about their own management of these symptoms. To explore experiences and management concerning residual symptoms despite a gluten-free diet in people with coeliac disease. A qualitative explorative design with semi-structured interviews with 22 adults with coeliac disease in Sweden. Data were analysed using qualitative content analysis. The informants had, at diagnosis, thought that their symptoms would disappear if they followed a gluten-free diet, but the disease was continuing to have a substantial impact on their lives, despite several years of treatment. They experienced cognitive, somatic as well as mental symptoms, including impact on personality (e.g. having a "shorter fuse", being more miserable or tired). However, only a few informants had sought medical care for persistent symptoms. Instead they tried to manage these by themselves, e.g. abstaining from food during periods of more intense symptom, or using distraction. The management of persistent symptoms resembled thorough detective work. To prevent problems related to residual symptoms the informants used withdrawal of social contact as well as acceptance of their situation. People with treated coeliac disease may experience residual symptoms of both a physical and psychological nature, causing major negative impacts on their lives in different ways. In the light of this, healthcare staff should change their practices regarding the follow-up of these people, and in addition to medical care should provide guidance on management strategies to facilitate the daily life. Furthermore, information to newly diagnosed persons should make them aware of the possibility to experience continued symptoms, despite treatment.


Increased methylation variation in epigenetic domains across cancer types.
Tumor heterogeneity is a major barrier to effective cancer diagnosis and treatment. We recently identified cancer-specific differentially DNA-methylated regions (cDMRs) in colon cancer, which also distinguish normal tissue types from each other, suggesting that these cDMRs might be generalized across cancer types. Here we show stochastic methylation variation of the same cDMRs, distinguishing cancer from normal tissue, in colon, lung, breast, thyroid and Wilms' tumors, with intermediate variation in adenomas. Whole-genome bisulfite sequencing shows these variable cDMRs are related to loss of sharply delimited methylation boundaries at CpG islands. Furthermore, we find hypomethylation of discrete blocks encompassing half the genome, with extreme gene expression variability. Genes associated with the cDMRs and large blocks are involved in mitosis and matrix remodeling, respectively. We suggest a model for cancer involving loss of epigenetic stability of well-defined genomic domains that underlies increased methylation variability in cancer that may contribute to tumor heterogeneity.


Cardiovascular morbidity in psoriatic arthritis.
Increasing evidence for cardiovascular mortality among patients with psoriasis and psoriatic arthritis (PsA) has accumulated, together with evidence for increased prevalence of risk factors for cardiovascular disease (CVD). To describe cardiovascular morbidity in PsA, determine its prevalence and identify risk factors for its development. At the University of Toronto, patients were followed up prospectively according to a standard protocol, including disease-related features and comorbidities. Patients with CVD, including myocardial infarction (MI), angina, hypertension and cerebrovascular accident (CVA), were identified. The prevalence of CVD morbidities in these patients was compared with data from the Canadian Community Health Survey through standardised prevalence ratios (SPRs). Cox relative risk regression analysis was used to analyse risk factors. At the time of analysis, 648 patients were registered in the database. After clinic entry, 122 developed hypertension, 38 had an MI and 5, 21 and 11 had CVA, angina and congestive heart failure (CHF), respectively. 155 patients had at least one of these conditions. The SPRs for MI (2.57; 95% CI 1.73 to 3.80), angina (1.97; 95% CI 1.24 to 3.12) and hypertension (1.90; 95% CI 1.59 to 2.27) were statistically significant, whereas the SPRs for CHF (1.19; 95% CI 0.50 to 2.86) and CVA (0.91; 95% CI 0.34 to 2.43) were not. Factors associated with CVD included diabetes, hyperlipidaemia and high Psoriasis Area and Severity Index scores. Patients with PsA are at increased risk of cardiovascular morbidities compared with the general population. In addition to known risk factors for CVD, severe psoriasis is an important predictor in patients with PsA.


Sports Sponsorships of Food and Nonalcoholic Beverages.
Food and nonalcoholic beverage companies spend millions of dollars on professional sports sponsorships, yet this form of marketing is understudied. These sponsorships are valuable marketing tools but prompt concerns when unhealthy products are associated with popular sports organizations, especially those viewed by youth. This descriptive study used Nielsen audience data to select 10 sports organizations with the most 2-17 year old viewers of 2015 televised events. Sponsors of these organizations were identified and assigned to product categories. We identified advertisements promoting food and/or nonalcoholic beverage sponsorships on television, YouTube, and sports organization Web sites from 2006 to 2016, and the number of YouTube advertisement views. The nutritional quality of advertised products was assessed. Youth watched telecasts associated with these sports organizations over 412 million times. These organizations had 44 food and/or nonalcoholic beverage sponsors (18.8% of sponsors), second to automotive sponsors (n = 46). The National Football League had the most food and/or nonalcoholic beverage sponsors (n = 10), followed by the National Hockey League (n = 7) and Little League (n = 7). We identified 273 advertisements that featured food and/or nonalcoholic beverage products 328 times and product logos 83 times (some advertisements showed multiple products). Seventy-six percent (n = 132) of foods had unhealthy nutrition scores, and 52.4% (n = 111) of nonalcoholic beverages were sugar-sweetened. YouTube sponsorship advertisements totaled 195.6 million views. Sports sponsorships are commonly used to market unhealthy food and nonalcoholic beverages, exposing millions of consumers to these advertisements.


Search for top squarks in R-parity-violating supersymmetry using three or more leptons and b-tagged jets.
A search for anomalous production of events with three or more isolated leptons and bottom-quark jets produced in pp collisions at √s=8 TeV is presented. The analysis is based on a data sample corresponding to an integrated luminosity of 19.5 fb(-1) collected by the CMS experiment at the LHC in 2012. No excess above the standard model expectations is observed. The results are interpreted in the context of supersymmetric models with signatures that have low missing transverse energy arising from light top-squark pair production with R-parity-violating decays of the lightest supersymmetric particle. In two models with different R-parity-violating couplings, top squarks are excluded below masses of 1020 GeV and 820 GeV when the lightest supersymmetric particle has a mass of 200 GeV.


From infection to immunotherapy: host immune responses to bacteria at the bladder mucosa.
The pathogenesis of urinary tract infection and mechanisms of the protective effect of Bacillus Calmette-Guerin (BCG) therapy for bladder cancer highlight the importance of studying the bladder as a unique mucosal surface. Innate responses to bacteria are reviewed, and although our collective knowledge remains incomplete, we discuss how adaptive immunity may be generated following bacterial challenge in the bladder microenvironment. Interestingly, the widely held belief that the bladder is sterile has been challenged recently, indicating the need for further study of the impact of commensal microorganisms on the immune response to uropathogen infection or intentional instillation of BCG. This review addresses the aspects of bladder biology that have been well explored and defines what still must be discovered about the immunobiology of this understudied organ.


Big Bang Tumor Growth and Clonal Evolution.
The advent and application of next-generation sequencing (NGS) technologies to tumor genomes has reinvigorated efforts to understand clonal evolution. Although tumor progression has traditionally been viewed as a gradual stepwise process, recent studies suggest that evolutionary rates in tumors can be variable with periods of punctuated mutational bursts and relative stasis. For example, Big Bang dynamics have been reported, wherein after transformation, growth occurs in the absence of stringent selection, consistent with effectively neutral evolution. Although first noted in colorectal tumors, effective neutrality may be relatively common. Additionally, punctuated evolution resulting from mutational bursts and cataclysmic genomic alterations have been described. In this review, we contrast these findings with the conventional gradualist view of clonal evolution and describe potential clinical and therapeutic implications of different evolutionary modes and tempos.


Estimating genetic ancestry proportions from faces.
Ethnicity can be a means by which people identify themselves and others. This type of identification mediates many kinds of social interactions and may reflect adaptations to a long history of group living in humans. Recent admixture in the US between groups from different continents, and the historically strong emphasis on phenotypic differences between members of these groups, presents an opportunity to examine the degree of concordance between estimates of group membership based on genetic markers and on visually-based estimates of facial features. We first measured the degree of Native American, European, African and East Asian genetic admixture in a sample of 14 self-identified Hispanic individuals, chosen to cover a broad range of Native American and European genetic admixture proportions. We showed frontal and side-view photographs of the 14 individuals to 241 subjects living in New Mexico, and asked them to estimate the degree of NA admixture for each individual. We assess the overall concordance for each observer based on an aggregated measure of the difference between the observer and the genetic estimates. We find that observers reach a significantly higher degree of concordance than expected by chance, and that the degree of concordance as well as the direction of the discrepancy in estimates differs based on the ethnicity of the observer, but not on the observers' age or sex. This study highlights the potentially high degree of discordance between physical appearance and genetic measures of ethnicity, as well as how perceptions of ethnic affiliation are context-specific. We compare our findings to those of previous studies and discuss their implications.


Impact of Cannabis Use on the Development of Psychotic Disorders.
The link between cannabis use and psychosis comprises three distinct relationships: acute psychosis associated with cannabis intoxication, acute psychosis that lasts beyond the period of acute intoxication, and persistent psychosis not time-locked to exposure. Experimental studies reveal that cannabis, tetrahydrocannabinol (THC) and synthetic cannabinoids reliably produce transient positive, negative, and cognitive symptoms in healthy volunteers. Case-studies indicate that cannabinoids can induce acute psychosis which lasts beyond the period of acute intoxication but resolves within a month. Exposure to cannabis in adolescence is associated with a risk for later psychotic disorder in adulthood; this association is consistent, temporally related, shows a dose-response, and is biologically plausible. However, cannabis is neither necessary nor sufficient to cause a persistent psychotic disorder. More likely it is a component cause that interacts with other factors to result in psychosis. The link between cannabis and psychosis is moderated by age at onset of cannabis use, childhood abuse and genetic vulnerability. While more research is needed to better characterize the relationship between cannabinoid use and the onset and persistence of psychosis, clinicians should be mindful of the potential risk of psychosis especially in vulnerable populations, including adolescents and those with a psychosis diathesis.


From concept representations to ontologies: a paradigm shift in health informatics?
This work aims at uncovering challenges in biomedical knowledge representation research by providing an understanding of what was historically called "medical concept representation" and used as the name for a working group of the International Medical Informatics Association. Bibliometrics, text mining, and a social media survey compare the research done in this area between two periods, before and after 2000. Both the opinion of socially active groups of researchers and the interpretation of bibliometric data since 1988 suggest that the focus of research has moved from "medical concept representation" to "medical ontologies". It remains debatable whether the observed change amounts to a paradigm shift or whether it simply reflects changes in naming, following the natural evolution of ontology research and engineering activities in the 1990s. The availability of powerful tools to handle ontologies devoted to certain areas of biomedicine has not resulted in a large-scale breakthrough beyond advances in basic research.


Differences in osteogenic and apoptotic genes between osteoporotic and osteoarthritic patients.
Osteoporosis is a metabolic disorder characterized by a reduction in bone mass and deterioration in the microarchitectural structure of the bone, leading to a higher risk for spontaneous and fragility fractures.The main aim was to study the differences between human bone from osteoporotic and osteoarthritic patients about gene expression (osteogenesis and apoptosis), bone mineral density, microstructural and biomechanic parameters. We analyzed data from 12 subjects: 6 with osteoporotic hip fracture (OP) and 6 with hip osteoarthritis (OA), as the control group. All subjects underwent medical history, analytical determinations, densitometry, histomorphometric and biochemical study. The expression of 86 genes of osteogenesis and 86 genes of apoptosis was studied in pool of bone samples from patients with OP and OA by PCR array. We observed that most of the genes of apoptosis and osteogenesis show a decrease in gene expression in the osteoporotic group in comparison with the osteoarthritic group. The histomorphometric study shows a lower bone quality in the group of patients with hip fractures compared to the osteoarthritic group. The bone tissue of osteoporotic fracture patients is more fragile than the bone of OA patients. Our results showed an osteoporotic bone with a lower capacities for differentiation and osteoblastic activity as well as a lower rate of apoptosis than osteoarthritic bone. These results are related with structural and biochemical parameters.


Role of muscarinic receptors in the activation of the ventral subiculum and the consequences for dopamine release in the nucleus accumbens.
The nucleus accumbens receives limbic inputs from a number of brain regions, including the ventral subiculum. In rats, activation of the ventral subiculum following microinjection of N-methyl-D-aspartate (NMDA) or carbachol increases locomotor activity, whilst ventral subiculum application of NMDA also increases dopamine efflux in the ipsilateral nucleus accumbens. Microdialysis experiments were therefore conducted to ascertain the consequences for dopamine release in the nucleus accumbens following ventral subiculum administration of carbachol, and to explore the acetylcholine receptor subtype(s) that might be involved. We report that, in anaesthetised rats, ventral subiculum administration of carbachol increased dopamine levels in the nucleus accumbens. The response was attenuated by co-administration with atropine, whilst administration of nicotine and the alpha-7 nicotinic acetylcholine receptor agonist AR-R17779 (spiro[1-azabicyclo[2,2,2]octane-3,5'-oxazolidine]-2'-one monohydrochloride) failed to evoke a response. Oxotremorine-M produced a dose-dependent increase in dopamine efflux confirming sensitivity to muscarinic receptor stimulation. However, the ventral subiculum was insensitive to xanomeline and pilocarpine, muscarinic M(1) receptor-preferring agonists, but sensitive to BuTAC ([5R-[exo]-6-[butylthio]-1,2,5-thiadiazol-3-yl]-1-azabicyclo[3.2.1])octane), a muscarinic M(2)/M(4) receptor agonist. The dopamine response to oxotremorine-M was significantly attenuated, although not abolished by co-administration with the M(2)/M(4) receptor antagonist methoctramine, and studies combining oxotremorine-M with (-)-bicuculline, indicated a dual action in the ventral subiculum that was dependent and independent of reduced GABA neurotransmission. The data presented indicates that activation of the ventral subiculum by carbachol increases dopamine efflux in the nucleus accumbens by stimulation of muscarinic receptors, and that the ventral subiculum-nucleus accumbens projection system is sensitive to muscarinic M(2)/M(4) receptor stimulation.


Environmental radiation alters the gut microbiome of the bank vole Myodes glareolus.
Gut microbiota composition depends on many factors, although the impact of environmental pollution is largely unknown. We used amplicon sequencing of bacterial 16S rRNA genes to quantify whether anthropogenic radionuclides at Chernobyl (Ukraine) impact the gut microbiome of the bank vole Myodes glareolus. Exposure to elevated levels of environmental radionuclides had no detectable effect on the gut community richness but was associated with an almost two-fold increase in the Firmicutes:Bacteroidetes ratio. Animals inhabiting uncontaminated areas had remarkably similar gut communities irrespective of their proximity to the nuclear power plant. Hence, samples could be classified to high-radiation or low-radiation sites based solely on microbial community with >90% accuracy. Radiation-associated bacteria had distinct inferred functional profiles, including pathways involved in degradation, assimilation and transport of carbohydrates, xenobiotics biodegradation, and DNA repair. Our results suggest that exposure to environmental radionuclides significantly alters vertebrate gut microbiota.


Computerised tomography of the cranium in patients with epilepsy: a preliminary report.
The findings are presented in 366 patients with seizures who were studied by computerised tomography of the cranium. The relative frequency of normal scans, cerebral tumours, atrophy and other pathological lesions is indicated. A more detailed analysis of the group of patients with atrophy was carried out. The frequency and severity of atrophy correlated significantly with age but not with length of seizure history. However, the more marked degrees of atrophy were found among patients with long-standing or poorly controlled epilepsy, an observation which has important implications with regard to the adequacy of seizure control in epileptic patients.


Diplopia and periorbital mass associated with Miragel buckling explant.
A 28-year-old female presented with a palpable mass lesion on the superonasal aspect of her right globe and she had a progressive diplopia. She had a scleral encircling surgery with a Miragel explant (MIRA, Waltham, Mass, USA) for the tractional retinal detachment associated with pars planitis 9 years previously. On examination, she revealed restricted eye movements of her right eye. The magnetic resonance imaging documented a swelling of the Miragel explant that mimicked a periorbital mass lesion. The Miragel explant was removed and fragmentation of the explant was found intraoperatively. The removed Miragel explant was examined by a scanning electron microscopy, and this demonstrated a disintergrated and swollen structural composition of the Miragel explant. Postoperatively, her extraocular movement was almost restored and the retina remained well attached. Alterations in the structural composition of the Miragel explant results in an excessive swelling that causes a restriction of the extraocular movement, and this can mimick a periorbital mass lesion.


An optimal network screening method of hotspot identification for highway crashes with dynamic site length.
We propose a novel network screening method for hotspot (i.e., sites that suffer from high collision concentration and have high potential for safety improvement) identification based on the optimization framework to maximize the total summation of a selected safety measure for all hotspots considering a resource constraint for conducting detailed engineering studies (DES). The proposed method allows the length of each hotspot to be determined dynamically based on constraints the users impose. The calculation of the Dynamic Site Length (DSL) method is based on Dynamic Programming, and it is shown to be effective to find the close-to-optimal solution with computationally feasible complexity. The screening method has been demonstrated using historical crash data from extended freeway routes in San Francisco, California. Using the Empirical Bayesian (EB) estimate as a safety measure, we compare the performance of the proposed DSL method with other conventional screening methods, Sliding Window (SW) and Continuous Risk Profile (CRP), in terms of their optimal objective value (i.e., performance of detecting sites under the highest risk). Moreover, their spatio-temporal consistency is compared through the site and method consistency tests. Findings show that DSL can outperform SW and CRP in investigating more hotspots under the same amount of resources allocated to DES by pinpointing hotspot locations with greater accuracy and showing improved spatio-temporal consistency.


The ultraviolet receptor of bird retinas.
The eyes of 15 species of birds from 10 families have some cones maximally sensitive at 370 nanometers in the near-ultraviolet. Spectral sensitivity was measured by recording extracellularly in opened eyecups , and a maximum in the ultraviolet was revealed by selectively adapting the retina with yellow background lights. The 370-nanometer spectral sensitivity function is attributed to receptors because its spectral position does not vary with the strength of adaptation and because it is present when the receptor potentials are isolated from the contributions of higher order retinal neurons by exposing the retina to sodium aspartate. These measurements demonstrate the basis for the ultraviolet sensitivity of birds that has been seen in behavioral experiments, and they provide further evidence that many vertebrates share with insects vision in the near-ultraviolet.


Expression of Ca(2+) channel subunits during cardiac ontogeny in mice and rats: identification of fetal alpha(1C) and beta subunit isoforms.
Functional cardiac L-type calcium channels are composed of the pore-forming alpha(1C) subunit and the regulatory beta(2) and alpha(2)/delta subunits. To investigate possible developmental changes in calcium channel composition, we examined the temporal expression pattern of alpha(1C) and beta(2) subunits during cardiac ontogeny in mice and rats, using sequence-specific antibodies. Fetal and neonatal hearts showed two size forms of alpha(1C) with 250 and 220 kDa. Quantitative immunoblotting revealed that the rat cardiac 250-kDa alpha(1C) subunit increased about 10-fold from fetal days 12-20 and declined during postnatal maturation, while the 220-kDa alpha(1C) decreased to undetectable levels. The expression profile of the 85-kDa beta(2) subunit was completely different: beta(2) was not detected at fetal day 12, rose in the neonatal stage, and persisted during maturation. Additional beta(2)-stained bands of 100 and 90 kDa were detected in fetal and newborn hearts, suggesting the transient expression of beta(2) subunit variants. Furthermore, two fetal proteins with beta(4) immunoreactivity were identified in rat hearts that declined during prenatal development. In the fetal rat heart, beta(4) gene expression was confirmed by RT-PCR. Cardiac and brain beta(4) mRNA shared the 3 prime region, predicting identical primary sequences between amino acid residues 62-519, diverging however, at the 5 prime portion. The data indicate differential developmental changes in the expression of Ca(2+) channel subunits and suggest a role of fetal alpha(1C) and beta isoforms in the assembly of Ca(2+) channels in immature cardiomyocytes.


Lipid metabolic changes in an early divergent fungus govern the establishment of a mutualistic symbiosis with endobacteria.
The recent accumulation of newly discovered fungal-bacterial mutualisms challenges the paradigm that fungi and bacteria are natural antagonists. To understand the mechanisms that govern the establishment and maintenance over evolutionary time of mutualisms between fungi and bacteria, we studied a symbiosis of the fungus Rhizopus microsporus (Mucoromycotina) and its Burkholderia endobacteria. We found that nonhost R. microsporus, as well as other mucoralean fungi, interact antagonistically with endobacteria derived from the host and are not invaded by them. Comparison of gene expression profiles of host and nonhost fungi during interaction with endobacteria revealed dramatic changes in expression of lipid metabolic genes in the host. Analysis of the host lipidome confirmed that symbiosis establishment was accompanied by specific changes in the fungal lipid profile. Diacylglycerol kinase (DGK) activity was important for these lipid metabolic changes, as its inhibition altered the fungal lipid profile and caused a shift in the host-bacterial interaction into an antagonism. We conclude that adjustments in host lipid metabolism during symbiosis establishment, mediated by DGKs, are required for the mutualistic outcome of the Rhizopus-Burkholderia symbiosis. In addition, the neutral and phospholipid profiles of R. microsporus provide important insights into lipid metabolism in an understudied group of oleaginous Mucoromycotina. Lastly, our study revealed that the DGKs involved in the symbiosis form a previously uncharacterized clade of DGK domain proteins.


Digital adherence technologies for the management of tuberculosis therapy: mapping the landscape and research priorities.
Poor medication adherence may increase rates of loss to follow-up, disease relapse and drug resistance for individuals with active tuberculosis (TB). While TB programmes have historically used directly observed therapy (DOT) to address adherence, concerns have been raised about the patient burden, ethical limitations, effectiveness in improving treatment outcomes and long-term feasibility of DOT for health systems. Digital adherence technologies (DATs)-which include feature phone-based and smartphone-based technologies, digital pillboxes and ingestible sensors-may facilitate more patient-centric approaches for monitoring adherence, though available data are limited. Depending on the specific technology, DATs may help to remind patients to take their medications, facilitate digital observation of pill-taking, compile dosing histories and triage patients based on their level of adherence, which can facilitate provision of individualised care by TB programmes to patients with varied levels of risk. Research is needed to understand whether DATs are acceptable to patients and healthcare providers, accurate for measuring adherence, effective in improving treatment outcomes and impactful in improving health system efficiency. In this article, we describe the landscape of DATs that are being used in research or clinical practice by TB programmes and highlight priorities for research.


KNT-artificial neural network model for flux prediction of ultrafiltration membrane producing drinking water.
This paper describes the prediction of flux behavior in an ultrafiltration (UF) membrane system using a Kalman neuro training (KNT) network model. The experimental data was obtained from operating a pilot plant of hollow fiber UF membrane with groundwater for 7 months. The network was trained using operating conditions such as inlet pressure, filtration duration, and feed water quality parameters including turbidity, temperature and UV254. Pre-processing of raw data allowed the normalized input data to be used in sigmoid activation functions. A neural network architecture was structured by modifying the number of hidden layers, neurons and learning iterations. The structure of KNT-neural network with 3 layers and 5 neurons allowed a good prediction of permeate flux by 0.997 of correlation coefficient during the learning phase. Also the validity of the designed model was evaluated with other experimental data not used during the training phase and nonlinear flux behavior was accurately estimated with 0.999 of correlation coefficient and a lower error of prediction in the testing phase. This good flux prediction can provide preliminary criteria in membrane design and set up the proper cleaning cycle in membrane operation. The KNT-artificial neural network is also expected to predict the variation of transmembrane pressure during filtration cycles and can be applied to automation and control of full scale treatment plants.


Majorization and measures of classical polarization in three dimensions.
There has been much discussion in the literature about rival measures of classical polarization in three dimensions. We gather and compare the various proposed measures of polarization, creating a geometric representation of the polarization state space in the process. We use majorization, previously used in quantum information, as a criterion to establish a partial ordering on the polarization state space. Using this criterion and other considerations, the most useful polarization measure in three dimensions is found to be one dependent on the Bloch vector decomposition of the polarization matrix.


Pressure Injuries at Intensive Care Unit Admission as a Prognostic Indicator of Patient Outcomes.
Pressure injuries, also known as pressure ulcers, are a serious complication of immobility. Patients should be thoroughly examined for pressure injuries when admitted to the intensive care unit to optimize treatment. Whether community-acquired pressure injuries correlate with poor hospital outcomes among critically ill patients is understudied. To determine whether pressure injuries present upon admission to the intensive care unit can serve as a predictive marker for longer hospitalization and increased mortality. This study retrospectively analyzed admissions of adult patients to a 24-bed medical-surgical intensive care unit in a large level I trauma center in the northeast United States from 2010 to 2012. The association of pressure injuries with mortality and length of stay was assessed, using multivariable logistic regression and generalized linear models, adjusted for age, comorbidities, Acute Physiology and Chronic Health Evaluation III score, and other patient characteristics. Among 2723 patients, 180 (6.6%) had a pressure injury at admission. Patients with a pressure injury had longer mean unadjusted stay (15.6 vs 10.5 days; P < .001) and higher in-hospital mortality rate (32.2% vs 18.3%; P < .001) than did patients without a pressure injury at admission. After multivariable adjustment, pressure injuries were associated with a mean increase in length of stay of 3.1 days (95% CI 1.5-4.7; P < .001). Pressure injuries were not associated with mortality after adjusting for the Acute Physiology and Chronic Health Evaluation III score, but they may serve as a marker for increased risk of mortality if an Acute Physiology and Chronic Health Evaluation III score is unavailable. Pressure injuries present at admission to the intensive care unit are an objective, easy-to-identify finding associated with longer stays. Pressure injuries might have a modest association with higher risk of mortality.


Brain-behaviour modes of covariation in healthy and clinically depressed young people.
Understanding how variations in dimensions of psychometrics, IQ and demographics relate to changes in brain connectivity during the critical developmental period of adolescence and early adulthood is a major challenge. This has particular relevance for mental health disorders where a failure to understand these links might hinder the development of better diagnostic approaches and therapeutics. Here, we investigated this question in 306 adolescents and young adults (14-24 y, 25 clinically depressed) using a multivariate statistical framework, based on canonical correlation analysis (CCA). By linking individual functional brain connectivity profiles to self-report questionnaires, IQ and demographic data we identified two distinct modes of covariation. The first mode mapped onto an externalization/internalization axis and showed a strong association with sex. The second mode mapped onto a well-being/distress axis independent of sex. Interestingly, both modes showed an association with age. Crucially, the changes in functional brain connectivity associated with changes in these phenotypes showed marked developmental effects. The findings point to a role for the default mode, frontoparietal and limbic networks in psychopathology and depression.


Toward a New Generation of Cross-Cultural Research.
In this article, we describe how cross-cultural research methodologies have evolved, with each phase of research addressing limitations of a previous one. We describe briefly the three previous phases and argue for embarking on a fourth phase that empirically establishes linkages between the active cultural ingredients hypothesized to cause between-country differences and the observed differences themselves. We discuss theoretical considerations and possible empirical methods to establish such linkages, and urge researchers to seriously consider incorporating these kinds of linkage studies in their programs of research.


Global health and cardiovascular disease.
The modern definition of Global Health has expanded its scope beyond neglected diseases and low-income and underdeveloped countries. The current initiatives focus on improvement of health, reduction of disparities and protection against global threats, seeking for interaction with health practices, policies and systems. There has been a growing interest on Global Health research, given the epidemiological transition currently underway in low and mid-income countries and the increasing epidemiological importance of cardiovascular and other non-communicable diseases, to the detriment of infectious diseases and nutritional deficiencies. Various aspects-formerly neglected-of these diseases, such as epidemiology, prevention, diagnosis and therapy, have been addressed in Global Health publications, leading to a better understanding of the importance of health as a public good, beyond borders. Scientific evidence supports broader initiatives in which governments, foundations and the civil society must share responsibilities and funding to achieve health equity, the main goal of Global Health.


Effects of environmental conditions on historical buildings: lichens and NOx gases.
Environmental conditions affect human life in various ways. One of the domains of environmental conditions is buildings, and amongst them, a major and important group is the historical buildings. To keep this inheritance alive, one needs to determine the effects of environmental conditions. In this work, effects of lichens and NOx on 7 historical buildings in Erzurum were investigated. Historical buildings are readily available for lichen growth, which takes a long time, and this growth was investigated as a sample of environmental effect that occurs through long periods of time. NOx, main source of which is traffic in Erzurum, were considered as the environmental effect of daily life.


The Use of Prescription Drugs, Recreational Drugs, and "Soft Enhancers" for Cognitive Enhancement among Swiss Secondary School Students.
The use of prescription or recreational drugs for cognitive enhancement (CE) is prevalent among students. However, the prevalence of CE among Swiss school students is unknown. We therefore performed a cross-sectional online survey including ≥ 16-year-old students from bridge-year schools (10th grade), vocational schools, and upper secondary schools (10th-12th grade) in the Canton of Zurich to investigate the prevalence of and motives for the use of prescription drugs, recreational drugs, and/or freely available soft enhancers for CE. A total of 1,139 students were included. Of these, 54.5% reported the use of prescription drugs (9.2%), recreational drugs including alcohol (6.2%), or soft enhancers (51.3%) explicitly for CE at least once in their lives. The last-year and last-month prevalence for CE considering all substances was 45.5% and 39.5%, respectively. Soft enhancers were the substances that were most commonly used (ever, last-year, and last-month, respectively), including energy drinks (33.3%, 28.4%, and 24.6%), coffee (29.8%, 25.1%, and 21.9%), and tobacco (12.6%, 9.3%, and 8.3%). CE with methylphenidate was less prevalent (4.0%, 2.8%, and 2.0%). However, the use of prescription drugs, alcohol, or illegal drugs for CE was reported by 13.3% of the participants. The most common motives for use were to stay awake and improve concentration. CE was more prevalent among students who reported higher levels of stress or performance pressure and students with psychiatric disorders. In conclusion, half of the school students had used a substance at least once in their lives to improve school performance. Soft enhancers were most commonly used. Prevalence rates were similar to those reported by Swiss university students, indicating that the use of prescription or recreational drugs for CE already occurs before starting higher education. Performance pressure, stress, and psychiatric disorders may be associated with CE.


Lung surfactants and different contributions to thin film stability.
The surfactant lining the walls of the alveoli in the lungs increases pulmonary compliance and prevents collapse of the lung at the end of expiration. In premature born infants, surfactant deficiency causes problems, and lung surfactant replacements are instilled to facilitate breathing. These pulmonary surfactants, which form complex structured fluid-fluid interfaces, need to spread with great efficiency and once in the alveolus they have to form a thin stable film. In the present work, we investigate the mechanisms affecting the stability of surfactant-laden thin films during spreading, using drainage flows from a hemispherical dome. Three commercial lung surfactant replacements Survanta, Curosurf and Infasurf, along with the phospholipid dipalmitoylphosphatidylcholine (DPPC), are used. The surface of the dome can be covered with human alveolar epithelial cells and experiments are conducted at the physiological temperature. Drainage is slowed down due to the presence of all the different lung surfactant replacements and therefore the thin films show enhanced stability. However, a scaling analysis combined with visualization experiments demonstrates that different mechanisms are involved. For Curosurf and Infasurf, Marangoni stresses are essential to impart stability and interfacial shear rheology does not play a role, in agreement with what is observed for simple surfactants. Survanta, which was historically the first natural surfactant used, is rheologically active. For DPPC the dilatational properties play a role. Understanding these different modes of stabilization for natural surfactants can benefit the design of effective synthetic surfactant replacements for treating infant and adult respiratory disorders.


Madura foot. A case presentation.
In this case presentation, the diagnosis was based solely on the histopathologic examination of tissue taken at the time of the first surgery. Subsequent cultures did not reveal any growth of organisms that would cause Madura foot. The patient must be monitored periodically, for it is rare that such an infection is cured with surgery other than amputation.


Measurement and modeling of exposure to selected air toxics for health effects studies and verification by biomarkers.
The overall aim of our investigation was to quantify the magnitude and range of individual personal exposures to a variety of air toxics and to develop models for exposure prediction on the basis of time-activity diaries. The specific research goals were (1) to use personal monitoring of non-smokers at a range of residential locations and exposures to non-traffic sources to assess daily exposures to a range of air toxics, especially volatile organic compounds (VOCs) including 1,3-butadiene and particulate polycyclic aromatic hydrocarbons (PAHs); (2) to determine microenvironmental concentrations of the same air toxics, taking account of spatial and temporal variations and hot spots; (3) to optimize a model of personal exposure using microenvironmental concentration data and time-activity diaries and to compare modeled exposures with exposures independently estimated from personal monitoring data; (4) to determine the relationships of urinary biomarkers with the environmental exposures to the corresponding air toxic. Personal exposure measurements were made using an actively pumped personal sampler enclosed in a briefcase. Five 24-hour integrated personal samples were collected from 100 volunteers with a range of exposure patterns for analysis of VOCs and 1,3-butadiene concentrations of ambient air. One 24-hour integrated PAH personal exposure sample was collected by each subject concurrently with 24 hours of the personal sampling for VOCs. During the period when personal exposures were being measured, workplace and home concentrations of the same air toxics were being measured simultaneously, as were seasonal levels in other microenvironments that the subjects visit during their daily activities, including street microenvironments, transport microenvironments, indoor environments, and other home environments. Information about subjects' lifestyles and daily activities were recorded by means of questionnaires and activity diaries. VOCs were collected in tubes packed with the adsorbent resins Tenax GR and Carbotrap, and separate tubes for the collection of 1,3-butadiene were packed with Carbopack B and Carbosieve S-III. After sampling, the tubes were analyzed by means of a thermal desorber interfaced with a gas chromatograph-mass spectrometer (GC-MS). Particle-phase PAHs collected onto a quartz-fiber filter were extracted with solvent, purified, and concentrated before being analyzed with a GC-MS. Urinary biomarkers were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS-MS). Both the environmental concentrations and personal exposure concentrations measured in this study are lower than those in the majority of earlier published work, which is consistent with the reported application of abatement measures to the control of air toxics emissions. The environmental concentration data clearly demonstrate the influence of traffic sources and meteorologic conditions leading to higher air toxics concentrations in the winter and during peak-traffic hours. The seasonal effect was also observed in indoor environments, where indoor sources add to the effects of the previously identified outdoor sources. The variability of personal exposure concentrations of VOCs and PAHs mainly reflects the range of activities the subjects engaged in during the five-day period of sampling. A number of generic factors have been identified to influence personal exposure concentrations to VOCs, such as the presence of an integral garage (attached to the home), exposure to environmental tobacco smoke (ETS), use of solvents, and commuting. In the case of the medium- and high-molecular-weight PAHs, traffic and ETS are important contributions to personal exposure. Personal exposure concentrations generally exceed home indoor concentrations, which in turn exceed outdoor concentrations. The home microenvironment is the dominant individual contributor to personal exposure. However, for those subjects with particularly high personal exposures, activities within the home and exposure to ETS play a major role in determining exposure. Correlation analysis and principal components analysis (PCA) have been performed to identify groups of compounds that share common sources, common chemistry, or common transport or meteorologic patterns. We used these methods to identify four main factors determining the makeup of personal exposures: fossil fuel combustion, use of solvents, ETS exposure, and use of consumer products. Concurrent with sampling of the selected air toxics, a total of 500 urine samples were collected, one for each of the 100 subjects on the day after each of the five days on which the briefcases were carried for personal exposure data collection. From the 500 samples, 100 were selected to be analyzed for PAHs and ETS-related urinary biomarkers. Results showed that urinary biomarkers of ETS exposure correlated strongly with the gas-phase markers of ETS and 1,3-butadiene. The urinary ETS biomarkers also correlated strongly with high-molecular-weight PAHs in the personal exposure samples. Five different approaches have been taken to model personal exposure to VOCs and PAHs, using 75% of the measured personal exposure data set to develop the models and 25% as an independent check on the model performance. The best personal exposure model, based on measured microenvironmental concentrations and lifestyle factors, is able to account for about 50% of the variance in measured personal exposure to benzene and a higher proportion of the variance for some other compounds (e.g., 75% of the variance in 3-ethenylpyridine exposure). In the case of the PAHs, the best model for benzo[a]pyrene is able to account for about 35% of the variance among exposures, with a similar result for the rest of the PAH compounds. The models developed were validated by the independent data set for almost all the VOC compounds. The models developed for PAHs explain some of the variance in the independent data set and are good indicators of the sources affecting PAH concentrations but could not be validated statistically, with the exception of the model for pyrene. A proposal for categorizing personal exposures as low or high is also presented, according to exposure thresholds. For both VOCs and PAHs, low exposures are correctly classified for the concentrations predicted by the proposed models, but higher exposures were less successfully classified.


Physical Activity Level Alterations Due to the Lockdowns: A Multi-Center Greek University-Based Study.
This cross-sectional study determines the impact of the pandemic lockdowns on physical activity, and evaluates the factors associated with physical activity cessation on students and personnel of eight Greek Higher Education Institutions. A total of 6,380 volunteer participants completed a survey reporting their physical activity levels and perceptions during the COVID-19 pandemic. The survey was made available through an online platform. Both the conduct and intensity of physical activity were significantly reduced from the pre-pandemic era to the second lockdown (P<0.001). Walking was the most frequently selected type of physical activity, in all periods except for the second lockdown. Loss of interest (52.4%) was the main, self-reported factor for cessation of physical activity. Females had a 31% lower probability of ceasing physical activity during lockdowns. The conduct and intensity of physical activity decreased significantly during the pandemic. Female gender, annual checkup attendance, and specific physical activity types during the pre-pandemic era were associated with a reduction in the risk of pausing physical activity during lockdowns. Lockdowns may be implemented in future health crises, hence measures for maintaining the physical activity of the general population, such as online group sessions and support from healthcare professionals, should be prepared.


Pupillary light reaction during high altitude exposure.
This study aimed to quantify the pupillary light reaction during high altitude exposure using the state of the art Compact Integrated Pupillograph (CIP) and to investigate a potential correlation of altered pupil reaction with severity of acute mountain sickness (AMS). This work is related to the Tübingen High Altitude Ophthalmology (THAO) study. Parameters of pupil dynamics (initial diameter, amplitude, relative amplitude, latency, constriction velocity) were quantified in 14 healthy volunteers at baseline (341 m) and high altitude (4559 m) over several days using the CIP. Scores of AMS, peripheral oxygen saturation and heart rate were assessed for respective correlations with pupil dynamics. For statistical analysis JMP was used and data are shown in terms of intra-individual normalized values (value during exposure/value at baseline) and the 95% confidence interval for each time point. During high altitude exposure the initial diameter size was significantly reduced (p<0.05). In contrast, the amplitude, the relative amplitude and the contraction velocity of the light reaction were significantly increased (p<0.05) on all days measured at high altitude. The latency did not show any significant differences at high altitude compared to baseline recordings. Changes in pupil parameters did not correlate with scores of AMS. Key parameters of the pupillary light reaction are significantly altered at high altitude. We hypothesize that high altitude hypoxia itself as well as known side effects of high altitude exposure such as fatigue or exhaustion after ascent may account for an altered pupillogram. Interestingly, none of these changes are related to AMS.