Tyrosine phosphorylation and cytoskeletal tension regulate the release of fibroblast adhesions.
We have investigated the mechanisms by which fibroblasts release their adhesions to the extracellular matrix substrata using a permeabilized cell system in which the adhesions remain relatively stable. A large number of different molecules were assayed for their effect on focal adhesion stability using immunofluorescence with antibodies against different focal adhesion constituents. ATP uniquely stimulates a rapid breakdown of focal adhesions, and at high ATP concentrations (> 5 mM), many cells are released from the dish. The remaining cells appear contracted with talin, alpha-actinin, and vinculin localized diffusely throughout the cell. Integrin containing tracks of variable intensity outline the regions where cells had resided before they detached from the substratum. At lower ATP concentrations (0.5-5 mM) the cells remain spread; however the focal adhesion components, including integrin, show an array of phenotypes ranging from diffusely localized throughout the cell to a localization in small, thin focal adhesions. Okadaic acid, a serine, threonine phosphatase inhibitor, enhances the contracted phenotype, even at low concentrations (0.5 mM) of ATP. The localization of focal adhesion components is different in okadaic acid-treated cells. In highly contracted cells, integrin is present in tracks where the cells resided before the contraction; however focal adhesions are no longer apparent. Talin, vinculin, and alpha-actinin localize in trabecular networks toward the periphery of the cell. Interestingly, phosphotyrosine staining as well as nascent, intracellular integrin precedes the recruitment of focal adhesion constituents into the trabecular network. The ATP-stimulated focal adhesion breakdown appears to operate through two mechanisms. First, ATP stimulates the tyrosine phosphorylation of several cytoskeletally associated proteins. These tyrosine phosphorylations correlated well with focal adhesion breakdown. Furthermore, addition of a recombinant, constitutively active tyrosine phosphatase inhibits both the tyrosine phosphorylations and the breakdown of the focal adhesions. None of the major tyrosine phosphoproteins are FAK, integrin, tensin, paxillin, or other phosphoproteins implicated in focal adhesion assembly. The second mechanism is cell contraction. High ATP concentrations, or lower ATP concentrations in the presence of okadaic acid induce cell contraction. Inhibiting the contraction by addition of a heptapeptide IRICRKG, which blocks the actin-myosin interaction, also inhibits focal adhesion breakdown. Neither the peptide nor the phosphatase inhibits focal adhesion breakdown under all conditions suggesting that both tension and tyrosine phosphorylations mediate the release of adhesions.


What informs care? Descriptions by multidisciplinary teams about burns care for Aboriginal and Torres Strait Islander children.
To investigate factors informing burns care for Aboriginal and Torres Strait Islander children. In-depth qualitative study with semi-structured interview questions. Multidisciplinary team members who provide care for Aboriginal and Torres Strait Islander children in six tertiary burn units across five Australian jurisdictions. Results from 76 interviews suggest that burns care in Australia is informed by a web of complex factors including evidence, resources and resourcing, individual clinician decision making processes and beliefs, and models of care. A Western biomedical health paradigm governs healthcare system policy for burns care, that participants report is not always aligned with Aboriginal and Torres Strait Islander families' concepts of health and healing. Within this paradigm, allocation of resources informs the provision (or not) of care; as does expert information and direction from senior clinicians. Participants reported that jurisdictional specific models of burns care developed using service and team experience, population data and other evidence derived in a scientific paradigm also influence delivery of care. There is a need for changes in the way evidence informs policy and practice in burns care for Aboriginal and Torres Strait Islander children and families so that it incorporates Indigenous constructs of health and wellbeing.


Importance of a radial head component in Sorbie unlinked total elbow arthroplasty.
The effects of a radial head component on total elbow arthroplasty kinematics and stability were evaluated using an anatomic design unlinked total elbow prosthesis. An electromagnetic tracking device recorded motion and varus and valgus displacements under various conditions in 10 cadaveric elbows. The motion patterns of the intact elbows and the Sorbie-Questor total elbow prostheses with a radial head component were similar, as both tended to have a valgus position in extension, varus at midflexion, and more valgus toward full flexion. Under conditions of simulated muscle loading, the maximum valgus and varus laxity of the elbow prosthesis was, on average, 8.6 degrees +/- 4.0 degrees greater than normal. Without the radial head component, however, significant kinematic disturbances and instabilities were seen. The varus and valgus displacements were 13.3 degrees +/- 5.5 degrees greater than the intact elbows. One total elbow arthroplasty without a radial head dislocated during testing. Increasing the muscle loading across the elbow significantly enhanced dynamic stability of the total elbow arthroplasties, especially in the extension half of elbow motion where instability is greatest. However, this dynamic enhancement of stability was seen only in those elbows in which the radial head component had been implanted. The radial head component is an important stabilizer, particularly in extension for this prosthesis, and possibly for other unlinked total elbow prostheses. Although instability of unlinked prostheses depends on the prosthetic design, the use of a radial head replacement may be an important factor in preventing such instability. Perhaps even more importantly, a radial head component balances the load distribution across the articulation, which could decrease stress on the ulnohumeral articulation and therefore possibly reduce polyethylene wear, osteolysis, and loosening.


Prevention of blindness from glaucoma using the King's College Hospital computerized problem orientated medical record.
(1) Chronic glaucoma accounts for a high proportion of blindness which is preventable and calls for energetic action because existing knowledge is not applied as it should be because of the indifference of the Department of Health and Social Security to the glaucoma problem. (2) The condition is frequently insidious and advanced before being identified, and requires life-long supervision. (3) When diagnosed, the management of glaucoma is frequently inadequate and intermittent for a variety of reasons. (4) AtKing's College Hospital, a Glaucoma Centre has been initiated to supervise accurately and regularly a large number of glaucoma patients, assisted by numerical recording and computer analysis. While we are fortunate in having a computer in the hospital, it is important to emphasize that the system can be operated without this facility, either by employing manual methods, or by batch processing. It would be both possible and desirable to organize recording a nd analysis on a regional basis in collaboration with hospitals wishing to participiate. (5) Attempts are being made to improve the early diagnosis ofglaucoma by better communication between the hospital ophthalmologists, and other members of the medical, optical, and ancillary professions by lectures, demonstrations, and publications. (6) Research is always hampered by the absence of factual knowledge. It is planned to use fully the opportunity for research into glaucoma made possible by this basic organization. At present however, we consider it more important to carry out investigations into the problems of organizing the investigation, treatment, and follow-up of glaucoma patients than t o embark on a few individual projects of research. We are serously hampered in our work by shortage of funds for staff and facilities, but we look forward confidently to the time when, with the essential support of the Department of Health, these methods will give us access to the facts of glaucoma, which besides enabling us to give a high standard of treatment to our patients, will give us an unprecedented opportunity of wide ranging research into all aspects of this important disorder.


The Opportunity Awaits to Lead Orthopaedic Telehealth Innovation: AOA Critical Issues.
Telehealth is a way to provide health-care services to a patient from a provider who is at another location. The most common methods include a live interactive visit with the patient, interpretation of imaging, and monitoring of patient progress. Principally, telehealth is a way of providing a service rather than a type of service. It is about patient care, not data care.Examples of orthopaedic applications include conducting patient examinations, interpreting imaging studies, and providing postoperative care. Teleconsultation has been shown to be cost-effective. Other examples in orthopaedic research include the application of telemedicine when measuring patient-reported outcomes. Especially in cases when the patient lives far away from the provider, telehealth reduces time, produces good patient satisfaction, and costs less than hands-on care. As in everyday life, consumers have learned to demand convenience, ease of use, choice, control, and direct access. The ubiquity of telecommunications, combined with consumer technology savviness, drives the demand for telehealth. Unfortunately, the nation's largest payer for health services is one of the most restrictive for telehealth coverage. Medicare's restrictions are mostly the work of the U.S. Congress under Part B law. Video visits are very narrowly covered. Another major policy barrier is that interstate telehealth requires multiple state licenses for the physician, who must be licensed in the jurisdiction of each patient as well as the provider's physical locations. As Medicare shifts toward capitated payment and other value-based methods, there are opportunities to remove such restrictions.Despite these challenges, some states have been proactive in implementing telehealth systems. Arkansas is one of these states, and being a rural state with 2 main population centers, specialty care is relatively sparse. Implemented in 2014, the hand trauma program has been a partnership between the University of Arkansas for Medical Sciences (UAMS) and the Arkansas Trauma Communications Center (ATCC). This program has been very successful in decreasing the rate of hand trauma transfer, allowing patients to be treated closer to home while having coordinated access to fellowship-trained hand surgeons when necessary.More widespread innovation of orthopaedic applications for telehealth requires physician buy-in and health-systems partnerships. The regulatory environment will need streamlining. Ultimately, consumer demand will drive the implementation of technology to make care more accessible, convenient, and cost-effective.


Best evidence topic report. Effervescent agents for oesophageal food bolus impaction.
A short cut review was carried out to establish whether fizzy drinks alone are effective at resolving food bolus impaction. Altogether 46 papers were found using the reported search, of which six presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.


BINDING OF AN ALPHA GLOBULIN TO HYALURONATEPROTEIN IN PATHOLOGICAL SYNOVIAL FLUIDS.
Rabbits were immunized with hyaluronateprotein isolated from normal or pathological synovial fluids. Immunoelectrophoresis of hyaluroni-dase-digested pathological hyaluronateprotein and its antiserum showed a single precipitin arc extending through both alpha globulin zones. Digested normal hyaluronateprotein formed no lines with either its antiserum or with that to pathological hyaluronateprotein. The antigenic component present in pathological hyaluronateprotein formed a reaction of complete fusion with a serum protein which was identified by immunoelectrophoresis as an alpha globulin.


Segment-interaction and its relevance to the control of movement during sprinting.
The aims of this study were to investigate the functions of muscle torque and its relation to other torque components during sprinting stance and swing phases. Three-dimensional kinematics and ground reaction force data were collected from eight elite male sprinters performing maximal-effort sprinting on a synthetic track. Intersegmental dynamics approach (ISD) was used to quantify lower extremity joint torque and their components during one gait cycle of the maximal speed phase during sprinting. Specifically, a modified version of the ISD was used to determine the relationship among the active muscle torque (MST), passive motion-dependent torque (MDT), ground reaction torque (EXT), gravitational torque (GTT), and net joint torque (NET) during stance and swing phases. The contribution of each torque component to lower extremity joint motion was quantified. Our results revealed that the active MST functioned to counteract EXT during stance phase. EXT acted to accelerate knee extension and hip flexion, meanwhile the muscles across these joints produced flexion torque at the knee and extension torque at the hip. During swing phase, MDT at the knee and hip joints was mainly produced by leg angular acceleration which was very significant at the moment when leg swing from forward to backward, active MST counterbalanced the effect of MDT. In summary, muscle torque functions mainly to push the ground to counter ground reaction force for controlling the movement during stance phase. However, the role of muscle torque changes during swing phase to mainly counteract the effect of MDT to control the movement direction of the lower extremity at both the hip and knee joints.


Mitochondrial genome of Savalia savaglia (Cnidaria, Hexacorallia) and early metazoan phylogeny.
Mitochondrial genomes have recently become widely used in animal phylogeny, mainly to infer the relationships between vertebrates and other bilaterians. However, only 11 of 723 complete mitochondrial genomes available in the public databases are of early metazoans, including cnidarians (Anthozoa, mainly Scleractinia) and sponges. Although some cnidarians (Medusozoa) are known to possess atypical linear mitochondrial DNA, the anthozoan mitochondrial genome is circular and its organization is similar to that of other metazoans. Because the phylogenetic relationships among Anthozoa as well as their relation to other early metazoans still need to be clarified, we tested whether sequencing the complete mitochondrial genome of Savalia savaglia, an anthozoan belonging to the order Zoantharia (=Zoanthidea), could be useful to infer such relationships. Compared to other anthozoans, S. savaglia's genome is unusually long (20,766 bp) due to the presence of several noncoding intergenic regions (3691 bp). The genome contains all 13 protein coding genes commonly found in metazoans, but like other Anthozoa it lacks most of the tRNAs. Phylogenetic analyses of S. savaglia mitochondrial sequences show Zoantharia branching closely to other Hexacorallia, either as a sister group to Actiniaria or as a sister group to Actiniaria and Scleractinia. The close relationships suggested between Zoantharia and Actiniaria are reinforced by strong similarities in their gene order and the presence of similar introns in the COI and ND5 genes. Our study suggests that mitochondrial genomes can be a source of potentially valuable information on the phylogeny of Hexacorallia and may provide new insights into the evolution of early metazoans.


Vitexin abrogates invasion and survival of hepatocellular carcinoma cells through targeting STAT3 signaling pathway.
Hepatocellular carcinoma (HCC) is a major malignancy that stands second in terms of global cancer-related mortality. STAT3 has been described as a latent transcription factor that promotes tumorigenesis. This study was designed to examine the effect of vitexin on STAT3 signaling and important hallmarks of cancer. HCC cells were employed to decipher the impact of vitexin on activation of STAT3 signaling using Western blotting, EMSA, immunocytochemistry, and reporter assay. The combinational apoptotic effects of vitexin with approved anti-cancer drugs was examined by live-dead assay, and its anti-invasive potential was studied using matrigel assay. The results obtained in cell-based assays were verified using in silico analysis. Vitexin effectively inhibited sustained activation of JAK1, JAK2, Src, and STAT3 in HCC cells. Vitexin downregulated DNA binding ability, reduced the nuclear pool of STAT3, and diminished epidermal growth factor (EGF)-driven STAT3 gene expression. Interestingly, treatment with tyrosine phosphatase inhibitor altered the vitexin-induced STAT3 phosphorylation, and the attenuation of STAT3 by vitexin was found to be driven through the upregulation of PTPεC. The combinational studies indicated that vitexin can exhibit substantial apoptotic effects with doxorubicin and sorafenib. It also suppressed the CXCL12-induced cell invasion. The results of cell-based assays are supported by in silico analysis as the vitexin displayed favorable interaction with kinase domain of JAK2 protein. Overall, this study demonstrated that vitexin can act as a potential blocker of the STAT3 signaling cascade and mitigate the survival as well as invasion of HCC cells.


Remote sensing image subpixel mapping based on adaptive differential evolution.
In this paper, a novel subpixel mapping algorithm based on an adaptive differential evolution (DE) algorithm, namely, adaptive-DE subpixel mapping (ADESM), is developed to perform the subpixel mapping task for remote sensing images. Subpixel mapping may provide a fine-resolution map of class labels from coarser spectral unmixing fraction images, with the assumption of spatial dependence. In ADESM, to utilize DE, the subpixel mapping problem is transformed into an optimization problem by maximizing the spatial dependence index. The traditional DE algorithm is an efficient and powerful population-based stochastic global optimizer in continuous optimization problems, but it cannot be applied to the subpixel mapping problem in a discrete search space. In addition, it is not an easy task to properly set control parameters in DE. To avoid these problems, this paper utilizes an adaptive strategy without user-defined parameters, and a reversible-conversion strategy between continuous space and discrete space, to improve the classical DE algorithm. During the process of evolution, they are further improved by enhanced evolution operators, e.g., mutation, crossover, repair, exchange, insertion, and an effective local search to generate new candidate solutions. Experimental results using different types of remote images show that the ADESM algorithm consistently outperforms the previous subpixel mapping algorithms in all the experiments. Based on sensitivity analysis, ADESM, with its self-adaptive control parameter setting, is better than, or at least comparable to, the standard DE algorithm, when considering the accuracy of subpixel mapping, and hence provides an effective new approach to subpixel mapping for remote sensing imagery.


Numerical analyses of optically coupled active and passive dielectric slab waveguides for TM modes.
Propagation characteristics of optically coupled dielectric waveguides including active and passive waveguides are studied in terms of scalar and vector field finite element methods. First, characteristics of couplings for asymmetric passive waveguides, i.e., modal dispersions and field distributions, are obtained using a vector field finite element method. Second, a scalar field finite element method is applied to active coupled slab waveguides, and modal propagation characteristics, i.e., dispersion relationships, modal gains, phase characteristics, and electromagnetic field distributions, are investigated in detail. Characteristics depending on parameters such as gain, symmetrical conditions of waveguides, and numbers of waveguides are obtained. As a result, weak coupling phenomena due to unequal gains are observed and it is found that a modal gain depends on optical power confinement factors. In this paper only TM modes are treated, but our method can be used to obtain TE modes.


Enough is enough.
Coinciding with the 50th anniversary of the first Surgeon General report on smoking and health (U.S. Department of Health, Education and Welfare, 1964) was the release of the 2014 Surgeon General report The Health Consequences of Smoking-50 Years of Progress (U.S. Department of Health and Human Services, 2014). During a press conference announcing the report in January 2014, Acting Surgeon General Rear Admiral Boris Lushniak, MD, MPH, repeated the refrain "Enough is enough" in frustration with the continuing burden of death and misery caused by tobacco use as he urged action to be taken. That challenge gives us an opportunity to ask ourselves whether, as nurses (particularly as oncology nurses), we have done enough to help patients who are still struggling with nicotine addiction.


The cost of teaching total knee arthroplasty surgery to orthopaedic surgery residents.
The higher costs associated with teaching hospitals have received some attention in the literature. The objective of the current study was to determine the increase in resource consumption associated with resident education in knee arthroplasty surgery. Seventy-four patients who underwent primary total knee arthroplasty in the same hospital were studied (50 private practice and 24 teaching practice). Time in the operating room and medical severity of illness were noted. Hospital charges were used as a measure of resource consumption. In addition, length of stay and in-hospital consultations and complications were observed. Kruskall-Wallis, chi square, and stepwise multiple regression analysis were performed. The mean age of the patients was 68 years. Patients who underwent surgery at the teaching service had higher charges ($30,311 +/- $3,325 versus $23,116 +/- $3,341) and longer times in the operating room (190 +/- 19 minutes versus 145 +/- 29 minutes). These patients also had a trend toward more associated comorbid medical conditions (0.71 versus 0.42). Stepwise multiple regression analysis showed that teaching was the most important predictor of charges and operating room time. The results show a 22% increase in perioperative resource consumption for patients who underwent surgery at a teaching service. The measured increase in cost is significantly lower than what has been reported in other series (82%). At the teaching institution, the anesthesia and orthopaedic surgery residents work together on all cases and perform a significant percent of the procedures under direct supervision. The increased resource consumption observed in a teaching service is most likely attributable to the hands-on approach taken to train residents.


HIV-1 causes an imbalance in the production of interleukin-18 and its natural antagonist in HIV-infected individuals: implications for enhanced viral replication.
Concentrations of interleukin (IL)-18 increase in the circulation of human immunodeficiency virus (HIV)-infected persons. However, nothing is known concerning the regulation of IL-18-binding protein (IL-18BP), which neutralizes IL-18 in vivo. This issue is addressed in the present study. Serum samples obtained from healthy subjects and HIV-infected patients were analyzed by enzyme-linked immunosorbent assay to determine their IL-18 and IL-18BP contents. Human monocyte-derived macrophages (MDMs) were infected in vitro with HIV type 1 (HIV-1), and the production of these 2 cytokines by these cells was measured. Finally, we determined the effect of IL-18 on HIV-1 replication in human cells. In contrast to IL-18 levels, IL-18BP levels decreased in the serum of HIV-infected patients. This decrease resulted in enhanced levels of free IL-18 in the serum of such patients. The infection increased production of IL-18 but decreased that of IL-18BP in MDMs. IL-10 and transforming growth factor-beta, concentrations of which are increased in HIV-infected persons, also decreased production of IL-18BP by human MDMs. Finally, recombinant human IL-18 enhanced HIV-1 replication in human CD4(+) T cells. Production of IL-18 and its antagonist becomes imbalanced in HIV-1-infected persons. The infection and the cytokine milieu play a role in this decreased production. The increased biological activities of IL-18 may enhance viral replication in human CD4(+) T cells.


Parent preferences and prenatal testing for neural tube defects.
Previous analyses of prenatal screening for neural tube defects have generally found benefits to exceed costs. The usual screening battery follows an elevated maternal serum alpha-fetoprotein level with high-resolution ultrasound and/or amniocentesis. Current thinking focuses on weighing the risk of a false-negative (an abnormality missed) against the risk of an amniocentesis-induced fetal loss. This thinking neglects the risk of a false-positive (an unaffected fetus labeled abnormal) and individual parents' preferences concerning a false-negative vs a fetal loss. With these risks included, we find that high-resolution ultrasound is appropriate for all women with elevated serum alpha-fetoprotein. Women with moderately elevated serum alpha-fetoprotein who have negative ultrasound scans need no further testing, nor do women with highly elevated serum alpha-fetoprotein and positive ultrasound scans. Further testing using amniocentesis to confirm the ultrasound result is appropriate for women with moderately elevated serum alpha-fetoprotein and positive ultrasound scans, and for women with highly elevated serum alpha-fetoprotein and negative ultrasound scans. The actual cutoffs defining normal, moderately elevated, and highly elevated serum alpha-fetoprotein depend on several parameters, particularly the underlying prevalence of neural tube defects and the parents' preferences.


First Report of Pilidium concavum Causing Tan-Brown Rot on Strawberry Fruit in Belgium.
In April 2010, pink-orange spore masses that later turned brown were observed on 7 to 50% of the transplant lots during a routine screening of Belgian strawberry (Fragaria × ananassa, cv. Elsanta) for the latent presence of Colletotrichum acutatum using the petiole freeze method (4). These spore masses contained hyaline, canoe-shaped to allantoid conidia (mean size 7.5 × 1.8 μm), which is not consistent with C. acutatum spore morphology. Subsequently, a spore mass was transferred onto potato dextrose agar (PDA) and a gray-to-brown colony with whitish, aerial mycelium was produced, which is also not consistent with C. acutatum isolates. To identify the fungus, the ITS1-5.8S-ITS2 rDNA region was amplified by PCR and sequenced. The 485-bp region was 100% identical to that of Pilidium concavum specimen voucher BPI 1107275 (GenBank Accession No. AY487094). P. concavum (Desm.) Höhn. (synanamorph Hainesia lythri; teleomorph Discohainesia oenotherae) is a pathogen of strawberry causing tan-brown rot of fruit and is a common secondary invader of roots and dead strawberry plant parts (3). A recent strain of P. concavum from strawberry, isolate UPL 50, obtained from Brazil (L. Zambolim, Univ. Fed. de Viçosa, personal communication) showed similar colony, microscopic (mean spore size of 6.8 × 1.8 μm), and molecular (ITS sequence 98% identical to that of P. concavum specimen voucher BPI 1107275) features as the Belgian isolate. Pathogenicity tests were conducted on mature strawberry fruits by submerging 15 fruits per isolate for 3 min in a conidial suspension (2 × 106 conidia ml-1 of water) obtained from a 2-week-old colony on PDA. Controls were submerged in sterile distilled water. The inoculated fruits were incubated in a moist chamber at 25°C. Sunken, yellowish brown lesions with pink and later orange-brown spore masses were observed starting 3 days after inoculation on 88 and 94% of the fruit for the Brazilian and Belgian isolate, respectively. The control fruits remained healthy. The fungal isolates were reisolated from symptomatic fruits and their identity was confirmed based on morphological features. During a strawberry field survey in July 2010 in Sint-Truiden (Belgium), lesions typical of those described above were observed on eight strawberry fruits (cv. Elsanta). The fungus was isolated from the symptomatic tissue of two fruits and characterized as described above. Since P. concavum was latently present on strawberry transplants and caused disease on the fruits in the field, we conclude that P. concavum is a potential threat for Belgian strawberry production. Moreover, no strawberry cultivars with resistance to the pathogen have been reported. The disease has previously been reported on strawberry in South America and Poland (1,2), but to our knowledge, this is the first report of P. concavum on strawberry in Belgium. Although the spore and colony morphology of P. concavum is different from C. acutatum, the spore masses of P. concavum can easily be confused with the spore masses of C. acutatum when using the freeze method. This suggests the need for microscopic analysis of these spore masses during routine analyses. References: (1) L. Cedeno et al. Interciencia 26:113, 2001. (2) U. P. Lopes et al. New Dis. Rep. 21:7, 2010. (3) J. L. Maas. Compendium of Strawberry Diseases. The American Phytopathological Society St. Paul, MN, 1998. (4) J. C. Mertely and D. E. Legard. Plant Dis. 88:407, 2004.


Benefit of bicarbonate dialysis during CAVHD.
The effect of bicarbonate dialysate (BD) on acid-base status in six pediatric CAVHD patients was examined during seven episodes of metabolic acidosis. When metabolic acidosis was not corrected with CAVHD, a sterile BD was substituted for either acetate- or lactate-based dialysate. Pre- and post-BD substitution levels of lactate, HCO3, PCO2, anion gap, and pH were recorded, as well as dose of intravenous (i.v.) bicarbonate. Improvements in pH and serum HCO3 were seen in all seven cases. Anion gap decreased in all but one of the patients who were switched from lactate to bicarbonate dialysate, with improvement most marked in those patients with marked elevation of the anion gap. No adverse effect on PCO2 was noted. Lactate dialysate may be less effective when serum lactate levels are high, and may contribute to further elevation of lactate levels and anion gap. These data suggest that bicarbonate dialysate may be preferable to lactate or acetate dialysate in CAVHD patients with persistent metabolic acidosis.


Pain and fatigue after concentric and eccentric muscle contractions.
1. Normal subjects performed a step test in which the quadriceps of one leg contracted concentrically while the contralateral muscle contracted eccentrically. 2. Maximal voluntary force and the force: frequency relationship were altered bilaterally as a result of the exercise, the changes being greater in the muscle which had contracted eccentrically. Recovery occurred over 24 h. 3. Electromyographic studies using three sites on each muscle showed an increase in electrical activation during the exercise only in the muscle which was contracting eccentrically. Recovery followed a time course similar to that of the contractile properties. 4. Pain and tenderness developed only in the muscle which had contracted eccentrically. Pain was first noted approximately 8 h after exercise and was maximal at approximately 48 h after exercise, at which time force generation and electrical activation had returned to pre-exercise values. 5. Eccentric contractions cause more profound changes in some aspects of muscle function than concentric contractions. These changes cannot be explained in simple metabolic terms, and it is suggested that they are the result of mechanical trauma caused by the high tension generated in relatively few active fibres during eccentric contractions.


Developmental trajectories and breakdown in F1 interpopulation hybrids of Tribolium castaneum.
When hybrid inviability is an indirect by-product of local adaptation, we expect its degree of severity between pairs of populations to vary and to be sensitive to the environment. While complete reciprocal hybrid inviability is the outcome of the gradual process of local adaptation, it is not representative of the process of accumulation of incompatibility. In the flour beetle, Tribolium castaneum, some pairs of populations exhibit complete, reciprocal F1 hybrid incompatibility while other pairs are fully or partially compatible. We characterize this naturally occurring variation in the degree and timing of expression of the hybrid incompatible phenotype to better understand the number of genes or developmental processes contributing to speciation. We assessed the morphological and developmental variation in four Tribolium castaneum populations and their 12 possible F1 hybrids at each life-history stage from egg to adult. We find that the rate of hybrid larval development is affected in all interpopulation crosses, including those eventually producing viable, fertile adults. Hybrid incompatibility manifests early in development as changes in the duration of instars and diminished success in the transition between instars are relative to the parent populations. Parent populations with similar developmental profiles may produce hybrids with disrupted development. The degree and timing of expression of hybrid inviability depends upon populations crossed, direction of the cross, and environment in which hybrids are raised. Our findings suggest that the coordinated expression of genes involved in transitional periods of development is the underlying cause of hybrid incompatibility in this species.


Opioid and Sedative-Hypnotic Prescriptions Among Post-9/11 Veteran VA Users Nationwide With Traumatic Brain Injury, 2012-2020.
Many post-9/11 Veterans have received Department of Veterans Affairs (VA) healthcare for traumatic brain injury (TBI). Pain conditions are prevalent among these patients and are often managed with opioid analgesics. Opioids may impose unique risks to Veterans with a history of TBI, especially when combined with other psychotropic medications. We examined receipt of opioid and sedative-hypnotic prescriptions among post-9/11 Veterans with TBI who received VA care nationally between 2012 and 2020. Nationwide VA outpatient care. Veterans with, versus without, clinician-confirmed TBI based on the VA's Comprehensive TBI Evaluation (CTBIE) were followed up for subsequent years in which they received VA care. A historical cohort study. Proportions of Veterans who received opioid, benzodiazepine, and nonbenzodiazepine sedative-hypnotic prescriptions were compared by CTBIE outcome (TBI yes/no) and by year; overlaps between medication classes, long-term opioid therapy, and high-dose opioid therapy were also examined. Among those with confirmed TBI, logistic regression was used to examine associations between veteran characteristics and likelihood of these potentially high-risk opioid use outcomes. Among 69 752 Veterans with clinician-confirmed TBI, 26.9% subsequently received opioids. The prevalence receiving opioids each year increased from 2012 (16.7%) to 2014 (17.7%), and then decreased each of the following years through 2020 (5.8%). Among Veterans with TBI who received opioids, large proportions also received benzodiazepine (30.1%) and nonbenzodiazepine (36.0%) sedative-hypnotic prescriptions; these proportions also decreased in recent years. In both bivariable and multivariable regression models, Veterans' demographic, TBI, and clinical characteristics were associated with likelihood of potentially high-risk opioid use. VA opioid prescribing to Veterans with TBI has decreased in recent years but remains an important source of risk, particularly when considering coprescriptions of sedative-hypnotic medication. Understanding patterns of psychotropic prescription use among Veterans with TBI can highlight important healthcare and rehabilitation needs in this large patient cohort.


Immunological and viral determinants of dengue severity in hospitalized adults in Ha Noi, Viet Nam.
The relationships between the infecting dengue serotype, primary and secondary infection, viremia and dengue severity remain unclear. This cross-sectional study examined these interactions in adult patients hospitalized with dengue in Ha Noi. 158 patients were enrolled between September 16 and November 11, 2008. Quantitative RT-PCR, serology and NS1 detection were used to confirm dengue infection, determine the serotype and plasma viral RNA concentration, and categorize infections as primary or secondary. 130 (82%) were laboratory confirmed. Serology was consistent with primary and secondary infection in 34% and 61%, respectively. The infecting serotype was DENV-1 in 42 (32%), DENV-2 in 39 (30%) and unknown in 49 (38%). Secondary infection was more common in DENV-2 infections (79%) compared to DENV-1 (36%, p<0.001). The proportion that developed dengue haemorrhagic fever (DHF) was 32% for secondary infection compared to 18% for primary infection (p = 0.14), and 26% for DENV-1 compared to 28% for DENV-2. The time until NS1 and plasma viral RNA were undetectable was shorter for DENV-2 compared to DENV-1 (p≤0.001) and plasma viral RNA concentration on day 5 was higher for DENV-1 (p = 0.03). Plasma viral RNA concentration was higher in secondary infection on day 5 of illness (p = 0.046). We didn't find an association between plasma viral RNA concentration and clinical severity. Dengue is emerging as a major public health problem in Ha Noi. DENV-1 and DENV-2 were the prevalent serotypes with similar numbers and clinical presentation. Secondary infection may be more common amongst DENV-2 than DENV-1 infections because DENV-2 infections resulted in lower plasma viral RNA concentrations and viral RNA concentrations were higher in secondary infection. The drivers of dengue emergence in northern Viet Nam need to be elucidated and public health measures instituted.


Sensory processing of motor inaccuracy depends on previously performed movement and on subsequent motor corrections: a study of the saccadic system.
When goal-directed movements are inaccurate, two responses are generated by the brain: a fast motor correction toward the target and an adaptive motor recalibration developing progressively across subsequent trials. For the saccadic system, there is a clear dissociation between the fast motor correction (corrective saccade production) and the adaptive motor recalibration (primary saccade modification). Error signals used to trigger corrective saccades and to induce adaptation are based on post-saccadic visual feedback. The goal of this study was to determine if similar or different error signals are involved in saccadic adaptation and in corrective saccade generation. Saccadic accuracy was experimentally altered by systematically displacing the visual target during motor execution. Post-saccadic error signals were studied by manipulating visual information in two ways. First, the duration of the displaced target after primary saccade termination was set at 15, 50, 100 or 800 ms in different adaptation sessions. Second, in some sessions, the displaced target was followed by a visual mask that interfered with visual processing. Because they rely on different mechanisms, the adaptation of reactive saccades and the adaptation of voluntary saccades were both evaluated. We found that saccadic adaptation and corrective saccade production were both affected by the manipulations of post-saccadic visual information, but in different ways. This first finding suggests that different types of error signal processing are involved in the induction of these two motor corrections. Interestingly, voluntary saccades required a longer duration of post-saccadic target presentation to reach the same amount of adaptation as reactive saccades. Finally, the visual mask interfered with the production of corrective saccades only during the voluntary saccades adaptation task. These last observations suggest that post-saccadic perception depends on the previously performed action and that the differences between saccade categories of motor correction and adaptation occur at an early level of visual processing.


Preliminary assessment of a prototype advanced mobility device in the work environment of veterans with spinal cord injury.
The INDEPENDENCE 3000 IBOT Transporter (IBOT) is an electronically stabilizing device for people with disabilities. The purpose of this study was to collect qualitative data on the potential for the IBOT to improve employment satisfaction of veterans who use wheelchairs to work. This study was based upon observations by trained clinicians, and responses to a survey completed by four men with traumatic spinal cord injury, who worked in an office environment. The mean age of the subjects was 52 +/- 8.8 years. The subjects used the devices to hold eye-level discussions with colleagues, climb stairs, ascend steep ramps, and negotiate curbs. When subjects were asked to rate the ease of getting around in the IBOT compared to their personal wheelchairs, they responded with a mean of 6.7 +/- 1.8 on a 10-point visual analog scale. The response to rating the overall function of the IBOT within their working environment yielded a rating of 6.0 +/- 2.8. Half of the users felt that the IBOT would help them at work and all thought it should be made available to veterans who use wheelchairs. A larger study should be conducted to determine if the IBOT affects work performance and the ability to return to work.


[Mutual relationship between prevalence statistics and mortality statistics in Parkinson's disease].
The purpose of this study is to determine whether the statistics from three published reports on Parkinson's disease (PD) are mutually interrelated and to clarify the relationship between the prevalence statistics and mortality statistics of PD. These statistics included data on "number of patients with PD (PD Patients)", "number of patients with PD receiving financial aid for treatment (PD Recipients)" as an indicator showing the prevalence of PD, and "number of deaths from PD (PD Deaths, i.e., mortality)". The data on PD Patients, PD Recipients and PD Deaths were cited from "Patient Survey" by Ministry of Health, Labour and Welfare, a report by the Research Committee on Epidemiology of Intractable Diseases and "Vital Statistics of Japan" by Ministry of Health, Labour and Welfare, respectively. The expected PD Patients, PD Recipients and PD Deaths were calculated as products of their respective rates for the entire country and prefecture population, adjusting for a difference in population composition. Observed/expected number ratios (O/E ratio) of PD Patients, PD Recipients and PD Patients were calculated by prefecture. The correlation between the O/E ratios was examined. In addition, the relationships of the O/E ratios with the number of hospitals or physicians per person were examined. There were no significant correlations between the O/E ratios of PD Patients, PD Recipients or PD Deaths. The O/E ratio of PD Recipients significantly correlated with the numbers of hospitals and physicians per person. PD Patients and PD Recipients were included in number of people with PD and PD Deaths was derived from people with PD. However, these statistics do not necessarily reflect the prevalence of PD in each prefecture. When using these published statistics as an indicator of the prevalence of PD, it is necessary to clarify the purpose of their use and to comprehend their characteristics.


Enzymatic treatments reveal differential capacities for xylan recognition and degradation in primary and secondary plant cell walls.
The capacity of four xylan-directed probes (carbohydrate-binding modules CfCBM2b-1-2 and CjCBM15; monoclonal antibodies LM10 and LM11) to recognize xylan polysaccharides in primary and secondary cell walls of tobacco stem sections has been determined. Enzymatic removal of pectic homogalacturonan revealed differential recognition of xylans in restricted regions of cortical primary cell walls. Monoclonal antibody binding to these exposed xylans was more sensitive to xylanase action than carbohydrate-binding module (CBM) binding. In contrast, the recognition of xylans by CBMs in secondary cell walls of the same organ was more sensitive to xylanase action than the recognition of xylans by the monoclonal antibodies. A methodology was developed to quantify indirect immunofluorescence intensities, and to evaluate xylanase impacts. The four xylan probes were also used to detect xylan populations in chromatographic separations of solubilized cell wall materials from tobacco stems. Altogether, these observations reveal the heterogeneity of the xylans in plant cell walls. They indicate that although CBM and antibody probes can exhibit similar specificities against solubilized polymers, they can have differential capacities for xylan recognition in muro, and that the access of molecular probes and enzymes to xylan epitopes/ligands also varies between primary and secondary cell walls that are present in the same organ.


Selecting for creativity and innovation potential: implications for practice in healthcare education.
The ability to innovate is an important requirement in many organisations. Despite this pressing need, few selection systems in healthcare focus on identifying the potential for creativity and innovation and so this area has been vastly under-researched. As a first step towards understanding how we might select for creativity and innovation, this paper explores the use of a trait-based measure of creativity and innovation potential, and evaluates its efficacy for use in selection for healthcare education. This study uses a sample of 188 postgraduate physicians applying for education and training in UK General Practice. Participants completed two questionnaires (a trait-based measure of creativity and innovation, and a measure of the Big Five personality dimensions) and were also rated by assessors on creative problem solving measured during a selection centre. In exploring the construct validity of the trait-based measure of creativity and innovation, our research clarifies the associations between personality, and creativity and innovation. In particular, our study highlights the importance of motivation in the creativity and innovation process. Results also suggest that Openness to Experience is positively related to creativity and innovation whereas some aspects of Conscientiousness are negatively associated with creativity and innovation. Results broadly support the utility of using a trait-based measure of creativity and innovation in healthcare selection processes, although practically this may be best delivered as part of an interview process, rather than as a screening tool. Findings are discussed in relation to broader implications for placing more priority on creativity and innovation as selection criteria within healthcare education and training in future.


Metabolic effects of low-dose dopamine infusion in normal volunteers.
1. Dopamine in 5% (w/v) D-glucose was infused into five healthy male volunteers at doses of 2, 5 and 10 micrograms min-1 kg-1 over three sequential periods of 45 min each. 2. Oxygen consumption, respiratory exchange ratio, blood glucose concentration and plasma levels of free fatty acids, glycerol, lactate, dopamine, adrenaline and noradrenaline were measured. The results were compared with values obtained during infusion over the same time period of the corresponding volumes of 5% (w/v) D-glucose alone. 3. Energy expenditure calculated from the oxygen consumption and the respiratory exchange ratio was higher than control values during infusion of dopamine (P less than 0.001, analysis of variance) specifically at a rate of 10 micrograms min-1 kg-1 (P less than 0.05) when it was 14% higher, but not at a rate 2 of or 5 micrograms min-1 kg-1. The plasma noradrenaline concentration was 74 and 230% and the blood glucose concentration was 21 and 36% higher than control values at 5 and 10 micrograms of dopamine min-1 kg-1, respectively (P less than 0.01). At 10 micrograms of dopamine min-1 kg-1 the plasma free fatty acid concentration was 70% and the plasma glycerol concentration was 80% higher than during the control infusion (P less than 0.01). The respiratory exchange ratio and the plasma lactate concentration were the same in the two groups and did not alter during the dopamine infusion. The plasma adrenaline concentration rose significantly (P less than 0.01), but only transiently, during dopamine infusion at a rate of 2 micrograms min-1 kg-1. 4. Dopamine at low doses has metabolic effects. It increases the blood glucose concentration and the circulating noradrenaline level at an infusion rate of 5 micrograms min-1 kg-1. It increases energy expenditure and circulating free fatty acid and glycerol levels at an infusion rate of 10 micrograms min-1 kg-1, presumably due to stimulation of lipolysis.


Ion transport across cat and ferret tracheal epithelia.
Sheets of trachea from ferret and cat were mounted in Ussing chambers and continuously short circuited. Under resting conditions, in both the cat and ferret there was little or no Cl secretion, and Na absorption accounted for most of the short-circuit current (Isc). Ouabain (10(-4) M, serosal bath) reduced Isc to zero in 30-60 min. This decline was matched by a decrease in net Na absorption. Amiloride (10(-4) M, luminal bath) caused a significant decrease in Isc and conductance (G) in both species. Bumetanide (10(-4) M, serosal bath) had negligible effects on Isc and G. In both species, isoproterenol increased Isc by stimulating Cl secretion. Methacholine induced equal amounts of Na and Cl secretion, with little change in Isc. In the cat, prostaglandins E2 and F2 alpha and bradykinin increased Isc, responses which were abolished in Cl-free medium. In open-circuited cat tissues, Na flux from the serosal to mucosal side was measured simultaneously with the secretion of nondialyzable 35S. Prostaglandins E1, E2, and F2 alpha, histamine, bradykinin, methacholine and isoproterenol all increased both Na and 35S-mucin secretion.


High-speed multi-jets printing using laser forward transfer: time-resolved study of the ejection dynamics.
This paper extends the current understanding of the laser-induced forward transfer (LIFT) process to the multi-jets ejection problem. LIFT has already been used to print micrometer-sized droplets from a liquid donor substrate with single pulse experiments. Here we study the dynamics of the high-speed multi-jets formation from silver nanoparticles ink films with a time-resolved imaging technique. A galvanometric mirrors head controls the spacing between adjacent pulses by scanning the focused beam of a high repetition rate UV picosecond laser along an ink-coated donor substrate. The laser pulses interact with the liquid film and generate cavitation bubbles that propel the ink away from the substrate and form the jets. When the spacing between consecutive pulses is substantially higher than the maximum diameter of the bubbles, there is no interaction between adjacent jets, and these remain unperturbed. However, when the pulses are brought closer significant jet-jet interaction takes place, which results in a clear deviation from the single jet dynamics. Thus, the cavitation bubbles acquire different shapes, the ink is ejected faster and along different directions depending on the spacing between the pulses, and each bubble alters the evolution of the previous one and shifts away from it.


Cost-effectiveness analysis between primary and secondary preventive strategies for gastric cancer.
The present study is done to assess the relative cost-effectiveness, optimal initial age, and interscreening interval between primary and secondary prevention strategies for gastric cancer. Base-case estimates, including variables of natural history, efficacy of intervention, and relevant cost, were derived from two preventive programs targeting a high-risk population. Cost-effectiveness was compared between chemoprevention with (13)C urea breath testing followed by Helicobacter pylori (H. pylori) eradication and high-risk surveillance based on serum pepsinogen measurement and confirmed by endoscopy. The main outcome measure was cost per life-year gained with a 3% annual discount rate. The incremental cost-effectiveness ratio (ICER) for once-only chemoprevention at age 30 years versus no screening was U.S. $17,044 per life-year gained. Eradication of H. pylori at later age or with a periodic scheme yielded a less favorable result. Annual high-risk screening at age of 50 years versus no screening resulted in an ICER of U.S. $29,741 per life-year gained. The ICERs of surveillance did not substantially vary with different initial ages or interscreening intervals. Chemoprevention could be dominated by high-risk surveillance when the initial age was older than 44 years. Otherwise, chemoprevention was more cost-effective than high-risk surveillance, either at ceiling ratios of U.S. $15,762 or up to U.S. $50,000. The relative cost-effectiveness was most sensitive to the infection rate of H. pylori and proportion of early gastric cancer in all detectable cases. Early H. pylori eradication once in lifetime seems more cost-effective than surveillance strategy. However, the choice is still subject to the risk of infection, detectability of early gastric cancer, and timing of intervention.


Therapeutic options in docetaxel-refractory metastatic castration-resistant prostate cancer: a cost-effectiveness analysis.
Docetaxel is an established first-line therapy to treat metastatic castration-resistant prostate cancer (mCRPC). Recently, abiraterone and cabazitaxel were approved for use after docetaxel failure, with improved survival. National Institute for Health and Clinical Excellence (NICE) preliminary recommendations were negative for both abiraterone (now positive in final recommendation) and cabazitaxel (negative in final recommendation). To evaluate the cost-effectiveness of abiraterone, cabazitaxel, mitoxantrone and prednisone for mCRPC treatment in US. A decision-tree model was constructed to compare the two mCRPC treatments versus two placebos over 18 months from a societal perspective. Chance nodes include baseline pain as a severity indicator, grade III/IV side-effects, and survival at 18 months. Probabilities, survival and health utilities were from published studies. Model cost inputs included drug treatment, side-effect management and prevention, radiation for pain, and death associated costs in 2010 US dollars. Abiraterone is a cost-effective choice at $94K/QALY (quality adjusted life years) compared to placebo in our base-case analysis. Cabazitaxel and abiraterone are the most effective, yet also most expensive agents. The incremental cost-effectiveness ratios (ICER) at base-case are $101K/QALY (extended dominated) for mitoxantrone vs. placebo, $91K/QALY for abiraterone vs. mitoxantrone, $956K/QALY for cabazitaxel vs. abiraterone. Abiraterone becomes less cost-effective as its AWP increases, or if the cost of mitoxantrone side-effect management decreases. Increases in the percentage of patients with baseline pain leads to an increased ICER for both mitoxantrone and abiraterone, but mitoxantrone does relatively better. Cabazitaxel remains not cost-effective. Our base case model suggests that abiraterone is a cost-effective option in docetaxel-refractory mCRPC patients. Newer treatments will also need a CEA assessment compared to abiraterone.


Effectiveness of percutaneous laser disc decompression versus conventional open discectomy in the treatment of lumbar disc herniation; design of a prospective randomized controlled trial.
The usual surgical treatment of refractory sciatica caused by lumbar disc herniation, is open discectomy. Minimally invasive procedures, including percutaneous therapies under local anesthesia, are increasingly gaining attention. One of these treatments is Percutaneous Laser Disc Decompression (PLDD). This treatment can be carried out in an outpatient setting and swift recovery and return to daily routine are suggested. Thus far, no randomized trial into cost-effectiveness of PLDD versus standard surgical procedure has been performed. We present the design of a randomized controlled trial, studying the cost-effectiveness of PLDD versus conventional open discectomy in patients with sciatica from lumbar disc herniation. The study is a randomized prospective multi-center trial, in which two treatment strategies are compared in a parallel group design. Patients (age 18-70 years) visiting the neurosurgery department of the participating hospitals, are considered for inclusion in the trial when sciatica due to lumbar disc herniation has lasted more than 8 weeks. Patients with disc herniation smaller than 1/3 of the spinal canal diameter, without concomitant lateral recess stenosis or sequestration, are eligible for participation, and are randomized into one of two treatment arms; either Percutaneous Laser Disc Decompression or conventional discectomy. The functional outcome of the patient, as assessed by the Roland Disability Questionnaire for Sciatica at 8 weeks and 1 year after treatment, is the primary outcome measure. The secondary outcome parameters are recovery as perceived by the patient, leg and back pain, incidence of re-intervention, complications, quality of life, medical consumption, absence of work and secondary costs. Open discectomy is still considered to be the golden standard in the surgical treatment of lumbar disc herniation. Whether Percutaneous Laser Disc Decompression has at least as much efficacy as the standard surgical procedure, and is more cost-effective, will be determined by this trial.


Chronic effects of ambient air pollution on lung function among Chinese children.
To examine the association between long-term exposure to air pollution and lung function among Chinese schoolchildren in Southern China (Hong Kong). We conducted a cross-sectional study among 3168 schoolchildren (aged 8-10 years) in 3 districts in Hong Kong. Annual means of ambient PM10 (particulate matter <10 µm), SO2, NO2 and O3 from 1996 to 2003 were used to estimate the individual exposure of the subjects. Children's lung function was measured for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), forced expiratory flow between 25% and 75% of FVC (FEF(25-75)) and forced expiratory flow at 75% of FVC (FEF75). Analysis of covariance was performed separately by gender to estimate the impact of air pollution on lung function, with adjustment for socioeconomic characteristics, respiratory morbidities, height and weight, physical activity level, indoor air contaminants and short-term exposure to the air pollutants. After controlling for potential confounding factors, FEV1, FEF(25-75) and FEF75 for boys in a high-pollution district (HPD) were significantly lower than those in a low-pollution district (LPD) by 3.0%, 7.6% and 8.4%, respectively. No significant differences were found for girls. Results from the comparison between a moderate-pollution district (MPD) and the HPD were similar. There were no differences between children in the LPD and MPD, except that a higher FEF75 was found in boys in the MPD. PM10 is the primary pollutant responsible for the lung function deficit. Asthmatic children were more vulnerable to exposure to air pollution. Long-term exposure to higher ambient air pollution levels was associated with lower lung function in Chinese schoolchildren, especially among boys. Adverse effects were observed on large and small airways, with a stronger effect on the latter.


Periodic structures consisting of germanium nanoparticles in buried channel waveguides.
Periodic structures consisting of Ge nanoparticles were formed in buried channel waveguides. Such periodic structures were created in GeO(2)-B(2)O(3)-SiO(2) thin glass films by the combination of exposure to interference patterns of ultraviolet laser light and thermally induced phase changes of the glasses. The periodic structures in the channels served as the Bragg gratings with high diffraction efficiencies in the optical communication wavelength. Transmission spectra measurements show the depths and positions of the diffraction peaks as 37.77 dB at 1536.2 nm and 38.72 dB at 1537.6 nm, respectively, for TE-like and TM-like modes. The diffraction efficiencies remain unchanged even after further annealing at temperatures as high as 500 degrees C.


Hierarchical motif vectors for prediction of functional sites in amino acid sequences using quasi-supervised learning.
We propose hierarchical motif vectors to represent local amino acid sequence configurations for predicting the functional attributes of amino acid sites on a global scale in a quasi-supervised learning framework. The motif vectors are constructed via wavelet decomposition on the variations of physico-chemical amino acid properties along the sequences. We then formulate a prediction scheme for the functional attributes of amino acid sites in terms of the respective motif vectors using the quasi-supervised learning algorithm that carries out predictions for all sites in consideration using only the experimentally verified sites. We have carried out comparative performance evaluation of the proposed method on the prediction of N-glycosylation of 55,184 sites possessing the consensus N-glycosylation sequon identified over 15,104 human proteins, out of which only 1,939 were experimentally verified N-glycosylation sites. In the experiments, the proposed method achieved better predictive performance than the alternative strategies from the literature. In addition, the predicted N-glycosylation sites showed good agreement with existing potential annotations, while the novel predictions belonged to proteins known to be modified by glycosylation.


Association of Mutations in TBK1 With Sporadic and Familial Amyotrophic Lateral Sclerosis and Frontotemporal Dementia.
Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are related neurodegenerative syndromes that occur sporadically or have been associated with mostly dominant inheritance of mutations in more than 30 genes. A critical issue is whether all reported mutations are disease causing or are coincidental findings. In this review we analyze the pathogenicity of nonsynonymous variants in the newly discovered gene encoding TANK-binding kinase 1 (TBK1). The available data suggest that mutations in TBK1 that cause a 50% reduction of TBK1 protein levels are pathogenic. In most cases, the almost complete loss of expression of the mutated TBK1 allele is due to loss-of-function mutations creating a premature termination codon and the degradation of the mutated messenger RNA by nonsense-mediated messenger RNA decay. In addition, TBK1 protein levels reduced by 50% have been proven for specific in-frame deletions of 1 or several amino acids, probably due to increased degradation of the mutated protein. Evaluation of many of the TBK1 missense mutations found in patients with ALS or FTD is prevented by missing data demonstrating cosegregation of the variants and incomplete knowledge about the TBK1 functions relevant for neurodegeneration. These findings suggest that haploinsufficiency of TBK1 is causative for ALS and FTD regardless of the type of mutation. Evaluation of TBK1 variants that do not cause haploinsufficiency is not possible without data demonstrating cosegregation.


Setting the scene for the Second Stroke Recovery and Rehabilitation Roundtable.
The Stroke Recovery and Rehabilitation Roundtable (SRRR) meetings bring together an international group of preclinical and clinical researchers along with statisticians, methodologists, funders and consumers, working to accelerate the development of effective treatments for stroke recovery and to support best-evidence uptake in rehabilitation practice. The first meeting (2016) focused on four recommendation areas: translation of preclinical evidence into human discovery trials; recovery biomarkers to provide knowledge of therapeutic targets and prognosis in human stroke; intervention development, monitoring, and reporting standards; and standardized measurement in motor recovery trials. The impact of SRRR is growing, with uptake of recommendations emerging, and funders exploring ways to incorporate research targets and recommendations. At our second meeting (SRRR2, 2018), we worked on new priority areas: (1) cognitive impairment, (2) standardizing metrics for measuring quality of movement, (3) improving development of recovery trials, and (4) moving evidence-based treatments into practice. To accelerate progress towards breakthrough treatments, formation of an International Stroke Recovery and Rehabilitation Alliance is our next step, where working groups will take recommendations and build partnerships needed to achieve our goals.


Structural and biophysical characterization of the Syk activation switch.
Syk is an essential non-receptor tyrosine kinase in intracellular immunological signaling, and the control of Syk kinase function is considered as a valuable target for pharmacological intervention in autoimmune or inflammation diseases. Upon immune receptor stimulation, the kinase activity of Syk is regulated by binding of phosphorylated immune receptor tyrosine-based activating motifs (pITAMs) to the N-terminal tandem Src homology 2 (tSH2) domain and by autophosphorylation with consequences for the molecular structure of the Syk protein. Here, we present the first crystal structures of full-length Syk (fl-Syk) as wild type and as Y348F,Y352F mutant forms in complex with AMP-PNP revealing an autoinhibited conformation. The comparison with the crystal structure of the truncated Syk kinase domain in complex with AMP-PNP taken together with ligand binding studies by surface plasmon resonance (SPR) suggests conformational differences in the ATP sites of autoinhibited and activated Syk forms. This hypothesis was corroborated by studying the thermodynamic and kinetic interaction of three published Syk inhibitors with isothermal titration calorimetry and SPR, respectively. We further demonstrate the modulation of inhibitor binding affinities in the presence of pITAM and discuss the observed differences of thermodynamic and kinetic signatures. The functional relevance of pITAM binding to fl-Syk was confirmed by a strong stimulation of in vitro autophosphorylation. A structural feedback mechanism on the kinase domain upon pITAM binding to the tSH2 domain is discussed in analogy of the related family kinase ZAP-70 (Zeta-chain-associated protein kinase 70). Surprisingly, we observed distinct conformations of the tSH2 domain and the activation switch including Tyr348 and Tyr352 in the interdomain linker of Syk in comparison to ZAP-70.


Physical stress triggers in simulated emergency care situations.
To practise emergency care situations during the education can be stressful. The aim of this study is to identify factors that cause stress in simulated emergency care. A descriptive observational study. Video recordings (N = 26) subjected to observation with written field notes in turn subjected to interpretive qualitative content analysis. To assess the patient's condition and decide what measures to take trigger stress reactions. If the students failed to connect the correct and relevant information in the conversation with the physician, the students showed signs of stress. Also, to calculate medication dosages stress the students.


A Nondestructive Eggshell Thickness Measurement Technique Using Terahertz Waves.
Eggshells play a number of important roles in the avian and reptile kingdom: protection of internal contents and as a major source of minerals for developing embryos. However, when researching these respective roles, eggshell thickness measurement remains a bottleneck due to the lack of a non-destructive measurement techniques. As a result, many avian and reptile research protocols omit consideration of eggshell thickness bias on egg or embryo growth and development. Here, we validate a non-destructive method to estimate eggshell thickness based on terahertz (THz) reflectance spectroscopy using chicken white coloured eggs. Since terahertz waves are reflected from outer air-eggshell interface, as well as the inner eggshell-membrane boundary, the resulting interference signals depend on eggshell thickness. Thus, it is possible to estimate shell thickness from the oscillation distance in frequency-domain. A linear regression-based prediction model for non-destructive eggshell thickness measurement was developed, which had a coefficient of determination (R2) of 0.93, RMSEP of 0.009, RPD of 3.45 and RER 13.67. This model can estimate eggshell thickness to a resolution of less than 10 μm. This method has the potential to expand the protocols in the field of avian and reptile research, as well as be applied to industrial grading of eggs.


Parent and physician perspectives on the treatment of primary nocturnal enuresis in Korea.
Parental decisions about the treatment of nocturnal enuresis (NE) are generally based on silent agreement with a physician's recommendation. However, physicians may have an insufficient understanding about parents' concerns and expectations regarding treatment. The aim of this study was to clarify the discrepancies between the perceptions of parents and physicians and to better understand the attitudes related to NE treatment. A survey was conducted in six centers and included 105 parents and 102 physicians. Two questionnaires, one for parents and another for physicians, were prepared. Each contained items on demographic characteristics, concerns, and NE treatment preferences. The parents completed the questionnaire during their child's first clinical visit, and the physicians completed the questionnaire via e-mail or individual interviews. Low self-esteem was the most common concern among both parents and physicians. Parents showed a more serious concern regarding disease progression and sequelae than did physicians. In the parent group, parents of younger children were mainly concerned about growth, whereas parents of children with daytime symptoms were mainly concerned about disease progression and relationships. Treatment outcome preferences differed significantly between the two groups. Physicians preferred treatments yielding immediate results, whereas parents preferred long-term treatments that would result in low recurrence. This survey presents the differences between parents and physicians regarding NE concerns and therapeutic preferences. Our study may provide valuable insight for physicians regarding parental attitudes toward NE treatment.


Construction of a high titer infectious HIV-1 subtype C proviral clone from South Africa.
The Human Immunodeficiency Virus type 1 (HIV-1) subtype C is currently the predominant subtype worldwide. Cell culture studies of Sub-Saharan African subtype C proviral plasmids are hampered by the low replication capacity of the resulting viruses, although viral loads in subtype C infected patients are as high as those from patients with subtype B. Here, we describe the sequencing and construction of a new HIV-1 subtype C proviral clone (pZAC), replicating more than one order of magnitude better than the previous subtype C plasmids. We identify the env-region for being the determinant for the higher viral titers and the pZAC Env to be M-tropic. This higher replication capacity does not lead to a higher cytotoxicity compared to previously described subtype C viruses. In addition, the pZAC Vpu is also shown to be able to down-regulate CD4, but fails to fully counteract CD317.


Social Change and the Relationships between Education and Employment.
The relationships between education and employment have long been of interest to social scientists. During the transition from a completely agricultural economy to one that is developing nonfarm opportunities, however, the relationships between education and employment may dramatically change. We examine how two components of education-schooling enrollment and attainment-affect the transition to employment for men and women in the Chitwan Valley of Nepal. Using discrete-time event history models, we find that school enrollment tends to delay employment, while school attainment accelerates employment. We also test how these effects may have changed across successive cohorts. Over time, the effects of enrollment have become stronger, while the effects of attainment appear to have weakened. These shifts in the nature of education may be related to increasing conflict between student and employee roles, as well as changes in the types and availability of employment.


Neuroinflammatory mechanisms in Parkinson's disease: potential environmental triggers, pathways, and targets for early therapeutic intervention.
Most acute and chronic neurodegenerative conditions are accompanied by neuroinflammation; yet the exact nature of the inflammatory processes and whether they modify disease progression is not well understood. In this review, we discuss the key epidemiological, clinical, and experimental evidence implicating inflammatory processes in the progressive degeneration of the dopaminergic (DA) nigrostriatal pathway and their potential contribution to the pathophysiology of Parkinson's disease (PD). Given that interplay between genetics and environment are likely to contribute to risk for development of idiopathic PD, recent data showing interactions between products of genes linked to heritable PD that function to protect DA neurons against oxidative or proteolytic stress and inflammation pathways will be discussed. Cellular mechanisms activated or enhanced by inflammatory processes that may contribute to mitochondrial dysfunction, oxidative stress, or apoptosis of dopaminergic (DA) neurons will be reviewed, with special emphasis on tumor necrosis factor (TNF) and interleukin-1-beta (IL-1beta) signaling pathways. Epigenetic factors which have the potential to trigger neuroinflammation, including environmental exposures and age-associated chronic inflammatory conditions, will be discussed as possible 'second-hit' triggers that may affect disease onset or progression of idiopathic PD. If inflammatory processes have an active role in nigrostriatal pathway degeneration, then evidence should exist to indicate that such processes begin in the early stages of disease and that they contribute to neuronal dysfunction and/or hasten neurodegeneration of the nigrostriatal pathway. Therapeutically, if anti-inflammatory interventions can be shown to rescue nigral DA neurons from degeneration and lower PD risk, then timely use of anti-inflammatory therapies should be investigated further in well-designed clinical trials for their ability to prevent or delay the progressive loss of nigral DA neurons in genetically susceptible populations.


Teaching mindfulness to occupational therapy students: pilot evaluation of an online curriculum.
How mindfulness can be learned by occupational therapy students to manage their own self-care processes has not been fully examined as yet. This article describes an online curriculum approach for teaching a general introductory mindfulness course and examines outcomes with master's entry-level occupational therapy students. Fifteen students participated in an 8-week online mindfulness curriculum and completed a pre- and post-training survey. The Mindfulness Attention and Awareness Scale (MAAS) was used to measure mindfulness. Demographic, MAAS-scored mindfulness, and clinical utility data were collected. Results showed a statistically significant change (t = -4.82, p = 0.002) in MAAS mindfulness scores from the program start to end. Informal practice exercises and guided meditations were perceived by participants as being more helpful ways for developing an understanding and approach to mindfulness than were readings about mindfulness. This study suggests that mindfulness can be taught using an online approach.


Characterizing self-injurious cognitions: Development and validation of the Suicide Attempt Beliefs Scale (SABS) and the Nonsuicidal Self-Injury Beliefs Scale (NSIBS).
Self-injurious cognitions (SICs) are cognitions about deliberately injuring oneself (self-injurious behavior [SIB]). Existing measures of the content of SICs provide varying coverage, highlighting a lack of consensus regarding which cognitions characterize SIB. Additionally, a central, unresolved conceptual and measurement issue concerns whether to conceptualize suicide attempts (SA) and nonsuicidal self-injury (NSSI), 2 forms of SIB, as separate constructs. We developed the Suicide Attempt Beliefs Scale (SABS) and the Nonsuicidal Self-Injury Beliefs Scale (NSIBS) to clarify which SICs characterize SA and NSSI and what factor structure best explains SA and NSSI cognitions. A series of factor analyses across 6 samples (N = 3,313) revealed that the SABS consists of 7 correlated factors and the NSIBS consists of 10 correlated factors. Both instruments contain factors that describe how SIB relates to oneself and others and demonstrate moderate to excellent test-retest reliability over 2-4 weeks and strong internal consistency; 95% of the correlations between SABS and NSIBS subscales were ≤ r = .5. Both instruments demonstrated small to moderate-sized correlations with a range of clinical variables, measures of well-being, and purportedly similar, existing SIB constructs. Various analyses indicate that SA and NSSI SICs are similar but distinct phenomena, supporting the use of separate terminology and definitions of SA and NSSI, and pointing to the importance of separating SA and NSSI in research and clinical practice. We hope that the development of the SABS and NSIBS may unify the field somewhat in its understanding and measurement of the basic constituent elements of SICs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Adaptive self-organization in a realistic neural network model.
Information processing in complex systems is often found to be maximally efficient close to critical states associated with phase transitions. It is therefore conceivable that also neural information processing operates close to criticality. This is further supported by the observation of power-law distributions, which are a hallmark of phase transitions. An important open question is how neural networks could remain close to a critical point while undergoing a continual change in the course of development, adaptation, learning, and more. An influential contribution was made by Bornholdt and Rohlf, introducing a generic mechanism of robust self-organized criticality in adaptive networks. Here, we address the question whether this mechanism is relevant for real neural networks. We show in a realistic model that spike-time-dependent synaptic plasticity can self-organize neural networks robustly toward criticality. Our model reproduces several empirical observations and makes testable predictions on the distribution of synaptic strength, relating them to the critical state of the network. These results suggest that the interplay between dynamics and topology may be essential for neural information processing.


The origin of enhanced optical absorption in solar cells with metal nanoparticles embedded in the active layer.
We analyze the enhancement in optical absorption of an absorbing medium when spherical metal nanoparticles are embedded in it. Our analysis uses generalized Mie theory to calculate the absorbed optical power as a function of the distance from the metal nanoparticle. This analysis is used to evaluate the potential of enhancing optical absorption in thin-film solar cells by embedding spherical metal nanoparticles. We consider the trade-off between maximizing overall optical absorption and ensuring that a large fraction of the incident optical power is dissipated in the absorbing host medium rather than in the metal nanoparticle. We show that enhanced optical absorption results from strong scattering by the metal nanoparticle which locally enhances the optical electric fields. We also discuss the effect of a thin dielectric encapsulation of the metal nanoparticles.


Do Fast Bowlers Fatigue in Cricket? A Paradox Between Player Anecdotes and Quantitative Evidence.
The manifestations of fatigue during fast bowling in cricket were systematically evaluated using subjective reports by cricket experts and quantitative data published from scientific studies. Narratives by international players and team physiotherapists were sourced from the Internet using criteria for opinion-based evidence. Research articles were evaluated for high-level fast bowlers who delivered 5- to 12-over spells with at least 1 quantitative fatigue measure. Anecdotes indicate that a long-term loss of bowling speed, tiredness, mental fatigue, and soreness occur. Scientific research shows that ball-release speed, bowling accuracy, bowling action (technique), run-up speed, and leg-muscle power are generally well maintained during bowling simulations. However, bowlers displaying excessive shoulder counterrotation toward the end of a spell also show a fall in accuracy. A single notable study involving bowling on 2 successive days in the heat showed reduced ball-release speed (-4.4 km/h), run-up speed (-1.3 km/h), and accuracy. Moderate to high ratings of perceived exertion transpire with simulations and match play (6.5-7.5 Borg CR-10 scale). Changes of blood lactate, pH, glucose, and core temperature appear insufficient to impair muscle function, although several potential physiological fatigue factors have not been investigated. The limited empirical evidence for bowling-induced fatigue appears to oppose player viewpoints and indicates a paradox. However, this may not be the case since bowling simulations resemble the shorter formats of the game but not multiday (test match) cricket or the influence of an arduous season, and comments of tiredness, mental fatigue, and soreness signify phenomena different from what scientists measure as fatigue.


Chronic pain among homeless persons: characteristics, treatment, and barriers to management.
Little information is available on the problem of chronic pain among homeless individuals. This study aimed to describe the characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use among a representative sample of homeless single adult shelter users who experience chronic pain in Toronto, Canada. Participants were randomly selected at shelters for single homeless adults between September 2007 and February 2008 and screened for chronic pain, defined as having pain in the body for ≥ 3 months or receiving treatment for pain that started ≥ 3 months ago. Cross-sectional surveys obtained information on demographic characteristics, characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use. Whenever possible, participants' physicians were also interviewed. Among 152 homeless participants who experienced chronic pain, 11 (8%) were classified as Chronic Pain Grade I (low disability-low intensity), 47 (32%) as Grade II (low disability-high intensity), 34 (23%) as Grade III (high disability-moderately limiting), and 54 (37%) as Grade IV (high disability-severely limiting). The most common self-reported barriers to pain management were stress of shelter life, inability to afford prescription medications, and poor sleeping conditions. Participants reported using over-the-counter medications (48%), street drugs (46%), prescribed medications (43%), and alcohol (29%) to treat their pain. Of the 61 interviewed physicians, only 51% reported treating the patient's pain. The most common physician-reported difficulties with pain management were reluctance to prescribe narcotics due to the patient's history of substance abuse, psychiatric comorbidities, frequently missed appointments, and difficulty getting the patient to take medications correctly. Clinicians who provide healthcare for homeless people should screen for chronic pain and discuss barriers to effective pain management with their patients.


No pets allowed? Companion animals, older people and residential care.
This article is concerned with a particular site of inter-species relationships. Using the lens of liminality, it examines forced separation of older people from their companion animals when they move to a residential or nursing home in the UK. Such residential spaces frequently either exclude companion animals or fail to make adequate provision for them to accompany their human caretakers. We see such separation as a major bereavement for an older person at a stage of life when they experience significant other losses, and suggest it is often experienced as akin to the loss of a family member. We deploy vulnerability theory to argue that exclusion of companion animals from care spaces exemplifies a failure to understand the relational vulnerabilities of older age and the significance of animal companionship in mitigating those vulnerabilities. Equally, such separation fails to recognise the implications for excluded animals who can end up in unsuitable homes, being signed over to already over-stretched animal rescues or euthanised. Vulnerability theory highlights how companion species are always already vulnerable, given their liminal position between person and property, while older people are rendered particularly vulnerable in the 'liminal zone' of the care home, denied the ability to shape their environment, control their private space or form/sustain relationships of their own choosing. This article explores the potential of law to respond to and mitigate these shared vulnerabilities, suggesting that human rights arguments grounded in shared vulnerability may be invoked to argue for a re-definition of the family to recognise the significance of the human-animal relationship. We draw on the reasoning in a recent Court of Protection case which hints at law's ability to recognise the value of interspecies relations and their role in sustaining health and well-being, and the ability to live well in old age.


The association between atopy and childhood/adolescent leukemia: a meta-analysis.
Atopic disease is hypothesized to be protective against several malignancies, including childhood/adolescent leukemia. To summarize the available epidemiologic evidence, the authors performed a meta-analysis of associations between atopy/allergies, asthma, eczema, hay fever, and hives and childhood/adolescent leukemia, acute lymphoblastic leukemia (ALL), and acute myeloid leukemia (AML). They searched MEDLINE literature (1952-March 2009) and queried international experts to identify eligible studies. Ten case-control studies were included. Summary odds ratios and 95% confidence intervals were computed via random-effects models. Odds ratios for atopy/allergies were 1.42 (95% confidence interval (CI): 0.60, 3.35) for 3 studies of leukemia overall, 0.69 (95% CI: 0.54, 0.89) for 6 studies of ALL, and 0.87 (95% CI: 0.62, 1.22) for 2 studies of AML, with high levels of heterogeneity detected for leukemia overall and ALL. Inverse associations were observed for ALL and asthma (odds ratio (OR) = 0.79, 95% CI: 0.61, 1.02), eczema (OR = 0.74, 95% CI: 0.58, 0.96), and hay fever (OR = 0.55, 95% CI: 0.46, 0.66) examined separately. Odds ratios for ALL differed by study design, exposure data source, and latency period, indicating that these factors affect study results. These results should be interpreted cautiously given the modest number of studies, substantial heterogeneity, and potential exposure misclassification but are useful in designing future research.


LAP proteins are localized at the post-synaptic membrane of neuromuscular junctions and appear to modulate synaptic morphology and transmission.
Erbin, Lano, Scribble, and Densin-180 belong to LAP (leucine-rich repeats and PDZ domain) adaptor proteins involved in cell signaling pathways. Previously, we identified Erbin, Lano, and Scribble, but not Densin-180, in muscle cells, where they are involved in regulating the aggregation of nicotinic acetylcholine receptors in vitro. Here, we analyzed their cellular localization at the neuromuscular junction (NMJ) in skeletal muscles of mice. Erbin, Lano, and Scribble were significantly accumulated at NMJs and localized in different synaptic cells. Moreover, we used mouse mutants to analyze the role of Erbin at the NMJ. We used two Erbin mutant mouse strains that either completely lack Erbin protein (Erbinnull/null ) or express a truncated Erbin mutant where the carboxy-terminal PDZ domain is replaced by β-galactosidase (ErbinΔC/ΔC ) thereby abolishing its interaction with ErbB receptor tyrosine kinases. Neither the lack of the PDZ domain of Erbin, nor its complete absence interfered with the general localization of LAP proteins at NMJs, but Lano and Scribble transcript levels were up-regulated in homozygous Erbin-null muscles. Furthermore, grip strength was reduced and neural transmission impaired in homozygous aged Erbin-null but not Erbin-ΔC mice. Erbin-null skeletal muscles did not reveal any conspicuous impairment of the muscle fiber. Localization of other NMJ marker proteins was not affected either. Quantitative 3D morphometry showed that NMJs of Erbin-null muscles were significantly smaller and fragmented in the soleus. We speculate that Erbin, Lano, and Scribble act at the post-synaptic membrane of NMJs in a concerted fashion to regulate nicotinic acetylcholine receptors cluster morphology and neural transmission. Cover Image for this issue: doi: 10.1111/jnc.13340.


The impact of economic crises on social inequalities in health: what do we know so far?
Since 2008, Western countries are going through a deep economic crisis whose health impacts seem to be fundamentally counter-cyclical: when economic conditions worsen, so does health, and mortality tends to rise. While a growing number of studies have presented evidence on the effect of crises on the average population health, a largely neglected aspect of research is the impact of crises and the related political responses on social inequalities in health, even if the negative consequences of the crises are primarily borne by the most disadvantaged populations. This commentary will reflect on the results of the studies that have analyzed the effect of economic crises on social inequalities in health up to 2013. With some exceptions, the studies show an increase in health inequalities during crises, especially during the Southeast Asian and Japanese crises and the Soviet Union crisis, although it is not always evident for both sexes or all health or socioeconomic variables. In the Nordic countries during the nineties, a clear worsening of health equity did not occur. Results about the impacts of the current economic recession on health equity are still inconsistent. Some of the factors that could explain this variability in results are the role of welfare state policies, the diversity of time periods used in the analyses, the heterogeneity of socioeconomic and health variables considered, the changes in the socioeconomic profile of the groups under comparison in times of crises, and the type of measures used to analyze the magnitude of social inequalities in health. Social epidemiology should further collaborate with other disciplines to help produce more accurate and useful evidence about the relationship between crises and health equity.


Knowledge and awareness of dental specialists, general dentists and dental assistants regarding SARS‑CoV‑2.
Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) has had drastic effects among healthcare professionals. This study aimed to assess knowledge and awareness among dental specialists, general dentists and dental assistants regarding standard patient care guidelines for minimizing the spread of the infection. A survey-based cross-sectional study was conducted on a sample of 84 participants. The participants were divided into groups of dental specialists, general dentists and dental assistants. A modified version of a validated questionnaire was used to evaluate knowledge and awareness regarding SARS‑CoV‑2 as per the Centers for Disease Control and Prevention (CDC) guidelines. Data was analyzed using the one-way analysis of variance (ANOVA) and post-hoc Tukey's tests to assess differences in knowledge regarding the SARS‑CoV‑2 guidelines across the 3 groups. The simple linear regression analysis was used to examine factors influencing the knowledge scores. Among all dental specialists, 13 orthodontists, 9 operative dentists, 8 maxillofacial surgeons, 4 prosthodontists, and 1 periodontist responded to the survey. The mean knowledge scores of dental specialists, general dentists and dental assistants were 10.05 ±2.10, 9.95 ±2.30 and 8.53 ±2.10, respectively. Overall, we found a significant difference (p = 0.02) in the knowledge scores between the groups, and pairwise comparisons showed that there was a significant difference (p = 0.03) in the knowledge scores between dental specialists and dental assistants. These findings suggest that hospitals should conduct mandatory workshops, training sessions and seminars to raise the awareness of the novel coronavirus pandemic and disinfection protocols, not only for specialists, but for all staff members.


Disability and marginal utility of income: evidence from hypothetical choices.
It is often assumed that disability reduces the marginal utility of income. In this article, individuals' marginal utility of income in two states-(i) paralyzed in both legs from birth and (ii) not mobility impaired at all-is measured through hypothetical choices between imagined lotteries behind a so-called veil of ignorance. The outcomes of the lotteries include both income and disability status. It is found that most people have higher marginal utility when paralyzed than when not mobility impaired at all. The two marginal utilities are evaluated at the same levels of income. Having personal experience of mobility impairment and supporting the Left Party, the Social Democratic Party, the Green Party, or the Liberal Party are associated with having a higher marginal utility when paralyzed. The results suggest that more than full insurance of income losses connected to being disabled is optimal. The results further suggest that, given a utilitarian social welfare function, resources should be transferred to rather than from disabled people. Finally, if the transfers are not large enough to smooth out the marginal utilities of the disabled and the nondisabled, distributional weights based on disability status should be used in cost-benefit analysis.


Survey of instructions to authors in Indian and British Dental Journals with respect to ethical guidelines.
Publication can become a symbol of presenting how meticulously a person has followed ethical principles in research. It is the duty of the investigators or authors to carefully read the instructions to authors and generate data with honesty and genuineness. In fulfillment of the basic requisite to publish, clearly defined instructions to authors should be provided by the journal. To assess the pattern of instructions regarding the ethical requirements given to authors in Indian Dental Journals and tried to compare the same with British Dental Journals. A cross-sectional survey of 'instructions for authors,' for analysis of guidelines on ethical processes, was done. Instructions to authors of Indian and British Dental Journals indexed in PubMed were reviewed for guidelines with regard to seven key ethical issues. Descriptive statistics were used and results were expressed in percentages as well as numbers. Of the 10 Indian Dental Journals, 7 (70%) cited ethical guidelines such as International Committee of Medical Journal Editors, Committee on Publication Ethics, Indian Council of Medical Research guidelines whereas out of 27 British Dental Journals, 16 (59.25%) cited these. Protection of human subjects such as approval from an institutional/independent ethics committee, obtaining informed consent and maintenance of confidentiality of patient records was covered with 8 (80%) Indian and 19 (70.3%) British Dental Journals. Four (40%) Indian and 13 (48.1%) instructed about animals welfare. Nine (90%) of the Indian and 25 (92.5%) British Dental Journals required declaration of conflicts of interest by authors. Publication issues and authorship/contributorship criteria were specified by all 10 Indian and 25 (92.5%) and 24 (88.8%) British journals respectively. 6 (60%) of Indian and 11 (40.75%) of British Journals explained about data management, in case of clinical trials. A significant proportion of Indexed Indian and British Dental Journals did not provide adequate instructions to authors regarding ethical issues.


Highly flexible MTF measurement system for tunable micro lenses.
We present an efficient, low-cost modulation transfer function (MTF) measurement approach, optimized for characterization of tunable micro-lenses; the MTF may easily be measured at a variety of different focal lengths. The approach uses a conventional optical microscope with an optimized approach for lens illumination and the measurement results have been correlated with a commercial MTF measurement system. Measurements on fixed-focus and tunable micro-lenses were performed; for the latter, resolution for lenses with back focal length of 11 mm was 55 lines/mm, decreasing to 40 lines/mm for a back focal length of 4 mm. In general, it was seen that performance was better for lenses with longer focal lengths.