Effect of concussion and blast exposure on symptoms after military deployment.
To examine whether blast exposure alone and blast-associated concussion result in similar neurologic and mental health symptoms. A 14-item questionnaire was administered to male US Marines on their return from deployment in Iraq and/or Afghanistan. A total of 2,612 Marines (median age 22 years) completed the survey. Of those, 2,320 (88.9%) reported exposure to ≥1 blast during their current and/or prior deployments. In addition, 1,022 (39.1%) reported ≥1 concussion during the current deployment, and 731 (28.0%) had experienced at least 1 prior lifetime concussion. Marines were more likely to have sustained a concussion during the current deployment if they had a history of 1 (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.2-2.0) or ≥1 (OR 2.3, 95% CI 1.7-3.0) prior concussion. The most common symptoms were trouble sleeping (38.4%), irritability (37.9%), tinnitus (33.8%), and headaches (33.3%). Compared to those experiencing blast exposure without injury, Marines either experiencing a concussion during the current deployment or being moved or injured by a blast had an increased risk of postinjury symptoms. There appears to be a continuum of increasing total symptoms from no exposure to blast exposure plus both current deployment concussion and past concussion. Concussion had a greater influence than blast exposure alone on the presence of postdeployment symptoms. A high blast injury score can be used to triage those exposed to explosive blasts for evaluation.


Penetration of milk-derived antimicrobial peptides into phospholipid monolayers as model biomembranes.
Three antimicrobial peptides derived from bovine milk proteins were examined with regard to penetration into insoluble monolayers formed with 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) or 1,2-dipalmitoyl-sn-glycero-3-phospho-rac-(1-glycerol) sodium salt (DPPG). Effects on surface pressure (Π) and electric surface potential (ΔV) were measured, Π with a platinum Wilhelmy plate and ΔV with a vibrating plate. The penetration measurements were performed under stationary diffusion conditions and upon the compression of the monolayers. The two type measurements showed greatly different effects of the peptide-lipid interactions. Results of the stationary penetration show that the peptide interactions with DPPC monolayer are weak, repulsive, and nonspecific while the interactions with DPPG monolayer are significant, attractive, and specific. These results are in accord with the fact that antimicrobial peptides disrupt bacteria membranes (negative) while no significant effect on the host membranes (neutral) is observed. No such discrimination was revealed from the compression isotherms. The latter indicate that squeezing the penetrant out of the monolayer upon compression does not allow for establishing the penetration equilibrium, so the monolayer remains supersaturated with the penetrant and shows an under-equilibrium orientation within the entire compression range, practically.


[A comparison of the effect of hydrocortisone and corticosterone on histone and chromatin DNA biosynthesis in regenerating rat liver].
Thymidin incorporation into DNA was depressed and glycin incorporation into histone proteins was decreased after the treatment of rats with hydrocortisone and corticosterone for 4 days (for 3 days before and on the day of partial hepatectomy). No significant differences in the action of these glucocorticoids on biosynthesis of DNA and histones in the course of regeneration were noted at the periods under study. There was no decrease in histones and nucleoprotein in comparison with control 6 hours after the operation at the time when the synthesis of DNA-like RNA was elevated. Apparently DNA synthesis was not imperative for biosynthesis of histone proteins, in any way--for the arginine-rich fraction of histones.


Acupuncture's Cardiovascular Actions: A Mechanistic Perspective.
Over the last several decades, there has been an explosion of articles on acupuncture, including studies that have begun to explore mechanisms underlying its analgesic and cardiovascular actions. Modulation of cardiovascular function is most effective during manual and low-frequency, low-intensity electroacupuncture (EA) at a select set of acupoints situated along meridians located over deep somatic nerves on the upper and lower extremities. Stimulation at these acupoints activates underlying sensory neural pathways that project to a number of regions in the central nervous system (CNS) that ultimately regulate autonomic outflow and hence cardiovascular function. A long-loop pathway involving the hypothalamus, midbrain, and medulla underlies EA modulation of reflex increases in blood pressure (BP). Actions of excitatory and inhibitory neurotransmitters in the supraspinal CNS underlie processing of the somatic input and adjustment of autonomic outflow during EA. Acupuncture also decreases elevated blood pressure through actions in the thoracic spinal cord. Reflexes that lower BP likewise are modulated by EA through its actions on sympathetic and parasympathetic nuclei in the medulla. The autonomic influence of acupuncture is slow in onset but prolonged in duration, typically lasting beyond the period of stimulation. Clinical studies suggest that acupuncture can be used to treat cardiac diseases, such as myocardial ischemia and hypertension, associated with overactivity of the sympathetic nervous system.


Synergistic effect of purine derivatives on the toxicity of pyrazofurin and 6-azauridine towards cultured mammalian cells.
A novel synergistic effect of several purine derivatives such as adenine, adenosine, hypoxanthine, and guanine on the toxicity of nucleoside analogs pyrazofurin and 6-azauridine towards cultured Chinese hamster ovary (CHO) cells has been observed. The presence of the above purine derivatives enhanced the toxicity of pyrazofurin and 6-azauridine, in a dose dependent manner. The growth inhibitory effects of these nucleoside analogs either alone or in combination with the purine derivatives were reversed by uridine and cytidine, providing evidence that the synergistic effect of the purine derivatives was exerted at the level of pyrimidine nucleotide biosynthesis. Studies with mutant cells lacking various purine phosphorylating enzymes show that phosphorylation of purine derivatives through reactions utilizing phosphoribosylpyrophosate (PRPP) is essential for observing the synergistic response. It is suggested that the above purine derivatives (including adenosine, via conversion to hypoxanthine) exert their synergistic effects by depleting the cellular pool of PRPP by two separate mechanisms (direct utilization and feedback inhibition of its synthesis), which as a result becomes rate limiting in the synthesis of orotidine monophosphate (OMP). The reduced levels of OMP, which is a competing substrate with pyrazofurin- and 6-azauridine-5'-monophosphates for binding to the target enzyme OMP decarboxylase, could then account for the inhibition of the enzyme at lower concentrations of these analogs.


Acetylator phenotype-dependent and -independent expression of arylamine N-acetyltransferase isozymes in rapid and slow acetylator inbred rat liver.
Although mouse, hamster, and rabbit models of the human N-acetylation polymorphism have been identified and characterized, many investigations of arylamine toxicity and carcinogenicity are carried out in the rat, particularly the Fischer 344 (F-344) inbred rat. We partially characterized a new rat model of the N-acetylation polymorphism by determining expression of arylamine N-acetyltransferase activities in liver cytosols derived from adult male inbred F-344, WKY, and their F1 hybrid rat strains. Levels of N-acetyltransferase activity differed significantly between the strains for many arylamine substrates, with highest levels in F-344, lowest levels in WKY, and intermediate levels in F1 hybrids of these two parental strains. However, for some other arylamine substrates, levels of N-acetyltransferase activity did not differ significantly between the rat strains. Partial purification of rat liver cytosols from the three strains resulted in identification of two N-acetyltransferase isozymes. The levels of N-acetyltransferase activity of one isozyme differed significantly between strains analogous to the pattern observed in crude cytosol. In contrast, the levels of N-acetyltransferase activity of the second isozyme did not differ between the strains. Based upon these results, the F-344 inbred strain is designated a rapid acetylator phenotype, the WKY inbred strain is designated a slow acetylator phenotype, and F1 hybrids of the two parental strains are designated intermediate acetylator phenotype. The identification of acetylator phenotype-dependent and -independent hepatic N-acetyltransferase isozymes in the inbred rat mimics the biochemical basis for acetylator phenotype-dependent and -independent expressions of N-acetylation in humans and other mammalian species.


The biological activity of the human epidermal growth factor receptor is positively regulated by its C-terminal tyrosines.
The epidermal growth factor receptor (EGF-R) C-terminus contains three conserved tyrosines (Y-1068, Y-1148, Y-1173) which are phosphorylated upon EGF activation. To clarify the functional role of these tyrosines, each has been mutated to phenylalanine and studied as single, double and triple mutants in the full length receptor. EGF-dependent transforming ability of the single point mutants is similar to that of the wild type, while that of double mutants is decreased and an even lower activity is present in the triple mutant. In each bioassay, including EGF-dependent focal transformation, growth in agar and growth in low serum, mutant receptors display a similar hierarchy of activity. The lower activity is intrinsic in the mutants since they are expressed at similar level as the wild type and bind EGF with similar affinity. Deletion mutants lacking the last 19 or 63 amino acids (Velu et al., 1989a) show a similar decline in biological activity when compared to the corresponding point mutants, although the reduction is more pronounced than with the point mutants. Deletion of the last 123 aa, which removes all three tyrosines (Dc123), results in a receptor that is almost inactive biologically. The EGF-R kinase activity is affected by tyrosine substitution since in vitro phosphorylation of exogenous substrates is reduced in the double and triple mutants. Autophosphorylation, in vivo and in vitro, is also reduced, but not totally abolished in the triple point mutant and Dc123 indicating the existence of other autophosphorylation sites. A new site of autophosphorylation is found in the Dc123 mutant. We conclude, therefore, that the tyrosines at the extreme C-terminus positively regulate the biological and transforming activity of the EGF-R, probably via autophosphorylation.


[Paraneoplastic syndromes with peripheral nerve involvement].
To review the paraneoplastic complications described affecting the peripheral nervous system. Different types of tumors, especially secretory carcinomas and some lymphomas may affect the peripheral nerves, and this may often precede clinical signs of the tumor. Depending on the clinical features we may consider sensory neuropathies, motor neuropathies, senso-motor neuropathies, autonomic neuropathies, mononeuritis, and neuromyotonia. They may present in an isolated form or as part of a more generalized involvement of the nervous system. The presence of certain anti-Hu antibodies, which act against nerves or antibodies which attack the voltage-dependent potassium channels in a peripheral nervous system disorder make one suspect a paraneoplastic origin.


A new microfluidic concept for parallel operated milliliter-scale stirred tank bioreactors.
Parallel miniaturized stirred tank bioreactors are an efficient tool for "high-throughput bioprocess design." As most industrial bioprocesses are pH-controlled and/or are operated in a fed-batch mode, an exact scale-down of these reactions with continuous dosing of fluids into the miniaturized bioreactors is highly desirable. Here, we present the development, characterization, and application of a novel concept for a highly integrated microfluidic device for a bioreaction block with 48 parallel milliliter-scale stirred tank reactors (V = 12 mL). The device consists of an autoclavable fluidic section to dispense up to three liquids individually per reactor. The fluidic section contains 144 membrane pumps, which are magnetically driven by a clamped-on actuator section. The micropumps are designed to dose 1.6 μL per pump lift. Each micropump enables a continuous addition of liquid with a flow rate of up to 3 mL h(-1) . Viscous liquids up to a viscosity of 8.2 mPa s (corresponds to a 60% v/v glycerine solution) can be pumped without changes in the flow rates. Thus, nearly all feeding solutions can be delivered, which are commonly used in bioprocesses. The functionality of the first prototype of this microfluidic device was demonstrated by double-sided pH-controlled cultivations of Saccharomyces cerevisiae based on signals of fluorimetric sensors embedded at the bottom of the bioreactors. Furthermore, fed-batch cultivations with constant and exponential feeding profiles were successfully performed. Thus, the presented novel microfluidic device will be a useful tool for parallel and, thus, efficient optimization of controlled fed-batch bioprocesses in small-scale stirred tank bioreactors. This can help to reduce bioprocess development times drastically.


Unit magnification optical system.
A simple self-conjugate optical arrangement, originally proposed by Dyson, consists of a spherical mirror and a plano-convex lens. Despite the fact that all the Seidel aberrations are corrected, the field coverage is severely limited by higher order tangential astigmatism. This paper discusses modifications to improve the field coverage. It also treats the creation of internal reflecting surfaces to separate the object and image planes. Finally a few possible applications are discussed, including one to the creation of a high speed spectrograph.


Differential Decomposition Among Pig, Rabbit, and Human Remains.
While nonhuman animal remains are often utilized in forensic research to develop methods to estimate the postmortem interval, systematic studies that directly validate animals as proxies for human decomposition are lacking. The current project compared decomposition rates among pigs, rabbits, and humans at the University of Tennessee's Anthropology Research Facility across three seasonal trials that spanned nearly 2 years. The Total Body Score (TBS) method was applied to quantify decomposition changes and calculate the postmortem interval (PMI) in accumulated degree days (ADD). Decomposition trajectories were analyzed by comparing the estimated and actual ADD for each seasonal trial and by fuzzy cluster analysis. The cluster analysis demonstrated that the rabbits formed one group while pigs and humans, although more similar to each other than either to rabbits, still showed important differences in decomposition patterns. The decomposition trends show that neither nonhuman model captured the pattern, rate, and variability of human decomposition.


A hemodynamic load in vivo induces cardiac expression of the cellular oncogene, c-myc.
To establish whether a hemodynamic load that causes cardiac hypertrophy in the intact animal might interact with cellular pathways that are thought to transduce growth signals in model systems, we have analyzed expression of the cellular oncogene, c-myc, after a systolic pressure load. Aortic constriction increased c-myc mRNA abundance in both the atria and left ventricle of 28-day rats, but did not activate a second "competence" gene, r-fos, whose expression by cardiac cells ceases upon termination of mitotic growth. In 80-day rats, c-myc was induced in the atria alone. Induction of c-myc by aortic constriction in vivo may correlate with the respective capacity of atrial and ventricular myocytes to replicate DNA during cardiac hypertrophy. Activation of c-myc was not sufficient to account for inhibition of muscle creatine kinase (mck) mRNA, which was decreased only in 28-day rats.


Simplifying phrases in depression screens: Interpreters' views on usefulness in six languages.
Assessments and treatments of mental health conditions such as depression use language that may be difficult to understand or translate. Here, we studied how interpreters assessed the usefulness of simplifying the language of a depression screen. Two alternative versions of the PRIME-MD PHQ depression screen were generated, with increasing linguistic simplicity. All the versions (standard, moderately simplified and most simplified) were translated from Finnish into Arabic, English, Farsi, Russian, and Swedish. Ten professional interpreters then assessed the different usefulness aspects of the three versions. The interpreters' perceptions of usefulness of the different language versions for clients varied, and both simplified versions of the depression screen were commonly considered useful for interpreting contexts. The usefulness of the simplified language versions was seen as especially important for clients with multiple linguistic challenges, caused by, for example, dementia and immigration backgrounds. The language of depression screens can be greatly simplified. Simplified versions may significantly improve the accessibility of questionnaires for the wide range of individuals with compromised language competence. Simplified versions may also be helpful for inter-language interpreting in health care, and importantly, they may facilitate the transparency and cross-cultural calibration needed in evidence-based medicine.


A long-term hypopigmentary effect of thorium-X on freckled skin.
Sixteen years ago, an area on the forearm of a freckled subject was painted with a solution containing 500 esu of thorium-X per ml. Since then, despite much exposure to solar irradiation, there has been a complete absence of freckles from this area, which stands out in marked contrast to the surrounding skin. Biopsy of the skin from the area was examined by the Dopa technique and by electron microscopy. Melanocytes are present in apparently normal numbers, but in a condition of almost complete inactivity. This depression of melanogenesis is difficult to account for either on the basis of an environmental effect, or of intracellular inhibitory mechanisms.


Acute myocardial infarction: tissue characterization with T1rho-weighted MR imaging--initial experience.
Acute myocardial injury was evaluated in 21 patients by using a contrast material-enhanced T1rho-weighted cine turbo field-echo magnetic resonance (MR) imaging sequence and a delayed-enhancement sequence. In 12 of 21 patients, conventional T1-weighted contrast-enhanced cine turbo field-echo MR images were also collected for direct comparison with T1rho-weighted images. Delayed-enhancement technique distinctly characterized irreversible injury (percentage enhancement, 588% +/- 344). With T1rho weighting, percentage enhancement of irreversibly injured myocardium was 68% +/- 41, compared with 23% +/- 24 without T1rho weighting (P <.006). The addition of T1rho weighting to contrast-enhanced cine turbo field-echo MR sequences may offer a new contrast enhancement mechanism for characterization of acutely infarcted myocardium.


Caloric restriction decreases orthostatic tolerance independently from 6° head-down bedrest.
Astronauts consume fewer calories during spaceflight and return to earth with an increased risk of orthostatic intolerance. Whether a caloric deficiency modifies orthostatic responses is not understood. Thus, we determined the effects of a hypocaloric diet (25% caloric restriction) during 6° head down bedrest (an analog of spaceflight) on autonomic neural control during lower body negative pressure (LBNP). Nine healthy young men completed a randomized crossover bedrest study, consisting of four (2 weeks each) interventions (normocaloric bedrest, normocaloric ambulatory, hypocaloric bedrest, hypocaloric ambulatory), each separated by 5 months. Muscle sympathetic nerve activity (MSNA) was recorded at baseline following normocaloric and hypocaloric interventions. Heart rate (HR) and arterial pressure were recorded before, during, and after 3 consecutive stages (7 min each) of LBNP (-15, -30, -45 mmHg). Caloric and posture effects during LBNP were compared using two-way ANOVA with repeated measures. There was a strong trend toward reduced basal MSNA following caloric restriction alone (normcaloric vs. hypocaloric: 22±3 vs. 14±4 burst/min, p = 0.06). Compared to the normocaloric ambulatory, both bedrest and caloric restriction were associated with lower systolic blood pressure during LBNP (p<0.01); however, HR responses were directionally opposite (i.e., increase with bedrest, decrease with caloric restriction). Survival analysis revealed a significant reduction in orthostatic tolerance following caloric restriction (normocaloric finishers: 12/16; hypocaloric finishers: 6/16; χ2, p = 0.03). Caloric restriction modifies autonomic responses to LBNP, which may decrease orthostatic tolerance after spaceflight.


A supervised patch-based approach for human brain labeling.
We propose in this work a patch-based image labeling method relying on a label propagation framework. Based on image intensity similarities between the input image and an anatomy textbook, an original strategy which does not require any nonrigid registration is presented. Following recent developments in nonlocal image denoising, the similarity between images is represented by a weighted graph computed from an intensity-based distance between patches. Experiments on simulated and in vivo magnetic resonance images show that the proposed method is very successful in providing automated human brain labeling.


Dopaminergic Projections from the Hypothalamic A11 Nucleus to the Spinal Trigeminal Nucleus Are Involved in Bidirectional Migraine Modulation.
Clinical imaging studies have revealed that the hypothalamus is activated in migraine patients prior to the onset of and during headache and have also shown that the hypothalamus has increased functional connectivity with the spinal trigeminal nucleus. The dopaminergic system of the hypothalamus plays an important role, and the dopamine-rich A11 nucleus may play an important role in migraine pathogenesis. We used intraperitoneal injections of glyceryl trinitrate to establish a model of acute migraine attack and chronicity in mice, which was verified by photophobia experiments and von Frey experiments. We explored the A11 nucleus and its downstream pathway using immunohistochemical staining and neuronal tracing techniques. During acute migraine attack and chronification, c-fos expression in GABAergic neurons in the A11 nucleus was significantly increased, and inhibition of DA neurons was achieved by binding to GABA A-type receptors on the surface of dopaminergic neurons in the A11 nucleus. However, the expression of tyrosine hydroxylase and glutamic acid decarboxylase proteins in the A11 nucleus of the hypothalamus did not change significantly. Specific destruction of dopaminergic neurons in the A11 nucleus of mice resulted in severe nociceptive sensitization and photophobic behavior. The expression levels of the D1 dopamine receptor and D2 dopamine receptor in the caudal part of the spinal trigeminal nucleus candalis of the chronic migraine model were increased. Skin nociceptive sensitization of mice was slowed by activation of the D2 dopamine receptor in SP5C, and activation of the D1 dopamine receptor reversed this behavioral change. GABAergic neurons in the A11 nucleus were activated and exerted postsynaptic inhibitory effects, which led to a decrease in the amount of DA secreted by the A11 nucleus in the spinal trigeminal nucleus candalis. The reduced DA bound preferentially to the D2 dopamine receptor, thus exerting a defensive effect against headache.


Microbialite resurgence after the Late Ordovician extinction.
Microbialites, including biogenic stromatolites, thrombolites and dendrolites, were formed by various microbial mats that trapped and bound sediments or formed the locus of mineral precipitation. Microbialites were common and diverse during the Proterozoic, but declined in abundance and morphological diversity when multicellular life diversified during the Cambrian Radiation. A second decline occurred during the Ordovician Radiation of marine animals, and from then until the present microbialites have been confined largely to high-stress environments where multicellular organisms are rare. The microbialite declines in the Phanerozoic are attributed to disruption of the mats by animals. A resurgence of stromatolite abundance and size during reduced animal diversity after the Permian extinction has been documented anecdotally. Here we show, with statistical support, that a microbialite resurgence also occurred after the Late Ordovician extinction event in western North America. The resurgences were associated with loss of mat-inhibiting animals, providing insights into shallow-water community structures after extinction events.


The association of depression, cognitive impairment without dementia, and dementia with risk of ischemic stroke: a cohort study.
To determine if depression, cognitive impairment without dementia (CIND), and/or dementia are each independently associated with risk of ischemic stroke and to identify characteristics that could modify these associations. This retrospective-cohort study examined a population-based sample of 7031 Americans older than 50 years participating in the Health and Retirement Study (1998-2008) who consented to have their interviews linked to their Medicare claims. The eight-item Center for Epidemiologic Studies Depression Scale and/or International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) depression diagnoses were used to identify baseline depression. The Modified Telephone Interview for Cognitive Status and/or ICD-9-CM dementia diagnoses were used to identify baseline CIND or dementia. Hospitalizations for ischemic stroke were identified via ICD-9-CM diagnoses. After adjusting for demographics, medical comorbidities, and health-risk behaviors, CIND alone (odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.11-1.69) and co-occurring depression and CIND (OR = 1.65, 95% CI = 1.24-2.18) were independently associated with increased odds of ischemic stroke. Depression alone was not associated with odds of ischemic stroke (OR = 1.11, 95% CI = 0.88-1.40) in unadjusted analyses. Neither dementia alone (OR = 1.09, 95% CI = 0.82-1.45) nor co-occurring depression and dementia (OR = 1.25, 95% CI = 0.89-1.76) were associated with odds of ischemic stroke after adjusting for demographics. CIND and co-occurring depression and CIND are independently associated with increased risk of ischemic stroke. Individuals with co-occurring depression and CIND represent a high-risk group that may benefit from targeted interventions to prevent stroke.


[Latero-cervical branchial cysts and fistulas].
Twenty-four cases of cysts and fistulae of the lateral part of the neck are presented. They come from the very important modification in the branchial apparatus arising during the embryogenesis of the neck. We found these vestigal anomalies moreover under the mandibula before the sterno-cleido-mastoidean muscle, but every where in the lateral part of the neck too. The differential diagnosis must be done between lymph nodes infections, dermoid cysts, benign and malignant tumors. Therefore the puncture seems very contributive. The best therapy is for everybody the radical removal.


[Diagnosis and treatment in infertile marriage].
The paper gives data on the frequency and pattern of infertile marriage by referrals to the clinic of infertility, Center of Obstetrics, Gynecology, and Perinatology, Russian Academy of Medical Sciences. Tubuloperitoneal disorders are the leading and challenging abnormality in aphoria. Endometriosis and endocrine types of infertility occupy the second place in their incidence. Emphasis is laid on the role of laparoscopy in the complex examination of infertile females. Analysis of the causes of male infertility suggests that abnormalities resultant from sexually transmitted diseases are prevalent. The diagnosis and treatment of marriage infertility caused by immunological and psychogenic factors call for further development.


Acknowledging communication: a milieu-therapeutic approach in mental health care.
This paper is a report of a study to develop milieu therapists' acknowledging communication in their relationships with patients. Gunderson's therapeutic processes in milieu therapy have come into use in a broad range of mental health contexts in many countries. Research in nursing indicates that validation needs a more concrete development for use in clinical work. Schibbye's theory, 'Intersubjective relational understanding', formed the theoretical foundation for a participatory action research project in 2004-2005. The data comprised the researcher's process notes written during participation in the group of group leaders every second week over a period of 18 months, clinical narratives presented by participants in the same group, and eight qualitative interviews of members of the reflection group. The core concept in acknowledging communication, mutuality, was described as inter-subjective sharing of feelings and beliefs in a respectful way. Participants presented their process of development as a movement from knowing what was best for the patient (acknowledging patients as competent persons, a milieu-therapy culture based on conformity), to appreciating diversity and stubborn talk, to reflective wondering questions. Misunderstanding of acknowledgement occurred, for instance, in the form of always being supportive and affirmative towards patients. The concrete approaches in acknowledging communication presented in this article could be a fruitful basis for educating in and developing milieu therapy, both for nursing and in a multi-professional approach in clinical practice and educational institutions. Future research should focus on broader development of various areas of acknowledging communication in practice, and should also include patients' experiences of such approaches.


2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) induces organ- specific differential gene expression in male Japanese medaka (Oryzias latipes).
2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a ubiquitous environmental contaminant with well-known adverse effects in fish. In this study, we initially exploited suppression subtractive hybridization (SSH) as a screening tool to assess qualitative gene expression changes in whole brain, liver, and testis of adult male Japanese medaka (Oryzias latipes) exposed for 48 h to a single intraperitoneal-injected dose of TCDD (10 microg TCDD/kg body weight). Across these three organs, SSH identified a total of 335 unique genes. Each set of forward- and reverse-subtracted organ cDNA libraries consisted of a distinct gene list and corresponding distribution of biological processes, suggesting that transcript profiles of these libraries were highly organ-specific. Based on sequence match significance and frequencies within each set of organ libraries, genes hypothesized to be strongly responsive (42 total) within male medaka brain, liver, or testis were semi-quantitatively screened with replicate cDNA nylon membrane arrays. In addition, TCDD-treated male medaka were surveyed for gross histological analysis of brain, liver, and testis. In general, adverse histopathological changes were not observed in the brain, and glycogen depletion was observed only in the liver. However, significant histological changes occurred in the testis, and included disorganization of spermatogenesis at the testis periphery, disruption of the interstitium, Leydig cell swelling, and Sertoli cell vacuolation. Of the 42 genes screened by cDNA array analysis, cytochrome P450 1A (CYP1A) mRNA was the only transcript significantly higher in TCDD-exposed brain, whereas 12 transcripts (including CYP1A) were significantly higher in TCDD-exposed liver, and 34 transcripts were significantly lower in TCDD-exposed testis. Therefore, the degree of TCDD-induced alterations observed in each organ at a gross histological level corresponded well with the number and ontology of gene transcripts affected on the array. Based on real-time reverse transcription polymerase chain reaction (RT-PCR), relative CYP1A (but not AHR1) transcript levels were confirmed to be significantly higher in TCDD-treated brain and liver. However, CYP1A was not significantly induced in TCDD-exposed testis, suggesting that gene expression and histopathological responses observed in the testis at 48 h may be CYP1A-independent. Based on these data, unique liver-specific and testis-specific mRNA-level targets in male medaka were identified as promising biomarkers of acute TCDD-induced toxicity.


A systematic review and meta-analysis of diet and nutrient intake in adults with irritable bowel syndrome.
Numerous individual and environmental factors including diet may play an important role in the pathophysiology of irritable bowel syndrome (IBS). It is unclear to what degree dietary intake is affected in individuals with IBS. We aimed to perform a systematic review and meta-analysis to summarize dietary intake of adults with IBS and to compare dietary intake between adults with IBS and non-IBS controls. Ovid MEDLINE, Embase, Cochrane, CINAHL, and Scopus were searched through February 2023 for clinical trials and observational studies measuring usual diet in adults with IBS. Pooled weighted averages were estimated for total energy, macronutrient, and micronutrient data. Mean differences (MD) in nutrient intake were estimated for adults with IBS versus non-IBS controls using a random effects model. Heterogeneity was assessed by the inconsistency index (I2). Sixty-three full-text articles were included in the review of which 29 studies included both IBS and control subjects. Nutrients not meeting the recommended intake level for any dietary reference values in the IBS population were fiber and vitamin D. Meta-regression by female proportion was positively correlated with total fat intake and negatively correlated with carbohydrate intake. Comparisons between participants with IBS and controls showed significantly lower fiber intake in participants with IBS with high heterogeneity (MD: -1.8; 95% CI: -3.0, -0.6; I2 = 85%). This review suggests that fiber and vitamin D intake is suboptimal in IBS; however, overall dietary intake does not appear to be comprised. Causes and consequences of reduced fiber in IBS deserve further study. Results of this systematic review and meta-analysis suggest that fiber and vitamin D intake is suboptimal in IBS. However, overall intake of other macro- and micronutrients does not appear to be compromised. Causes and consequences of reduced fiber and Vitamin D intake in IBS deserve further study.


Benzyl derivative facilitation of transcription in Escherichia coli at the ara and lac operon promoters: metabolite gene regulation (MGR).
A number of benzyl derivatives have been tested for their ability to induce the expression of the araBAD operon in an Escherichia coli K-12 strain. Those derivatives shown to be stimulatory include: benzoic acid (BA), para-amino benzoic acid (PABA), para-hydroxy benzoic acid (PHBA), ortho-amino benzoic acid (OABA), 3-hydroxy-4-methoxy phenylethylamine (MTA), and 4-hydroxy-3-methoxyphenol acetic acid (HVA). The araC gene product was necessary to facilitate the induction. To further characterize if the inductive effect was mediated at the level of transcription, an araBAD-tetracycline resistant (Tcr) operon fusion plasmid (pAP-B) was employed. Benzyl derivatives which induce expression of the araBAD operon in situ also induced a Tcr phenotype with pAP-B. Both indole acetic acid (IAA) and imidazole (IM), which were previously shown to circumvent the necessity for cAMP in the induction of the araBAD operon, also induced a Tcr phenotype with pAP-B. Induction of lac or other cAMP responding operons with the inducing molecules at the chromosomal level was not detectable when assessed by carbon utilization. However, a lacZYA-Tcr operon fusion plasmid (pLPI) did respond to IAA and several of the inducing benzyl derivatives. Catabolite repression of chromosomal araBAD expression was reversed when the exogenous concentration of OABA was elevated. Similar effects on the Tcr phenotypes conferred by pAP-B and pLP1 were observed when OABA or several other inducing benzyl derivatives were present exogenously.


Photoexcited bacterial luminescence. Spectral properties and mechanistic implication of a reduced flavine-like prosthetic group associated with photoexcitable luciferase.
A prosthetic group, designated B, has been isolated from bacterial photoexcitable luciferase and found to possess spectral and photochemical properties characteristic of substituted reduced flavines. Its fluorescence when bound to luciferase has an excitation maximum at 375 nm, correlating well with the absorption spectrum, and an emission peaking at 495 nm. However, free B is nonfluorescent in aqueous solution at ambient temperature. Both free and luciferase-bound B show similar negative circular dichroism in the region 330-475 nm with troughs at 375 and 380 nm, respectively. In the luciferase reaction initiated by FMNH2, B is an inhibitor competitive with FMNH2. Irradiation of photoexcitable luciferase converts B to FMN, the latter identified spectrally, enzymatically, and chromatographically. These findings lead to the suggestion that B is a substituted FMNH2. The luciferase-bound B resembles but is not identical with the normal flavine intermediate obtainable by reacting luciferase with reduced flavine mononucleotide and oxygen. It is hypothesized that B is a false intermediate of the bacterial bioluminescence reaction, and a mechanism for the photoexcited bioluminescence reaction is suggested.


Differential dissociation of chromatin digests: a novel approach revealing a hierarchy of DNA-protein interactions within chromatin domains.
We describe here a novel approach to the dissection of chromatin structure by extracting DNA fragments from digested nuclei irreversibly immobilized (via proteins) on Celite columns. Three successive gradients (NaCl, LiCl-urea, temperature) are used to release three families of DNA fragments: namely, the 'DNA adherence' classes DNA-0, DNA-I and DNA-II, respectively. This 'protein image' DNA chromatography separates DNA fragments in accordance with the tightness of their bonds with proteins in situ. There are at least two DNA-skeleton attachment sites differing from each other by their resistance to the dissociating agents used as well as their susceptibility to DNAase I and S1 nuclease treatments, DNA cross-linking and single-stranded breaks. Several lines of evidence show a specific, topological rather than chemical, DNA-protein linkage at the tight attachment site. A hierarchy of chromatin loops demarcated by these attachment sites was determined. The technique described is generally applicable and can be used both to probe DNA-protein interactions and to map specific DNA sequences within the chromatin domain.


[Level and ratio of prostaglandins group E and F2(alpha) in bronchoalveolar washes in pulmonary tuberculosis patients].
Content of prostaglandins PGE and PGF2 alpha was studied by means of radioimmunoassay; their ratio was calculated in bronchoalveolar lavages obtained from impaired lung and from contralateral, intact lung of 86 patients with various forms of pulmonary tuberculosis. Concentration of prostaglandins was calculated per 1 mg of protein in lavage to standardize the data obtained. In the patients with tuberculosis production of PGE was increased in both lungs. However, the prostaglandin content was distinctly higher in the impaired lung but approximately similar in various forms of the disease. Hyperproduction of PGF2 alpha occurred in the impaired lung and depended on the type of the process. Content of PGF2 alpha was maximal in complicated destructive forms of tuberculosis. Bronchial muscle tension depended on the ratio of both groups of prostaglandins in bronchoalveolar space. Bronchial obstruction was accompanied by a decrease of PGE content in intact lung and by high concentration of PGF2 alpha near the tuberculosis focus.


Plasma triglycerides predict ten-years all-cause mortality in outpatients with type 2 diabetes mellitus: a longitudinal observational study.
Cardiovascular disease (CVD) is the leading cause of death in type 2 diabetes mellitus (T2DM). American Diabetes Association standards of care set a series of targets recommended for the CVD prevention: blood pressure, LDL and HDL cholesterol (LDL-C and HDL-C), triglycerides and HbA1c goals. The aim of this study was to evaluate cardiovascular risk factors in a T2DM outpatient population in order to estimate their specific clinical value in predicting long-term overall mortality. Our study population was composed of 1917 T2DM outpatients attending the hospital-based Diabetes Clinic of Ferrara for a mean follow-up period of 10 years; recorded information included personal, clinical and biochemical data, and pharmacological treatment. A Cox proportional hazard analysis was performed, pointing out as age (HR:1.08; IC95%: 1.06-1.11), sex (males: HR:1.97; IC95%: 1.26-3.07), mean triglycerides levels during follow-up (III vs I tertile: HR:1.87; IC95%: 1.12-3.12) and lipid-lowering treatment (HR:0.56; IC95%: 0.35-0.90) were significantly associated with all-cause mortality, independent of confounding factors such as mean values of LDL-C, HDL-C, HbA1c, blood pressure, BMI, fasting glucose, and antihypertensive and antidiabetic treatment. This finding suggests that more attention should be given to the management of cardiovascular risk in type 2 diabetic patients with high triglycerides levels.


Diagnostic value of quantitative contrast-enhanced ultrasound (CEUS) for early detection of renal hyperperfusion in diabetic kidney disease.
To investigate the diagnostic value of quantitative contrast-enhanced ultrasound (CEUS) for early detection of renal hyperperfusion in diabetic kidney disease (DKD). 55 DKD patients with estimated glomerular filtration rate (eGFR) >30 ml/min/1.73 m(2) and 26 normal controls (NCs) were enrolled. Clinical data was well documented. Blood samples were drawn for evaluation of renal function including blood urea nitrogen (BUN), serum creatinine (SCr) and serum uric acid (SUA), and urine samples were assayed for total protein quantification, and various microprotein markers. According to eGFR level, DKD patients were divided into early-stage DKD (eGFR ≥90 ml/min/1.73 m(2), n = 18) and middle-stage DKD (eGFR 30-90 ml/min/1.73 m(2), n = 37). Based on urinary microalbumin/creatinine ratio (MALB/UCR), early-stage DKD patients were further classified into two groups: MALB/UCR <10 g/mol (n = 11) and MALB/UCR ≥10 g/mol (n = 7). Then, CEUS was performed to observe the real-time renal perfusion, and low acoustic power contrast-specific imaging was used for quantitative analysis. The renal perfusion images of CEUS were well developed successively. The corresponding perfusion curves based on echo-power signals in time series were constructed. Quantitative analysis showed that area under the descending curve (AUC2) was significantly increased in early-stage DKD compared to middle-stage DKD (p < 0.05), but AUC showed no significant difference. Further comparison between different MALB/UCR levels of early-stage DKD showed that patients with MALB/UCR ≥10 g/mol had significantly increased levels of AUC, AUC2 and proteinuria than patients with low MALB/UCR (p < 0.05). Also, high MALB/UCR DKD patients had increased proteinuria but similar eGFR compared to low MALB/UCR patients. Renal microvascular hyperperfusion may be responsible for overt proteinuria until decline of renal filtration in DKD. AUC2 could be an early and sensitive marker for early renal injury and renal microvascular hyperperfusion in DKD.


The case of the floating gel.
In patients with chronic renal failure, blood samples for laboratory analysis are often taken via dialysis catheters. This report describes a case of gross spurious hypernatraemia in a blood sample collected from a patient undergoing haemodialysis. After centrifugation of the blood sample in question, the separator gel formed the topmost layer, with the serum in the middle and the clot at the bottom. Subsequent analysis of the serum showed severe hypernatraemia (serum sodium, 744 mmol/litre). It was established that the blood sample had been taken from the patient's dialysis catheter into which 3 ml of Citra-Lock (46.7% trisodium citrate) had been instilled previously as a "catheter locking" solution. The hypernatraemia seen in this case was recognised immediately as an artefact, but it was found that even minimal contamination of blood samples with Citra-Lock may significantly affect sodium concentrations. This contamination may be missed, with potentially adverse consequences for patient management.


[False allegations of child sexual abuse and paranoid disorder: a report of 2 cases].
Allegations of child sexual abuse have considerable consequences for individuals and society. Herein, we report 2 cases of false allegations of child sexual abuse by mothers diagnosed as paranoid disorder. Case 1, a 31-year-old mother accused her husband of sexually abusing her 3 daughters, aged 2, 4, and 6 years. Case 2 is a 30-year-old mother that went to the public prosecutor with allegations of sexual abuse of her 6-year-old daughter by a nursery teacher and a stranger. Examination of both alleged victims did not reveal objective findings of sexual abuse. Based on psychiatric examinations, both mothers were diagnosed with paranoid disorder. Consequently, the public prosecutor decided not to prosecute. Considering the possibility of false allegations in such cases, psychiatric examination of the complainant should be performed in order to provide accurate information necessary for legal proceedings and to protect the child.


[Effect of levorin and its combination with a modifying factor on the fatty acid composition of Crithidia oncopelti lipids].
It was shown by us earlier that the sensitivity of Crithidia oncopelti to levorin, a polyene antibiotic, increased in the presence of sodium acetate as a modifying factor. A simultaneous change in the ratio of C. oncopelti structural lipids was also observed. The present paper deals with investigation of the effect of levorin and its combination with the modifying factor on the fatty acid composition of C. oncopelti lipids. The study showed that addition of sodium acetate in a concentration of 40 mg/ml to the medium for cultivation of C. oncopelti resulted in an increase in the total level of fatty acid unsaturation at the expense of a significant increase in the content of linoleic acid and polyunsaturated acids. The content of monoene fatty acids simultaneously decreased. In a concentration of 1 microgram/ml levorin had no effect on the growth of C. oncopelti and did not practically change the relative content of its fatty acids. Combined addition of levorin (1 microgram/ml) and sodium acetate (40 mg/ml) to the medium resulted in inhibition of the culture growth by 60-80 per cent and a marked increase in the total content of saturated acids with a decrease in the level of monounsaturated and polyunsaturated acids. The trypanostatic concentration of levorin (10 micrograms/ml) had the same effect and also lowered the total level of unsaturated fatty acids of C. oncopelti.(ABSTRACT TRUNCATED AT 250 WORDS)


Architecture of a transcribing-translating expressome.
DNA transcription is functionally coupled to messenger RNA (mRNA) translation in bacteria, but how this is achieved remains unclear. Here we show that RNA polymerase (RNAP) and the ribosome of Escherichia coli can form a defined transcribing and translating "expressome" complex. The cryo-electron microscopic structure of the expressome reveals continuous protection of ~30 nucleotides of mRNA extending from the RNAP active center to the ribosome decoding center. The RNAP-ribosome interface includes the RNAP subunit α carboxyl-terminal domain, which is required for RNAP-ribosome interaction in vitro and for pronounced cell growth defects upon translation inhibition in vivo, consistent with its function in transcription-translation coupling. The expressome structure can only form during transcription elongation and explains how translation can prevent transcriptional pausing, backtracking, and termination.


Characterization of a lead breast shielding for dose reduction in computed tomography.
Several studies have been published regarding the use of bismuth shielding to protect the breast in computed tomography (CT) scans and, up to the writing of this article, only one publication about barium shielding was found. The present study was aimed at characterizing, for the first time, a lead breast shielding. The percentage dose reduction and the influence of the shielding on quantitative imaging parameters were evaluated. Dose measurements were made on a CT equipment with the aid of specific phantoms and radiation detectors. A processing software assisted in the qualitative analysis evaluating variations in average CT number and noise on images. The authors observed a reduction in entrance dose by 30% and in CTDIvol by 17%. In all measurements, in agreement with studies in the literature, the utilization of cotton fiber as spacer object reduced significantly the presence of artifacts on the images. All the measurements demonstrated increase in the average CT number and noise on the images with the presence of the shielding. As expected, the data observed with the use of lead shielding were of the same order as those found in the literature about bismuth shielding.


Aberrant promoter methylation profiles of tumor suppressor genes in hepatocellular carcinoma.
Hepatocellular carcinoma (HCC) is one of the most fatal human malignancies, but the molecular mechanisms of hepatocarcinogenesis remain unclear. Although p53 mutations are frequently observed in Asian HCC, it is not a common event in Western HCC. Recent studies suggest that tumor suppressor genes (TSGs) can also be silenced through epigenetic disruption, such as promoter CpG island methylation, during carcinogenesis. To further understand the molecular mechanism of hepatocarcinogenesis, we have investigated the promoter methylation status of nine TSGs (SOCS-1, GSTP, APC, E-cadherin, RAR-beta, p14, p15, p16, and p73) in 51 cases of HCC using methylation-specific polymerase chain reaction. We found that 82% of HCCs had methylation of at least one TSG promoter. The most frequently methylated TSGs in HCC were: SOCS-1 (65%), GSTP (54%), APC (53%), E-cadherin (49%), and p15 (49%). Methylation of SOCS-1, GSTP, APC, E-cadherin, and p15 was more frequent in HCC than in nontumor liver (P < 0.05). Methylation of SOCS-1, GSTP, and p15 was also significantly more frequent in HCC than cirrhotic liver (P < 0.05). Although methylation of one or two genes could be seen in both nontumor and cirrhotic livers, 53% of the HCC cases had three or more TSG promoters methylated, in comparison to 0% in nontumor liver and 13% in cirrhosis (P = 0.001). Methylation of SOCS-1, APC, and p15 was more frequently seen in hepatitis C virus-positive HCC than hepatitis C virus/hepatitis B virus-negative HCC. Our data suggest that promoter hypermethylation of TSGs is a common event in HCC and may play an important role in hepatocarcinogenesis.


Surgical Management of Non-small Cell Lung Cancer with Solitary Hematogenous Metastases.
The treatment of patients with solitary hematogenous metastases from non-small cell lung cancer (NSCLC) remains controversial, although numerous retrospective studies have reported favorable results for patients offered combined surgical therapy. Our aim was to determine the role of surgical resection in the management of NSCLC with solitary extrapulmonary metastases and to investigate for possible prognostic factors. Between January 2004 and December 2012, 12 patients with NSCLC, from two Institutions, underwent metastasectomy for their solitary metastatic lesion. Sites of metastases included brain (n=3), adrenal gland (n=6), thoracic wall (n=2) and diaphragm (n=1). All patients had undergone pulmonary resections for their primary NSCLC. Median survival for the entire cohort was 24.1 months, whereas 1- and 5-year survival rates were 73% and 39%, respectively. Patients with stage III intrathoracic disease had significantly worse survival than those with lower tumor stage. A tendency for adenocarcinomatous histology to positively affect survival was recognized, although it was proven not to be statistically significant. Despite the retrospective nature of our study and the small cohort size, it is emerging that combined surgical resection might offer patients with NSCLC with solitary hematogenous metastases a survival benefit. Limited intrathoracic disease and adenocarcinomatous histology might be associated with better outcomes.


Weight change, blood pressure, lipids and glycemic control among patients with type 2 diabetes.
Although weight loss in patients with type 2 diabetes is very important, available data on the effects of long-term weight change on blood pressure (BP), lipids and glycemic control in these patients are limited. The aim of this study was to assess the long-term impact of weight change on BP, plasma lipids and glycemic control among patients with type 2 diabetes receiving routine care. During the mean [standard deviation (SD)] follow-up period of 9.2 (3.4; range 2-15) years, 7,712 patients with type 2 diabetes were examined to determine changes in weight, BP, plasma lipids and glycemic control using a linear mixed-effects model for repeated measures. The mean (SD) age of participants was 51.3 (10.5) years with a mean (SD) duration of diabetes of 6.3 (6.3) years at initial registration. The change in fasting plasma glucose and glycosylated hemoglobin (HbA(1c)) from baseline to the last follow-up examination was significantly more favorable in those patients who gained weight during follow-up than in those who lost weight or whose weight remained stable. Systolic and diastolic BP and lipids also rose more significantly in the group with weight gain. Although this population of type 2 diabetes in Iran had negligible weight change over mean 9.2 years, this weight gain was associated with an increase in BP and plasma lipids, but also an improvement in glycemic control.


Taxonomy and nomenclature of viruses.
In his article The species concept in plant virology Milne1 describes the CMI/AAB Descriptions of Plant Viruses2 as providing the 'creeping barrage' (for the 'anti-species' views of many plant virologists and others) in the seemingly unending trench warfare over virus taxonomy and nomenclature. As an editor since 1970 (with BD Harrison) of this continuing series, I am moved to fire a few additional shots in support of Milne's thesis.


The distribution of a rabbit thymic antigen and membrane immunoglobulins in lymphoid tissue, with special reference to mucosal lymphocytes.
We have examined rabbit lymphocytes from several tissue sources for membrane immunoglobulins with anti-antiserum for alpha, mu and iota heavy chains, as well as with an antiserum specific for a rabbit thymus lymphocyte antigen (RTLA). Among lymphocytes from bronchus-associated lymphoid tissue (BALT), Peyer's patches, thoracic duct and gut mucosa exclusive of Peyer's patches, alpha and mu predominated with roughly equal percentages of each being found. The distribution of cells with iota receptors was approximately half that of either of the two other classes. In splenic lymphocytes mu predominated, followed, respectively, in numbers by iota and alpha. Detection of RTLA on almost all thymus lymphocytes (94%), most thoracic duct lymphocytes (72%), and lower numbers of peripheral blood lymphocytes (44%), Peyer's patch lymphocytes (17%), and splenic lymphocytes (20%) indicated a similar distribution of this antigen between the lymphoid organs as has been found for the mouse thymus lymphocyte-specific antigens. Low numbers of RTLA-bearing lymphocytes were detected in both the BALT (18%) and the gut mucosa (11%). An unexpected finding was the number of "null" cells among the gut mucosa population, bearing neither thymic nor heavy chain markers. These results in toto support the view that lymphoid aggregates in lung and gut may both contain precursor populations of B cells destined for IgA production.


Retinal ganglion cells in goldfish: a qualitative classification into four morphological types, and a quantitative study of the development of one of them.
In this paper we describe the dendritic morphology of ganglion cells that have been retrogradely stained with HRP taken up by the cut optic nerve. This technique produces an extensive Golgi-like filling of the cells. From their appearance in the retinal whole-mount, they were classified as four types, according to the sizes of the soma and dendritic field, the thickness of the primary dendrites, and the density of the arbors. Each type was subdivided according to the level(s) of stratification of the dendrites within the inner and outer plexiform layer(s) to yield a total of 15 subtypes (four for three types, three for the other). The retina of the goldfish grows by a balloon-like expansion, and by the addition of new neurons, in annuli, at the margin. Therefore, a similar cell type may be examined at a variety of stages of development in the same retina, as well as in the retinae from fish of various ages. We have used a computer-assisted microscope to do so, quantitatively, for one large and easily identified subtype. In small fish (ca. 4 cm long), the number of dendritic branch points, the total dendritic length, and the dendritic field sizes of these cells are constant inside a central zone extending to 70-80% of the retinal radius. The magnitudes of all three numeric descriptors decrease closer to the margin. In large fish (ca. 14 cm long), the central zone extends to more than 90% of the retinal radius, and the same pattern holds. The area of the dendritic fields and the total dendritic lengths are both greater in the central zone of the large fish than in the small, but the number of branches is the same in both. This suggests that once a cell has achieved the "mature" number of dendritic branches, further growth is interstitial. A comparison of dendritic morphologies across the retina shows that the pattern of dendritic outgrowth in peripheral retina is initially directed parallel to the margin, and, later, toward the margin. This suggests that dendritic growth is impeded by the dendrites present in more central retina and proceeds preferentially where they are absent. Cells of the same age are at different distances from the optic disk in the small and large retinae. In some cases, they have quite different dendritic morphologies. This implies that dendritic development depends not only on the age and subtype of the cell, but on extrinsic factors as well.(ABSTRACT TRUNCATED AT 400 WORDS)


Glucose testing and insufficient follow-up of abnormal results: a cohort study.
More than 6 million Americans have undiagnosed diabetes. Several national organizations endorse screening for diabetes by physicians, but actual practice is poorly understood. Our objectives were to measure the rate, the predictors and the results of glucose testing in primary care, including rates of follow-up for abnormal values. We conducted a retrospective cohort study of 301 randomly selected patients with no known diabetes who received care at a large academic general internal medicine practice in New York City. Using medical records, we collected patients' baseline characteristics in 1999 and followed patients through the end of 2002 for all glucose tests ordered. We used multivariate logistic regression to measure associations between diabetes risk factors and the odds of glucose testing. Three-fourths of patients (78%) had at least 1 glucose test ordered. Patient age (> or = 45 vs. < 45 years), non-white ethnicity, family history of diabetes and having more primary care visits were each independently associated with having at least 1 glucose test ordered (p < 0.05), whereas hypertension and hyperlipidemia were not. Fewer than half of abnormal glucose values were followed up by the patients' physicians. Although screening for diabetes appears to be common and informed by diabetes risk factors, abnormal values are frequently not followed up. Interventions are needed to trigger identification and further evaluation of abnormal glucose tests.


A proposed revision to the ACR20: the hybrid measure of American College of Rheumatology response.
Although use of the American College of Rheumatology 20% improvement criteria (ACR20) has standardized response measurement in rheumatoid arthritis (RA) trials, the ACR20 has been criticized as less sensitive to change than are continuous measures of response, and its threshold for response (> or = 20%) is thought to be low. Our goal was to redefine response in RA in a manner that 1) corresponds to a clinical impression of response (clinical validity), 2) maximizes sensitivity to change, and 3) allows for calculation of the ACR20 to continue standardization of reporting. We examined multiple different ways of defining response, including dichotomous definitions (patient improved versus not improved), ordinal definitions (degree of response scored on an ordinal scale), disease activity indexes, continuous definitions, and definitions that were hybrids of continuous and ordinal measures. Candidate definitions included the ACR20, ACR50, ACR70, the Disease Activity Score, the Simplified Disease Activity Index, the ACR-N, the nACR, and the European League Against Rheumatism (EULAR) response. We also tested variations on these approaches. To test clinical validity, we administered a survey involving patients from a previous trial who had various levels of improvement and asked rheumatologists whether and by how much these patients improved. To determine sensitivity to change, we collected data from 11 large multicenter trials of disease-modifying antirheumatic drugs (DMARDs) in RA comprising 3,665 patients (7 anti-tumor necrosis factor alpha arms, 4 conventional DMARD arms, 2 biologic arms) and ranked candidate definitions of response according to their average P value across trials in distinguishing active treatment from placebo or combination therapy versus single-drug therapy. All 135 tested measures had clinical validity based on survey responses, although dichotomous measures did not capture the range of responses (e.g., the ACR20 did not capture the extra clinical improvement between the ACR20 and the ACR50). In trial analyses, continuous measures had the best sensitivity to change. Among the best scoring measures was a hybrid measure that retained information on the ACR20, ACR50, and ACR70 and combined that with the mean percent improvement in core set measures. When comparing 2 treatments, this hybrid measure had an average P value much lower than that for the ACR20. If a trial needed 200 patients to have 80% power (2-sided alpha = 0.05) to detect a difference between treatments if it used the ACR20, the same trial would need 108 patients if the hybrid measure were used. We suggest use of a new hybrid measure of RA response that maximizes sensitivity to change, correlates well with rheumatologists' impressions of improvement, and preserves the ACR20.


The treatment of anomia using errorless learning.
In the contemporary literature, errorless learning is thought to have benefits over more traditional trial-and-error methods. The most prominent investigations of errorless learning are those designed for rehabilitation of severe memory impairments, including numerous demonstrations of effective amelioration of word-finding difficulties (Baddeley & Wilson, 1994; Clare, Wilson, Breen, & Hodges, 1999; Clare et al., 2000; Evans et al., 2000). Despite this, there are very few reports on the application of purely errorless learning to people with aphasia (Fillingham, Hodgson, Sage, & Lambon Ralph, 2003). The aim of this study was to compare directly the efficacy of errorless and errorful learning in a case series of 11 aphasic people with pronounced word-finding difficulties. Previous studies of errorless learning and, more recently, studies of rehabilitation have suggested that cognition is an important factor for determining outcome (Helm-Estabrooks, 2002; Robertson & Murre, 1999). Therefore, a thorough language and neuropsychological assessment battery was completed with each participant. Naming therapy was carried out to contrast errorless and errorful therapy in a case series analysis. Errorless learning proved to be as effective as the more traditional, errorful approach in the majority of cases in terms of both immediate improvement and at follow up assessment. Without exception, the patients preferred the errorless learning therapy. Strikingly, it was found that language skill did not predict therapy outcome. Participants who responded better overall, had better recognition memory, executive/problem solving skills and monitoring ability. This replicates recent findings that frontal executive skills are crucial for rehabilitation (Robertson & Murre, 1999). Also, participants who did better at errorful treatment were those with the best working and recall memory, and attention. It is probable that these factors are essential cognitive components for providing effective monitoring and feedback systems to a more general learning mechanism.


Management of an endodontic infection with an extra oral sinus tract in a single visit: a case report.
Chronic apical periodontitis can drain through a sinus tract, which may be intra-oral or extra-oral, though an intra-oral drainage is more common. Though such cases can be treated in a single visit, there is no report on a single visit endodontic treatment for a chronic apical periodontitis with a draining sinus. This case report demonstrates that the apical periodontitis with a cutaneous sinus tract can be successfully treated endodontically as a single visit procedure, if the patient is in good systemic health.


Complete Genome Sequence of Vibrio coralliilyticus RE22, a Marine Bacterium Pathogenic toward Larval Shellfish.
Vibrio coralliilyticus RE22 is an indigenous marine pathogen that infects larval bivalve shellfish. This strain is particularly problematic in oyster hatcheries, where it causes high larval mortality. It contains two circular chromosomes and one megaplasmid. Annotation reveals multiple genes which may encode important virulence factors.


The affective benefits of real-world exploration during the COVID-19 pandemic.
Increasing daily exploration is linked to improvements in affective well-being. However, COVID-19 elevated uncertainty when leaving the home, altering the risk-reward of balance of geospatial novelty. To this end, we simultaneously collected real-world geospatial tracking and experience sampling of emotion, prior to and during the first year of the pandemic in 630 individuals. COVID-19 reduced exploration and subjective well-being. Yet, despite the health risks of exploring during the pandemic, the days of highest affective well-being were those when individuals explored the most. However, this was not true for everyone: during the first months of the pandemic, at the height of the uncertainty surrounding the transmissibility and prognosis of a COVID-19 infection, more anxious individuals experienced no affective benefit to leaving home. Taken together, real-world exploration improved well-being regardless of the presence of real-world threat, but anxiety mitigated these benefits. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Detection of Molecular Signatures of Homologous Recombination Deficiency in Bladder Cancer.
Poly (ADP ribose)-polymerase (PARP) inhibitors are approved for use in breast, ovarian, prostate, and pancreatic cancers, which are the solid tumor types that most frequently have alterations in key homologous recombination (HR) genes, such as BRCA1/2. However, the frequency of HR deficiency (HRD) in other solid tumor types, including bladder cancer, is less well characterized. Specific DNA aberration profiles (mutational signatures) are induced by HRD, and the presence of these "genomic scars" can be used to assess the presence or absence of HRD in a given tumor biopsy even in the absence of an observed alteration of an HR gene. Using whole-exome and whole-genome data, we measured various HRD-associated mutational signatures in bladder cancer. We found that a subset of bladder tumors have evidence of HRD. In addition to a small number of tumors with biallelic BRCA1/2 events, approximately 10% of bladder tumors had significant evidence of HRD-associated mutational signatures. Increased levels of HRD signatures were associated with promoter methylation of RBBP8, which encodes CtIP, a key protein involved in HR. A subset of bladder tumors have genomic features suggestive of HRD and therefore may be more likely to benefit from therapies such as platinum agents and PARP inhibitors that target tumor HRD.


Intracellular trafficking pathways in the assembly of connexins into gap junctions.
Trafficking pathways underlying the assembly of connexins into gap junctions were examined using living COS-7 cells expressing a range of connexin-aequorin (Cx-Aeq) chimeras. By measuring the chemiluminescence of the aequorin fusion partner, the translocation of oligomerized connexins from intracellular stores to the plasma membrane was shown to occur at different rates that depended on the connexin isoform. Treatment of COS-7 cells expressing Cx32-Aeq and Cx43-Aeq with brefeldin A inhibited the movement of these chimera to the plasma membrane by 84 +/- 4 and 88 +/- 4%, respectively. Nocodazole treatment of the cells expressing Cx32-Aeq and Cx43-Aeq produced 29 +/- 16 and 4 +/- 7% inhibition, respectively. In contrast, the transport of Cx26 to the plasma membrane, studied using a construct (Cx26/43T-Aeq) in which the short cytoplasmic carboxyl-terminal tail of Cx26 was replaced with the extended carboxyl terminus of Cx43, was inhibited 89 +/- 5% by nocodazole and was minimally affected by exposure of cells to brefeldin A (17 +/-11%). The transfer of Lucifer yellow across gap junctions between cells expressing wild-type Cx32, Cx43, and the corresponding Cx32-Aeq and Cx43-Aeq chimeras was reduced by nocodazole treatment and abolished by brefeldin A treatment. However, the extent of dye coupling between cells expressing wild-type Cx26 or the Cx26/43T-Aeq chimeras was not significantly affected by brefeldin A treatment, but after nocodazole treatment, transfer of dye to neighboring cells was greatly reduced. These contrasting effects of brefeldin A and nocodazole on the trafficking properties and intercellular dye transfer are interpreted to suggest that two pathways contribute to the routing of connexins to the gap junction.


Leaf-shaped lesions of ocular fundus and white eyelashes in tuberous sclerosis.
A 5-year-old white girl with tuberous sclerosis had, in addition to bilateral retinal hamartomas, two hypopigmented leaf-shaped areas in the right fundus. These areas may be akin to the well known ash-leaf white cutaneous macules of tuberous sclerosis. Also, poliosis circumscripta was present in the left upper eyelid. Both findings may be rare associated signs of tuberous sclerosis.


Genetic structure of arbuscular mycorrhizal populations in fallow and cultivated soils.
The impact of fallowing on the genetic structure of arbuscular mycorrhizal fungi (AMF) was studied by hierarchical sampling of spores from four plots in a fallow and a cultivated field. A nested multiplex PCR approach was used to assign the spores to genotypes. Variable introns of the two protein-coding genes GmFOX2 and GmTOR2 were used as co-dominant genetic markers together with the large subunit (LSU) rDNA. The gene diversity and genetic structure of Glomus mosseae, Glomus geosporum and Glomus caledonium were compared within and between the fields. Spores of G. caledonium and G. geosporum were more abundant in the cultivated field, whereas G. mosseae was more frequent in the fallow field. The number of genotypes was not different between the two fields. Analysis of gene diversity of G. caledonium in the fallow field indicated that a larger part of the heterogeneity could be attributed to variation between plots rather than subplots, suggesting that the lack of soil cultivation resulted in more heterogeneous population genetic structures. Analyses of haplotype networks of the fungi suggested a subdivision of G. mosseae haplotypes between the two fields, whereas no such division was seen in G. geosporum and G. caledonium. The results show that agricultural practices differently affect both the abundance and the population structure of different AMF species.


Increased expression of protein kinase CK2α correlates with poor patient prognosis in epithelial ovarian cancer.
Epithelial ovarian cancer (EOC) is one of the deadly gynecological malignancies. The function of protein kinase CK2α (CK2α) in EOC is still unknown. Our study aimed to investigate the relationship between the protein expression of CK2α and the tumor progression, the prognosis of human EOC. In this study, we analyzed the expression levels of CK2α through Western blot, using EOC cell lines like A2780, HO8910, COV644, OVCAR3, SKOV3, and the primary normal ovarian surface epithelial (NOSE) cells. Furthermore, OVCAR3 and SKOV3 EOC cells were employed as a cellular model to study the role of CK2α on cell growth, migration, invasion, apoptosis, and cell cycle distribution. In addition, we investigated CK2α protein expression in tumor tissues from patients with EOC by immunohistochemistry and analyzed the association between CK2α expression and clinicopathologic parameters and prognosis of EOC patients. And we found that compared with NOSE cells, CK2α protein expression was increased in A2780, HO8910, OVCAR3, and SKOV3 ovarian cancer cell lines. Decreased CK2α expression suppressed OVCAR3 and SKOV3 cell growth and induced more apoptosis. CK2α knockdown using specific siRNAs inhibited migration and invasion ability of OVCAR3 and SKOV3 cells. In addition, high CK2α protein expression was found in 68.4% (80/117) of EOC patients. Increased CK2α expression of was significantly correlated with FIGO staging and peritoneal cytology. Patients with higher CK2α expression had a significantly poorer overall survival compared with those with lower CK2α expression. Multi-variate Cox regression analysis proved that increased CK2α expression was an independent prognostic marker for EOC. Taken together, our data displayed that CK2α may play a role in tumor aggressive behavior of EOC and could be used as a marker for predicting prognosis of EOC patient. High CK2α expression might predict poor patient survival.


Seroprevalence of Toxoplasma gondii in free-ranging and feral cats on Amami Oshima Island, Japan.
On Amami Oshima Island, free-ranging and feral cats are harmful to wildlife populations. In this study, the seroprevalence of Toxoplasma gondii in these cats was examined using a newly developed Gaussia luciferase immunoprecipitation system assay. Of 1,363 cats, 123 cats (9.0%) was positive for T. gondii. The prevalence was significantly different in different areas; among cats in the rural area, where many wild animals live, including endangered species, T. gondii infection was more prevalent than in the urban area of the island. This finding indicates a possible risk to wildlife of infection from free-ranging and feral cats. Therefore, management of cats is important for wildlife conservation.


Ebola Virus Causes Intestinal Tract Architectural Disruption and Bacterial Invasion in Non-Human Primates.
In the 2014⁻2016 West Africa Ebola Virus (EBOV) outbreak, there was a significant concern raised about the potential for secondary bacterial infection originating from the gastrointestinal tract, which led to the empiric treatment of many patients with antibiotics. This retrospective pathology case series summarizes the gastrointestinal pathology observed in control animals in the rhesus EBOV-Kikwit intramuscular 1000 plaque forming unit infection model. All 31 Non-human primates (NHPs) exhibited lymphoid depletion of gut-associated lymphoid tissue (GALT) but the severity and the specific location of the depletion varied. Mesenteric lymphoid depletion and necrosis were present in 87% (27/31) of NHPs. There was mucosal barrier disruption of the intestinal tract with mucosal necrosis and/or ulceration most notably in the duodenum (16%), cecum (16%), and colon (29%). In the intestinal tract, hemorrhage was noted most frequently in the duodenum (52%) and colon (45%). There were focal areas of bacterial submucosal invasion in the gastrointestinal (GI) tract in 9/31 (29%) of NHPs. Only 2/31 (6%) had evidence of pancreatic necrosis. One NHP (3%) experienced jejunal intussusception which may have been directly related to EBOV. Immunofluorescence assays demonstrated EBOV antigen in CD68+ macrophage/monocytes and endothelial cells in areas of GI vascular injury or necrosis.


[Study on relationship between length of homologous sequences and chromosomic recombination rate in Saccharopolyspora erythraea].
In order to study the relationship between lengths of homologous fragments and chromsomic recombination rate in Saccharopolyspora erythraea, three homologous sequences, with mutant loci and different flanking sequences, (26bp + 27bp), (500bp + 576bp) and (1908bp + 1749bp), were synthesized by chemical reaction or PCR amplification, and cloned into pWHM3 to construct homologous recombination plasmids, pWHM1113, pWHM1116 and pWHM1119. When the plasmids were transformed into protoplast of Saccharopolyspora erythraea A226 under PEG mediated, on an average 30, 69 and 170 transformants grew on each plate for the three plasmids respectively, but chromosomic integration frequency were 0, 2% and 19% among corresponding transformants. Both pWHM1116 and pWHM1119 could take double crossover recombination, and exchange the mutant loci in the chromosome. It was concluded that when the flanking sequences were equal or more than (500bp + 576bp), they could take effective single and double recombination with Saccharopolyspora erythraea chromosome.


Early adversity and children's regulatory deficits: Does postadoption parenting facilitate recovery in postinstitutionalized children?
Children reared in orphanages typically experience the lack of stable, reliable caregivers and are at increased risk for deficits in regulatory abilities including difficulties in inhibitory control, attention, and emotion regulation. Although adoption results in a radical shift in caregiving quality, there remains variation in postadoption parenting, yet little research has examined postadoption parenting that may promote recovery in children experiencing early life adversity in the form of institutional care. Participants included 93 postinstitutionalized children adopted between 15 and 36 months of age and 52 nonadopted same-aged peers. Parenting was assessed four times during the first 2 years postadoption (at 2, 8, 16, and 24 months postadoption) and children's regulation was assessed at age 5 (M age = 61.68 months) and during kindergarten (M age = 71.55 months). Multiple parenting dimensions including sensitivity/responsiveness, structure/limit setting, and consistency in routines were examined. Both parental sensitivity and structure moderated the effect of preadoption adversity on children's emotion regulation while greater consistency was associated with better inhibitory control and fewer attention problems. Results support the notion that postadoption parenting during toddlerhood and the early preschool years promotes better regulation skills following early adversity.


Effects of atrial natriuretic peptide on proximal epicardial coronary arteries and coronary blood flow in conscious dogs.
The effects of atrial natriuretic peptide (ANP) on proximal epicardial coronary artery dimensions and coronary blood flow were examined in 7 awake dogs chronically instrumented with miniature coronary dimension crystals and Doppler flow probes on the circumflex coronary artery. ANP (10, 50, and 150 micrograms) was infused as a bolus via the left atrial catheter. Aortic pressure, left ventricular end-diastolic pressure, heart rate, and dP/dt did not change significantly with any dose of ANP. ANP caused transient (1-5 minutes) dose-related increases in coronary blood flow; maximum increases were 28.1 +/- 6.9%, 40.2 +/- 6.2%, and 73.9 +/- 12.5% with the 10-, 50-, and 150-micrograms doses, respectively. ANP also induced prolonged (average 70.2 +/- 28.6 minutes with 150-micrograms dose) dose-related increases in coronary diameter; maximum increases were 3.1 +/- 1.0%, 3.9 +/- 1.5%, and 5.7 +/- 1.3% with the 10-, 50-, and 150-micrograms doses, respectively. The increase in diameter was not attenuated when the transient increase in blood flow was prevented by partial occlusion with a pneumatic snare. Combined autonomic blockade with propranolol (1 mg/kg), phentolamine (1 mg/kg), and atropine (0.06 mg/kg) attenuated the relative increase in coronary flow but did not alter the increases in epicardial coronary diameter produced by ANP. These data demonstrate that bolus injection of ANP effects preferential, sustained, dose-dependent, flow-independent increases in epicardial coronary dimensions and relatively brief dose-dependent increases in coronary blood flow. The vasodilator effects of ANP on epicardial vessels are direct and are not mediated via the autonomic nervous system.(ABSTRACT TRUNCATED AT 250 WORDS)


Comparison of drainage techniques for biliary atresia.
Traditional Kasai portoenterostomy and porto-appendiceal duodenostomy have been utilized for biliary atresia. Differences in outcome between patients who underwent either Kasai portoenterostomy or porto-appendiceal duodenostomy were compared. A review of all children who underwent a drainage procedure for biliary atresia from 1986 to 2000 (n = 30) was performed. Age at drainage procedure, subsequent liver transplantation, and outcomes were evaluated. Outcome variables included success rates (total bilirubin < 2.0 mg/dL) and survival rate. Statistical analysis was done with chi2 and Student's t test. Long-term follow-up was available on 28 of 30 patients. Age at biliary drainage was insignificant. Success rates between porto-appendiceal duodenostomy (31%) and Kasai portoenterostomy (82%) were statistically significant. Survival rate for patients who underwent a Kasai portoenterostomy was 10 of 11 patients. Survival rate for patients who underwent porto-appendiceal duodenostomy was 14 of 16 patients. Overall survival rate was comparable between porto-appendiceal duodenostomy (88%) and Kasai portoenterostomy (91%). Although overall survival rate was comparable, patients who underwent porto-appendiceal duodenostomy were less successful in alleviating hyperbilirubinemia compared with Kasai portoenterostomy. This is shown further by the greater incidence of subsequent liver transplantation in infants with prior porto-appendiceal duodenostomy. Although the appendix may serve as an alternative biliary conduit, traditional Kasai portoenterostomy appears to achieve better biliary drainage.


The future of UK healthcare: problems and potential solutions to a system in crisis.
The UK's Health System is in crisis, central funding no longer keeping pace with demand. Traditional responses-spending more, seeking efficiency savings or invoking market forces-are not solutions. The health of our nation demands urgent delivery of a radical new model, negotiated openly between public, policymakers and healthcare professionals. Such a model could focus on disease prevention, modifying health behaviour and implementing change in public policy in fields traditionally considered unrelated to health such as transport, food and advertising. The true cost-effectiveness of healthcare interventions must be balanced against the opportunity cost of their implementation, bolstering the central role of NICE in such decisions. Without such action, the prognosis for our healthcare system-and for the health of the individuals it serves-may be poor. Here, we explore such a new prescription for our national health.


Concurrent chemoradiotherapy for locally advanced and metastatic esophageal cancer: longterm results of a phase II study of UFT/CDDP with radiotherapy.
No effective treatment for advanced esophageal cancer extending to adjacent organs or associated with distant metastasis is known. We prospectively analyzed the efficacy of concurrent chemoradiotherapy with uracil plus tegafur (UFT) and cisplatin (CDDP) for such cases of advanced esophageal cancer. Patients with advanced cancers received 60 to 70 Gy of radiotherapy given during a period of 7 weeks, concurrently with daily oral UFT (200 mg/m(2) per day), and a 24-h infusion of CDDP (70 mg/m(2)) on days 8 and 36. After chemoradiotherapy, UFT (250 mg/m(2)/per day) was administered daily for 1 year, while CDDP (80 mg/m(2)) was administered twice every 4 weeks. Patients with stage III disease numbered 31, while 24 had stage IV disease according to the tumor-node-metastasis (TNM) staging. Including all patients, complete response (CR) occurred in 20% and partial response (PR) in 51%. In stage III patients, CR, PR, and CR+PR rates were 29%, 48%, and 77%, respectively. In stage IV patients, CR, PR, and CR+PR rates were 8%, 54%, and 63%. Grade 4 leukocytopenia occurred in 22% of patients, and grade 3 pain, nausea/vomiting, and oral mucositis occurred in 7%, 9%, and 4% of patients respectively, but resolved after the reduction or discontinuation of chemoradiotherapy. Median survival in stage III patients was 415 days (range, 3 to 3046 days), and in stage IV patients, it was 187 days (range, 75 to 764 days). The 2-year survival rate in stage III patients was 25% and it was 4% in stage IV patients. The 5-year survival rate in stage III patients was 7%, while in stage IV patients it was 0%. This combined treatment may be a promising nonsurgical management option for locally advanced esophageal cancer, and can achieve good palliative effects in patients with distant metastasis.


Estimating uncertainty in multivariate responses to selection.
Predicting the responses to natural selection is one of the key goals of evolutionary biology. Two of the challenges in fulfilling this goal have been the realization that many estimates of natural selection might be highly biased by environmentally induced covariances between traits and fitness, and that many estimated responses to selection do not incorporate or report uncertainty in the estimates. Here we describe the application of a framework that blends the merits of the Robertson-Price Identity approach and the multivariate breeder's equation to address these challenges. The approach allows genetic covariance matrices, selection differentials, selection gradients, and responses to selection to be estimated without environmentally induced bias, direct and indirect selection and responses to selection to be distinguished, and if implemented in a Bayesian-MCMC framework, statistically robust estimates of uncertainty on all of these parameters to be made. We illustrate our approach with a worked example of previously published data. More generally, we suggest that applying both the Robertson-Price Identity and the multivariate breeder's equation will facilitate hypothesis testing about natural selection, genetic constraints, and evolutionary responses.


Health promotion interventions for African Americans delivered in U.S. barbershops and hair salons- a systematic review.
African American adults suffer disproportionately from obesity-related chronic diseases, particularly at younger ages. In order to close the gap in these health disparities, efforts to develop and test culturally appropriate interventions are critical. A PRISMA-guided systematic review was conducted to identify and critically evaluate health promotion interventions for African Americans delivered in barbershops and hair salons. Subject headings and keywords used to search for synonyms of 'barbershops,' 'hair salons,' and 'African Americans' identified all relevant articles (from inception onwards) from six databases: Academic Search Ultimate, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, PsycINFO, PubMed, Web of Science (Science Citation Index and Social Sciences Citation Index). Experimental and quasi-experimental studies for adult (> 18 years) African Americans delivered in barbershops and hair salons that evaluated interventions focused on risk reduction/management of obesity-related chronic disease: cardiovascular disease, cancer, and type 2 diabetes were included. Analyses were conducted in 2020. Fourteen studies met criteria for inclusion. Ten studies hosted interventions in a barbershop setting while four took place in hair salons. There was substantial variability among interventions and outcomes with cancer the most commonly studied disease state (n = 7; 50%), followed by hypertension (n = 5; 35.7%). Most reported outcomes were focused on behavior change (n = 10) with only four studies reporting clinical outcomes. Health promotion interventions delivered in barbershops/hair salons show promise for meeting cancer screening recommendations and managing hypertension in African Americans. More studies are needed that focus on diabetes and obesity and utilize the hair salon as a site for intervention delivery. PROSPERO CRD42020159050 .


In vivo evaluation of centrifugal blood pump for cardiopulmonary bypass-Spiral Pump.
The Spiral Pump (SP), a centrifugal blood pump for cardiopulmonary bypass (CPB), has been developed at the Dante Pazzanese Institute of Cardiology/Adib Jatene Foundation laboratories, with support from Sintegra Company (Pompeia, Brazil). The SP is a disposable pump with an internal rotor-a conically shaped fuse with double entrance threads. This rotor is supported by two ball bearings, attached to a stainless steel shaft fixed to the housing base. Worm gears provide axial motion to the blood column, and the rotational motion of the conically shaped impeller generates a centrifugal pumping effect, improving pump efficiency without increasing hemolysis. In vitro tests were performed to evaluate the SP's hydrodynamic performance, and in vivo experiments were performed to evaluate hemodynamic impact during usual CPB. A commercially available centrifugal blood pump was used as reference. In vivo experiments were conducted in six male pigs weighing between 60 and 90 kg, placed on CPB for 6 h each. Blood samples were collected just before CPB (T0) and after every hour of CPB (T1-T6) for hemolysis determination and laboratory tests (hematological and biochemical). Values of blood pressure, mean flow, pump rotational speed, and corporeal temperature were recorded. Also, ergonomic conditions were recorded: presence of noise, difficulty in removing air bubbles, trouble in installing the pump in the drive module (console), and difficulties in mounting the CPB circuit. Comparing the laboratory and hemolysis results for the SP with those of the reference pump, we can conclude that there is no significant difference between the two devices. In addition, reports made by medical staff and perfusionists described a close similarity between the two devices. During in vivo experiments, the SP maintained blood flow and pressure at physiological levels, consistent with those applied in cardiac surgery with CPB, without presenting any malfunction. Also, the SP needed lower rotational speed to obtain average blood flow and pressure, compared with the reference pump.


Perfusion of the human placenta with red blood cells and xanthine oxidase mimics preeclampsia in-vitro.
Preeclampsia is a major obstetric problem of unknown etiology. The fact that removal of the placenta is the only cure for preeclampsia, has led to the well-established hypothesis, that the placenta is central in the etiology. Gene profiling and proteomics studies have suggested oxidative stress caused by reperfusion and free oxygen radicals as a potential pathophysiological mechanism in preeclampsia. In this study, the dual placental perfusion model was used in order to evaluate the damaging effects of oxidative stress induced by xanthine/xanthine oxides and free hemoglobin. The dual placenta perfusion model is a well-established in vitro model for functional placental studies. Placentas were perfused with medium containing either xanthine/xanthine oxidase or erythrocytes as a source of free hemoglobin. Concentration of free hemoglobin in the medium was measured by means of ELISA. Whole genome microarray technique and bioinformatics were used to evaluate the gene expression profile in the two groups. Substantial levels of free adult hemoglobin were detected in the perfusions. A total of 58 genes showed altered gene expression, the most altered were hemoglobin alpha, beta and gamma, tissue factor pathway inhibitor 2 and superoxide dismutase 2. Bioinformatics revealed that biological processes related to oxidative stress, anti-apoptosis and iron ion binding were significantly altered. The results suggest that perfusion with xanthine/xanthine oxidase and free hemoglobin induce changes in gene expression similar to what has been described for the preeclamptic placenta.


Specific immune serum to the Epstein-Barr virus DNA polymerase.
Epstein-Barr virus (EBV) DNA polymerase was released from phorbol ester-treated tamarin (Saguinus oedipus) cells (B95-8) and prepared for use as an antigen by sequential column chromatography with DEAE-Sephadex A-25, DEAE-cellulose, phosphocellulose, and single-stranded DNA cellulose. Proteins from single-stranded DNA cellulose with DNA polymerase activity in 100 mM ammonium sulfate were mixed with complete Freund adjuvant and injected intradermally into rats and rabbits. Immune sera that were screened for specific antibody by indirect immunofluorescence procedures reacted with approximately 3% of the cells in EBV-producer cultures (B95-8 and P3HR-1) but not with EBV genome-negative cells (BJAB). In functional enzyme assays, immune sera or the immunoglobulin fraction inhibited the activity of purified EBV DNA polymerase 90%. Inhibition of enzyme activity was not affected by absorption of immune sera with insoluble matrices of proteins prepared with tamarin and human cells which lacked the EBV genome. Cellular DNA polymerase alpha was not inhibited by immune sera to the EBV enzyme.


Inhaled fluticasone versus placebo for chronic asthma in adults and children.
Inhaled fluticasone propionate (FP) is a relatively new inhaled corticosteroid for the treatment of asthma. 1. To assess efficacy and safety outcomes in studies that compared FP to placebo for treatment of chronic asthma.2. To explore the presence of a dose-response effect. We searched the Cochrane Airways Group Trial Register (January 2004), reference lists of articles, contacted trialists and searched abstracts of major respiratory society meetings (1997-2004). Randomised trials in children and adults comparing FP to placebo in the treatment of chronic asthma. Two reviewers independently assessed articles for inclusion and methodological quality. Two reviewers extracted data. Quantitative analyses where undertaken using RevMan Analyses 4.2.7. Sixty eight studies met the inclusion criteria (11, 104 participants). Methodological quality was high. In non-oral steroid treated asthmatics with mild and moderate disease FP resulted in improvements from baseline compared with placebo across all dose ranges (100 to 1000 mcg/d) in FEV1 (between 0.13 to 0.45 litres); morning PEF (between 27 and 47 L/min); symptom scores (based on a standardised scale, between 0.5 and 0.85); reduction in rescue beta-2 agonist use (between 1.2 and 2.2 puffs/d). High dose FP reduced the number of patients dependent on prednisolone: FP 1000-1500 mcg/d Peto Odds Ratio 0.07 (95% CI 0.05 to 0.10). FP at all doses led to a greater likelihood of sore throat, hoarseness and oral Candidiasis, but 21 patients would need to be treated for one extra to develop Candidiasis (FP 500 mcg/day), whilst only three or four patients need to be treated to avoid one extra patient being withdrawn due to lack of efficacy at all doses of FP. Doses of FP in the range 100-1000 mcg/d are effective. In most patients with mild-moderate asthma improvements with low dose FP are only a little less than those associated with high doses when compared with placebo. High dose FP appears to have worthwhile oral-corticosteroid reducing properties. FP use is accompanied by an increased likelihood of oropharyngeal side effects.