Antioxidant protects against increases in low molecular weight hyaluronan and inflammation in asphyxiated newborn pigs resuscitated with 100% oxygen.
Newborn resuscitation with 100% oxygen is associated with oxidative-nitrative stresses and inflammation. The mechanisms are unclear. Hyaluronan (HA) is fragmented to low molecular weight (LMW) by oxidative-nitrative stresses and can promote inflammation. We examined the effects of 100% oxygen resuscitation and treatment with the antioxidant, N-acetylcysteine (NAC), on lung 3-nitrotyrosine (3-NT), LMW HA, inflammation, TNFα and IL1ß in a newborn pig model of resuscitation. Newborn pigs (n = 40) were subjected to severe asphyxia, followed by 30 min ventilation with either 21% or 100% oxygen, and were observed for the subsequent 150 minutes in 21% oxygen. One 100% oxygen group was treated with NAC. Serum, bronchoalveolar lavage (BAL), lung sections, and lung tissue were obtained. Asphyxia resulted in profound hypoxia, hypercarbia and metabolic acidosis. In controls, HA staining was in airway subepithelial matrix and no 3-NT staining was seen. At the end of asphyxia, lavage HA decreased, whereas serum HA increased. At 150 minutes after resuscitation, exposure to 100% oxygen was associated with significantly higher BAL HA, increased 3NT staining, and increased fragmentation of lung HA. Lung neutrophil and macrophage contents, and serum TNFα and IL1ß were higher in animals with LMW than those with HMW HA in the lung. Treatment of 100% oxygen animals with NAC blocked nitrative stress, preserved HMW HA, and decreased inflammation. In vitro, peroxynitrite was able to fragment HA, and macrophages stimulated with LMW HA increased TNFα and IL1ß expression. Compared to 21%, resuscitation with 100% oxygen resulted in increased peroxynitrite, fragmentation of HA, inflammation, as well as TNFα and IL1ß expression. Antioxidant treatment prevented the expression of peroxynitrite, the degradation of HA, and also blocked increases in inflammation and inflammatory cytokines. These findings provide insight into potential mechanisms by which exposure to hyperoxia results in systemic inflammation.


Conspiracy mentality and political orientation across 26 countries.
People differ in their general tendency to endorse conspiracy theories (that is, conspiracy mentality). Previous research yielded inconsistent findings on the relationship between conspiracy mentality and political orientation, showing a greater conspiracy mentality either among the political right (a linear relation) or amongst both the left and right extremes (a curvilinear relation). We revisited this relationship across two studies spanning 26 countries (combined N = 104,253) and found overall evidence for both linear and quadratic relations, albeit small and heterogeneous across countries. We also observed stronger support for conspiracy mentality among voters of opposition parties (that is, those deprived of political control). Nonetheless, the quadratic effect of political orientation remained significant when adjusting for political control deprivation. We conclude that conspiracy mentality is associated with extreme left- and especially extreme right-wing beliefs, and that this non-linear relation may be strengthened by, but is not reducible to, deprivation of political control.


[Seasonal changes in the body and muscle heat resistance of the green toad].
A study was made of the dynamics of seasonal changes in heat resistance of the organism and muscles of the green toad taken from micropopulation living in the North-Eastern suburbs of Tashkent. The heat resistance of the organism was determined by the time of onset of the irreversible heat shock caused by the immersion of animals into water at 39 +/- 0.1 degrees C. The heat resistance of muscles (m. gastrocnemius) was determined by the time of the loss of response to electrical stimulus during heating in the Ringer solution (41 +/- 0.1 degrees). It has been shown that the organism as a whole is much more dependent on seasonal variations of environmental temperature as compared with muscle tissue. Of much importance for the changes in the heat resistance of muscle tissue are cyclic hormonal changes in the organism associated with the process of reproduction and preparation to it.


[Study on hypotensive effect of latanoprost vs timolol-dorzolamide association].
To compare hypotensive effect of latanoprost versus timolol-dorzolamide association on patients with glaucoma. We studied 102 eyes in 52 patients with intraocular pressure (IOP) higher than 21 mmHg, previously treated with a betablocker. Patients were divided in two groups. Treatment was changed on group 1 (51 eyes in 27 patients) to a timolol-dorzolamide association. Group 2 (51 eyes in 27 patients) changed treatment to latanoprost. After determination of previous IOP, readings were taken at 1, 3 and 8 months later. Both groups showed a decrease in IOP levels: Group 1, 5.6 mmHg and Group 2, 8.5 mmHg. Association between timolol and dorzolamide reached the highest hypotensive effect after the first month of treatment and remained constant during the rest of the study period. Latanoprost showed a maximal effect after the third month of treatment and maintained its effect all through the study as well. Latanoprost behaved similar to associated timolol-dorzolamide not showing significant differences during the first month of treatment. Significant differences appeared at third and eighth month favoring latanoprost (p<0.005 and p<0.001 respectively). There was a similarity in efficacy of both treatments. However, after the third month latanoprost became more effective than the timolol-dorzolamide association.


Spontaneous rupture of a hepatic epithelioid angiomyolipoma: damage control surgery. A case report.
Angiomyolipoma (AML) is a rare mesenchymal tumor composed by blood vessels, adipose tissue and smooth muscle cells in variable proportions. Although it is most often diagnosed in the kidney, this tumor may originate from any part of the liver. It is often misdiagnosed as hepatocellular carcinoma (HCC) or other benign liver tumor. We describe a case of spontaneous rupture of hepatic angiomyolipoma in a young woman, with evidence of internal hemorrhage and hemoperitoneum. Liver tumor rupture is a rare but real surgical emergency. In our case it has been managed according to the trauma principles of the damage control surgery. At the time of the observation, the patient presented an instable condition, so the decision-making was oriented toward a less invasive first step of liver packing instead of a more aggressive intervention such as one shot hepatic resection. Damage control surgery with deep parenchymal sutures of the liver and pro-coagulant tissue adhesives packing abbreviates surgical time before the development of critical and irreversible physiological endpoints and permits a more confident second time surgery. This surgical management concept helps to reduce the mortality rate and the incidence of complications not only in traumatic liver damages, it works very well in spontaneous liver ruptures as well.


Persistence of translocation frequencies in blood lymphocytes following radiotherapy: implications for retrospective radiation biodosimetry.
Chromosome aberration analysis using a G-banding technique was performed on peripheral blood lymphocyte cultures from eight individuals over a 5 year period following therapeutic radiation exposure. Samples were placed in three time periods comprising 0-12, 12-36 and 36-60 months post-treatment. The group was heterogeneous with respect to exposure and this resulted in wide differences in initial total translocation yields. Total translocation frequencies declined in seven of the eight cases, reaching significance in four cases. This decline was attributed to a decrease in cells, which in addition to translocations, also contained aberrations such as dicentrics which resulted in them being unstable. In all eight cases, when only stable cells were considered, no significant differences were observed in translocation frequencies between the different time periods post-treatment. Thus, although the frequency of translocations in stable cells is persistent over time, extrapolating to total initial yield, and using this to equate to dose, is not possible in cases where the exposure has been high and non-homogeneous. In practice, retrospective biological dosimetry is more often required in cases of historical, usually protracted, exposures which will have been essentially uniform and not of a sufficiently high dose for many cells to have acquired more than one aberration. In such cases the frequency of translocations observed some years after the exposure can be assumed to reflect induced frequencies and be used for dose estimation.


Mast cell phenotypes in the allograft after lung transplantation.
The burden of mast cell (MC) infiltration and their phenotypes, MC-tryptase (MCT ) and MC-tryptase/chymase (MCTC ), after lung transplantation (LT) has not been evaluated in human studies. We reviewed 20 transbronchial lung biopsy (TBLB) specimen from patients with early normal allograft (<6 months post-LT, n=5), late normal allograft (>6 months, n=5), A2 or worse acute cellular rejection (ACR, n=5), and chronic lung allograft dysfunction (CLAD, n=5). Slides were immunostained for tryptase and chymase. Total MC, MCT , MCTC and MCTC to-MCT ratio were compared between the four groups using a generalized linear mixed model. Irrespective of clinicopathologic diagnosis, MC burden tends to increase with time (r(2) =.56, P=.009). MCTC phenotype was significantly increased in the CLAD group (8.2±4.9 cells per HPF) in comparison with the other three groups (early normal: 1.6±1.7, P=.0026; late normal: 2.5±2.3, P=.048; ACR: 2.7±3.5, P=.021). Further, the ratio of MCTC to MCT was significantly increased in CLAD group as compared to the other three groups (P<.001 for all comparisons). The burden of MC may increase in the allograft as function of time. Patients with CLAD have an increased relative and absolute burden of MCTC phenotype MC. Future studies are needed to confirm these findings and evaluate the potential pathologic role of MCTC in allograft dysfunction.


Survivor identity and post-traumatic growth after participating in challenge-based peer-support programmes.
The social construction of breast cancer (BC) survivor identity has produced a powerful image of woman as survivor. Group membership through peer-support programmes can provide positive role models, shape survivor identity and promote post-traumatic growth (PTG). The main objective of this study was to conduct a qualitative investigation based on a phenomenological framework in order to understand the lived experience of BC survivors participating in a peer-support programme based on a challenge event. This is a qualitative semi-structured and written narrative study. Interviews were subjected to interpretative phenomenological analysis and the written narratives via thematic analysis. Interviews were conducted with 27 participants who were new to the peer-support event for women diagnosed with BC, and 10 participants who had taken part in multiple events provided written narratives of their experience. Interviews and surveys were completed pre- and post-event. Important elements of the peer-support environment included a safe network of other survivors, which provided understanding and acceptance. Overcoming challenges during the event and the opportunity to bond with positive role models affirmed a strong survivor identity and promoted PTG. For some participants, a shift in identity was evident with a newfound positive identification with the term BC survivor. Peer-support programmes based on challenge events have the potential to extend the type of supportive care that is available for women diagnosed with BC by providing an alternative to the traditional support group format.


Hyaluronic acid enhances the zona pellucida-induced acrosome reaction of macaque sperm.
Hyaluronic acid (HA) not only surrounds the zona pellucida as part of the cumulus matrix but also is present throughout the zona pellucida and the perivitelline space of many mammalian oocytes. However, most in vitro techniques to study sperm-oocyte interaction eliminate HA from the oocyte through enzymatic digestion and/or do not expose sperm to HA prior to zona pellucida binding. This study explores the effect of preincubation of sperm or oocytes with HA on sperm-zona pellucida binding and subsequent acrosome reaction of bound sperm. Cynomolgus macaque semen was washed. Incubated, chemically capacitated with dibutryl cyclic adenosine monophosphate (dbcAMP) and caffeine, and sperm-zona pellucida binding assays were performed. In one experiment, sperm were pretreated with HA (100 micrograms/ml) during the last 10 minutes of the 30-minute period for chemical capacitation. In another experiment, only the oocytes were preincubated in the media containing HA. In the third experiment, gametes were exposed to HA for 10 minutes after sperm had been allowed to bind to zonae pellucida. The preincubation of either sperm or zonae pellucida with HA enhanced the percentage of bound sperm that were acrosome reacted. However, HA did not affect the number of sperm bound to zonae pellucida. When sperm already bound to the zonae pellucida were exposed to HA, there was no increase in the percentage of bound acrosome-reacted sperm. The HA enhancement of the acrosome reaction of sperm bound to the zona pellucida shown in this study required less than 1 minute of sperm exposure to HA-treated zonae during the zona binding process. However, this enhancement was observed only if the HA exposure preceded sperm-zona binding. This result suggests that HA is interacting with the sperm surface, possibly via a receptor, at the time of initiation of the acrosome reaction. It is unlikely that the effects noted in the current experiments were the result of motility retention or improvement because the full enhancement of the acrosome reaction was observed when only the oocytes were pretreated with HA.


Shangaan patients and traditional healers management strategies of hypertension in Limpopo Province.
The study explored the cultural care beliefs, values and attitudes of Shangaans patients' and traditional healers' management strategies of hypertension in the Limpopo Province. The study aimed to describe the cultural values, beliefs and practices including taboos, rituals and religion within the world-view of the Shangaans. The study was undertaken in the Mopani region of the Greater Giyani area, with the purpose of recommending improvements to patient care in this area. Data collection was done by conducting focus groups and individual interviews. The following themes emerged. Hypertension. The traditional healer: the instrumental role. Traditional medicine versus Western medicine. Magico-religious healings. Cultural beliefs of Shangaans and hypertension. Experiences of hypertensive patients with regard to traditional healers and hypertension.


GH is a regulator of IGF2 promoter-specific transcription in human liver.
The regulation of the insulin-like growth factor-II gene (IGF2) is complex and involves the usage of four promoters resulting in different 5' untranslated regions, but with a common translated product. The IGF2 gene product is a mitogenic and survival factor that has been suggested to be important for a normal fetal development and cancer. In this paper we present evidence suggesting that the human IGF2 gene is regulated by GH, and that this regulation occurs in a promoter-specific way. Three lines of evidence support this finding. First, in vivo data from patients treated with GH (one injection or daily injections for 5 consecutive days) showed an increase in the IGF2 P2 promoter derived transcript after acute treatment, and of the P4 promoter transcript after short-term treatment while the P1 promoter derived transcript did not show any significant change. Secondly, isolated human liver cells treated with GH for 2 h displayed an upregulation of the P2 promoter derived transcript. Thirdly, employing transfection experiments in GH-receptor positive CHO cells with P2 and P4 promoter-luciferase constructs, an upregulation by GH was evident, while a P1 promoter construct was unresponsive. We suggest that GH may be a physiological regulator of IGF2 in humans.


Photos that increase feelings of learning promote positive evaluations.
Research shows that when semantic context makes it feel easier for people to bring related thoughts and images to mind, people can misinterpret that feeling of ease as evidence that information is positive. But research also shows that semantic context does more than help people bring known concepts to mind-it also teaches people new concepts. In five experiments, we show that when photos increase these feelings of learning, they also increase positive evaluations. People saw fictitious wine names and evaluated claims about each. Within subjects, wine names appeared with (or without) photos depicting the noun in the names. We found that photos promoted positive evaluations, did so most when they were most likely to help people learn new words, and even led people to think the wines tasted better. Together, these findings fit with the idea that semantic context promotes positive evaluations in part by teaching people new concepts. (PsycINFO Database Record


Adaptive and predictive control of a simulated robot arm.
In this work, a basic cerebellar neural layer and a machine learning engine are embedded in a recurrent loop which avoids dealing with the motor error or distal error problem. The presented approach learns the motor control based on available sensor error estimates (position, velocity, and acceleration) without explicitly knowing the motor errors. The paper focuses on how to decompose the input into different components in order to facilitate the learning process using an automatic incremental learning model (locally weighted projection regression (LWPR) algorithm). LWPR incrementally learns the forward model of the robot arm and provides the cerebellar module with optimal pre-processed signals. We present a recurrent adaptive control architecture in which an adaptive feedback (AF) controller guarantees a precise, compliant, and stable control during the manipulation of objects. Therefore, this approach efficiently integrates a bio-inspired module (cerebellar circuitry) with a machine learning component (LWPR). The cerebellar-LWPR synergy makes the robot adaptable to changing conditions. We evaluate how this scheme scales for robot-arms of a high number of degrees of freedom (DOFs) using a simulated model of a robot arm of the new generation of light weight robots (LWRs).


Information and communication technology: connecting the public and first responders during disasters.
Lack of success in disaster recovery occurs for many reasons, with one predominant catalyst for catastrophic failure being flawed and inefficient communication systems. Increased occurrences of devastating environmental hazards and human-caused disasters will continue to promulgate throughout the United States and around the globe as a result of the continuous intensive urbanization forcing human population into more concentrated and interconnected societies. With the rapid evolutions in technology and the advent of Information and communication technology (ICT) interfaces such as Facebook, Twitter, Flickr, Myspace, and Smartphone technology, communication is no longer a unidirectional source of information traveling from the newsroom to the public. In the event of a disaster, time critical information can be exchanged to and from any person or organization simultaneously with the capability to receive feedback. A literature review of current information regarding the use of ICT as information infrastructures in disaster management during human-caused and natural disasters will be conducted. This article asserts that the integrated use of ICTs as multidirectional information sharing tools throughout the disaster cycle will increase a community's resiliency and supplement the capabilities of first responders and emergency management officials by providing real-time updates and information needed to assist and recover from a disaster.


4-(2-aminooxyethoxy)-2-(ethylureido)quinoline-oligonucleotide conjugates: synthesis, binding interactions, and derivatization with peptides.
Oligo-2'-O-methylribonucleotides conjugated with 4-(2-aminooxyethoxy)-2-(ethylureido)quinoline (AOQ) and 4-ethoxy-2-(ethylureido)quinoline (EOQ) were prepared by reaction of the AOQ or EOQ phosphoramidite with the protected oligonucleotide on a controlled pore glass support. Deprotection with ethylenediamine enabled successful isolation and purification of the highly reactive AOQ-conjugated oligomer. Polyacrylamide gel electrophoresis mobility shift experiments showed that the dissociation constants of complexes formed between an AOQ- or EOQ-conjugated 8-mer and complementary RNA or 2'-O-methyl-RNA targets (9- and 10-mers) were in the low nM concentration range at 37 degrees C, whereas no binding was observed for the corresponding nonconjugated oligomer, even at a concentration of 500 nM. Fluorescence studies suggested that this enhanced affinity is most likely due to the ability of the quinoline ring of the AOQ or EOQ group to stack on the last base pair formed between the oligomer and target, thus stabilizing the duplex. The binding affinity of a 2'-O-methyl RNA 15-mer, which contained an alternating methylphosphonate/phosphodiester backbone, for a 59-nucleotide stem-loop HIV TAR RNA target, increased 2.3 times as a consequence of conjugation with EOQ. The aminooxy group of AOQ-conjugated oligomers is a highly reactive nucleophile, which reacts readily with aldehydes and ketones to form stable oxime derivatives. This feature was used to couple an AOQ-oligomer with leupeptin, a tripeptide that contains a C-terminus aldehyde group. A simple method was developed to introduce a ketone functionality into peptides that contain a cysteine residue by reacting the peptide with bromoacetone. The resulting keto-peptide was then coupled to the AOQ-oligomer. This procedure was used to prepare oligonucleotide conjugates of a tetrapeptide, RGDC, and a derivative of HIV tat peptide having a C-terminus cysteine. The combination of the unique reactivity of the aminooxy group and enhanced binding affinity conferred by its quinoline ring suggests that AOQ may serve as a useful platform for the preparation of novel oligonucleotide conjugates.


Riboflavin photoactivation by upconversion nanoparticles for cancer treatment.
Riboflavin (Rf) is a vitamin and endogenous photosensitizer capable to generate reactive oxygen species (ROS) under UV-blue irradiation and kill cancer cells, which are characterized by the enhanced uptake of Rf. We confirmed its phototoxicity on human breast adenocarcinoma cells SK-BR-3 preincubated with 30-μM Rf and irradiated with ultraviolet light, and proved that such Rf concentrations (60 μM) are attainable in vivo in tumour site by systemic intravascular injection. In order to extend the Rf photosensitization depth in cancer tissue to 6 mm in depth, we purpose-designed core/shell upconversion nanoparticles (UCNPs, NaYF4:Yb3+:Tm3+/NaYF4) capable to convert 2% of the deeply-penetrating excitation at 975 nm to ultraviolet-blue power. This power was expended to photosensitise Rf and kill SK-BR-3 cells preincubated with UCNPs and Rf, where the UCNP-Rf energy transfer was photon-mediated with ~14% Förster process contribution. SK-BR-3 xenograft regression in mice was observed for 50 days, following the Rf-UCNPs peritumoural injection and near-infrared light photodynamic treatment of the lesions.


Not Part of the Temporal Lobe, but Still of Importance? Substantia Nigra and Subthalamic Nucleus in Epilepsy.
The most researched brain region in epilepsy research is the temporal lobe, and more specifically, the hippocampus. However, numerous other brain regions play a pivotal role in seizure circuitry and secondary generalization of epileptic activity: The substantia nigra pars reticulata (SNr) and its direct input structure, the subthalamic nucleus (STN), are considered seizure gating nuclei. There is ample evidence that direct inhibition of the SNr is capable of suppressing various seizure types in experimental models. Similarly, inhibition via its monosynaptic glutamatergic input, the STN, can decrease seizure susceptibility as well. This review will focus on therapeutic interventions such as electrical stimulation and targeted drug delivery to SNr and STN in human patients and experimental animal models of epilepsy, highlighting the opportunities for overcoming pharmacoresistance in epilepsy by investigating these promising target structures.


Barriers to access to opioid medicines for patients with opioid dependence: a review of legislation and regulations in eleven central and eastern European countries.
Barriers linked to drug control systems are considered to contribute to inequitable access to controlled medicines, leaving millions of people in pain and suffering. Most studies focus on access to opioids for the treatment of severe (cancer) pain. This study aims to identify specific access barriers for patients with opioid dependence in legislation and regulations of 11 central and eastern European countries. This study builds on a previous analysis of legislation and regulations as part of the EU 7th Framework Access To Opioid Medication in Europe (ATOME) project. An in-depth analysis was undertaken to determine specific barriers for patients with opioid dependence in need of opioid analgesics or opioid agonist therapy (OAT). For each country, the number and nature of specific potential barriers for these patients were assessed according to eight categories: prescribing; dispensing; manufacturing; usage; trade and distribution; affordability; penalties; and other. An additional keyword search was conducted to minimize the omission of barriers. Barriers in an additional category, language, were recorded qualitatively. Countries included Bulgaria, Cyprus, Estonia, Greece, Hungary, Latvia, Lithuania, Serbia, Slovakia, Slovenia and Turkey. Ten of the 11 countries (all except Estonia) showed specific potential barriers in their legislation and regulations. The total number of barriers varied from two (Slovenia) to 46 (Lithuania); the number of categories varied from one (Slovenia) to five (Lithuania). Most specific potential barriers were shown in the categories 'prescribing', 'usage' and 'other'. The total number in a single category varied from one to 18 (Lithuania, prescribing). Individual differences between countries in the same specific potential barrier were shown; for example, variation in minimum age criteria for admission to OAT ranging from 15 (Lithuania, in special cases) to 20 years (Greece). All countries had stigmatizing language in their legislation. Patients with opioid dependence are likely to experience specific barriers to accessing opioids in addition to those experienced by other non-dependent patients.


Renal immunocytochemical distribution and pharmacological properties of the dual angiotensin II/AVP receptor.
We have recently characterized a novel angiotensin II/vasopressin (Ang II/AVP) dual receptor coupled to adenylate cyclase and responding with equal sensitivity to Ang II and AVP. To gain insight into putative renal physiological roles of the dual Ang II/AVP receptor, we determined its pharmacological binding properties and renal immunocytochemical distribution. The effective displacement of [3H]AVP by [1-deamino-Val14,D-Arg8]-vasopressin (DVDAVP), a specific antidiuretic AVP analogue, supports a V2-type AVP receptor characteristic of the Ang II/AVP receptor. Displacement of 125I-Ang II by losartan but not by PD 123319 defines the Ang II/AVP receptor as a novel AT1 receptor isoform coupled to adenylate cyclase, in contrast to prototype Ca(2+)-mobilizing AT1 receptors. Neither Ang II nor AVP displace each other, corroborating the predicted discrete binding domains for Ang II and AVP but presenting an enigma for the dissection of putative Ang II- and AVP-specific hierarchical roles of the dual Ang II/AVP receptor. The renal cytolocalization of the Ang II/AVP receptor to the outer medullary thick ascending limb tubules and inner medullary collecting ducts is consistent with the well-established AVP stimulation of sodium and water reabsorption in these tubules. These data suggest that the Ang II/AVP receptor might provide the molecular basis for the observed similar stimulatory effects of Ang II and AVP on renal tubular sodium and fluid reabsorption at physiological hormone concentrations.


Parthenolide Influences Herpes simplex virus 1 Replication in vitro.
Parthenolide is a sesquiterpene lactone that is present in plants of the Tanacetum genus, for which many biological effects have already been reported, including antiherpetic activity. Although the effectiveness of parthenolide against Herpes simplex virus 1 (HSV-1) has already been demonstrated, such findings are still controversial. The objective of this study was to investigate the ways in which parthenolide exerts anti-HSV-1 activity. The cytotoxicity and antiviral activity of parthenolide were determined by the MTT method and plaque reduction assay, respectively. The expression of cell and viral proteins during the treatment of infected cells was investigated by Western blot. Both strains of HSV-1 were sensitive to parthenolide, and parthenolide was active only after penetration of the virus into the host cell. The expression of p65 protein decreased, the expression of caspases 8 and 9 increased, and the expression of c-Jun N-terminal kinase (JNK) and p38 protein was altered in infected cells after parthenolide treatment, resulting in lower cell survival. The low expression of viral proteins gB, gD, and ICP0 confirmed the reduction of HSV-1 particle production. Parthenolide exerts anti-HSV-1 activity by impairing cell viability, which consequently interferes with the efficient infection and production of new viral particles.


A Mixed-Methods Study of Users' Journey Mapping Experience and Acceptance of Telehealthcare Technology in Taiwan.
Background: The integration of telehealthcare technologies into geriatric care has clear advantages, but poses challenges for key stakeholders, including the telehealthcare service industry, smart device developers, marketers and, of course, users. The purpose of this study was to gain insight into user experience and acceptance of telehealthcare technology in Taiwan. Materials and Methods: Taking an integrated mixed-methods approach, 51 participants-33 women (64.71%) and 18 men (35.29%) (mean age: 52.1 years)-were examined before, during, and after using a telehealthcare device. A questionnaire was used to assess users' acceptance of the technology. Interviews were conducted to gather feedback. Results: The quantitative analysis revealed that (1) effort expectancy and relatives significantly influenced users' behavior intentions, (2) error and memorability significantly affected users' satisfaction, and (3) intention and satisfaction significantly affected users' behavior. The qualitative analysis revealed two key implications. First, participants generally were not satisfied with the telehealthcare device. Second, participants suggested the redesign of the telehealthcare device to reduce operating errors and time consumption to meet users' needs. Conclusions: Contemporary telehealthcare devices do not meet users' needs. Participants were made to adapt to the equipment rather than the equipment tailored to meet their needs. Although there were key benefits from home telehealthcare, the systems require enhanced technology, improved usability, and an expanded scale of services backed by government before widespread implementation can successfully proceed.


Phylogenetic relationships of living and recently extinct bandicoots based on nuclear and mitochondrial DNA sequences.
Bandicoots (Peramelemorphia) are a major order of australidelphian marsupials, which despite a fossil record spanning at least the past 25 million years and a pandemic Australasian range, remain poorly understood in terms of their evolutionary relationships. Many living peramelemorphians are critically endangered, making this group an important focus for biological and conservation research. To establish a phylogenetic framework for the group, we compiled a concatenated alignment of nuclear and mitochondrial DNA sequences, comprising representatives of most living and recently extinct species. Our analysis confirmed the currently recognised deep split between Macrotis (Thylacomyidae), Chaeropus (Chaeropodidae) and all other living bandicoots (Peramelidae). The mainly New Guinean rainforest peramelids were returned as the sister clade of Australian dry-country species. The wholly New Guinean Peroryctinae was sister to Echymiperinae. The poorly known and perhaps recently extinct Seram Bandicoot (Rhynchomeles) is sister to Echymipera. Estimates of divergence times from relaxed-clock Bayesian methods suggest that living bandicoots originated in the late Oligocene or early Miocene, much earlier than currently thought based on fossils. Subsequent radiations within Peramelemorphia probably took place on the Australian mainland during the Miocene, with diversification of rainforest taxa on the newly emergent New Guinean landmasses through the middle-late Miocene and complete establishment of modern lineages by the early Pliocene.


Tandem mass spectrometry investigation of ADP-ribosylated kemptide.
Bacterial adenosine diphosphate-ribosyltransferases (ADPRTs) are toxins that play a significant role in pathogenicity by inactivating host proteins through covalent addition of ADP-ribose. In this study we used ADP-ribosylated Kemptide (LRRASLG) as a standard to examine the effectiveness of three common tandem mass spectrometry fragmentation methods for assignment of amino acid sequence and site of modification. Fragmentation mechanisms investigated include low-energy collision-induced dissociation (CID), infrared multiphoton dissociation (IRMPD), and electron-capture dissociation (ECD); all were performed on a hybrid linear ion trap Fourier transform ion cyclotron resonance mass spectrometer. We show that ECD, but neither CID nor IRMPD, of ADP-ribosylated Kemptide produces tandem mass spectra that are interpretable with regard to amino acid sequence assignment and site of modification. Examination of CID and IRMPD tandem mass spectra of ADP-ribosylated Kemptide revealed that fragmentation was primarily focused to the ADP-ribose region, generating several potential diagnostic ions for use in discovery of ADP-ribosylated proteins. Because of the lower relative sensitivity of ECD during data-dependent acquisition to CID, we suggest a 2-fold strategy where CID and IRMPD are first used to detect ADP-ribosylated peptides, followed by sequence assignment and location of modification by ECD analysis.


Chikungunya: Its History in Africa and Asia and Its Spread to New Regions in 2013-2014.
Chikungunya virus (CHIKV) is transmitted by Aedes aegypti and Aedes albopictus mosquitoes and causes febrile illness with severe arthralgia in humans. There are 3 circulating CHIKV genotypes, Asia, East/Central/South Africa, and West Africa. CHIKV was first reported in 1953 in Tanzania, and up until the early 2000s, a few outbreaks and sporadic cases of CHIKV were mainly reported in Africa and Asia. However, from 2004 to 2005, a large epidemic spanned from Kenya over to the southwestern Indian Ocean region, India, and Southeast Asia. Identified in 2005, the E1 glycoprotein A226V mutation of the East/Central/South Africa genotype conferred enhanced transmission by the A. albopictus mosquito and has been implicated in CHIKV's further spread in the last decade. In 2013, the Asian CHIKV genotype emerged in the Caribbean and quickly took the Americas by storm. This review will discuss the history of CHIKV as well as its expanding geographic distribution.


Be(com)ing social: Daily-life social interactions and parental bonding.
Parents are known to provide a lasting basis for their children's social development. Understanding parent-driven socialization is particularly relevant in adolescence, as an increasing social independence is developed. However, the relationship between key parenting styles of care and control and the microlevel expression of daily-life social interactions has been insufficiently studied. Adolescent and young adult twins and their nontwin siblings (N = 635; mean age = 16.6; age range = 14.2-21.9; 58.6% female; 79.5% in or having completed higher secondary/tertiary education; 2.8% speaking language other than Dutch at home) completed the Parental Bonding Instrument (PBI) on parental care and control. Participants also completed a 6-day experience sampling period (10 daily beeps, mean compliance = 68.0%) to assess daily-life social interactions. Higher overall parental bonding quality (of both parents) related to more positive social experiences in daily life (e.g., belonging in company), but not to more social behaviors (e.g., being with others). Factor analysis indicated a three-factor structure of the PBI, with care, denial of psychological autonomy, and encouragement of behavioral freedom. Paternal care was uniquely predictive of better social experiences. These findings demonstrate how parenting styles may be uniquely associated with how adolescents experience their social world, with a potentially important role for fathers in particular. This complements the long-held idea of socialization through parenting by bringing it into the context of daily life and implies how both conceptualizations of social functioning and interventions aimed at alleviating social dysfunction might benefit from a stronger consideration of day-to-day social experiences. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


[Evaluation of surgical approaches and early and midterm results of treatment for atrioventricular septal defect].
We evaluated patients who underwent complete or partial surgical correction for atrioventricular septal defect (AVSD) with regard to surgical techniques and early and midterm results. Forty-six patients were treated for complete (n=28) or partial (n=18) AVSD between 2000 and 2007. There were nine boys and 19 girls (mean age 5.5 months; range 1.5 to 11 months) with complete AVSD. Of these, 17 patients underwent total repair, while 11 patients underwent palliative procedures. Five males and 13 females (mean age 11 years; range 1 to 50 years) with partial AVSD were treated with total repair. Down syndrome was seen in nine patients (32.1%) and one patient (5.6%) in complete and partial AVSD groups, respectively. Twenty-one patients (75%) and 14 patients (77.8%) could be followed-up for a mean of 26.3 months (range 1-72) and 21.8 months (range 2 to 71) in the two groups, respectively. Total repair of partial AVSD resulted in no mortality or significant morbidity. Early postoperative mortality occurred in three cases (10.7%) after repair of complete AVSD, one of which had Down syndrome. Six patients required prolonged mechanical ventilation beyond one week. Two patients without Down syndrome underwent reoperation due to severe atrioventricular (AV) valve insufficiency in the early postoperative period. None of the patients required permanent pacemaker implantation. Clinical and echocardiographic monitoring showed moderate left AV valve insufficiency in three patients in each group, while the remaining patients had no or minimal insufficiency. Total repair of complete AVSD should be the procedure of choice in early infancy. Left AV valve insufficiency continues to be the most important cause of postoperative morbidity in these cases.


Pregnancy-related effects on tenofovir pharmacokinetics: a population study with 186 women.
According to the European AIDS Clinical Society, tenofovir disoproxil fumarate can be used in HIV-infected pregnant women if started prior to pregnancy, although no data are available on the pharmacokinetics of tenofovir (TFV) during pregnancy. The aim of this study was to describe TFV pharmacokinetics in HIV-infected women and to evaluate the effect of pregnancy on TFV disposition. Samples were collected according to a therapeutic drug monitoring in 186 women, including 46 pregnant women treated with TFV and retrospectively analyzed by a population approach. TFV pharmacokinetics were ascribed to an open two-compartment model with linear absorption and elimination. The mean population parameter estimates (between-subject variability) were as follows: absorption rate constant, 0.56 h(-1); elimination clearance, 59.9 liters h(-1) (0.436); central volume of distribution, 552 liters (1.96); intercompartmental clearance, 172 liters/h; and peripheral volume of distribution, 1,390 liters. Pregnant women had a 39% higher apparent clearance compared to nonpregnant women. Apparent clearance significantly decreased with age. In order to obtain an exposure similar to the known exposure in adults and guarantee similar trough concentrations (C(min)) as observed in adults, an increase in the TFV dose should be considered for women from the second trimester to delivery.


Utilisation of carbon sources by pythium, phytophthora and fusarium species as determined by biolog® microplate assay.
This study examined the metabolic activity of pure cultures of five root pathogens commonly found in closed hydroponic cultivation systems (Phytophthora cryptogea (PC), Phytophthora capsici (PCP), Pythium aphanidermatum (PA), Fusariumoxysporum f.sp. radicis-lycopersici (FORL) and Fusarium solani (FS)) using sole carbon source utilisation in order to develop effective biocontrol strategies against these pathogens. Aliquots of 150 microL of the mycelial suspension were inoculated in each well of GN2 microtitre plates. On the basis of average well colour development and number of positive wells, the pathogens were divided into two groups, (i) PA and FORL and (ii) PC, PCP and FS. Group (i) was characterised by a short lag-phase, a rapid exponential phase involving almost all carbon sources offered and a long stationary phase, while group (ii) had a more extended lag-phase and a slower utilisation rate of the carbon sources offered. The three isolates in group (ii) differed significantly during their exponential phase. The lowest utilisation rate of carbon sources and number of sources utilised was found for PCP. Of the major group of carbon sources, six carbohydrates, three carboxylic acids and four amino acids were rapidly used by all isolates tested at an early stage. The carbon sources gentibiose, alpha-D-glucose, maltose, sucrose, D-trehalose, L-aspartic acid, L-glutamic acid, L-proline persisted to the end of the exponential phase.Moreover, similarities between the metabolic profiles of the tested pathogen and the those of the resident microflora could also be found. These findings are of great importance as regards the role of the resident microflora in the biocontrol.


Avidin-dendrimer-(1B4M-Gd)(254): a tumor-targeting therapeutic agent for gadolinium neutron capture therapy of intraperitoneal disseminated tumor which can be monitored by MRI.
Peritoneal carcinomatosis is a late stage in cancer progress, for which no effective therapeutic modality exists. Targeting therapeutic agents to disseminated lesions may be a promising modality for treating peritoneal carcinomatosis. Gadolinium ((157,155)Gd) is known to generate Auger and internal conversion electrons efficiently by irradiation with a neutron beam. Auger electrons from neutron-activated Gd(III) are strongly cytotoxic, but only when Gd(III) atoms have been internalized into the cells. In the present investigation, we have developed a quickly internalizing tumor-targeting system to deliver large quantities of Gd(III) atoms into tumor cells to generate the Auger emission with an external neutron beam. Simultaneously, one would be able to image its biodistribution by MRI with a shortened T1 relaxation time. Avidin-G6-(1B4M-Gd)(254) (Av-G6Gd) was synthesized from generation-6 polyamidoamine dendrimer, biotin, avidin, and 2-(p-isothiocyanatobenzyl)-6-methyl-diethylenetriaminepentaacetic acid (1B4M). The Av-G6Gd was radiolabeled with Gd(III) doped with (153)Gd. All of the 1B4M's on the conjugate were fully saturated with Gd(III) atoms. An in vitro internalization study showed that Av-G6Gd accumulated and was internalized into SHIN3 cells (a human ovarian cancer) 50- and 3.5-fold greater than Gd-DTPA (Magnevist) and G6-(1B4M-Gd)(256) (G6Gd). In addition, accumulation of Gd(III) in the cells was detected by the increased signal on T1-weighted MRI. A biodistribution study was performed in nude mice bearing intraperitoneally disseminated SHIN3 tumors. Av-G6Gd showed specific accumulation in the SHIN3 tumor (103% ID/g) 366- and 3.4-fold greater than Gd-DTPA (0.28% ID/g, p < 0.001) and G6Gd (30% ID/g, p < 0.001) 1 day after i.p. injection. Seventy-eight percent of the tumor-related radioactivity of Av-G6Gd in the SHIN3 tumor was located inside the cells. The SHIN3 tumor-to-normal tissue ratio was greater than 17:1 in all organs and increased up to 638:1 at 1 day after i.p. injection. In conclusion, a sufficient amount (162 ppm) of Av-G6Gd was accumulated and internalized into the SHIN3 cells both in vitro and in vivo to kill the cell using (157/155)Gd with external irradiation with an appropriate neutron beam while monitoring with MRI. Thus, Av-G6Gd may be a promising agent for Gd neutron capture therapy of peritoneal carcinomatosis. This reagent also has the potential to permit monitoring of its pharmacokinetic progress with MRI.


Activation of β-catenin signalling leads to temporomandibular joint defects.
Despite extensive research in knee and hip osteoarthritis (OA), the underlying mechanism of temporomandibular joint (TMJ) disorder remains largely unknown. The purpose of this study was to determine whether the constitutive activation of β-catenin in the middle and deep layers of the articular cartilage can compromise the homeostasis of this tissue in the TMJ. Col2CreERT2 transgenic mice were bred with RosamT/mG reporter mice to determine Cre recombination efficiency. Col2CreERT2 mice were then crossed with β-cateninflox(ex3)+ mice to generate β-catenin conditional activation mice, β-catenin(ex3)Col2ER. TMJ samples were harvested when the mice were 1-, 3- or 6-month-old and evaluated using histology, histomorphometry and immunohistochemistry. β-catenin(ex3)Col2ER mice were further crossed with Mmp13flox/flox and Adamts5-/- mice to generate (β-catenin(ex3)/Mmp13)Col2ER and β-catenin(ex3)Col2ER)/Adamts5-/- double mutant mice to investigate the role of Mmp13 and Adamts5 in the development of TMJ disorder. High levels of Cre-recombination were seen in Col2CreERT2;RosamT/mGmice. Progressive TMJ defects developed in 1-, 3- and 6-month-old β-catenin(ex3)Col2ER mice, as revealed by histology and histomorphometry. Results further demonstrated that the defects observed in β-catenin(ex3)Col2ER mice were significantly decelerated after deletion of the Mmp13 or Adamts5 gene in (β-catenin(ex3)/Mmp13)Col2ER or β-catenin(ex3)Col2ER/Adamts5-/- double mutant mice. In summary, we found that β-catenin is a critical gene in the induction of TMJ cartilage degeneration, and over-expressing β-catenin in TMJ cartilage leads to defects assembling an OA-like phenotype. Deletion of Mmp13 and Adamts5 in β-catenin(ex3)Col2ER mice ameliorates the development of TMJ defects. This study suggests that Mmp13 and Adamts5 could be potential therapeutic targets for the treatment of TMJ disorders.


Choroid plexus papilloma of the third ventricle: angiography, preoperative embolization, and histology.
We report a unique case of choroid plexus papilloma of the third ventricle in an 8-month-old girl in which preoperative embolization played a salient role in management. Initial surgery was aborted due to excessive bleeding. Cerebral angiography demonstrated enlarged posterior choroidal arteries feeding the tumor, and intense, persistent tumor staining. These vessels were effectively embolized to stasis with polyvinyl alcohol particles. The patient underwent a second craniotomy and complete resection of the tumor with minimal blood loss. Postsurgical histology showed postembolization iatrogenic intratumoral necrosis.


Resveratrol and quercetin interact to inhibit neointimal hyperplasia in mice with a carotid injury.
Restenosis is a critical complication of angioplasty and stenting. Restenosis is multifactorial, involving endothelial injury, inflammation, platelet activation, and vascular smooth muscle cell (VSMC) proliferation. Thus, dietary strategies to prevent restenosis likely require the use of more than one agent. Resveratrol (R) and quercetin (Q) are polyphenols that are known to exhibit vascular protective effects. We tested whether R and Q administered in the diet interact to inhibit vessel stenosis in mice with a carotid injury. B6.129 mice were administered a high-fat diet containing 21% fat and 0.2% cholesterol along with R (25 mg/kg), Q (10 mg/kg), or R + Q for 2 wk. A carotid injury was induced and the mice were again administered the enriched diet for 2 wk. Compared with the controls, R significantly decreased stenosis, assessed as an intima:media ratio, by 76%. Although Q treatment alone exhibited no effect, it potentiated the effect of R in that treatment with R + Q significantly decreased the intima:media ratio by 94%. Moreover, this effect was greater than that of R treatment alone (P < 0.05). Although treatments with R, Q, and R + Q significantly affected platelet activation and endothelial function, the responses observed for R + Q were less than additive. Specifically, the effects of R + Q were less than the sum of effects for treatments with R and Q alone. In contrast, treatment with R + Q exhibited more-than-additive effects on inflammatory markers and significant interactions between R and Q were observed. The presence of synergy between R and Q was thus tested in cultures of VSMC and macrophages. Isobolographic analysis revealed that 2:1 molar ratios of R:Q exhibited synergistic inhibition of VSMC proliferation and macrophage chemotaxis. In conclusion, in combination, R and Q can interact to reduce the extent of restenosis, perhaps due to their synergistic inhibition of VSMC proliferation and inflammation.


Surgical aspects in the treatment of patients with unilateral wilms tumor: a report from the SIOP 93-01/German Society of Pediatric Oncology and Hematology.
To assess surgical aspects in the treatment of children with unilateral Wilms tumor based on data from the Cooperative Tumor Study SIOP 93-01 of the German Society of Pediatric Hematology and Oncology. Although multiple international study trials exist for the treatment of nephroblastoma, the impact of surgical details and the outcome of the patients have not yet been described comparing different approaches of the trials. Treatment results of SIOP 93-01 of the German Society of Pediatric Hematology and Oncology were analyzed regarding frequencies of operations by surgeons and hospitals, surgical approaches, and operating subspecialties. Special attention was given to surgical complications, postoperative tumor stages and event-free survival. Data sets from 757 of 1020 registered patients were received for evaluation. A unilateral Wilms tumor was observed in 512 of 757 children.Median follow-up was 4.8 years (1.2-10.7). Event-free survival rates were comparable for frequencies of operation by surgeons and hospitals, surgical approaches, and surgical specialties. Intraoperative tumor rupture rates were 12% in primarily operated patients (protocol violations) versus 3.2% inpatients after preoperative chemotherapy. There were 7% intraoperative ruptures for hospitals and surgeons performing 1 operation per year, and 3%when more than 4 operations per year were carried out. Sampling of hilar lymph nodes was often incomplete for all surgical subspecialties. While the event-free survival for all groups is equal, there may be some long-term complications as a result of the more intensified therapy required for patients who suffer intraoperative ruptures. This will be defined only with longer term studies of late effects of the more intensified therapy. There is,however an increased rate of complications and ruptures associated with the use of midline laparotomy rather than a transverse or thoracoabdominal incision.


Cerebral Malaria Complicated by Blindness, Deafness and Extrapyramidal Tract Manifestation.
Cerebral malaria is a severe manifestation of a parasitic infection caused by Plasmodium falciparum. The sequelae of this disease such as blindness, deafness, loss of motor function could be emotionally traumatic and physically disabling. We, therefore, present this case of an 8-year-old boy who presented with high-grade intermittent fever associated with multiple convulsions and prolonged coma. He regained consciousness after 12 days of treatment with intravenous quinine but was found to have blindness, sensory-neural deafness and extrapyramidal sign. This extrapyramidal sign regressed following treatment with chlorpromazine. He also regained his sight and auditory function before he was discharged though not completely. This report is aimed at emphasizing these rare complications of cerebral malaria as well as reminding clinicians working in malaria endemic areas of the world on the need for early diagnosis and prompt treatment.


Recommendations on the diagnosis, treatment and monitoring of late-onset hypogonadism in men - a suggested update.
Recommendations on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in men were first published by ISSAM in 2002 In 2005, and, in 2008, updated recommendations were published in the International Journal of Andrology, the Journal of Andrology, the Aging Male and European Urology. Towards discussions at the next ISSAM/ESSAM meeting in Moscow, 29 November 2013, we suggest the following update.


[Can disinfectants contribute to antibiotic resistance?].
Disinfectants are widely used in medicine, veterinary medicine, and the food processing industry. Increasingly, disinfectants are included in consumer products. Broad-scale use of antiseptics and disinfectants may have detrimental ecological consequences, for instance the development of antimicrobial resistance. We give an overview of the correlation between the use of certain antiseptics and disinfectants, bacterial resistance to these agents, and antibiotic resistance. The mechanisms of antibiotic and biocide resistance share many common characteristics. There are links between disinfectant resistance and antibiotic resistance. Some biocides have the ability to select for antibiotic resistant mutants and vice versa. Resistance genes are often located on transferable genetic elements that facilitate horizontal gene transfer between microorganisms. Antibiotic resistance and disinfectant resistance may be stabilized and maintained even in the absence of a direct selective pressure. Higher incidence of bacteria resistant to certain disinfectants have been reported in environments where such agents are frequently used compared to environments where they are not in regular use. Increased domestic usage of non-antibiotic antimicrobial agents may select for antibiotic-resistant bacteria of clinical significance. The use of antiseptics and disinfectants should be restricted to products and areas where they have an essential and documented effect.


Hepatitis C virus: virology, diagnosis and management of antiviral therapy.
Hepatitis C virus (HCV) infects approximately 170 million individuals worldwide. Prevention of HCV infection complications is based on antiviral therapy with the combination of pegylated interferon alfa and ribavirin. The use of serological and virological tests has become essential in the management of HCV infection in order to diagnose infection, guide treatment decisions and assess the virological response to antiviral therapy. Anti-HCV antibody testing and HCV RNA testing are used to diagnose acute and chronic hepatitis C. The HCV genotype should be systematically determined before treatment, as it determines the indication, the duration of treatment, the dose of ribavirin and the virological monitoring procedure. HCV RNA monitoring during therapy is used to tailor treatment duration in HCV genotype 1 infection, and molecular assays are used to assess the end-of-treatment and, most importantly the sustained virological response, i.e. the endpoint of therapy.


Pain-related differential expression of NGF, GDNF, IL-6, and their receptors in human vasculitic neuropathies.
Pain-related differential expressions of nerve growth factor (NGF), glial cell line-derived neurotrophic factor (GDNF) and interleukin-6 (IL-6), and their receptors were investigated in human vasculitic neuropathies. The mRNA levels of pain-related neurotrophic factors, NGF, GDNF and IL-6, were examined in the sural nerves of 22 painful and non-painful patients with acute necrotizing vasculitic neuropathies, together with their concomitant soluble receptors (p75, GFR(alpha)-1 and IL-6R(alpha)). The mRNAs for these factors and receptors in the lesioned nerves were up-regulated to a variable extent in both groups. NGF mRNA expression was more closely correlated with that of p75 in painful neuropathy with relatively preserved large fiber density, compared with non-painful neuropathy, though the NGF mRNA level in painful neuropathy was lower than that in non-painful neuropathy. GDNF was closely associated with GFR(alpha)-1 in mRNA levels regardless of the pain state, but IL-6 was not associated with IL-6R(alpha). The differential expression of neurotrophic factors and their cognate soluble receptors in human vasculitic neuropathy suggests that NGF, which was effectively transferred to sensory axons with p75, may induce pain.


Numerical investigation of flow and scour around a vertical circular cylinder.
Flow and scour around a vertical cylinder exposed to current are investigated by using a three-dimensional numerical model based on incompressible Reynolds-averaged Navier-Stokes equations. The model incorporates (i) k-ω turbulence closure, (ii) vortex-shedding processes, (iii) sediment transport (both bed and suspended load), as well as (iv) bed morphology. The influence of vortex shedding and suspended load on the scour are specifically investigated. For the selected geometry and flow conditions, it is found that the equilibrium scour depth is decreased by 50% when the suspended sediment transport is not accounted for. Alternatively, the effects of vortex shedding are found to be limited to the very early stage of the scour process. Flow features such as the horseshoe vortex, as well as lee-wake vortices, including their vertical frequency variation, are discussed. Large-scale counter-rotating streamwise phase-averaged vortices in the lee wake are likewise demonstrated via numerical flow visualization. These features are linked to scour around a vertical pile in a steady current.


[Relationship between malocclusion and TMJ dysfunction. Literature review].
The purpose of this paper is to discuss some current concepts of maloclusion and TMJ Syndrome by reviewing the most significative literature. This analysis the great differences between well-knowing authors about very important subjects in occlusion, as the condylar position in centric relation and in TMJ Syndrome, or what kind of malocclusion (morphologic and functional, skeletal or dental) was the cause of TMJ Syndrome. The theory of emotional stress would be useful to explain some of the discrepancies, by reducing the occlusal disharmony to predisposal factors depending on the personal adaptation to stress.


Cell-specificity of transforming growth factor-beta response is dictated by receptor bioavailability.
Members of the transforming growth factor-beta (TGFbeta) family control diverse cellular responses including differentiation, proliferation, controlled cell death and migration. The response of a cell to an individual ligand is highly restricted yet the signaling pathways for TGFbeta, activin and bone morphogenic proteins share a limited number of receptors and activate similar intracellular cytoplasmic co-regulators, Smads. A central question in the study of this family of ligands is how cells titrate and integrate each TGFbeta-like signal in order to respond in a cell- and ligand-specific manner. This study uses the pituitary gonadotrope cell line, LbetaT2, as a model to delineate the relative contribution of TGFbeta and activin ligands to follicle-stimulating hormone (FSH) biosynthesis. It was found that pituitary gonadotrope cells do not express the TGFbeta type II (TbetaRII) receptor and are therefore not responsive to the TGFbeta ligand. Transfection of the receptor restores TGFbeta signaling capabilities and the TGFbeta-mediated stimulation of FSHbeta gene transcription in LbetaT2 cells. Consequently, we evaluated the presence of the TbetaRII in the adult mouse pituitary. TbetaRII does not co-localize with FSH-producing cells; however it is detected on the cell surface of prolactin- and growth hormone-positive cells. Taken together, these results suggest that the bioavailability of the TGFbeta-specific receptor rather than TGFbeta dictates pituitary gonadotrope selectivity to activin, which is necessary to maintain normal reproductive function. It is likely that the ligand-restricted mechanisms employed by the gonadotrope are present in other cells, which could explain the distinct control of many cellular processes by members of the TGFbeta superfamily.


Overview of microbicides for the prevention of human immunodeficiency virus.
Human immunodeficiency virus (HIV) prevention tools that women can use and control are urgently needed. Microbicides are chemical products applied to the vagina or rectum to prevent the sexual transmission of HIV. Four classes of candidate microbicides have been tested to date: those that (1) enhance the natural defences in the vagina to inactivate HIV; (2) inactivate HIV in the vagina; (3) prevent HIV from attaching to, and fusing with, the host cells; and (4) prevent HIV from replicating in genital tract host cells. Despite numerous disappointing efficacy trial results over the past 20 years, substantial progress is now being made in microbicide development after the release of the CAPRISA 004 trial, which provided proof-of-concept that topical antiretroviral microbicides can prevent sexual transmission of HIV and herpes simplex type-2 infection. Microbicides, which fill an important gap for women-controlled prevention methods, have the potential to alter the course of the HIV pandemic.


Jail-Based Case Management Improves Retention in HIV Care 12 Months Post Release.
Continuous and coordinated HIV care is essential for persons living with HIV to benefit from the advances in medical treatment of the disease. Approximately one in seven individuals living with HIV pass through correctional facilities annually. While sentenced individuals may receive discharge planning services, detainees in local jails usually do not. The multisite evaluation of the EnhanceLink initiative demonstrated that jail based services including discharge planning were associated with high rates of linkage to community HIV care upon release. Follow up for the multisite evaluation was limited to 6 months. This paper extends follow up to 12 months at one site and demonstrates that clients who were linked by the jail based case manager to a Ryan White community based case manager were more than nine times more likely to be retained in care at 12 month post release. (OR 9.39, CI 1.11-79.12).


Exploring racial and sociodemographic trends in physician behavior, physician trust and their association with blood pressure control.
Racial disparities in several facets of healthcare have been widely documented, showing that African Americans face disproportionately high health risks when compared to whites. With respect to hypertension, 40% of the > or = 36 million African Americans are affected. We examined the correlation between the patient-physician relationship and the racial disparities in healthcare. We hypothesized that increased physician counseling would lead to higher patient trust and, thus, a greater likelihood of having controlled blood pressure. Four-hundred-sixty black and 333 white Veteran Affairs (VA) patients previously diagnosed with hypertension were included. Patients with a systolic reading > or = 140 mmHg and/or a diastolic reading > or = 90 mmHg at a recent doctor visit were considered to have uncontrolled blood pressure. By using patient exit interviews (PEIs), we quantified the number of counseling behaviors performed by physicians. Patient trust in physician was measured by validated questions answered on a 1-5 agreement scale. Results showed no racial disparity in blood pressure control. While blacks were found to receive more counseling, whites reported higher trust. Controlling for sociodemographic factors, we found that regardless of race, higher PEI scores were associated with higher trust; however, they were also associated with uncontrolled blood pressure. The association of physician behavior with blood pressure was not mediated by trust. We were unable to make direct cause-and-effect conclusions because the measures were recorded from a one-time questionnaire. Future research should focus on uncovering causal relationships, allowing physicians to work towards ending the established healthcare disparities.


Characteristics and therapeutic efficacy of sulfasalazine in patients with mildly and moderately active ulcerative colitis.
To investigate the characteristics and short-term efficacy of sulfasalazine (SASP) in patients with mildly and moderately active ulcerative colitis (UC). Two hundred and twenty-eight patients with mildly and moderately active UC were recruited, 106 patients in 1993-1995, and 122 patients in 2000-2002, they were assigned as the 1990s group (n = 106) and the 2000s group (n = 122), prospectively. The general characteristics, clinical manifestations, colonoscopic and histological data were compared between the two groups. The short-term efficacy and safety of SASP 3 g per d were evaluated. Between 2000s and 1990s groups, the gender ratio of men to women was 1:1.18 and 1:1.04, 57.4% and 50.9% of the patients were between 30 and 49 years old. The gender ratio and age of UC patients were not significantly different. The total course of 50.0% and 37.1% of UC patients was less than 1 year (P<0.05), 10.6% and 31.2% of the cases had a duration of more than 5 years (P<0.05) in 2000s and 1990s groups, respectively. The most common clinical type was first episode in 2000s group and chronic relapse in 1990s group. The patients showed a higher frequency of abdominal pain and tenderness in 1990s group than in 2000s group. Erosions were found in 84.4% and 67.9% of patients in 2000s and 1990s groups (P<0.05). Rough and granular mucosa (67.9% vs 43.4%, P<0.05) and polyps (47.2% vs 32.8%, P<0.05) were identified in 1990s group more than in 2000s group. There were no significant differences in clinical, colonoscopic and histological classifications. After SASP (1 g thrice per d) treatment for 6 wk, the clinical, colonoscopic and histological remission rates were 71.8%, 21.8% and 16.4%, respectively. In 79 patients with clinical remission, 58.2% and 67.1% remained grade 1 in colonoscopic and histological findings, respectively. The overall effects in first episode type (complete remission in 10, 18.9%, partial remission in 28, 52.8%, and improvement in 9, 17.0%) were better than in chronic relapse type (complete remission in 3, 7.5%; partial remission in 16, 40.0%; and improvement in 15, 37.5%) and chronic persistent type (complete remission in 1, 5.9%; partial remission in 6, 35.3%; and improvement in 6, 35.3%) respectively (P<0.05). In 110 patients treated with SASP, 18 patients (16.4%) had adverse reactions. Except for two cases of urticaria and one case of WBC decrease, none of the patients had to stop the treatment because of severe adverse reactions. Patients with mildly and moderately active UC in 2000s group had a shorter disease course, milder clinical manifestations, more first episode type and higher frequency of acute mucosal lesions in colonoscopy than in 1990s group. The patients in 1990s group had higher proportion of chronic relapse type and chronic mucosal change in colonoscopy than in 2000s group. The short-term efficacy of SASP could be mainly remission of clinical manifestations. But more than half of the patients still had light inflammation in colonoscopy and histology. The overall effects of SASP in first episode type were better than those in other types. SASP was a safe and effective drug to treat mildly and moderately active UC.


The epidemiology of anterior cruciate ligament injury in football (soccer): a review of the literature from a gender-related perspective.
Football (soccer), the most popular sport worldwide, is associated with a high injury risk, and the knee joint is often affected. Several studies have found female players to be more susceptible to knee injury, anterior cruciate ligament (ACL) injury in particular, compared to their male counterparts. There is, however, some controversy regarding the magnitude of this risk increase and a few studies have found no differences. The influence of age and activity type on gender-related differences in injury risk is only scarcely investigated. In this paper, the literature reporting gender-specific ACL injury risk in football is reviewed. A literature search yielded 33 relevant articles that were included for review. These show that female players have a 2-3 times higher ACL injury risk compared to their male counterparts. Females also tend to sustain their ACL injury at a younger age than males, and a limiting factor in the existing literature is that age is not adjusted for in comparisons of ACL injury risk between genders. Furthermore, the risk increase in females is primarily evident during match play, but type of exposure is also rarely adjusted for. Finally, the studies included in this review share important methodological limitations that are discussed as a starting point for future research in the field.


Macronutrient and Micronutrient Intake during Pregnancy: An Overview of Recent Evidence.
Nutritional status during pregnancy can have a significant impact on maternal and neonatal health outcomes. Requirements for macronutrients such as energy and protein increase during pregnancy to maintain maternal homeostasis while supporting foetal growth. Energy restriction can limit gestational weight gain in women with obesity; however, there is insufficient evidence to support energy restriction during pregnancy. In undernourished women, balanced energy/protein supplementation may increase birthweight whereas high protein supplementation could have adverse effects on foetal growth. Modulating carbohydrate intake via a reduced glycaemic index or glycaemic load diet may prevent gestational diabetes and large-for-gestational-age infants. Certain micronutrients are also vital for improving pregnancy outcomes, including folic acid to prevent neural tube defects and iodine to prevent cretinism. Newly published studies support the use of calcium supplementation to prevent hypertensive disorders of pregnancy, particularly in women at high risk or with low dietary calcium intake. Although gaps in knowledge remain, research linking nutrition during pregnancy to maternofoetal outcomes has made dramatic advances over the last few years. In this review, we provide an overview of the most recent evidence pertaining to macronutrient and micronutrient requirements during pregnancy, the risks and consequences of deficiencies and the effects of supplementation on pregnancy outcomes.


Design of nucleoside, oligonucleotide and polynucleotide analogues as antiviral agents.
Several approaches can be envisaged in the design of nucleoside and oligo- or polynucleotide analogues with selective antiviral activity: (i) deoxythymidine (dThd) or deoxycytidine (dCyd) analogues which are specifically recognized as substrate by the virus-induced dThd-dCyd kinase; (ii) adenosine analogues which impair transmethylation reactions (or polyamine biosynthesis), by virtue of an inhibition of S-adenosylhomocysteine hydrolase; (iii) (2'-5')-oligonucleotide analogues derived from pppA(2'p5'A)2, an important intermediate in the antiviral action of interferon; (iv) oligo(deoxy)nucleotides that are complementary to a well-defined nucleotide sequence of the viral genome; (v) single-stranded homopolynucleotides that act as antitemplates for virus-associated RNA or DNA polymerases; and (vi) double-stranded homopolynucleotides that may be pursued for their interferon-inducing potentials.


Characterization and quantification of amorphous material in milled and spray-dried salbutamol sulfate: a comparison of thermal, spectroscopic, and water vapor sorption approaches.
A study has been undertaken using a range of established and novel approaches to examine the effects of milling on the structure and crystallization behavior of salbutamol sulfate. A combination of modulated temperature differential scanning calorimetry, attenuated total reflectance Fourier-transform infrared spectroscopy, powder X-ray diffraction, and gravimetric vapor sorption analysis have been employed, with a particular view to examining the validity of using spray-dried material as a comparator. Although the expected increase in amorphization with milling time was observed, several unexpected observations were made including an apparently anomalous relationship between glass transition temperature and water content; this was used as the basis for the development of a novel method of quantifying amorphous content. Reasonable agreement was found between the data obtained from the spectroscopic and thermal methods, particularly those latter approaches that do not rely on recrystallization for quantification. The activation energy for the onset process was determined and found to be similar for all materials studied. The study has indicated that when using spray-dried material as a standard, the associated limitations must be appreciated, particularly in terms of the assumption of comparability of the recrystallization process between materials that is embedded in many quantification techniques.


Intermetallic: A Pseudoelement for Catalysis.
A clear correlation between electronic structure and CO2 selectivity for steam reforming of methanol (SRM) was obtained with PdZn, PtZn, NiZn, and PdCd intermetallics on the basis of experiments and calculations. In order to rule out the effects of oxide supports, the intermetallic powders were simply prepared by alloying in an arc furnace followed by crushing in a mortar. PdZn and PdCd exhibit valence electronic densities of states similar to that of Cu and significant chemical shifts (larger than 1 eV) of Pd 3d states with respect to pure Pd, as verified by high-resolution hard X-ray photoelectron spectroscopy (HXPS) measurements and density functional theory (DFT) calculations. Consequently, they show the similar high selectivity of CO2 for the SRM reaction. However, this is not the case for PtZn and NiZn because of the slight differences in their valence electronic structures from that of PdZn. The interval between the Fermi level and the top of the d band is closely related to the selectivity of CO2 for the SRM: the larger the interval is, the higher is the selectivity of CO2. According to DFT calculations for bulk PdZn performed by Chen et al. ( Phys. Rev. B 2003 , 68 , 075417 ), the (111) and (100) surfaces exposing Zn and Pd in an equimolar ratio are more stable than the (001) or (110) surfaces terminated by alternative Zn or Pd layers. First-principles slab calculations for PdZn, PtZn, and NiZn show that bond breaking on the surface leads to a reduction in the d bandwidth but that the d band for stable (111) or (100) surfaces remains essentially unchanged from that of the bulk. It is intriguing that PdZn and PdCd do not contain Cu but show similar valence electronic structure and catalytic selectivity, and hence, a concept is proposed where PdZn and PdCd are regarded as pseudoelements of Cu. The basis of this concept is like electronic structure, like catalysis, which has been demonstrated by experiments and calculations. This is a logical way to enable us to look for new catalysts in which precious metals are partially or completely replaced by base metals. We do not expect that this concept can be applied to all catalytic reactions, but this approach is one of most promising ways to derive a better understanding of the origin of catalytic mechanisms and eventually allow us to design useful catalysts intentionally in the future. This Account reviews the authors' published works on this topic.


Evaluation of the hemostatic effects of Ankaferd blood stopper during dental extractions in patients on antithrombotic therapy.
This study evaluated the early hemostatic effects of a novel hemostatic agent (Ankaferd blood stopper [ABS]) during dental extractions in patients on antithrombotic therapy, without interruption or diminution of the medication. In total, 25 patients, who are on antithrombotic therapy and in need of simple dental extractions, were randomized into 2 groups. In group I (control group), which consisted of 10 patients, local hemostasis was achieved with direct packing with gauze. In group II, which consisted of 15 patients, local hemostasis was achieved by the local application of ABS on the extraction sockets. The bleeding time was compared between 2 groups following the tooth extraction. The bleeding time in the dental sockets treated with ABS was statistically lower compared to the sockets of the control group (p = 0.0001). It is concluded that the dental extractions could be performed without interruption of the medication in patients on antithrombotic therapy. The ABS appears to be sufficient as an alternative hemostatic agent.


Sourdough Fermented Breads are More Digestible than Those Started with Baker's Yeast Alone: An In Vivo Challenge Dissecting Distinct Gastrointestinal Responses.
As a staple food, bread digestibility deserves a marked nutritional interest. Combining wide-spectrum characterization of breads, in vitro nutritional indices, and in vivo postprandial markers of gastrointestinal function, we aimed at comparing the digestibility of sourdough and baker's yeast breads. Microbiological and biochemical data showed the representativeness of the baker´s yeast bread (BYB) and the two sourdough breads (SB and t-SB, mainly differing for the time of fermentation) manufactured at semi-industrial level. All in vitro nutritional indices had the highest scores for sourdough breads. Thirty-six healthy volunteers underwent an in vivo challenge in response to bread ingestion, while monitoring gallbladder, stomach, and oro-cecal motility. SB, made with moderate sourdough acidification, stimulated more appetite and induced lower satiety. t-SB, having the most intense acidic taste, induced the highest fullness perception in the shortest time. Gallbladder response did not differ among breads, while gastric emptying was faster with sourdough breads. Oro-cecal transit was prolonged for BYB and faster for sourdough breads, especially when made with traditional and long-time fermentation (t-SB), whose transit lasted ca. 20 min less than BYB. Differences in carbohydrate digestibility and absorption determined different post-prandial glycaemia responses. Sourdough breads had the lowest values. After ingesting sourdough breads, which had a concentration of total free amino acids markedly higher than that of BYB, the levels in blood plasma were maintained at constantly high levels for extended time.


Topical Triamcinolone on "Sweet Spots" to Block Dynamic Pain after Tonsillectomy and Uvulo-Palato-Pharyngo-Plasty.
Severe pain on swallowing (or dynamic pain) has long been a problem in patients receiving tonsillectomy and uvulopalatopharyngoplasty for the treatment of obstructive sleep apnea syndrome and/or snoring. We have previously verified that dynamic pain after laser-assisted uvulopalatoplasty could immediately be mitigated by local treatments with topical triamcinolone on the "sweet spots" of the wounds. This study aimed to assess the efficacy of applying triamcinolone on "sweet spot" in surgical incisions instead of whole surgical wounds to alleviate dynamic pain of some oropharyngeal surgeries such as tonsillectomy and uvulopalatopharyngoplasty. This study is a retrospective case series based on chart review of the participants. Forty-five subjects (31 males; 12~68 years, mean 34 years) with obstructive sleep apnea syndrome and/or snoring treated with tonsillectomy or uvulopalatopharyngoplasty were studied. Local treatments were done to sweet spots with triamcinolone on the 1st, 2nd, 3rd, and 7th days after the surgery. Evaluation of dynamic pain relief was performed by using a visual analogous scale. Sweet spots treatment led to instantaneous reduction of dynamic pain. The average improvement level was ≥72% (P ≤ .002). No gender effect was noted. Dynamic pain after tonsillectomy and uvulopalatopharyngoplasty could immediately be mitigated by local treatments upon sweet spots. Local treatments upon sweet spots were highly suggested to begin early post-operatively and be included in the take-home routines for patients receiving tonsillectomy and uvulopalatopharyngoplasty.


Peroxidative metabolism of a carcinogen, N-hydroxy-N-2-fluorenylacetamide, by rat uterus and mammary gland in vitro.
Lactoperoxidase-catalyzed metabolism of N-hydroxy-N-2-fluorenylacetamide (N-OH-2-FAA) may be via one-electron oxidation to nitroxyl free radical which dismutates to equimolar N-acetoxy-N-2-fluorenylacetamide and 2-nitrosofluorene (2-NOF) and/or a Br(-)-dependent oxidative cleavage to 2-NOF. Hence, the 2-NOF:N-acetoxy-N-2-fluorenylacetamide ratios reflect the relative contributions of the two peroxidative pathways to the metabolism of N-OH-2-FAA. Peroxidative activities of rat uterus (UT) and mammary gland (MG) were extracted with a cationic detergent, cetyltrimethylammonium bromide (Cetab). MG extracts had 1 to 5% the specific activity of UT extracts when assayed with guaiacol as hydrogen donor. At 0.004% Cetab, which in the incubation media corresponds to the approximate physiological levels of 0.1 mM Br(-), oxidation of N-OH-2-FAA by UT extracts yielded a product ratio indicative of both peroxidative pathways with Br(-)-dependent oxidation prevailing. At 0.4% Cetab, one-electron oxidation was negligible and Br(-)-dependent conversion of N-OH-2-FAA to 2-NOF was markedly enhanced. At both 0.004 and 0.4% Cetab, MG extracts yielded only 2-NOF, suggesting solely Br(-)-dependent oxidation. With equivalent guaiacol units of peroxidative activities, MG extracts produced much lower amounts of 2-NOF than did UT extracts. The low specific activities of MG extracts necessitated the use of larger amounts of protein, which might have interfered with peroxidative metabolism. At 0.004% Cetab, formation of 2-NOF by the Br(-)-dependent pathway was greater at pH 5.5 than at 7.4. At acid pH, small amounts of 2-nitrofluorene were also formed by UT and MG extracts and could be attributed to further oxidation of 2-NOF. Peroxidative activities of the UT and MG extracts may be of granular leukocyte origin and their potential role in carcinogen activation and tumorigenesis is discussed.


A method for detergent-free isolation of membrane proteins in their local lipid environment.
Despite the great importance of membrane proteins, structural and functional studies of these proteins present major challenges. A significant hurdle is the extraction of the functional protein from its natural lipid membrane. Traditionally achieved with detergents, purification procedures can be costly and time consuming. A critical flaw with detergent approaches is the removal of the protein from the native lipid environment required to maintain functionally stable protein. This protocol describes the preparation of styrene maleic acid (SMA) co-polymer to extract membrane proteins from prokaryotic and eukaryotic expression systems. Successful isolation of membrane proteins into SMA lipid particles (SMALPs) allows the proteins to remain with native lipid, surrounded by SMA. We detail procedures for obtaining 25 g of SMA (4 d); explain the preparation of protein-containing SMALPs using membranes isolated from Escherichia coli (2 d) and control protein-free SMALPS using E. coli polar lipid extract (1-2 h); investigate SMALP protein purity by SDS-PAGE analysis and estimate protein concentration (4 h); and detail biophysical methods such as circular dichroism (CD) spectroscopy and sedimentation velocity analytical ultracentrifugation (svAUC) to undertake initial structural studies to characterize SMALPs (∼2 d). Together, these methods provide a practical tool kit for those wanting to use SMALPs to study membrane proteins.


A comparison of Icare PRO and Tono-Pen XL tonometers in anesthetized children.
Tonometry in the anesthetized child, vital for evaluating known or suspected glaucoma, remains limited to tonometers capable of supine recording. The Icare PRO measures intraocular pressure (IOP) in the sitting or supine patient. The purpose of this study was to compare Icare PRO and Tono-Pen tonometry during examination under anesthesia in eyes of supine children with normal eyes and glaucoma and/or corneal pathology. In this prospective study of children undergoing examination under anesthesia, IOP was recorded in both eyes with Icare PRO and Tono-Pen immediately after mask anesthesia induction, with instrument order randomized. A total of 100 eyes of 50 children (median age, 58 months) were included. IOP range was 6-50 mm Hg by Icare PRO and 6-53 mm Hg by Tono-Pen. Mean IOP measured by Tono-Pen (18.9 ± 7.5) was higher than that measured by Icare PRO (16.7 ± 7.1 mm Hg) by 2.2 mm Hg (P < 0.001). The presence of corneal edema was associated with IOP measurements higher by Tono-Pen than by Icare PRO (mean difference, 8.4 mm Hg). When eyes with corneal edema were excluded from analysis, there was no correlation between central corneal thickness and the difference in IOP between the two instruments. IOP in eyes of supine children under anesthesia measured approximately 2 mm Hg higher by Tono-Pen than Icare PRO and this difference was greater in eyes with frank corneal edema. Icare PRO may become a valuable tool for tonometry in supine infants and children, but a confirmatory test should be considered in eyes with corneal edema.


Difficulty Breathing or Just a Case of the Nerves? Incidental Finding of Primary Pleural Schwannoma in a COVID-19 Survivor.
Schwannoma is a rare tumor that arises from the Schwann cells, which are specialized, myelin-producing cells of the peripheral nerve sheaths. As anatomic logic would dictate, these masses commonly occur in the skull base, cerebellopontine angle, and posterior spinal roots. Of this already rare entity, rarer still are the pleural schwannomas, representing approximately 1-2% of thoracic tumors. These tumors commonly affect adults with a propensity for the third and sixth decades of life and a comparative male predilection. Schwannomas are benign, indolent, and follow an asymptomatic course. As such, they often come to light incidentally. Here we report a case of primary pleural schwannomas in a 68-year-old female, found incidentally on a CT scan of the chest. To the best of our knowledge and literature review, no other similar case has been reported in our country, Pakistan. Around three weeks before her presentation, she was diagnosed with COVID-19. Her infection had run a mild course with quick recovery without the need for any hospitalization. Therefore, the manifestation of shortness of breath after resolution of all other symptoms prompted a further workup. Radiographic chest x-ray revealed an incidental finding of a large right upper lobe lung mass, slightly impinging on the trachea. This was followed by a chest CT scan at our radiological imaging facility, which showed a large, well-encapsulated, right upper lobe lung mass in the paraspinal apical location. She then underwent an image-guided biopsy of the aforementioned mass, pathological analysis of which was suggestive of a benign peripheral nerve sheath tumor (PNST) arising from the pleura (pleural schwannoma). She underwent right posterolateral thoracotomy with uneventful complete surgical removal of the pleural-based lung mass. Postoperative investigations included a chest x-ray that showed interval complete resection of the mass. Currently, she is asymptomatic and her clinical condition has improved with the successful resumption of her daily routine. Physicians thus need to keep pleural schwannomas in mind as a probable diagnosis of intrathoracic tumors. Indolent and asymptomatic, they are very amenable to surgical resection with little to no chances of recurrence in the long term. However, these patients should be closely followed with repeat imaging studies when symptomatic.


Is There a Relationship Between Kinesiophobia and Physical Activity Level in Patients with Knee Osteoarthritis?
To investigate the levels of kinesiophobia, physical activity, depression, disability, and quality of life in patients with knee osteoarthritis. A cross-sectional study. A tertiary health care center. Ninety-six patients with knee osteoarthritis. Pain intensity was evaluated by the Visual Analog Scale, kinesiophobia by the Tampa Scale of Kinesiophobia and Brief Fear of Movement Scale, depression by the Beck Depression Inventory, disability by the Western Ontario and McMaster Universities Arthritis Index, physical activity level by the International Physical Activity Questionnaire short form, and quality of life by the Short Form 12 Health Survey Questionnaire. Of the patients, 85.7% had high-level kinesiophobia, 70.6% had depression, and 64.4% had low, 27.8% moderate, and 7.8% high physical activity levels. Age, activity-related pain score of the Visual Analog Scale, Tampa Scale of Kinesiophobia and Brief Fear of Movement Scale scores, and Western Ontario and McMaster Universities Arthritis Index and Beck Depression Inventory scores were higher in the group with high-level kinesiophobia, whereas the mental, physical, and total scores obtained from the Short Form 12 Health Survey Questionnaire were higher in the group with low-level kinesiophobia (P < 0.05). As the treatment of pain alone in patients with knee osteoarthritis is not sufficient to reduce fear of movement, we suggest that approaches to increase awareness of fear of movement and physical activity and cognitive behavioral therapy related to fear of movement should be included in the treatment program.


LncRNA HOXA-AS2 Promotes Tumor Progression by Suppressing miR-567 Expression in Oral Squamous Cell Carcinoma.
Growing evidence suggests that long non-coding RNAs (lncRNAs), such as lncRNA HOXA-AS2, are critical regulators involved in human cancer. However, the biological functions and detailed mechanisms underlying how lncRNA HOXA-AS2 affects oral squamous cell carcinoma (OSCC) remain unexplored. The expression of lncRNA HOXA-AS2 and miR-567 was determined in OSCC cell lines and clinical tissues by quantitative real-time PCR (qRT-PCR). Target site prediction and luciferase report assays were used to explore their potential interaction and binding sites between lncRNA HOXA-AS2 and miR-567. Overexpression or silencing expression of lncRNA HOXA-AS2 was performed to confirm that miR-567 was suppressed by lncRNA HOXA-AS2. WST-1 assay, crystal staining assay, and cell cycle analysis were used to assess the cell viability and proliferation ability. The target gene of miR-567 was predicted by Targetscan and validated by luciferase report assay as well as qRT-PCR and Western Blot. Xenograft nude mice model was done to demonstrate that lncRNA HOXA-AS2 promoted cell proliferation via targeting miR-567/CDK8 in vivo. LncRNA HOXA-AS2 was up-regulated in OSCC cells and tissues with the expression of miR-567 decreased. The tissue lncRNA HOXA-AS2 expression was found to positively correlate with the TNM stage and lymph node metastasis of OSCC patients. In terms of the mechanism, we found that lncRNA HOXA-AS2 negatively regulates miR-567 expression via a direct interaction. Functionally, overexpression of lncRNA HOXA-AS2 significantly promoted OSCC cell proliferation, while knockdown of lncRNA HOXA-AS2 significantly inhibited it. We also observed that miR-567 directly targets the 3' UTR of CDK8. Moreover, silencing lncRNA HOXA-AS2 inhibited tumor growth with the expression of miR-567 increased and CDK8 decreased in vivo. LncRNA HOXA-AS2 was up-regulated in OSCC, and its up-regulation correlated with poor clinical outcomes. The lncRNA also promoted OSCC cell proliferation by directly binding to miR-567, leading to an increase in CDK8 expression. The potential prognostic value of lncRNA HOXA-AS2 should be explored in future studies.


[Bacteremia due to Rothia mucilaginosa after chemotherapy for myeloid malignancies].
The number of reported cases of bacteremia due to Rothia mucilaginosa (R. mucilaginosa), a component of the normal flora of human gastrointestinal tract mucosa, is limited. We encountered three cases of bacteremia due to R. mucilaginosa during neutropenia after chemotherapy for myeloid malignancies. Although all three patients were successfully treated with antimicrobial agents, one patient developed disseminated lesions in the lungs and soft tissue. The portal of R. mucilaginosa bacteremia is reportedly mucositis or dental disorders; however, no such complications were identified in our patients. Even in the absence of a preexisting portal, R. mucilaginosa should be recognized as a potential causative pathogen of bacteremia during neutropenic periods. Accumulations of cases and isolates are required to further elucidate the risk factors for developing R. mucilaginosa bacteremia, its clinical course, and the optimal antimicrobial treatment.


Quality of life in menopausal women: a Brazilian Portuguese version of the Cervantes Scale.
We present the translation, cultural adaptation and validation of the Cervantes Scale to Brazilian Portuguese. The Cervantes Scale (CS) was originally described in Spanish, and is a tool to measure health-related quality of life in perimenopausal and menopausal women. A cross-sectional study was carried out with 180 women aged 45 to 64 years. In addition to the CS, the following questionnaires were applied: Women's Health Questionnaire (WHQ) and abbreviated version of the World Health Organization's Quality of Life Questionnaire (Abbreviated WHOQOL-bref). In conclusion, the Brazilian Portuguese version of the CS is easy to apply and understand. The evaluation of its psychometric properties was satisfactory, and it can be applied to assess health-related QoL in Brazilian perimenopausal and menopausal women.


Health in All Social Work Programs: Findings From a US National Analysis.
To establish a baseline of health content in 4 domains of US social work education-baccalaureate, master's, doctoral, and continuing education programs-and to introduce the Social Work Health Impact Model, illustrating social work's multifaceted health services, from clinical to wide-lens population health approaches. We analyzed US social work programs' Web site content to determine amount and types of health content in mission statements, courses, and specializations. Coding criterion determined if content was (1) health or health-related (HHR) and (2) had wide-lens health (WLH) emphasis. A second iteration categorized HHR and WLH courses into health topics. We reviewed 4831 courses. We found broad HHR content in baccalaureate, master's, and continuing education curricula; doctoral programs had limited health content. We identified minimal WLH content across all domains. Topical analysis indicated that more than 50% of courses concentrated on 3 areas: mental and behavioral health, abuse and violence, and substance use and addictions. As a core health profession, social work must strengthen its health and wide-lens content to better prepare graduates for integrated practice and collaboration in the changing health environment.


Reassortment between avian H5N1 and human H3N2 influenza viruses in ferrets: a public health risk assessment.
This study investigated whether transmissible H5 subtype human-avian reassortant viruses could be generated in vivo. To this end, ferrets were coinfected with recent avian H5N1 (A/Thailand/16/04) and human H3N2 (A/Wyoming/3/03) viruses. Genotype analyses of plaque-purified viruses from nasal secretions of coinfected ferrets revealed that approximately 9% of recovered viruses contained genes from both progenitor viruses. H5 and H3 subtype viruses, including reassortants, were found in airways extending toward and in the upper respiratory tract of ferrets. However, only parental H5N1 genotype viruses were found in lung tissue. Approximately 34% of the recovered reassortant viruses possessed the H5 hemagglutinin (HA) gene, with five unique H5 subtypes recovered. These H5 reassortants were selected for further studies to examine their growth and transmissibility characteristics. Five H5 viruses with representative reassortant genotypes showed reduced titers in nasal secretions of infected ferrets compared to the parental H5N1 virus. No transmission by direct contact between infected and naïve ferrets was observed. These studies indicate that reassortment between H5N1 avian influenza and H3N2 human viruses occurred readily in vivo and furthermore that reassortment between these two viral subtypes is likely to occur in ferret upper airways. Given the relatively high incidence of reassortant viruses from tissues of the ferret upper airway, it is reasonable to conclude that continued exposure of humans and animals to H5N1 alongside seasonal influenza viruses increases the risk of generating H5 subtype reassortant viruses that may be shed from upper airway secretions.