Mental Fatigue and Basketball Performance: A Systematic Review.
Mental fatigue (MF) is a psycho-biological state that impairs sports-related performances. Recently, it has been proved that MF can affect basketball performance. However, a systematic overview detailing the influences of MF on basketball performance is still lacking. This study aims to investigate the effects of MF on the physical, technical, tactical, and cognitive performance of basketball. We used the databases of PubMed, Web of Science, SPORTDiscus, Scopes, and CKNI for articles published up to 31 May 2021. The articles included in this study were projected to test whether MF influences basketball athlete performance. Only experimental design studies were selected, and the control condition was without MF. Finally, seven articles fit the inclusion criteria. The results imply that MF impairs the technical aspects of basketball (free throws, three-point shots, and total turnover) and the players' cognitive [take-the-first (TTF) heuristics and decision-making] performance, which results in athletes not using their techniques skillfully and being unable to make practical decisions during critical points in the game. In addition to that, the influences of MF on physical and tactical performance have not been studied. Further studies should look into comprehensive research on the influences of MF on basketball performance, especially on a player's physical and tactical performance. Systematic Review Registration: [https://inplasy.com/] [INPLASY2021100017].


The enzymic properties of a modified ox heart myosin adenosine triphosphatase on covalent binding to an insoluble cellulose matrix.
The preparation of ox heart myosin and its partial digestion with cellulose-bound papain is described. A procedure is outlined by which heavy meromyosin subfragment 1 can be covalently bound to a cellulose ion-exchange matrix. Attachment of heavy meromyosin subfragment 1 to the insoluble matrix results in a change in the ion specificity towards ATP hydrolysis. Unlike the soluble enzyme the bound form is activated by both Ca(2+) and Mg(2+). Maximal activation by Ca(2+) occurred at a lower concentration for the bound enzyme. Mg(2+) activates at a concentration which causes near-maximal inhibition of the Ca(2+)-activated adenosine triphosphatase (ATPase) of the non-bound enzyme. The Mg(2+)-activated ATPase of the bound enzyme was in turn inhibited by the presence of Ca(2+). The activation by Mg(2+) resembles the characteristic enzymic action of the actin-subfragment 1 complex.


Drug use among African Americans: ethnic identity as a protective factor.
This study examined the multiple components of ethnic identity, the place of this ethnic identity set in the mediational model of the path to drug use predicted by our family interactional framework, and the protective role of each component of ethnic identity. The participants were 259 male and 368 female African Americans in late adolescence. They responded to a structured questionnaire in individual interviews. We found that few of the specific components of ethnic identity were significantly related as main effects to drug use. Most of the effect of ethnic identity was mediated by the family set of variables. Each of the components of ethnic identity offset risks or enhanced protective factors from the ecology, family, personality, and peer domains, thereby lessening drug use. This pattern highlights the importance of incorporating ethnic identity into drug prevention programs which serve African-American youth.


The association between first and second wave COVID-19 mortality in Italy.
The relation between the magnitude of successive waves of the COVID-19 outbreak within the same communities could be useful in predicting the scope of new outbreaks. We investigated the extent to which COVID-19 mortality in Italy during the second wave was related to first wave mortality within the same provinces. We compared data on province-specific COVID-19 2020 mortality in two time periods, corresponding to the first wave (February 24-June 30, 2020) and to the second wave (September 1-December 31, 2020), using cubic spline regression. For provinces with the lowest crude mortality rate in the first wave (February-June), i.e. < 22 cases/100,000/month, mortality in the second wave (September-December) was positively associated with mortality during the first wave. In provinces with mortality greater than 22/100,000/month during the first wave, higher mortality in the first wave was associated with a lower second wave mortality. Results were similar when the analysis was censored at October 2020, before the implementation of region-specific measures against the outbreak. Neither vaccination nor variant spread had any role during the study period. These findings indicate that provinces with the most severe initial COVID-19 outbreaks, as assessed through mortality data, faced milder second waves.


Superlubricity and Stress-Shielding of Graphene Enables Ultra Scratch-Resistant Glasses.
Glasses, when subjected to scratch loading, incur damages affecting their optical and mechanical integrity. Here, it is demonstrated that silica glasses protected with mechanically exfoliated few-layer graphene sheets can exhibit remarkable improvement in scratch resistance. To this extent, the friction and wear characteristics of silica glasses with exfoliated graphene using atomic force microscopy (AFM) are explored. The friction forces recorded during AFM scratch tests of the graphene-glass surfaces at multiple loads exhibit ∼98% reduction compared to that of the bare silica glass, with the friction coefficient falling in the superlubricity regime. This dramatic reduction in friction achieved by the graphene sheets results in significantly lower wear of the graphene-glass surfaces postscratching. Further investigations employing atomistic simulations reveal that the stress-shielding mechanism is due to the reduced deformation of graphene-glass surfaces, thereby curtailing the overall damage. Altogether, the present work provides a new fillip toward the development of glasses with enhanced scratch resistance exploiting two-dimensional coatings.


Intrinsic optical signals in rat hippocampal slices during hypoxia-induced spreading depression-like depolarization.
In interfaced rat hippocampal slices spreading depression (SD) and hypoxia-induced SD-like depolarization are associated with increased light reflectance and decreased light transmittance, indicating increased light scattering. By contrast, mild hypotonicity or electrical stimulation decrease light scattering, which is usually taken to be caused by cell swelling. This difference has been attributed to experimental conditions, but in our laboratory moderate osmotic challenge and SD produced opposite intrinsic optical signals (IOSs) in the same slice under identical conditions. To decide whether the SD-induced IOS is related to cell swelling, we investigated the effects of Cl(-) transport inhibitors and Cl(-) withdrawal on both light reflectance and transmittance, as well as on changes in interstitial volume and tissue electrical resistance. In normal [Cl(-)](o), early during hypoxia, there was a slight decrease in light reflectance paired with increase in transmittance. At the onset of hypoxic SD, coincident with the onset of cell swelling (restriction of TMA(+) space), the IOS signals suddenly inverted, indicating sharply increased scattering. The SD-related IOSs started in a single spot and spread out over the entire CA1 region without invading CA3. Application of 2 mM furosemide decreased IOS intensity. When [Cl(-)](o) was substituted by methylsulfate or gluconate, the SD-related reflectance increase and transmittance decrease were suppressed and replaced by opposite signals, indicating scattering decrease. Yet Cl(-) withdrawal did not prevent cell swelling measured as shrinkage of TMA(+) space. The SD-related increase of tissue electrical resistance was reduced when bath Cl(-) was replaced by methylsulfate and almost eliminated when replaced by gluconate. The TMA(+) signal is judged to be a more reliable indicator of interstitial space than tissue resistance. Neither application of cyclosporin A nor raising [Mg(2+)](o) depressed the SD-related reflectance increase, suggesting that Cl(-) flux through mitochondrial "megachannels" may not be a major factor in its generation. Fluoroacetate poisoning of glial cells (5 mM) accelerated SD onset and enhanced the SD-induced reflectance increase threefold. This suggests, first, that glial cells normally moderate the SD process and, second, that neurons are the predominant generators of the light-scattering increase. We conclude that light scattering by cerebral tissue can be changed by at least two different physical processes. Cell swelling decreases light scattering, whereas a second process increases scattering. During hypoxic SD the scattering increase masks the swelling-induced scattering decrease, but the latter is revealed when Cl(-) is removed. The scattering increase is Cl(-) dependent, nevertheless it is apparently not related to cell volume changes. Its underlying mechanism is as yet not clear; possible factors are discussed.


A nursing information system. The outcome of implementing nursing diagnoses.
The use of nursing diagnosis, as the focus for care planning and as a role expectation for professional nursing practice, has evolved throughout the years into a concept that has permeated all other systems in the Department of Nursing. Systems that were previously mutually exclusive were organized through the use of nursing diagnosis-based care planning and were integrated to improve both nursing efficiency and efficacy. Full computerization of the Nursing Information System Model (Fig. 1) will have the nursing diagnosis-based patient care plan and the medical orders for nursing intervention as the source of all clinical nursing data and will provide the majority of nursing administrative management data.


What happens after forensic psychiatric care? A latent class analysis of dimensions of welfare for former forensic psychiatric patients.
Mentally disordered offenders are a heterogenous group regarding psychopathology as well as background factors, which makes it likely that more than one stereotypical life situation will apply to all forensic psychiatric patients following discharge. Knowledge about typical life situations would be valuable for optimising support for improving the overall life situation of these individuals. This paper investigates life situations from the perspective of level of living research and resources in terms of different welfare dimensions. Included were all all individuals (n = 1146) who had been discharged from forensic psychiatric care in Sweden during 2009-2018 and were included in the Swedish National Forensic Psychiatric Register. Follow-up time varied from 4 to 3644 days, (m = 1697, Md = 1685). Register data from several different registers was combined. Data was analysed using latent class analysis, and multinominal logistic regression analysis investigated what background factors were associated with class membership. The results show that there are four subgroups of post-discharge life situations: the high support group, the general psychiatric needs group, the working group, and the family group. The high support group was the largest, representing 54% of the entire sample. There are background factors associated with group membership, including both age at discharge, length of stay in forensic psychiatric care and pre-index crime historical factors. This study contributes to the understanding of the post-discharge lives of former forensic psychiatric patients and shows that for several subgroups, negative outcomes are rare. Knowledge about these subgroups could be drawn upon to make informed decisions about in- and outpatient forensic psychiatric care, discharge from forensic psychiatric services, and what support is offered to former forensic psychiatric patients.


[Allergy to asparagus].
Asparagus (Asparagus officinalis) is a widely grown vegetable; together with garlic, the onion and the leek, it belongs to the Liliaceae family. Both delayed cell-mediated reactions and IgE-mediated reactions secondary to asparagus have been described. While the former (allergic contact dermatitis) are a fairly common cause of occupational disease, only a few case-reports of IgE-mediated reactions have been published. IgE-mediated reactions can be further grouped into food allergy and reactions due to cutaneous or respiratory exposure, which is often occupational. Anaphylaxis is the most common clinical picture of food allergy, while contact urticaria, rhinitis and asthma, appearing either isolated or associated, are clinical pictures of the latter. Sensitization to different allergens is the likely cause of the different clinical pictures due to asparagus. Their detection and early diagnosis is of prime importance due to the different prognosis and treatment. In the present article we resume our experience over the last 5 years.


Do We Need to Stabilize All Reduced Metaphyseal Both-bone Forearm Fractures in Children with K-wires?
Short-term follow-up studies have shown that reduced metaphyseal both-bone forearm fractures in children should be treated with K-wires to prevent redisplacement and inferior functional results. Minimum 5-year follow-up studies are limited. Range of motion, patient-reported outcome measures, and radiographic parameters at minimum 5-year follow-up should be evaluated because they could change insights into how to treat pediatric metaphyseal forearm fractures. (1) Does K-wire stabilization of reduced metaphyseal both-bone forearm fractures in children provide better forearm rotation at minimum 5-year follow-up? (2) Do malunions (untreated redisplaced fractures) of reduced metaphyseal both-bone forearm fractures in children induce worse functional results? (3) Which factors lead to limited forearm rotation at minimum 5-year follow-up? We analyzed the extended minimum 5-year follow-up of a randomized controlled trial in which children with a reduced metaphyseal both-bone forearm fracture were randomized to either an above-elbow cast (casting group) or fixation with K-wires and an above-elbow cast (K-wire group). Between January 2006 and December 2010, 128 patients were included in the original randomized controlled trial: 67 in the casting group and 61 in the K-wire group. For the current study, based on an a priori calculation, it was determined that, with an anticipated mean limitation in prosupination (forearm rotation) of 7° ± 7° in the casting group and 3° ± 5° in the K-wire group, a power of 80% and a significance of 0.05, the two groups should consist of 50 patients each. Between January 2014 and May 2016, 82% (105 of 128) of patients were included, with a mean follow-up of 6.8 ± 1.4 years: 54 in the casting group and 51 in the K-wire group. At trauma, patients had a mean age of 9 ± 3 years and had mean angulations of the radius and ulna of 25° ± 14° and 23° ± 18°, respectively. The primary result was limitation in forearm rotation. Secondary outcome measures were radiologic assessment, patient-reported outcome measures (QuickDASH and ABILHAND-kids), handgrip strength, and VAS score for cosmetic appearance. Assessments were performed by the first author (unblinded). Multivariable logistic regression analysis was performed to analyze which factors led to a clinically relevant limitation in forearm rotation. There was a mean limitation in forearm rotation of 5° ± 11° in the casting group and 5° ± 8° in the K-wire group, with a mean difference of 0.3° (95% CI -3° to 4°; p = 0.86). Malunions occurred more often in the casting group than in the K-wire group: 19% (13 of 67) versus 7% (4 of 61) with an odds ratio of 0.22 for K-wiring (95% CI 0.06 to 0.80; p = 0.02). In patients in whom a malunion occurred (malunion group), there was a mean limitation in forearm rotation of 6° ± 16° versus 5° ± 9° in patients who did not have a malunion (acceptable alignment group), with a mean difference 0.8° (95% CI -5° to 7°; p = 0.87). Factors associated with a limited forearm rotation ≥ 20° were a malunion after above-elbow casting (OR 5.2 [95% CI 1.0 to 27]; p = 0.045) and a refracture (OR 7.1 [95% CI 1.4 to 37]; p = 0.02). At a minimum of 5 years after injury, in children with a reduced metaphyseal both-bone forearm fracture, there were no differences in forearm rotation, patient-reported outcome measures, or radiographic parameters between patients treated with only an above-elbow cast compared with those treated with additional K-wire fixation. Redisplacements occurred more often if treated by an above-elbow cast alone. If fracture redisplacement is not treated promptly, this leads to a malunion, which is a risk factor for a clinically relevant (≥ 20°) limitation in forearm rotation at minimum 5-year follow-up. Children with metaphyseal both-bone forearm fractures can be treated with closed reduction and casting without additional K-wire fixation. Nevertheless, a clinician should inform parents and patient about the high risk of fracture redisplacement (and therefore malunion), with risk for limited forearm rotation if left untreated. Weekly radiographic monitoring is essential. If redisplacement occurs, remanipulation and fixation with K-wires should be considered based on gender, age, and direction of angulation. Future research is required to establish the influence of (skeletal) age, gender, and the direction of malunion angulation on clinical outcome. Level I, therapeutic study.


The vanishing health care safety net: new data on uninsured Americans.
New data obtained from the Census Bureau shows that the number of Americans without any health insurance increased by 1.3 million between 1989 and 1990, bringing the total number of uninsured to 34.7 million, more than at any time since the passage of Medicare and Medicaid 25 years ago. This increase coincided with a 10.5 percent increase in health spending, the second largest in the past three decades. The number of people covered by Medicaid grew by 3.1 million, due to a one-time expansion of eligibility mandated by Congress, but this was more than counter-balanced by a population growth of 3 million and a decrease of 1.3 million in people covered by private insurance. Had Medicaid not been expanded, the number of uninsured would have increased by 4.4 million. The increase in the uninsured affected virtually all parts of the nation. Seven states had increases of more than 100,000 persons each. Only Texas experienced a decrease of that magnitude, but still had the second highest rate of uninsurance of any state. Of the 1.3 million additional uninsured in 1990, 77 percent were male, 32 percent had family incomes in excess of $50,000 per year, and 74 percent had annual family incomes above $25,000. Fewer than 9 percent had incomes below the poverty line. The numbers of uninsured children and senior citizens fell slightly (but not significantly), while the number of uninsured working-age adults rose by 1.4 million. The number of uninsured workers in each of four of 20 major industry groups increased by more than 100,000 in 1990. None of the industry groups showed a significant decline in the number of uninsured. Among professionals, there were substantial numbers of uninsured doctors, engineers, teachers, college professors, clergy, and others, but all legislators and judges were insured. The data presented here largely predate the recession and understate current problems. In 1991 the number of uninsured will likely reach nearly 40 million. Also, these estimates are based on the number of people uninsured at a single time during 1990; a far higher number were temporarily uninsured at some point during the year. Moreover the Census Bureau survey ignores the problem of the underinsurance of at least 50 million insured Americans. Patchwork public programs are grossly inadequate to plug the holes. A national health program covering all Americans could assure access to care and contain costs.


Identification and validation of FES physiological musculoskeletal model in paraplegic subjects.
The knowledge and prediction of the behavior of electrically activated muscles are important requisites for the movement restoration by FES in spinal cord injured subjects. The whole parameter's identification of a physiological musculoskeletal model for FES is investigated in this work. The model represents the knee and its associated quadriceps muscle. The identification protocol is noninvasive and based on the in-vivo experiments on paraplegic subjects. The isometric and nonisometric data was obtained by stimulating the quadriceps muscles of 3 paraplegic subjects through surface electrodes. A cross validation has been carried out using nonisometric data set. The normalized RMS errors between the identified model and the measured knee response are presented for each subject.


Collagen protein abnormalities produced by site-directed mutagenesis of the pro alpha 1(I) gene.
Site-directed mutagenesis of collagen genes offers a powerful new approach for studying structure-function relationships. The construction of engineered mutant collagen genes coding for glycine substitutions and their expression giving rise to the osteogenesis imperfecta type II phenotype in cells and transgenic mice has recently been achieved. This paper further defines the molecular abnormalities of collagen and bone pathology resulting from the expression of the mutant genes.


Do alcohol use reasons and contexts differentiate adolescent high-intensity drinking? Data from U.S. high school seniors, 2005-2016.
The purpose of this study was to examine associations between (a) self-reported reasons for and contexts of alcohol use and (b) high-intensity drinking (i.e., having 10+ drinks in a row in the past 2 weeks) among national samples of U.S. 12th grade students. Data were obtained from 16,902 students who reported any past 12-month alcohol use from nationally representative annual 12th grade student samples from 2005-2016. When asked about drinking behavior during the past 2 weeks, 72% reported consuming less than 5 drinks at most during 1 drinking occasion; 14% reported 5-9 drinks, 7% reported 10-14 drinks, and 7% reported 15+ drinks. Adolescent drinkers in all categories (<5, 5-9, 10-14, and 15+ drinks) endorsed "to have a good time" as the most prevalent reason for alcohol use, and "at a party" as the most prevalent context of alcohol use. However, high-intensity drinking was particularly likely among adolescents drinking for coping, compulsive use, and drug effect reasons, as well as those who enjoyed the taste. Having 15+ drinks (vs. 10-14 drinks) was particularly associated with compulsive use and enjoying the taste. The relative risk of any high-intensity drinking, and of higher levels of high-intensity drinking involvement, increased with the total number of reasons and contexts endorsed. Alcohol appears to serve a larger number of functions for high-intensity drinking adolescents than non-high-intensity drinking youth. (PsycINFO Database Record


Spirochetes isolated from the blood of two patients with Lyme disease.
We isolated spirochetes from the blood of 2 of 36 patients in Long Island and Westchester County, New York, who had signs and symptoms suggestive of Lyme disease. The spirochetes were morphologically similar and serologically identical to organisms recently found to infect lxodes dammini ticks, which are endemic to the area and have been epidemiologically implicated as vectors of Lyme disease. In both patients, there was a rise in specific antispirochetal antibodies in paired specimens of serum. We conclude that the l. dammini spirochete has an etiologic role in Lyme disease.


Phase stability of a reversible supramolecular polymer solution mixed with nanospheres.
Theory is presented for the phase stability of mixtures containing nanospheres and non-adsorbing reversible supramolecular polymers. This was made possible by incorporating the depletion thickness and osmotic pressure of reversible supramolecular polymer chains into generalized free-volume theory, recently developed for investigating the phase behaviour of colloidal spheres mixed with interacting polymers (Fleer and Tuinier 2008 Adv. Colloid Interface Sci. 143 1-47). It follows that the fluid-fluid phase stability region where reversible supramolecular polymer chains can be mixed with nanospheres is sensitive to the energy of scission between the monomers and to the nanoparticle radius. One can then expect the fluid-fluid coexistence curves to have a strong dependence on temperature and that shifting of phase boundaries within a single experimental system should be possible by varying the temperature. The calculations reveal the width of the stability region to be rather small. This implies that phase homogeneity of product formulations containing reversible supramolecular polymers is only possible at low nanoparticle concentrations.


Diindolocarbazole - achieving multiresonant thermally activated delayed fluorescence without the need for acceptor units.
In this work we present a new multi-resonance thermally activated delayed fluorescence (MR-TADF) emitter paradigm, demonstrating that the structure need not require the presence of acceptor atoms. Based on an in silico design, the compound DiICzMes4 possesses a red-shifted emission, enhanced photoluminescence quantum yield, and smaller singlet-triplet energy gap, ΔEST, than the parent indolocarbazole that induces MR-TADF properties. Coupled cluster calculations accurately predict the magnitude of the ΔEST when the optimized singlet and triplet geometries are used. Slow yet optically detectable reverse intersystem crossing contributes to low efficiency in organic light-emitting diodes using DiICzMes4 as the emitter. However, when used as a terminal emitter in combination with a TADF assistant dopant within a hyperfluorescence device architecture, maximum external quantum efficiencies of up to 16.5% were achieved at CIE (0.15, 0.11). This represents one of the bluest hyperfluorescent devices reported to date. Simultaneously, recognising that MR-TADF emitters do not require acceptor atoms reveals an unexplored frontier in materials design, where yet greater performance may yet be discovered.


Understanding the Dynamics of Violent Political Revolutions in an Agent-Based Framework.
This paper develops an agent-based computational model of violent political revolutions in which a subjugated population of citizens and an armed revolutionary organisation attempt to overthrow a central authority and its loyal forces. The model replicates several patterns of rebellion consistent with major historical revolutions, and provides an explanation for the multiplicity of outcomes that can arise from an uprising. The relevance of the heterogeneity of scenarios predicted by the model can be understood by considering the recent experience of the Arab Spring involving several rebellions that arose in an apparently similar way, but resulted in completely different political outcomes: the successful revolution in Tunisia, the failed protests in Saudi Arabia and Bahrain, and civil war in Syria and Libya.


Recombinant factor VIIa prophylaxis in a patient with severe congenital factor VII deficiency.
Use of recombinant factor VIIa (rFVIIa, NovoSeven in patients with congenital FVII deficiency has been reported for the prophylactic management of surgical bleeding and for the treatment of acute bleeding episodes. Because of its short half-life, the use of rFVIIa on a regular prophylactic regimen has not been routinely adopted. In this report, we describe our successful experience with rFVIIa prophylaxis in preventing recurrent target joint bleeding in a severely FVII-deficient adolescent.


18F-fluorodeoxyglucose PET/computed tomography in locoregional staging and assessment of biological and clinical aggressiveness of breast cancer subtypes.
We aimed to evaluate the availability of fluorine-18-fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT) in initial axillary lymph node (ALN) staging in breast cancer. The secondary objective is to evaluate the role of FDG PET/CT as a pretest in sentinel lymph node biopsy vs. axillary lymph node dissection when predicting disease aggressiveness. The study evaluated retrospectively 194 breast cancer patients who underwent preoperative 18F-FDG. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FDG PET/CT for ALN metastases were confirmed with histopathology as the gold standard. The value of the area under curve (AUC), sensitivity and specificity for ALN metastases were determined as 0.847, 78.8% and 92.6%, respectively. The cut-off value of the maximum standardized uptake value (SUVmax) for metastatic ALN detection was calculated as 1.79. PPV, NPV and the accuracy of 18F-FDG PET/CT were 0.933 (93.3%), 0.75 (75%) and 0.837 (83.7%), respectively. The SUVmax value of the primary lesion was significantly correlated with grade, estrogen receptor (ER) status, progesterone receptor (PR) status, SUVmax value of metastatic ALN, Her-2 status and Ki-67 level. Molecular subtypes revealed no statistically significant difference in terms of mean SUVmax value. High values of AUC, sensitivity, specificity, NPV and PPV encourage utilization of PET/CT for locoregional staging of nonmetastatic breast carcinoma. The significant correlation between the primary tumor SUVmax value and grade, ER status, PR status and Ki-67 level increases the prognostic predictive value of the preoperative PET/CT.


Halogenations of anthracenes and Dibenz
Halogenation of dibenz[a,c]anthracene (1) by NBS in CCl(4) affords the products of 9- and 10-monobromination in the ratio of 9:1. The reaction is accelerated by iodine, and HBr effects rearrangement of 9-bromo product to the sterically less crowded 10-bromo isomer. The mechanism is proposed to involve reversible addition of Br(2), followed by elimination of HBr. Reaction of NCS with 1 in CCl(4) requires addition of HCl and affords exclusively 9-chlorination. The different reactivities of NBS and NCS are ascribed to the relative amounts of free halogen produced (due to differences in N-X bond strengths involving Br and Cl), and the different sizes of the halogens. Under similar conditions, NCS chlorinates 9-bromoanthracene (2a) to afford 9,10-dichloroanthracene and 9-bromo-10-chloroanthracene in the ratio of 65:35. This reaction ostensibly occurs by addition of Cl(2) to 2a, followed by preferential loss of HBr rather than HCl. 9-Methylanthracene (3) affords exclusively 9-(bromomethyl)anthracene with NBS in the absence of iodine, but mainly (67%) 9-bromo-10-methylanthracene in the presence of iodine. Chlorination of 3 with NCS in the presence of HCl also affords mostly (65%) nuclear halogenation. Nuclear bromination of anthracene, 9-methylanthracene, and dibenz[a, c]anthracene by NBS in the absence of added HBr is accelerated by iodine. This effect is probably due to an increase in the amount of bromine produced from NBS in the presence of iodine.


[Regulation of the activity of brain cytoplasmic creatine kinase by pyridine nucleotides].
Effect of oxidized and reduced forms of pyridine nucleotides on activity of creatine kinase BB was studied in rat brain. NAD did not affect the enzymatic activity at concentrations of 1.0-4.0 mM, while in presence of NADH activity of creatine kinase BB was gradually decreased as the coenzyme concentration increased. The plot of 1/V against 1/S at various NADH concentrations produced a series of lines intersecting at one point (-1/Km), thus indicating the noncompetitive type of brain cytoplasmic creatine kinase inhibition by reduced pyridine nucleotides. Apparent Ki value for NADH was about 1.5 mM which was lower than the known parameter for cytoplasmic creatine kinase isozymes from skeletal and heart muscles. Dependence of brain creatine kinase BB on the rate of pyridine nucleotide reduction suggested a possible mechanism for the enzyme regulation under hypoxic conditions.


Menstruation per urethram. A case report.
The case history is presented of a 24-year-old woman who had a uterus duplex, grossly underdeveloped cervices, absent vagina and who menstruated regularly through a communication between one cervical canal and the urethra.


Lapatinib as a component of neoadjuvant therapy for HER2-positive operable breast cancer (NSABP protocol B-41): an open-label, randomised phase 3 trial.
We studied the effect on tumour response to neoadjuvant therapy of the substitution of lapatinib for trastuzumab in combination with weekly paclitaxel after doxorubicin plus cyclophosphamide treatment, and of the addition of lapatinib and trastuzumab combined after doxorubicin plus cyclophosphamide treatment in patients with HER2-positive operable breast cancer to determine whether there would be a benefit of dual HER2 blockade in these patients. For this open-label, randomised phase 3 trial we recruited women aged 18 years or older with an ECOG performance status of 0 or 1 with operable HER2-positive breast cancer. Each received four cycles of standard doxorubicin 60 mg/m(2) and cyclophosphamide 600 mg/m(2) intravenously on day 1 every 3 weeks followed by four cycles of weekly paclitaxel (80 mg/m(2)) intravenously on days 1, 8, and 15, every 4 weeks. Concurrently with weekly paclitaxel, patients received either trastuzumab (4 mg/kg load, then 2 mg/kg intravenously) weekly until surgery, lapatinib (1250 mg orally) daily until surgery, or weekly trastuzumab plus lapatinib (750 mg orally) daily until surgery. After surgery, all patients received trastuzumab to complete 52 weeks of HER2-targeted therapy. Randomisation (ratio 1:1:1) was done centrally with stratification by clinical tumour size, clinical nodal status, hormone-receptor status, and age. The primary endpoint was the pathological complete response in the breast, and analysis was performed on an intention-to-treat population. Patient accrual started on July 16, 2007, and was completed on June 30, 2011; 529 women were enrolled in the trial. 519 patients had their pathological response determined. Breast pathological complete response was noted in 93 (52·5%, 95% CI 44·9-59·5) of 177 patients in the trastuzumab group, 91 (53·2%, 45·4-60·3) of 171 patients in the lapatinib group (p=0·9852); and 106 (62·0%, 54·3-68·8) of 171 patients in the combination group (p=0·095). The most common grade 3 and 4 toxic effects were neutropenia (29 [16%] patients in the trastuzumab group [grade 4 in five patients (3%), 28 [16%] in the lapatinib group [grade 4 in eight patients (5%)], and 29 [17%] in the combination group [grade 4 in nine patients (5%)]) and grade 3 diarrhoea (four [2%] patients in the trastuzumab group, 35 [20%] in the lapatinib group, and 46 [27%] in the combination group; p<0·0001). Symptomatic congestive heart failure defined as New York Heart Association Class III or IV events occurred in seven (4%) patients in the trastuzumab group, seven (4%) in the lapatinib group, and one (<1%) in the combination group; p=0·185). Substitution of lapatinib for trastuzumab in combination with chemotherapy resulted in similar high percentages of pathological complete response. Combined HER2-targeted therapy produced a numerically but insignificantly higher pathological complete response percentage than single-agent HER2-directed therapy; these findings are consistent with results from other studies. Trials are being undertaken to further assess these findings in the adjuvant setting.


Progression of puberty after initiation of androgen therapy in patients with idiopathic hypogonadotropic hypogonadism.
Onset of puberty in boys usually occurs by 14 years of age. Some boys may exhibit delayed sexual maturation till about 17-18 years of age. However, pubertal onset beyond 18 years of age is exceedingly rare. Patients diagnosed as idiopathic hypogonadotropic hypogonadism (IHH) who had onset of puberty (increase in testicular volume >10 ml) while on androgen therapy were studied. These patients were evaluated prospectively. There were nine subjects that were included in the study. The pre-therapy testicular volumes ranged from 3 to 6 ml. Luteinizing hormone (LH) levels increased from 1.2 ± 0.96 to 2.8 ± 1.0 IU/L, follicular stimulating hormone (FSH) levels increased from 1.5 ± 0.79 to 3.5 ± 1.9 IU/L, and testosterone increased from 0.36 ± 0.16 to 3.4 ± 2.1 ng/ml. Three out of nine patients had testosterone levels below 3 ng/ml. Our present study indicates that pubertal development can occur in patients presenting with hypogonadotropic hypogonadism after 18 years of age. However, acquired pubertal status may be subnormal.


Anti-CD11d monoclonal antibody treatment for rat spinal cord compression injury.
This study was initiated due to an NIH "Facilities of Research-Spinal Cord Injury" contract to support independent replication of published studies. Transient blockage of the CD11d/CD18 integrin has been reported to reduce secondary neuronal damage as well as to improve functional recovery after spinal cord injury (SCI) in rats. The purpose of this study was to determine whether treatment with an anti-CD11d monoclonal antibody (mAb) would improve motor performance, reduce pain and histopathological damage in animals following clip-compression injury as reported. Adult male Wistar rats (250g) were anesthetized with isoflurane, and the T12 spinal cord exposed by T10 and T11 dorsal laminectomies followed by a 60s period of clip compression utilizing a 35g clip. Control animals received an isotype-matched irrelevant antibody (1B7) while the treated group received the anti-CD11d mAb (217L; 1.0mg/kg) systemically. Open-field locomotion and sensory function were assessed and animals were perfusion-fixed at twelve weeks after injury for quantitative histopathological analysis. As compared to 1B7, 217L treated animals showed an overall non-significant trend to better motor recovery. All animals showed chronic mechanical allodynia and anti-CD11d mAb treatment did not significantly prevent its development. Histopathological analysis demonstrated severe injury to gray and white matter after compression with a non-significant trend in anti-CD11d protection compared to control animals for preserved myelin. Although positive effects with the anti-CD11d mAb treatment have been reported after compressive SCI, it is suggested that this potential treatment requires further investigation before clinical trials in spinal cord injured patients are implemented.


Strain estimates for small-ring cyclic allenes and butatrienes.
Isodesmic and homodesmic equations at the B3LYP/6-311+G(d,p)+ZPVE level of theory have been used to estimate strain for the homologous series of cyclic allenes and cyclic butatrienes. A simple fragment deformation approach also has been applied and appears to work better for the larger rings. For the cyclic allene series, estimates for allene functional group strain (kcal/mol) include: 1,2-cyclobutadiene, 65; 1,2-cyclopentadiene, 51; 1,2-cyclohexadiene, 32; 1,2-cycloheptadiene, 14; 1,2-cyclooctadiene, 5; 1,2-cyclononadiene, 2; 1,2,4-cyclohexatriene, 34; and bicyclo[3.2.1]octa-2,3-diene, 39. For cyclic butatrienes, functional group strain estimates include: 1,2,3-cyclobutatriene, >100; 1,2,3-cyclopentatriene, 80; 1,2,3-cyclohexatriene, 50; 1,2,3-cycloheptatriene, 26; 1,2,3-cyclooctatriene, 17; and 1,2,3-cyclononatriene, 4. Barriers to interconversion of enantiomers in cyclic allenes are reduced with increasing strain. Newly predicted values include: 1,2-cyclopentadiene <1 kcal/mol and bicyclo[3.2.1]octa-2,3-diene, 7.4 kcal/mol. Estimated levels of strain parallel the known reactivity of these substances.


A new class of quasi-Newtonian methods for optimal learning in MLP-networks.
In this paper, we present a new class of quasi-Newton methods for an effective learning in large multilayer perceptron (MLP)-networks. The algorithms introduced in this work, named LQN, utilize an iterative scheme of a generalized BFGS-type method, involving a suitable family of matrix algebras L. The main advantages of these innovative methods are based upon the fact that they have an O(nlogn) complexity per step and that they require O(n) memory allocations. Numerical experiences, performed on a set of standard benchmarks of MLP-networks, show the competitivity of the LQN methods, especially for large values of n.


Adipose Tissue-Derived Biomarkers of Intestinal Barrier Functions for the Characterization of Diarrhoea-Predominant IBS.
Alterations of the small-intestinal permeability (s-IP) might play an essential role in a subgroup of diarrhoea-predominant IBS (D-IBS) patients. (a) To analyse in D-IBS patients the symptom profile in relation to the altered (+) or not (-) s-IP using the Gastrointestinal Symptom Rating Scale (GSRS). (b) To assess the circulating levels of the adipokines IL-6, IL-8, TNF-α, leptin, and adiponectin, along with LPS, TLR-4, neurotensin, and brain-derived neurotrophic factor (BDNF). The frequency distribution of SNPs at the loci for the investigated molecules and leptin receptor was evaluated. The study included 34 D-IBS patients and 17 healthy controls (HC). s-IP permeability was assayed by high-performance liquid chromatography determination in the urine of the lactulose to mannitol ratio. Concentrations of IL-6, IL-8, TNF-α, LPS, TLR-4, leptin, adiponectin, neurotensin, and BDNF were assayed by ELISA. Screening of genetic variants was done employing the restriction fragment length polymorphism-polymerase chain reaction method. D-IBS(-) patients had a significantly higher GSRS cluster pain and diarrhoea profile than D-IBS(+) ones. Significant correlations were found between the symptoms clusters and immune activation and inflammation markers. The levels of adipo(cyto)kines in D-IBS(+) patients were higher than those of controls, and IL-6 levels correlated with those of LPS. Leptin and BDNF were significantly higher, and neurotensin levels were significantly lower in D-IBS(+) than in controls. No differences were found in the frequency distribution of genotypes among the study groups. Results from this study could be of some help in the characterization of the D-IBS and highlight the contribution of an altered intestinal barrier in the pathogenesis of this syndrome. Besides, a role could be ascribed to molecules secreted by the visceral adipose tissue that can impact on barrier functions.


Repeat breast-conserving treatment of ipsilateral breast cancer recurrence: a nationwide survey amongst breast surgeons and radiation oncologists in the Netherlands.
In line with the paradigm to minimize surgical morbidity in patients with primary breast cancer, there is increasing evidence for the safety of a repeat breast-conserving treatment (BCT) of an ipsilateral breast tumour recurrence (IBTR) in selected patients. The conditions for the feasibility of a repeat BCT vary widely in literature. In clinical practice, many physicians have ongoing concerns about the oncological safety and possible toxicity of repeat BCT. To investigate the attitude of Dutch breast surgeons and radiation oncologists towards repeat BCT and to report on their experiences with, objections against and perceived requirements to consider a repeat BCT in case of IBTR. An online survey consisting of a maximum of 26 open and multiple-choice questions about repeat BCT for IBTR was distributed amongst Dutch breast surgeons and radiation oncologists. Forty-nine surgeons representing 49% of Dutch hospitals and 20 radiation oncologists representing 70% of Dutch radiation oncology centres responded. A repeat BCT was considered feasible in selected cases by 28.7% of breast surgeons and 55% of radiation oncologists. The most important factors to consider a repeat BCT for both groups were the patient's preference to preserve the breast and surgical feasibility of a second lumpectomy. Arguments against a repeat BCT were based on the perceived unacceptable toxicity and cosmesis of a second course of radiotherapy. The technique of preference for re-irradiation would be partial breast irradiation (PBI) according to all radiation oncologists. Differentiating between new primary tumours (NPT) and true recurrences (TR) was reported to be done by 57.1% of breast surgeons and 60% of radiation oncologists. The most important reason to differentiate between NPT and TR was to establish prognosis and to consider whether a repeat BCT would be feasible. An increasing number of Dutch breast cancer specialists is considering a repeat BCT feasible in selected cases, at the patient's preference and with partial breast re-irradiation.


Occurrence and clinical correlates of psychiatric comorbidity in patients with psychotic disorders.
The aim of this study was to explore patterns and clinical correlates of psychiatric comorbidity in patients with schizophrenia spectrum disorders and mood spectrum disorders with psychotic features. Ninety-six consecutively hospitalized patients with current psychotic symptoms were recruited and included in this study. Index episode psychotic diagnosis and psychiatric comorbidity were assessed using the Structured Clinical Interview for DSM-III-R-Patient Version (SCID-P). Psychopathology was assessed by the SCID-P, Brief Psychiatric Rating Scale, Scale for the Assessment of Negative Symptoms, and Hopkins Symptom Checklist. Awareness of illness was assessed with the Scale to Assess Unawareness of Mental Disorders. The total lifetime prevalence of psychiatric comorbidity in the entire cohort was 57.3% (58.1% in schizophrenia spectrum disorders and 56.9% in mood spectrum psychoses). Overall, panic disorder (24%), obsessive-compulsive disorder (24%), social phobia (17.7%), substance abuse (11.5%), alcohol abuse (10.4%), and simple phobia (7.3%) were the most frequent comorbidities. Within the group of mood spectrum disorders, negative symptoms were found to be more frequent among patients with psychiatric comorbidity than among those without comorbidity, while such a difference was not detected within the group of schizophrenia spectrum disorders. Social phobia, substance abuse disorder, and panic disorder comorbidity showed the greatest association with psychotic features. An association between earlier age at first hospitalization and comorbidity was found only in patients with unipolar psychotic depression. Patient self-reported psychopathology was more severe in schizophrenia spectrum patients with comorbidity than in those without, while such a difference was less pronounced in mood spectrum psychoses. These findings suggest that psychiatric comorbidity is a relevant phenomenon in psychoses and is likely to negatively affect the phenomenology of psychotic illness. Further studies in larger psychotic populations are needed to gain more insight into the clinical and therapeutic implications of psychiatric comorbidity in psychoses.


Rotavirus-associated seizures and reversible corpus callosum lesion.
Rotavirus is a non-enveloped double-stranded RNA virus that causes severe gastroenteritis in children, but complications are rarely reported. Some reports have shown that rotavirus can induce diverse complications of the central nervous system, such as seizures, encephalopathy with a reversible splenial lesion, encephalitis, cerebral white matter abnormalities, and cerebellitis. Here, we present a 2-year-old patient with seizures, who had an isolated splenial lesion in the corpus callosum on neuroimaging, and the rotavirus antigen detected in faeces.


A Comprehensive Review on the Techniques for Extraction of Bioactive Compounds from Medicinal Cannabis.
Cannabis is well-known for its numerous therapeutic activities, as demonstrated in pre-clinical and clinical studies primarily due to its bioactive compounds. The Cannabis industry is rapidly growing; therefore, product development and extraction methods have become crucial aspects of Cannabis research. The evaluation of the current extraction methods implemented in the Cannabis industry and scientific literature to produce consistent, reliable, and potent medicinal Cannabis extracts is prudent. Furthermore, these processes must be subjected to higher levels of scientific stringency, as Cannabis has been increasingly used for various ailments, and the Cannabis industry is receiving acceptance in different countries. We comprehensively analysed the current literature and drew a critical summary of the extraction methods implemented thus far to recover bioactive compounds from medicinal Cannabis. Moreover, this review outlines the major bioactive compounds in Cannabis, discusses critical factors affecting extraction yields, and proposes future considerations for the effective extraction of bioactive compounds from Cannabis. Overall, research on medicinal marijuana is limited, with most reports on the industrial hemp variety of Cannabis or pure isolates. We also propose the development of sustainable Cannabis extraction methods through the implementation of mathematical prediction models in future studies.


Health technology assessment in Canada.
Canada's health system is a unique combination of public financing and private provision. With the significant government role in financing health services, health technology assessment (HTA) has found a ready audience as a form of policy research. In addition, Canada has been a leader in HTA and is entering a phase of deepening and maturation of HTA activities. The relative absence of dramatic change in the overall health system, coupled with public faith in the Canadian approach has been favorable to HTA's development in Canada. Emerging issues, beyond the demographic and economic pressures facing all Organisation for Economic Co-operation and Development health systems, include the convergence of assessment modalities and organizations for drug and nondrug technologies, increasing public concerns about the viability of Canada's approach to healthcare services, and the transition of HTA from an activity targeting macro-level policy makers to a management tool for healthcare facilities and providers.


Risk factors across the life course and dementia in a Brazilian population: results from the Sao Paulo Ageing & Health Study (SPAH).
Several mechanisms have been suggested to explain the association between adversities across life and dementia. This study aimed to investigate the association between indicators of socioeconomic disadvantages throughout the life-course and dementia among older adults in Sao Paulo, Brazil and to explore possible causal pathways. We used baseline data from the SPAH study which involved participants aged 65 years and older (n = 2005). The outcome of interest was prevalent dementia. Exposures included in the analyses were socioeconomic position (SEP) indicators in childhood (place of birth and literacy) and adulthood (occupation and income), anthropometric measurements as markers of intrauterine and childhood environment (head circumference and leg length), smoking, diabetes and hypertension. Logistic regression models were used to test the hypothesized pathways and to assess whether there was an association between cumulative adversities across the life course and prevalent dementia. Indicators of socioeconomic disadvantage in early life were associated with increased prevalence of dementia. This association was partially mediated through adulthood SEP. Head circumference and leg length were also clearly associated with dementia but there was no evidence that this association was mediated by early life socioeconomic disadvantage. There was an association between cumulative unfavourable conditions across the life course and dementia. Early life disadvantages seem to operate through biological mechanisms associated with passive brain reserve and opportunities in life representing active cognitive reserve. Prevention of dementia should start early in life and continue through life span as seen with many other chronic diseases.


Data transformations for improved display and fitting of single-channel dwell time histograms.
A.L. Blatz and K.L. Magleby (1986a. J. Physiol. [Lond.]. 378:141-174) have demonstrated the usefulness of plotting histograms with a logarithmic time axis to display the distributions of dwell times from recordings of single ionic channels. We derive here the probability density function (pdf) corresponding to logarithmically binned histograms. Plotted on a logarithmic time scale the pdf is a peaked function with an invariant width; this and other properties of the pdf, coupled with a variance-stabilizing (square root) transformation for the ordinate, greatly simplify the interpretation and manual fitting of distributions containing multiple exponential components. We have also examined the statistical errors in estimation, by the maximum-likelihood method, of kinetic parameters from logarithmically binned data. Using binned data greatly accelerates the fitting procedure and introduces significant errors only for bins spaced more widely than 8-16 per decade.


Technology evaluation: AAV factor IX gene therapy, Avigen Inc.
Avigen has developed a recombinant adeno-associated viral vector expressing human blood-coagulation Factor IX (F.IX) for the potential treatment of hemophilia B. In a phase I clinical trial being conducted at The Children's Hospital of Philadelphia and Stanford University Medical Center, the vector, AAV-CMV-hF.IX (Coagulin-B), was injected at a low dose into three patients with severe hemophilia B. No evidence of toxicity, germline transmission of vector sequences, or formation of inhibitory antibodies against F.IX was observed, and in two of the three patients there was an indication of a modest clinical response.


Strengths and Limitations of Web-Based Cessation Support for Individuals Who Smoke, Dual Use, or Vape: Qualitative Interview Study.
Tobacco use has shifted in recent years, especially with the introduction of e-cigarettes. Despite the current variable and intersecting tobacco product use among tobacco users, most want to quit, which necessitates cessation programs to adapt to these variable trends (vs focusing on combustible cigarettes alone). The use of web-based modalities for cessation support has become quite popular in recent years and has been compounded by the COVID-19 pandemic. Therefore, understanding the current strengths and limitations of existing programs to meet the needs of current various tobacco users is critical for ensuring the saliency of such programs moving forward. The purpose of this study was to understand the strengths and limitations of web-based cessation support offered through QuitNow to better understand the needs of a variety of end users who smoke, dual use, or vape. Semistructured interviews were conducted with 36 nicotine product users in British Columbia. Using conventional content analysis methods, we inductively derived descriptive categories and themes related to the strengths and limitations of QuitNow for those who smoke, dual use, or vape. We analyzed the data with the support of NVivo (version 12; QSR International) and Excel (Microsoft Corporation). Participants described several strengths and limitations of QuitNow and provided suggestions for improvement, which fell under 2 broad categories: look and feel and content and features. Shared strengths included the breadth of information and the credible nature of the website. Individuals who smoke were particularly keen about the site having a nonjudgmental feeling. Moreover, compared with individuals who smoke, individuals who dual use and individuals who vape were particularly keen about access to professional quit support (eg, quit coach). Shared limitations included the presence of too much text and the need to create an account. Individuals who dual use and individuals who vape thought that the content was geared toward older adults and indicated that there was a lack of information about vaping and personalized content. Regarding suggestions for improvement, participants stated that the site needed more interaction, intuitive organization, improved interface esthetics, a complementary smartphone app, forum discussion tags, more information for different tobacco user profiles, and user testimonials. Individuals who vape were particularly interested in website user reviews. In addition, individuals who vape were more interested in an intrinsic approach to quitting (eg, mindfulness) compared with extrinsic approaches (eg, material incentives), the latter of which was endorsed by more individuals who dual use and individuals who smoke. The findings of this study provide directions for enhancing the saliency of web-based cessation programs for a variety of tobacco use behaviors that hallmark current tobacco use.


Bis(tetra-n-butylammonium) di-mu-chloro-bis[(tetramethyl buta-1,3-diene-1,2,3,4-tetracarboxylato-kappa(2)C(1),C(4))palladium].
The anionic complex in the title compound, (C(16)H(36)N)(2)[Pd(2)(C(12)H(12)O(8))(2)Cl(2)], lies on a centre of inversion, so that the [Pd(2)(mu-Cl)(2)] core is planar, which is the most frequent conformation found for complexes containing this moiety in the Cambridge Structural Database [October 2001 Release; Allen & Kennard (1993). Chem. Des. Autom. News, 8, 1, 31-37]. This dinuclear complex has a Pd...Pd distance of 3.5119 (4) A. The bite angle of the chelating ligand [79.79 (8) degrees] distorts the square-planar coordination around the metal atom.


Expression and prognostic value of the cell polarity PAR complex members in thyroid cancer.
Establishment and maintenance of the apical-basal cell polarity, required for proper replication, migration, specialized functions and tissue morphogenesis, relies on three evolutionary conserved complexes: PAR, CRUMBS and SCRIBBLE. Loss of cell polarity/cohesiveness (LOP/C) is implicated in cancer progression, and members of the polarity complex have been described as either oncogenes or oncosuppressors. However, no information on their role in thyroid cancer (TC) progression is available. In the present study, we evaluated the gene expression of the PAR complex members aPKCι, PARD3α/β and PARD6α/β/γ in 95 papillary TC (PTC), compared to their normal matched tissues and in 12 anaplastic TC (ATC). The mRNA and protein levels of investigated genes were altered in the majority of PTC and ATC tissues. In PTC, univariate analysis showed that reduced expression of aPKCι, PARD3β and PARD6γ mRNAs is associated with increased tumor size, and the reduced expression of PARD3β mRNA is associated also with recurrences. Multivariate analysis demonstrated that the presence of lymph node metastasis at diagnosis and the reduced expression of PARD3β are independent risk factors for recurrences, with hazard ratio, respectively, of 8.21 (p=0.006) and 3.04 (p=0.029). The latter result was confirmed by the Kaplan-Meier analysis, which evidenced the association between decreased PARD3β mRNA levels and shorter disease-free interval. In conclusion, we demonstrated that the expression of PAR complex components is deregulated in the majority of PTC and there is a general trend towards their reduction in ATC tissues. Moreover, a prognostic value for the PARD3β gene in PTCs is suggested.


Social and Economic Burden Associated With Typhoid Fever in Kathmandu and Surrounding Areas: A Qualitative Study.
Typhoid fever is a significant contributor to infectious disease mortality and morbidity in low- and middle-income countries, particularly in South Asia. With increasing antimicrobial resistance, commonly used treatments are less effective and risks increase for complications and hospitalizations. During an episode of typhoid fever, households experience multiple social and economic costs that are often undocumented. In the current study, qualitative interview data from Kathmandu and surrounding areas provide important insights into the challenges that affect those who contract typhoid fever and their caregivers, families, and communities, as well as insight into prevention and treatment options for health providers and outreach workers. When considering typhoid fever cases confirmed by blood culture, our data reveal delays in healthcare access, financial and time costs burden on households, and the need to increase health literacy. These data also illustrate the impact of limited laboratory diagnostic equipment and tools on healthcare providers' abilities to distinguish typhoid fever from other febrile conditions and treatment challenges associated with antimicrobial resistance. In light of these findings, there is an urgent need to identify and implement effective preventive measures including vaccination policies and programs focused on at-risk populations and endemic regions such as Nepal.


Quantitative analysis of biofilm formation of methicillin-resistant Staphylococcus aureus (MRSA) strains from patients with orthopaedic device-related infections.
Biofilms play a pivotal role in medical device-related infections. However, epidemiological analysis of biofilm formation and genotyping among clinical methicillin-resistant Staphylococcus aureus (MRSA) isolates from patients with orthopaedic infections has rarely been reported. A total of 168 MRSA strains were examined: 23 strains from patients with device-related infection (the device group); 55 from patients with device-non-related infection (the nondevice group); and 90 from asymptomatic nasal carriers (the colonization group). Pulsed-field gel electrophoresis analysis and five genotyping methods including agr typing were performed. Biofilm formation was quantified using a microtitre plate assay. The device group had a significantly higher incidence of agr-2 than the colonization group (78.3% vs. 34.4%, P=0.001). The biofilm index of the agr-2 (0.523 ± 0.572) strains was significantly higher than those of agr-1 (0.260 ± 0.418, P<0.0001) and agr-3 (0.379 ± 0.557, P=0.045). The prevalence of strong biofilm formers in the device group (43.5%) was significantly higher than that in the nondevice group (12.7%, P=0.003) and the colonization group (20.0%, P=0.020). agr-2 MRSA strains may be more likely to cause orthopaedic device infection because of their strong biofilm formation ability.


Effectiveness of a community-based strategic anthelmintic treatment programme in the control of gastrointestinal nematodes and Fasciola gigantica in cattle in Kilolo district, Tanzania.
A longitudinal demonstration project was carried out in 2005/2006 for thirteen months to determine the effectiveness of a strategic community-based worm control (CBWC) programme in the control of gastrointestinal (GI) nematodes and Fasciola gigantica in cattle. Two villages namely, a CBWC village (Ilula-Masukanzi) and a village without CBWC (Kilolo-Luganga) were randomly selected in Kilolo district, Iringa region of Tanzania. Animals in both villages were under the traditional management system and used the village communal grazing area. At the village with CBWC, 60 zebu cattle (6-18 months old) from 10 farms in the village were selected and ear tagged for monthly sampling and weghing. A strategic CBWC programme was instituted whereby all animals in the village (tagged and non-tagged) were treated with albendazole 10% drench at 10 mg/kg four times a year e.g. middle of the rainy season (February), end of the rainy season (May), middle of the dry season (September) and late dry/early rainy season (December). In the village without CBWC, 68 zebu cattle (6-18 months old) from 11 farms in the village were selected and tagged for monthly sampling and weighing. Farmers in the village without CBWC were allowed to continue with their normal management practices including anthelmintic treatments. Faecal and blood samples from tagged animals and pasture samples from communal grazing areas were collected on monthly basis for 13 months. Results showed that strategic CBWC programme was highly effective in reducing faecal egg counts (FEC) and the proportion of animals passing Fasciola eggs in faeces. The strategic CBWC significantly reduced FEC of animals by an average of 60% compared to animals at the village without CBWC (P < 0.01). Four strategic CBWC treatments per year significantly reduced the proportion of animals passing Fasciola eggs in faeces by an average of 82.5% compared to animals at the village without CBWC (P < 0.05). From commencement to the end of the trial, animals at the village with CBWC significantly outgained animals at the village without CBWC by an average of 13.9 kg per year (P < .05). It is concluded that strategic CBWC programme was highly effective in reducing FEC, reducing the proportion of animals passing Fasciola eggs in faeces and improved weight gain in animals.


Evaluation of the family health strategy implementation in Santa Catarina in 2004 and 2008.
This study aimed to evaluate the implementation of the Family Health Program in municipalities of the State of Santa Catarina, Brazil at two different periods (2004 and 2008). Two hundred forty-four (83%) municipalities with complete health information data comprised the sample. Indicators of coverage, evidence of change in the healthcare model, and impact were calculated based on health system database. Official documents and observed distribution of measures at the country level were used in order to classify municipalities within each indicator. A high coverage level increased from 73 to 83% of the cities between 2004 and 2008. Most of them showed poor evidence of change in the healthcare model at both time points. Increased proportion of cities showed low levels of morbidity by diseases sensible to the primary health care from 2004 to 2008. Despite the fact that was improvement in coverage and impact indicators over four years, most of the cities studied showed poor evidence of change in the healthcare model, warning to the review of the health care practices and organization by health professionals and managers.


Mechanisms of chronic nicotine treatment-induced enhancement of the sensitivity of cortical neurons to the neuroprotective effect of donepezil in cortical neurons.
We have previously shown that chronic donepezil treatment induces nicotinic acetylcholine receptor up-regulation and enhances the sensitivity of the neurons to the neuroprotective effect of donepezil. Further analyses revealed that the nicotinic receptor is involved in this enhancement. In this study, we examined whether nicotinic receptor stimulation is sufficient to make neurons more sensitive to donepezil. We treated primary cultures of rat cortical neurons with nicotine and confirmed that chronic nicotine treatment induced nicotinic receptor up-regulation and made the neurons more sensitive to the neuroprotective effects of donepezil. Analyses with receptor antagonists and kinase inhibitors revealed that the effects of chronic nicotine treatment are mediated by nicotinic receptors and their downstream effectors including phosphatidylinositol 3-kinase. In contrast to chronic donepezil treatment that enhanced the level of nicotine-induced Ca(2+) influx, chronic nicotine treatment did not significantly alter the level of Ca(2+) influx.


Reason and Timing for Conversion to Sternotomy in Robotic-Assisted Coronary Artery Bypass Grafting and Patient Outcomes.
Conversion to sternotomy is a primary bailout method for robotically assisted coronary artery bypass grafting procedures. The aims of this study were to identify the primary reasons for conversion from robotically assisted coronary artery bypass grafting to sternotomy and to evaluate the in-hospital outcomes in such patients. Prospectively collected data from February 2004 to April 2017 were reviewed for 72 patients (56 men; mean age = 63.8 years) who required conversion to sternotomy during a robotically assisted coronary artery bypass grafting procedure with planned endoscopic left internal thoracic artery harvest and anastomosis to the left anterior descending on the beating heart. The overall rate of conversion was 12.4% (72/581). Conversions occurred either during attempted endoscopic left internal thoracic artery harvest (31.9%), during endoscopic left anterior descending isolation (40.3%), during manual isolation and anastomosis of the left anterior descending (19.4%), or after anastomosis due to unsatisfactory flow (8.3%). Overall, the most common reason for conversion was an intramyocardial left anterior descending (43.1%). The median stay in the intensive care unit was 1 day (range = 0-20) and the median hospital length of stay was 5 days (range = 3-43). In-hospital complications included new atrial fibrillation (16.7%), need for blood transfusion (20.8%), mediastinitis (4.2%), postoperative myocardial infarction (2.8%), exploration for bleeding (2.8%), and 1 in-hospital death. The reasons for conversion were primarily related to anatomical factors that created difficulties for endoscopic left internal thoracic artery harvesting and left anterior descending identification. Patients who required conversion to sternotomy from robotically assisted coronary artery bypass grafting demonstrated acceptable outcomes and low complication rates.


A novel method for determining residence time distribution in intricately structured microreactors.
A precise characterisation of microreactors can be achieved by determining the residence time distribution as one of the most important flow characteristics. An approach specially designed for microreactor applications was developed, which employs a tracer 'injection' using the optical activation of a caged fluorescent dye. Furthermore, the effect of the laminar flow on the determination of the residence time distribution in microreactors has been taken into account during the measurements and their interpretation to fulfill the requirements of the so-called 'mixing-cup-problem' on the microscale. Residence time distributions for an intricately structured thin microreactor were determined for different velocities. The ideality of the stimulus signal generated by the newly introduced technique is demonstrated for an analytically well-defined straight channel and compared with a signal derived from deconvolution of non-ideal input signals.


Serological analysis of specific IgA to Chlamydia pneumoniae: increased sensitivity of IgA antibody detection using prolonged incubation and high antigen concentration.
The microimmunofluorescence technique (MIF) is recognized as the only test hitherto allowing discrimination between different Chlamydia species and is considered to be the reference method for serology. This method was developed for the detection of IgG and IgM antibodies only. We investigated the effects of some test parameters on the ability of MIF to detect Chlamydia pneumoniae IgA. These parameters were the time needed for binding of serum IgA to C. pneumoniae antigen and the effect of antigen concentration on the outcome of IgA antibody testing. It was found that the most sensitive MIF tests for the detection of serum IgA antibodies were those in which an overnight incubation of sera with antigen slides containing high concentrations of chlamydial elementary bodies was employed. The number of patients with chronic infections found to have elevated IgA titers was increased by 25% using longer incubation times for the antibody-antigen reaction. Thirty-two sera from patients with coronary artery disease and confirmed chronic C. pneumoniae infection were used to compare antigen slides with low and high concentrations of elementary bodies with respect to IgA levels; 31/32 patients were found to have specific IgA antibodies to C. pneumoniae using the high antigen concentration, as opposed to only 22/32 patients using the low antigen concentration.


Interaction of gelatin with polyenes modulates antifungal activity and biocompatibility of electrospun fiber mats.
Topical application of antifungals does not have predictable or well-controlled release characteristics and requires reapplication to achieve therapeutic local concentration in a reasonable time period. In this article, the efficacy of five different US Food and Drug Administration-approved antifungal-loaded (amphotericin B, natamycin, terbinafine, fluconazole, and itraconazole) electrospun gelatin fiber mats were compared. Morphological studies show that incorporation of polyenes resulted in a two-fold increase in fiber diameter and the mats inhibit the growth of yeasts and filamentous fungal pathogens. Terbinafine-loaded mats were effective against three filamentous fungal species. Among the two azole antifungals compared, the itraconazole-loaded mat was potent against Aspergillus strains. However, activity loss was observed for fluconazole-loaded mats against all of the test organisms. The polyene-loaded mats displayed rapid candidacidal activities as well. Biophysical and rheological measurements indicate strong interactions between polyene antifungals and gelatin matrix. As a result, the polyenes stabilized the triple helical conformation of gelatin and the presence of gelatin decreased the hemolytic activity of polyenes. The polyene-loaded fiber mats were noncytotoxic to primary human corneal and sclera fibroblasts. The reduction of toxicity with complete retention of activity of the polyene antifungal-loaded gelatin fiber mats can provide new opportunities in the management of superficial skin infections.


Management of routine postoperative pain for children undergoing cardiac surgery: a Paediatric Acute Care Cardiology Collaborative Clinical Practice Guideline.
Pain following surgery for cardiac disease is ubiquitous, and optimal management is important. Despite this, there is large practice variation. To address this, the Paediatric Acute Care Cardiology Collaborative undertook the effort to create this clinical practice guideline. A panel of experts consisting of paediatric cardiologists, advanced practice practitioners, pharmacists, a paediatric cardiothoracic surgeon, and a paediatric cardiac anaesthesiologist was convened. The literature was searched for relevant articles and Collaborative sites submitted centre-specific protocols for postoperative pain management. Using the modified Delphi technique, recommendations were generated and put through iterative Delphi rounds to achieve consensus. 60 recommendations achieved consensus and are included in this guideline. They address guideline use, pain assessment, general considerations, preoperative considerations, intraoperative considerations, regional anaesthesia, opioids, opioid-sparing, non-opioid medications, non-pharmaceutical pain management, and discharge considerations. Postoperative pain among children following cardiac surgery is currently an area of significant practice variability despite a large body of literature and the presence of centre-specific protocols. Central to the recommendations included in this guideline is the concept that ideal pain management begins with preoperative counselling and continues through to patient discharge. Overall, the quality of evidence supporting recommendations is low. There is ongoing need for research in this area, particularly in paediatric populations.


Sex distribution of offspring-parents obesity: Angel's hypothesis revisited.
This study, which is based on two cross sectional surveys' data, aims to establish any effect of parental obesity sex distribution of offspring and to replicate the results that led to the hypothesis that obesity may be associated with sex-linked recessive lethal gene. A representative sample of 4,064 couples living in Renfrew/Paisley, Scotland was surveyed 1972-1976. A total of 2,338 offspring from 1,477 of the couples screened in 1972-1976, living in Paisley, were surveyed in 1996. In this study, males represented 47.7% among the total offspring of the couples screened in 1972-1976. In the first survey there was a higher male proportion of offspring (53%, p < 0.05) from parents who were both obese, yet this was not significant after adjustment for age of parents. Also, there were no other significant differences in sex distribution of offspring according to body mass index, age, or social class of parents. The conditions of the original 1949 study of Angel ( 1949 ) (which proposed a sex-linked lethal recessive gene) were simulated by selecting couples with at least one obese daughter. In this subset, (n = 409), obesity in fathers and mothers was associated with 26% of offspring being male compared with 19% of offspring from a non-obese father and obese mother. Finally we conclude that families with an obese father have a higher proportion of male offspring. These results do not support the long-established hypotheses of a sex-linked recessive lethal gene in the etiology of obesity.


[performance evaluation of the programs aimed at myocardial infraction prevention by relevant mortality rates].
Despite implemented measures and general favourable trend, number of patients with myocardial infarction remains high, younger people are increasingly becoming ill and dying. The study purpose: to estimate age-sex mortality dynamics from acute and recurrent myocardial infarction in adults in Moscow compared to Russia's average in 2007-2021 to reveal patterns of mortality change within the implementation period of state prevention programs. Standardized adult mortality rates for Moscow and Russia, mean expected age at death within interval 20-85 years and gain in life expectancy when eliminating this cause calculated and analyzed. Moscow morbidity rates for acute and recurrent myocardial infarction are twice lower than Russia's, there are higher reduction rates for both diseases - by 16% and 58% respectively. During study period, mortality from myocardial infarction in men was by 45% higher than in women. In 2007 Moscow male-female difference estimated 3% and in 15 years it became 32% due to faster female mortality reduction. Whereas Russia's average age of death from myocardial infarction in 2021 returned to 2010-2011 levels, then in Moscow during 2020-2021 female rates returned to 2008's and male rates fall out the study period. Since implementation of the first programs on reducing mortality from chronic non-infectious diseases during the 15 years period morbidity and mortality rates from myocardial infarction reduced in Russia and Moscow in all ages. Acute and recurrent myocardial infarction have rejuvenated both in men and women as a negative effect of the pandemic.


Special considerations for the use of lung transplantation in pediatrics.
Lung transplantation has become an accepted therapy in infants, children and adolescents suffering from end-stage lung diseases, an impaired quality of life as well as a reduced life expectancy. Within Europe, pediatric lung transplantation is largely performed in predominantly adult centers due to a relatively low overall case volume. Children do represent a specific and challenging cohort facing a transplant procedure, where the selection of potential candidates becomes a crucial step to maximize net survival benefit. Therefore, interdisciplinary evaluation and early listing in view of current indications and contraindications, adequate preoperative education of the child and family members, discussion of possibly required bridging procedures in case of deterioration, appropriate technical planning of the operation, adherence to postoperative medical treatment and follow-up are all crucial steps in this demanding puzzle. In this article, the authors review recent advances in the field of pediatric lung transplantation and outline challenges in the future.


Predicting passenger seat comfort and discomfort on the basis of human, context and seat characteristics: a literature review.
This literature review focused on passenger seat comfort and discomfort in a human-product-context interaction. The relationships between anthropometric variables (human level), activities (context level), seat characteristics (product level) and the perception of comfort and discomfort were studied through mediating variables, such as body posture, movement and interface pressure. It is concluded that there are correlations between anthropometric variables and interface pressure variables, and that this relationship is affected by body posture. The results of studies on the correlation between pressure variables and passenger comfort and discomfort are not in line with each other. Only associations were found between the other variables (e.g. activities and seat characteristics). A conceptual model illustrates the results of the review, but relationships could not be quantified due to a lack of statistical evidence and large differences in research set-ups between the reviewed papers. Practitioner Summary: This literature review set out to quantify the relationships between human, context and seat characteristics, and comfort and discomfort experience of passenger seats, in order to build a predictive model that can support seat designers and purchasers to make informed decisions. However, statistical evidence is lacking from existing literature.


Characteristic features of an alpha-galactosidase from mung beans.
Two molecular forms, I and II (high and low molecular mass) of alpha-galactosidase were demonstrated in dry mung beans and a multi-step procedure was developed for isolating the tetrameric enzyme I in good yield. Two affinity chromatographic techniques were employed and an overall 10 000-fold purification was achieved. The enzyme was able to catalyse the hydrolysis of alpha-galactosidic linkages as well as agglutinate rabbit erythrocytes (clot formation). The clot was temporary and dissolved on longer incubation, yielding free galactose. The pH optima for both activities were similar. The enzyme also destroyed human-blood-group-B activity and increased H activity. The effect of pH on Km and Vmcx of the enzyme indicated the importance of carboxyl (pK approximately equal to 4.0) and histidine (pK approximately equal to 6.5) groups for activity. This was confirmed by amino acid modification experiments in the absence and presence of the substrate. The stoichiometry of enzyme inactivation showed the probable presence of 12 carboxyl groups and 9 histidine imidazole groups/molecule enzyme in the active site. The effects of modification of the groups on enzymic and hemagglutinating activities were parallel. A model explaining the display of both the activities by the enzyme, is presented in which hemagglutination is shown to be due to the formation of slightly stable enzyme-substrate complex. It is proposed that a true lectin should not alter the covalent status of the binding sugar.


Molecular Characterization of the Coproduced Extracellular Vesicles in HEK293 during Virus-Like Particle Production.
Vaccine therapies based on virus-like particles (VLPs) are currently in the spotlight due to their potential for generating high immunogenic responses while presenting fewer side effects than conventional vaccines. These self-assembled nanostructures resemble the native conformation of the virus but lack genetic material. They are becoming a promising platform for vaccine candidates against several diseases due to the ability of modifying their membrane with antigens from different viruses. The coproduction of extracellular vesicles (EVs) when producing VLPs is a key phenomenon currently still under study. In order to characterize this extracellular environment, a quantitative proteomics approach has been carried out. Three conditions were studied: non-transfected, transfected with an empty plasmid as control, and transfected with a plasmid coding for HIV-1 Gag polyprotein. A shift in EV biogenesis has been detected upon transfection, changing the production from large to small EVs. Another remarkable trait found was the presence of DNA being secreted within vesicles smaller than 200 nm. Studying the protein profile of these biological nanocarriers, it was observed that EVs were reflecting an overall energy homeostasis disruption via mitochondrial protein deregulation. Also, immunomodulatory proteins like ITGB1, ENO3, and PRDX5 were identified and quantified in VLP and EV fractions. These findings provide insight on the nature of the VLP extracellular environment defining the characteristics and protein profile of EVs, with potential to develop new downstream separation strategies or using them as adjuvants in viral therapies.


The nutrient supply of pathogenic fungi; a fertile field for study.
SUMMARY Phytopathogenic fungi must feed on their hosts to propagate and cause disease. Their ability to access the rich nutrient supply offered by living plants is one of the most obvious properties that distinguish pathogens from saprophytes. Successful invasion by pathogens depends as much on their ability to utilize the available nutrient sources offered by plants as on their ability to penetrate plants and evade defensive mechanisms. Here, we review current knowledge on the nature of the nutrient supplies utilized by pathogens during infection. The available evidence is rudimentary in most cases. There is much evidence to suggest that fungal metabolism can be divided into at least two phases. The first is based on lipolysis and occurs during germination and penetration of the host. The second phase uses glycolysis and predominates during the invasion of host tissue. We also propose, mainly on theoretical grounds, that a third phase of nutrition occurs late in infection during which new spores are produced. Contrary to early assumptions, the nitrogen sources available to some pathogens appear to be abundant. The idea that nitrogen starvation is a cue that controls fungal gene expression during infection may need to be reassessed. Very little is known about the micronutrient (Fe, S, P) or vitamin supply. The knowledge gained from this research may enable the design of new antifungal strategies targeting potential weaknesses in fungal metabolism and will also impact on agronomic practices.


The role of food in the epidemiology of cholera.
Cholera is an acute dehydrating diarrhoeal disease, traditionally caused by vibrio cholerae O1, and also more recently by V. cholerae O139 (Bengal). Traditionally, water was recognized as the primary vehicle for transmission of cholera, but in the past 30 years, outbreaks of cholera associated with eating contaminated food have demonstrated that food also plays an important role, although in many instances water is the source of contamination of foods. Most commonly associated with cholera is seafood, both molluscan shellfish and crustaceans. Seafood may be contaminated in its natural environment or during preparation. Other food items associated with outbreaks are fruit and vegetables, meat, cooked grains, etc. Vegetables are usually contaminated by contact with sewage in soil and fruits when injected with contaminated water to increase weight and turgor. Food items initially free from V. cholerae organism may become contaminated when mixed with water, or other contaminated food, or through handling by infected persons who have not observed proper hygiene. Refrigeration, freezing, alkaline pH, high concentration of carbohydrate, humidity and absence of competing flora enhance the survival of V. cholerae in food. Survival of V. cholerae is shorter in food with acidic pH. Foodborne cholera can be averted by the hygienic preparation of food and its consumption. However, since the vehicles of transmission vary markedly from place to place, being affected by local customs and practices, selected control and preventive measures that are most important locally must be implemented. To this end, application of the Hazard Analysis and Critical Control Point system to food preparation is essential in order to identify the practices which may present a risk. Restrictions on importation of foods which do not present a risk of being contaminated from areas where cholera is endemic is not warranted.


An assessment of bovine herpes virus 4 as a causative agent in abortions and neonatal death.
Numerous viruses, including bovine viral diarrhoea virus (BVDV), bovine herpes virus 1 (BoHV-1) and bovine herpes virus 4 (BoHV-4), and other pathogens are the most common causes of reproductive disorders and are responsible for huge economic losses in livestock production. This study investigates the aetiological role of BoHV-4 in fertility problems such as abortions, stillbirth and birth with unviable calves. Retrospective samples from 38 animals, including 17 aborting cows, 17 aborted foetuses, three stillborn calves and one unviable newborn calf were analysed. The BoHV-4 genome was detected in 25 (65.7%) animals by polymerase chain reaction. In 14 of these infected animals, we detected co-infection with BVDV, while the co-presence of BoHV-1 was also detected in one animal. In addition to the high prevalence of BoHV-4 genome in materials related to fertility problems, isolation of BoHV-4 from the brain of one stillborn calf indicated a causal link between BoHV-4 and fertility problems, such as abortion, stillbirths or birth with unviable calves.


Properties of the slow K+ current of the nodal membrane.
1. In voltage clamped myelinated nerve fibres, some properties of the slow K+ current (Dubois, 1981 b) were analysed under different experimental conditions. 2. The instantaneous slow current-voltage relationships are linear in low and high K+ solutions, and the variation of the reversal potential with external K+ concentration agrees with the predicted Nernst changes for the K+ equilibrium potential. 3. Li+, Na+ and Cs+ are virtually impermeant in the slow channels. Rb+ is permeant and the permeability ratio PRb/PK (calculated from the reversal potential and the Goldman-Hodgkin-Katz equation) is a function of the external K+ and Rb+ concentrations. 4. External and internal Cs+ block respectively the slow inward and outward K+ current and the block is voltage dependent. 5. The closing kinetics of the slow channels are independent of the external K+ concentration but depend on the conditioning pulse duration.


[Lymphocyte subpopulations in malignant bone tumors and their relation to the immune response to the tumor].
Comparative studies of the subpopulations of lymphocytes, isolated from the tumor tissue and blood of 15 osteosarcoma patients, showed that the total lymphocyte count in the neoplasms ranged from 0 to 19% of the total cell population. In various patients tumor lymphocytes were represented either mainly by T cells (up to 80% of lymphocytes) or by "null" cells lacking any surface markers. The population of lymphocytes with surface membrane immunoglobulins with complement and Fc receptors was usually low although the tumors contained up to 90% of nonlymphoid cells with the same markers. Lower (less than 60%) counts of blood T lymphocytes were found only in one third of osteosarcoma patients. The immune response of blood lymphocytes against living autologous tumor cells was found in 85% of the patients, and its intensity depended on the content of T lymphocytes in tumor but not in blood.


Lean body mass positively associate with blood pressure in Chinese adults: the roles of ages and body fat distribution.
The relationship between lean body mass (LBM) and blood pressure (BP) is controversial and limited. This study investigated the associations between LBM indexes and BP in adults of different ages and with varying body fat distribution. The data for the present analysis was obtained from a cross-sectional survey of 1,465 adults (50.7% males) aged 18-70 years conducted in Beijing, China. Regional LBM and fat distribution, including fat mass (FM) and android to gynoid fat ratio (AOI), were assessed using a dual-energy X-ray bone densitometer. Generalized Liner Model (GLM) was employed. Confounders, including age, sex, height, weight, smoking, and alcohol use, were evaluated through questionnaires and physical examinations. Males had higher rates of hypertension (11.19% vs. 4.92%) and prehypertension (21.57% vs. 14.59%) than females. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 122.04 mmHg and 76.68 mmHg. There were no significant associations between LBM and DBP (p > 0.05). However, arms LBM (β = 1.86, 95% CI: 0.77, 2.94) and trunk LBM (β = 0.37, 95% CI: 0.01, 0.73) were significantly associated with SBP. The association of LBM on DBP was stronger with increasing ages, and stronger in females than in males (p < 0.001). The association between adults' arms LBM and SBP was stronger in the high level FM group (β = 2.74 vs. β = 1.30) and high level AOI group (β = 1.80 vs. β = 2.08). The influence of LBM on SBP increases with age, particularly after the age twenty years in females. For adults with high FM or high AOI, LBM in the arms, showed a stronger positive predictive association with SBP. This suggests that, in addition to controlling fat content, future efforts to improve cardiovascular health in adults should include the management of LBM (especially in the upper body).


Mixed infection and clonal representativeness of a single sputum sample in tuberculosis patients from a penitentiary hospital in Georgia.
Studies on recurrent tuberculosis (TB), TB molecular epidemiology and drug susceptibility testing rely on the analysis of one Mycobacterium tuberculosis isolate from a single sputum sample collected at different disease episodes. This scheme rests on the postulate that a culture of one sputum sample is homogeneous and representative of the total bacillary population in a patient. We systematically analysed several pre-treatment isolates from each of 199 smear-positive male adult inmates admitted to a prison TB hospital by standard IS6110 DNA fingerprinting, followed by PCR typing based on multiple loci containing variable number of tandem repeats (VNTRs) on a subset of isolates. Drug susceptibility testing (DST) was performed on all isolates for isoniazid, rifampicin, streptomycin and ethambutol. We found mixed infection in 26 (13.1%) cases. In contrast, analysis of a single pre-treatment isolate per patient would have led to missed mixed infections in all or 14 of these 26 cases by using only standard DNA fingerprinting or the PCR multilocus-based method, respectively. Differences in DST among isolates from the same patient were observed in 10 cases, of which 6 were from patients with mixed infection. These results suggest that the actual heterogeneity of the bacillary population in patients, especially in high TB incidence settings, may be frequently underestimated using current analytical schemes. These findings have therefore important implications for correct interpretation and evaluation of molecular epidemiology data and in treatment evaluations.


Spindle Cell Lipoma Occurring in the Submandibular Space: Fifth Case Reported along with a Concise Review of the Literature.
Spindle cell lipoma (SCL) is an uncommon histological variant of lipoma that accounts for 1.5% of all adipose tumors. It rarely occurs in the oral cavity. The most common sites of involvement are the buccal mucosa, tongue, lip, alveolar mucosa, gingiva, and palate. Submandibular space is a very rare site of occurrence for SCL. When occurs in this site, SCL mainly involves the 4th-7th decade with a female predominance. Due to wide communications of submandibular space, the actual extent and appearance of the lesions present here gets masked up especially those involving the deeper tissues leading to an inaccurate diagnosis. Wide overlap of clinical and histopathological features of SCL to other clinical pathologies leads to a challenging task for the clinicians to reach an accurate diagnosis. To our knowledge, only four cases of intraoral SCL involving the submandibular region directly or indirectly have been reported in the literature. Here we represent another rare case of SCL in an 18-year-old male patient along with a concise review of the literature. This case appears to be quite rare due to its location (submandibular space), age, and sex of the patient (18/M).


Single Units in the Posterior Parietal Cortex Encode Patterns of Bimanual Coordination.
Bimanual coordination is critical for a broad array of behaviors. Drummers, for example, must carefully coordinate movements of their 2 arms, sometimes beating on the same drum and sometimes on different ones. While coordinated behavior is well-studied, the early stages of planning are not well understood. In the parietal reach region (PRR) of the posterior parietal cortex (PPC), the presence of neurons that modulate when either arm moves by itself has been taken as evidence for a role in bimanual coordination. To test this notion, we recorded neurons during both unilateral and bimanual movements. We find that the activity that precedes an ipsilateral arm movement is primarily a sensory response to a target in the neuron's visual receptive field and not a plan to move the ipsilateral arm. In contrast, the activity that precedes a contralateral arm movement is the sum of a movement plan plus a sensory response. Despite not coding ipsilateral arm movements, about half of neurons discriminate between different patterns of bimanual movements. These results provide direct evidence that PRR neurons represent bimanual reach plans, and suggest that bimanual coordination originates in the sensory-to-motor processing stream prior to the motor cortex, within the PPC.


Lesions in the ocular posterior segment of raptors.
Thirty-eight free-living raptors, including various hawks, owls, and an eagle, had lesions of the ocular posterior segment believed to be the result of trauma. Although lesions of the anterior ocular segment and of the rest of the body often were seen, the lesions of the posterior segment of the eye were disproportionately more severe and usually were not suspected by rehabilitation personnel. The tightly encased raptor eye, with its anteriorly placed scleral ossicles, may have rendered the eye more susceptible to contrecoup damage. In the birds that were treated, ocular lesions were resolved and some vision was restored.