[Health Risk Assessment of Drinking Water Quality in Tianjin Based on GIS].
This study intends to assess the potential health hazards of drinking water quality and explore the application of geographic information system( GIS) in drinking water safety in Tianjin. Eight hundred and fifty water samples from 401 sampling points in Tianjin were measured according to the national drinking water standards. The risk assessment was conducted using the environmental health risk assessment model recommended by US EAP, and GIS was combined to explore the information visualization and risk factors simultaneously. The results showed that the health risks of carcinogens, non-carcinogens were 3.83 x 10⁻⁵, 5.62 x 10⁻⁹ and 3.83 x 10⁻⁵ for total health risk respectively. The rank of health risk was carcinogen > non-carcinogen. The rank of carcinogens health risk was urban > new area > rural area, chromium (VI) > cadmium > arsenic > trichlormethane > carbon tetrachloride. The rank of non-carcinogens health risk was rural area > new area > urban, fluoride > cyanide > lead > nitrate. The total health risk level of drinking water in Tianjin was lower than that of ICRP recommended level (5.0 x 10⁻⁵), while was between US EPA recommended level (1.0 x 10⁻⁴-1.0 x 10⁻⁶). It was at an acceptable level and would not cause obvious health hazards. The main health risks of drinking water came from carcinogens. More attentions should be paid to chromium (VI) for carcinogens and fluoride for non-carcinogens. GIS can accomplish information visualization of drinking water risk assessment and further explore of risk factors.


The Effect of Omega-3 Fatty Acids on ARDS: A Randomized Double-Blind Study.
The aim of this study was to evaluate the effect of an enteral nutrition diet, enriched with omega-3 fatty acids because of its anti-inflammatory effects on treatment of patients with mild to moderate ARDS. This randomized clinical trial was performed in two ICUs of Tabriz University of Medical Sciences from Jun 2011 until Sep 2013 in north west of Iran. Fifty-eight patients with mild to moderate ARDS were enroled in this clinical trial. All patients received standard treatment for ARDS based on ARDS network trial. In intervention group, patients received 6 soft-gels of omega-3/day in addition to the standard treatment. Tidal volume, PEEP, pH, PaO2/FiO2 , SaO2, P platue and PaCO2 on the 7(th) and 14(th) days didn't have significant difference between two groups. Indices of lung mechanics (Resistance, Compliance) had significant difference between the groups on the 14(th) day. Pao2 had significant difference between two groups on both 7(th) and 14(th) days. Trend of PaO2 changes during the study period in two groups were significant. We showed that adjusted mortality rate did not have significant difference between two groups. It seems that adding omega-3 fatty acids to enteral diet of patients with ARDS has positive results in term of ventilator free days, oxygenation, lung mechanic indices; however, we need more multi center trials with large sample size and different doses of omega-3 fatty acids for their routine usage as an adjuant for ARDS treatment.


Pulsed Ultrasound-Assisted Extraction as an Alternative Method to Conventional Maceration for the Extraction of the Polyphenolic Fraction of Ribes nigrum Buds: A New Category of Food Supplements Proposed by The FINNOVER Project.
In this research, for the first time, an alternative method to produce Ribes nigrum bud derivatives is presented. Pulsed ultrasound-assisted extraction (PUAE), using a food-grade solvent according to green chemistry principles, has been employed and compared to the conventional extraction method. Traditionally, bud derivatives, a category of botanicals marketed as plant food supplements in the European Community, are produced by macerating meristematic tissues of trees and plants mainly spontaneously collected. Buds are a challenging raw material for the UAE, since meristematic tissues are much softer and fragile than their corresponding adult phenological stage. It is therefore important to assess whether the polyphenolic fraction, very susceptible to degradation, is conserved after UAE. Untargeted polyphenolic fingerprints (UV-Visible and fluorescence) coupled with chemometrics are employed to quickly screen the best extraction conditions, evaluated by the design of experiment (DoE) method. The polyphenolic fraction of the optimized PUAE extract was quantified by targeted HPLC fingerprint and its antiradical activity was determined. PUAE on a lab pilot reactor was proven to be the most practical approach for a rapid (20 min vs. 21 days maceration) and efficient extraction of bioactive polyphenolics from Ribes nigrum buds, encouraging the scale up to an industrial plan.


Insensitivity of tests for reproductive problems.
Studies of reproductive capacity in rodents have been conducted for decades using a design which has had little refinement over the years. Most commonly, one or two litters from each of one through three generations are raised. The variability between studies, generations, groups, and animals often precludes the resolution of subtle toxicologic effects on reproductive parameters. Nonreproductive parameters yield more reliable data than reproductive parameters. Changes in design and additions to the protocol which will provide additional data are discussed. These include semen evaluation and the use of larger group sizes in reproduction studies.


RLIP76 in defense of radiation poisoning.
To determine the role of RLIP76 in providing protection from radiation and chemotherapy. In the present report, we used RLIP76 to refer to both the mouse (Ralbp1) and the human (RLIP76) 76-kDa splice variant proteins (RLIP76) for convenience and to avoid confusion. In other reports, Ralbp1 refers to the mouse enzyme (encoded by the Ralbp1 gene), which is structurally and functionally homologous to RLIP76, the human protein encoded by the human RALBP1 gene. Median lethal dose studies were performed in RLIP76(-/-) and RLIP76(+/+) C57B mice after treatment with a single dose of RLIP76 liposomes 14 h after whole body radiation. The radiosensitivity of the cultured mouse embryonic fibroblasts and the effects of buthionine sulfoximine (BSO), amifostine, c-jun N-terminal kinase (JNK), protein kinase B (Akt), and MAPK/ERK kinase (MEK) were determined by colony-forming assays. Glutathione-linked enzyme activities were measured by spectrophotometric assays, glutathione by dithiobis-2-nitrobenzoic acid (DTNB), lipid hydroperoxides by iodometric titration, and aldehydes and metabolites by thiobarbitauric acid reactive substances and liquid chromatography-mass spectrometry (LCMS). RLIP76(-/-) mice were significantly more sensitive to radiation than were the wild-type, and RLIP76 liposomes prolonged survival in a dose-dependent manner in both genotypes. The levels of 4-hydroxynonenal and glutathione-conjugate of 4-hydroxynonenal were significantly increased in RLIP76(-/-) tissues compared with RLIP76(+/+). RLIP76(-/-) mouse embryonic fibroblasts were markedly more radiosensitive than RLIP76(+/+) mouse embryonic fibroblasts, despite increased glutathione levels in the former. RLIP76 augmentation had a remarkably greater protective effect compared with amifostine. The magnitude of effects of RLIP76 loss on radiation sensitivity was greater than those caused by perturbations of JNK, MEK, or Akt, and the effects of RLIP76 loss could not be completely compensated for by modulating the levels of these signaling proteins. The results of our study have shown that RLIP76 plays a central role in radiation resistance.


Localization of the A kinase anchoring protein AKAP79 in the human hippocampus.
The phosphorylation state of the proteins, regulated by phosphatases and kinases, plays an important role in signal transduction and long-term changes in neuronal excitability. In neurons, cAMP-dependent protein kinase (PKA), protein kinase C (PKC) and calcineurin (CN) are attached to a scaffold protein, A kinase anchoring protein (AKAP), thought to anchor these three enzymes to specific sites of action. However, the localization of AKAP, and the predicted sites of linked phosphatase and kinase activities, are still unknown at the fine structural level. In the present study, we investigated the distribution of AKAP79 in the hippocampus from postmortem human brains and lobectomy samples from patients with intractable epilepsy, using preembedding immunoperoxidase and immunogold histochemical methods. AKAP79 was found in the CA1, presubicular and subicular regions, mostly in pyramidal cell dendrites, whereas pyramidal cells in the CA3, CA2 regions and dentate granule cells were negative both in postmortem and in surgical samples. In some epileptic cases, the dentate molecular layer and hilar interneurons also became immunoreactive. At the subcellular level, AKAP79 immunoreactivity was present in postsynaptic profiles near, but not attached to, the postsynaptic density of asymmetrical (presumed excitatory) synapses. We conclude that the spatial selectivity for the action of certain kinases and phosphatases regulating various ligand- and voltage-gated channels may be ensured by the selective presence of their anchoring protein, AKAP79, at the majority of glutamatergic synapses in the CA1, but not in the CA2/CA3 regions, suggesting profound differences in signal transduction and long-term synaptic plasticity between these regions of the human hippocampus.


Fast- and slow-growing transplantable tumors derived from spontaneous mammary tumors of the DBA/2 Ha-DD mouse.
Nineteen transplantable tumor lines were established from individual spontaneous mammary tumors of the DBA/2 Ha-DD mouse. Of these lines, 5 were classified as fast growing, 8 as medium growing, and 6 as slow growing, based on the time required for the tumors to reach a size of 10 mm in average diameter and on the average survival time of tumor-bearing syngeneic hosts. The relative differences in rate of growth among 5 of these lines remained stable during 11 to 19 transplant generations. In DBA/2J mice, a slow-growing and a fast-growing tumor line were cross-immunogenic. The differences in growth rate between these 2 tumor lines were not primarily related to differences in immunogenicity since they were not abolished in preirradiated hosts. The growth of cell populations from these 2 tumor lines in culture was comparable; however, cells from the fast-growing line had a plating efficiency about 4 times higher than those from the slow-growing line.


Osteoconductive potential of barrier nanoSiO2 PLGA membranes functionalized by plasma enhanced chemical vapour deposition.
The possibility of tailoring membrane surfaces with osteoconductive potential, in particular in biodegradable devices, to create modified biomaterials that stimulate osteoblast response should make them more suitable for clinical use, hopefully enhancing bone regeneration. Bioactive inorganic materials, such as silica, have been suggested to improve the bioactivity of synthetic biopolymers. An in vitro study on HOB human osteoblasts was performed to assess biocompatibility and bioactivity of SiO2 functionalized poly(lactide-co-glycolide) (PLGA) membranes, prior to clinical use. A 15 nm SiO2 layer was deposited by plasma enhanced chemical vapour deposition (PECVD), onto a resorbable PLGA membrane. Samples were characterized by X-ray photoelectron spectroscopy, atomic force microscopy, scanning electron microscopy, and infrared spectroscopy (FT-IR). HOB cells were seeded on sterilized test surfaces where cell morphology, spreading, actin cytoskeletal organization, and focal adhesion expression were assessed. As proved by the FT-IR analysis of samples, the deposition by PECVD of the SiO2 onto the PLGA membrane did not alter the composition and other characteristics of the organic membrane. A temporal and spatial reorganization of cytoskeleton and focal adhesions and morphological changes in response to SiO2 nanolayer were identified in our model. The novedous SiO2 deposition method is compatible with the standard sterilization protocols and reveals as a valuable tool to increase bioactivity of resorbable PLGA membranes.


Ultrasound-guided dry needling versus traditional dry needling for patients with knee osteoarthritis: A double-blind randomized controlled trial.
To compare the effect of ultrasound (US)-guided dry needling (DN) with traditional DN in the treatment of pain and dysfunction for patients with knee osteoarthritis (KOA). A double-blind, randomized controlled trial. Patients (25 male and 65 female), age 50-80 years diagnosed with KOA were recruited and randomly assigned to one of three groups in a 1:1:1 ratio for intervention: real US-guided DN with exercise therapy (G1), placebo US-guided DN with exercise therapy (G2), and exercise therapy solely (G3). G1 and G2 were blinded to the application of real or placebo US guidance by turning the monitor of US imaging out-of-view from participants' vantage points. The effectiveness of blinding was evaluated by asking the participants whether they had received real-US guided DN. The responses were assessed by Chi-square test. Visual Analogue Scale (VAS), Knee injury, and Osteoarthritis Outcome Score (KOOS) subscales (KOOS-pain, KOOS-symptoms, KOOS-quality-of-life (QoL)) were collected at baseline, 4 weeks, and 8 weeks by a blinded assessor. Data were analyzed by mixed model analysis of variance (ANOVA) with Bonferroni correction. Eighty-four participants (61.26±5.57 years) completed the study. G1 achieved significant improvement in VAS at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = -15.61, 95% CI [-25.49, -5.51], p = 0.001; G1 vs. G3: MD = -19.90, 95% CI [-29.71, -10.08], p< 0.001). G1 achieved significant improvement in KOOS-pain at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = 9.76, 95% CI [2.38, 17.14], p = 0.006; G1 vs. G3: MD = 9.48, 95% CI [2.31, 16.66], p = 0.010). KOOS-symptoms and KOOS-QoL were not statistically significant between groups. G2 had no significant difference of the perceptions as G1 with p = 0.128. G2 were successfully blinded to placebo US-guided DN. US-guided DN with exercise therapy may be more effective than traditional DN with exercise therapy or exercise therapy alone in reduce pain of KOA.


[The significance of free radicals and antioxidants due to the load induced by sport activity].
Sport performance is followed by a high production of free radicals. The main reasons are reperfusion after the previous imbalance between the increased need of the organism and the ability of blood supply by oxygen, increased production of ATP, decomposition of the cells particularly white blood cells, oxidation of the purin basis from DNA, stress, output of epinephrine release of free iron, increased temperature in the muscle and its inflammation, and the reception of free radicals from external environment. Peroxidation of lipids, proteins, DNA and other compounds follows the previous biochemical steps. Antioxidants are consumed by free radicals, antioxidative enzymes are released into blood plasma, intracellular calcium is increased, the production of nitric oxide rises, the levels of hydrogen peroxide and hypochlorous acid increase. These penetrate through the membranes and oxidatively damage the tissues. Training improves the ability of the organism to balance the increased load of free radicals. The damage can be lowered by the application of a mixture of antioxidants, the most important are vitamin C, A, E, glutathione, selenium, carnosine, eventually bioflavonoids and ginkgo biloba. The lack of antioxidants can significantly diminish the sport performance and therefore the supplementation with antioxidants is for top sportsmen but also for aged people advisable.


c-Met overexpression contributes to the acquired apoptotic resistance of nonadherent ovarian cancer cells through a cross talk mediated by phosphatidylinositol 3-kinase and extracellular signal-regulated kinase 1/2.
Ovarian cancer is the most lethal gynecologic cancer mainly because of widespread peritoneal dissemination and malignant ascites. Key to this is the capacity of tumor cells to escape suspension-induced apoptosis (anoikis), which also underlies their resistance to chemotherapy. Here, we used a nonadherent cell culture model to investigate the molecular mechanisms of apoptotic resistance of ovarian cancer cells that may mimic the chemoresistance found in solid tumors. We found that ovarian cancer cells acquired a remarkable resistance to anoikis and apoptosis induced by exposure to clinically relevant doses of two front-line chemotherapeutic drugs cisplatin and paclitaxel when grown in three-dimensional than monolayer cultures. Inhibition of the hepatocyte growth factor (HGF) receptor c-Met, which is frequently overexpressed in ovarian cancer, by a specific inhibitor or small interfering RNA blocked the acquired anoikis resistance and restored chemosensitivity in three-dimensional not in two-dimensional cultures. These effects were found to be dependent on both phosphatidylinositol 3-kinase (PI3K)/Akt and extracellular signal-regulated kinase (ERK) 1/2 signaling pathways. Inhibitors of PI3K/Akt abrogated ERK1/2 activation and its associated anoikis resistance in response to HGF, suggesting a signaling relay between these two pathways. Furthermore, we identified a central role of Ras as a mechanism of this cross talk. Interestingly, Ras did not lie upstream of PI3K/Akt, whereas PI3K/Akt signaling to ERK1/2 involved Ras. These findings shed new light on the apoptotic resistance mechanism of nonadherent ovarian cancer ascites cells and may have important clinical implications.


Recent advances in targeting mTOR signaling pathway using small molecule inhibitors.
Targeted-based cancer therapy (TBCT) or personalized medicine is one of the main treatment modalities for cancer that has been developed to decrease the undesirable effects of chemotherapy. Targeted therapy inhibits the growth of tumor cells by interrupting with particular molecules required for tumorigenesis and proliferation of tumor cells rather than interfering with dividing normal cells. Therefore, targeted therapies are anticipated to be more efficient than former tumor treatment agents with minimal side effects on non-tumor cells. Small molecule inhibitors (SMIs) are currently one of the most investigated anti-tumor agents of TBCT. These small organic agents target several vital molecules involved in cell biological processes and induce target cells apoptosis and necrosis. Mechanistic (mammalian) target of rapamycin (mTOR) complexes (mTORC1/2) control different intracellular processes, including growth, proliferation, angiogenesis and metabolism. Signaling pathways, in which mTOR complexes are involved in are usually dysregulated in various tumors and have been shown to be ideal targets for SMIs. Currently, different mTOR-SMIs are in the clinic for the treatment of cancer patients, and several others are in preclinical or clinical settings. In this review, we summarize recent advances in developing different mTOR inhibitors, which are currently in preclinical and clinical investigations or have been approved for cancer treatment.


[Databases for surgical specialists in Cancún, Quintana Roo].
Our aim was to identify the level of knowledge of surgical health-area specialists in Cancún, Quintana Roo, Mexico, from the personal productivity database. We carried out an investigation of 37 surgical specialists: 24 belonged to the Mexican Social Security Institute (IMSS), while 13 belonged to the Mexican Health Secretariat (SSA). In our research, we found that 61% of surgical health-area specialist physicians were familiar with some aspects of the institutional surgical registry, including the following: 54% knew of the existence of a personal registry of surgeries carried out, and 43% keep a record of their personal activities. From the latter percentage, 69% of surgical health-area specialist physicians mentioned keeping their records manually, while 44% used the computer. Results of the research suggest that these physicians would like to have some kind of record of the surgeries carried out by each. An important percentage of these specialists do not keep a personal record on a database; due to this lack of knowledge, we obtain incorrect information in institutional records of the reality of what is actually done. We consider it important to inform surgical specialists concerning the existence of personal institutional records in database form or even of record done manually, as well as correct terminology for the International Codification (CIE-9 & 10). We inform here of the need to encourage a culture in records and databases in the formative stage of surgeon specialists.


[Intestinal invagination in children older than one year].
The results of treatment of 51 children at the age over 1 year with intestinal invagination were analysed. Intestinal invagination in them is caused by the organic factors, the course is atypical, clinical signs--as in other acute abdominal diseases. For timely diagnosis of intestinal invagination, it is necessary to use the roentgenological, endoscopic methods of investigation and laparoscopy. Rational tactics permitted the authors to achieve the positive results of treatment in all the patients.


Ingroup favoritism and intergroup cooperation under indirect reciprocity based on group reputation.
Indirect reciprocity in which players cooperate with unacquainted other players having good reputations is a mechanism for cooperation in relatively large populations subjected to social dilemma situations. When the population has group structure, as is often found in social networks, players in experiments are considered to show behavior that deviates from existing theoretical models of indirect reciprocity. First, players often show ingroup favoritism (i.e., cooperation only within the group) rather than full cooperation (i.e., cooperation within and across groups), even though the latter is Pareto efficient. Second, in general, humans approximate outgroup members' personal characteristics, presumably including the reputation used for indirect reciprocity, by a single value attached to the group. Humans use such a stereotypic approximation, a phenomenon known as outgroup homogeneity in social psychology. I propose a model of indirect reciprocity in populations with group structure to examine the possibility of ingroup favoritism and full cooperation. In accordance with outgroup homogeneity, I assume that players approximate outgroup members' personal reputations by a single reputation value attached to the group. I show that ingroup favoritism and full cooperation are stable under different social norms (i.e., rules for assigning reputations) such that they do not coexist in a single model. If players are forced to consistently use the same social norm for assessing different types of interactions (i.e., ingroup versus outgroup interactions), only full cooperation survives. The discovered mechanism is distinct from any form of group selection. The results also suggest potential methods for reducing ingroup bias to shift the equilibrium from ingroup favoritism to full cooperation.


Malingering on subjective complaint tasks: an exploration of the deterrent effects of warning.
Assessing patient's subjective experience of illness is an important component of neuropsychological assessment. This information can be assessed using standardized self-reported complaint (SRC) checklists and may have specific applications in the assessment of malingering. Previous research suggests that subjective complaints can be faked under some circumstances, however, the extent to which this occurs when assessments are made using standardized SRC measures is less well understood. In addition, if complaints can be faked, this raises the question: What might reduce the likelihood of faked symptom reports? In this study, we randomly allocated 60 first-year undergraduate subjects to one of the three conditions: malingering, malinger-with-warning, and control. Using a repeated-measures analogue design, we assessed differences between groups on selected SRC measures. The measures used were the Neuropsychological Symptoms Checklist (NSC), the General Health Questionnaire-30 (GHQ-30), and the Depression, Anxiety, and Stress Scales (DASS). We expected to find that SRC measures would be vulnerable to faking, but also that warning malingerers about the possibility of detection would reduce faking behavior. Further, control group scores on SRC measures were calculated to produce preliminary complaint base rate data for these tests. Our results showed that SRC measures were vulnerable to faking. In addition, contrary to expectations, we found that warnings did not significantly deter malingering, although we observed that a trend in the expected direction and future studies with a larger sample size or a modified warning may be needed to further investigate warning efficacy. Broader implications of these findings are discussed in light of deterrence theory and recent debate over the use of SRC measures in the assessment of malingering.


Secondary metabolites in floral nectar reduce parasite infections in bumblebees.
The synthesis of secondary metabolites is a hallmark of plant defence against herbivores. These compounds may be detrimental to consumers, but can also protect herbivores against parasites. Floral nectar commonly contains secondary metabolites, but little is known about the impacts of nectar chemistry on pollinators, including bees. We hypothesized that nectar secondary metabolites could reduce bee parasite infection. We inoculated individual bumblebees with Crithidia bombi, an intestinal parasite, and tested effects of eight naturally occurring nectar chemicals on parasite population growth. Secondary metabolites strongly reduced parasite load, with significant effects of alkaloids, terpenoids and iridoid glycosides ranging from 61 to 81%. Using microcolonies, we also investigated costs and benefits of consuming anabasine, the compound with the strongest effect on parasites, in infected and uninfected bees. Anabasine increased time to egg laying, and Crithidia reduced bee survival. However, anabasine consumption did not mitigate the negative effects of Crithidia, and Crithidia infection did not alter anabasine consumption. Our novel results highlight that although secondary metabolites may not rescue survival in infected bees, they may play a vital role in mediating Crithidia transmission within and between colonies by reducing Crithidia infection intensities.


The RNA-binding protein HuR regulates the expression of cyclooxygenase-2.
The cyclooxygenase-2 (COX-2) gene encodes the inducible prostaglandin synthase enzyme implicated in inflammation, cell growth, and tumorigenesis. Regulation of the COX-2 gene expression at the post-transcriptional level is poorly understood. For example, protein factors that regulate the post-transcriptional mRNA metabolism of COX-2 have not been fully characterized. In this study, we demonstrate that the RNA-binding protein HuR binds to COX-2 mRNA and regulates its expression. We show that there are three binding sites for HuR in the 3'-untranslated region of human COX-2. These sites are located at the following positions in the COX-2 3'-untranslated region: 39-84 nucleotides (nt), 1155-1187 nt, and 1244-1256 nt (hereinafter referred to as Sites I, II and III, respectively). Although all three sites are present in the 4.6-kb COX-2 mRNA, only site I is present in the shorter 2.8-kb isoform. HuR in MDA-MB-231 cell extracts associated with COX-2 mRNA at the identified sites. Further, HuR location in the cytoplasm was induced by serum withdrawal, a stimulus known to induce COX-2 mRNA. Down-regulation of HuR by two independent methods, namely RNA interference as well as antisense RNA expression, significantly attenuated serum withdrawal-induced increase in COX-2 mRNA (both the 4.6- and 2.8-kb isoforms) and protein levels. These data suggest that HuR binding to COX-2 is critical for its post-transcriptional mRNA stabilization.


Spin crossover and polymorphism in a family of 1,2-bis(4-pyridyl)ethene-bridged binuclear iron(II) complexes. A key role of structural distortions.
Two polymorphic modifications 1 and 3 of binuclear compound [{Fe(dpia)(NCS)(2)}(2)(bpe)] and pseudo-polymorphic modification [{Fe(dpia)(NCS)(2)}(2)(bpe)]·2CH(3)OH (2), where dpia = di-(2-picolyl)amine, bpe = 1,2-bis(4-pyridyl)ethene, were synthesized, and their structures, magnetic properties, and Mössbauer spectra were studied. Variable-temperature magnetic susceptibility measurements of three binuclear compounds show different types of magnetic behaviour. The complex 1 exhibits a gradual two-step spin crossover (SCO) suggesting the occurrence of the mixed [HS-LS] (HS: high spin, LS: low spin) pair at the plateau temperature (182 K), at which about 50% of the complexes undergoes a thermal spin conversion. The complex 2 displays an abrupt full one-step spin transition without hysteresis, centred at about 159 K. The complex 3 is paramagnetic over the temperature range 20-290 K. The single-crystal X-ray studies show that all three compounds are built up from the bpe-bridged binuclear molecules. The structure of 1 was solved for three spin isomers [HS-HS], [HS-LS], and [LS-LS] at three temperatures 300 K, 183 K, and 90 K. The crystal structures for 2 and 3 were determined for the [HS-HS] complexes at room temperature. The analysis of correlations between the structural characteristics and different types of magnetic behaviour for new 1-3 binuclear complexes, as well as for previously reported binuclear compounds, revealed that the SCO process (occurrence of full one-step, two-step, or partial (50%) SCO) is specified by the degree of distortion of the octahedral geometry of the [FeN(6)] core, caused by both packing and strain effects arising from terminal and/or bridging ligands. The comparison of the magnetic properties and the networks of intra- and inter-molecular interactions in the crystal lattice for the family of related SCO binuclear compounds suggests that the intermolecular interactions play a predominant role in the cooperativeness of the spin transition relative to the intramolecular interactions through the bridging ligand.


[Experimental study of up-regulating PTEN gene on increasing the chemosensitivity in K562/ADM cells].
To investigate the mechanism of decreasing the K562/ADM cells chemosensitivity by up-regulating expression of PTEN gene. K562/ADM cells were transient transfected with pGFP-PTEN or vector. The level of PTEN in K562/ADM cells was assayed by Western blot and RT-PCR. Cell viability on K562/ADM was determined by MTT assay. Cell apoptosis by flow cytometry. Activity of caspase-3 by Caspase Colorimetric Assay Kit. The proteins expression of LC3-I/II, Beclin1, p-Akt, p-p70S6K by Western blot. The autophagic vacuoles by MDC stain and Electron microscopy. (1) The mRNA and protein levels of PTEN in K562/ADM cells transfected with pGFP-PTEN were significantly increased compared with the control (untreated and transfected with empty vector). (2) Enhanced expression of PTEN by gene transfection resulted in a reversal of resistance to ADM. Compared with empty vector group, cell viability decreased from (94.07 ± 2.6)% to (53.83 ± 4.2)%, the cell apoptotic rate increased from (11.89 ± 1.7)% to (43.69 ± 2.3)%, meanwhile, pretreated with caspase-3 inhibitor (Z-DEVE-FMK) didn't completely inhibit the cytotoxicity of ADM to K562/ADM cells. (3) After treated with ADM for 12 and 24 h, the activities of caspase-3 in PTEN-transfected K562/ADM cells increased compared with those in pGFP-transfected K562/ADM cells \[(2.27 ± 0.13) vs (1.19 ± 0.14)\] at 12h, \[(3.15 ± 0.08) vs (1.48 ± 0.05)\] at 24 h (P < 0.05). (4) The protein levels of LC3-II and Beclin1 in K562/ADM cells transfected with pGFP-PTEN were increased by 83% and 18% respectively, and the protein levels of p-Akt and p-p70S6K were declined by 96% and 87% respectively, compared with those in K562/ADM cells transfected with pGFP plasmid. (5) The upregulation of PTEN in K562/ADM cells improved the number of autophagic vacuoles compared with the empty vector group. The upregulation of PTEN expression increases the chemosensitivity of K562/ADM to ADM, which may related with the inhibition of PI3K/AKT/mTOR pathway induced by PTEN gene transfection.


An Stomatin, Prohibitin, Flotillin, and HflK/C-Domain Protein Required to Link the Phage-Shock Protein to the Membrane in Bacillus subtilis.
Membrane surveillance and repair is of utmost importance to maintain cellular integrity and allow cellular life. Several systems detect cell envelope stress caused by antimicrobial compounds and abiotic stresses such as solvents, pH-changes and temperature in bacteria. Proteins containing an Stomatin, Prohibitin, Flotillin, and HflK/C (SPFH)-domain, including bacterial flotillins have been shown to be involved in membrane protection and membrane fluidity regulation. Here, we characterize a bacterial SPFH-domain protein, YdjI that is part of a stress induced complex in Bacillus subtilis. We show that YdjI is required to localize the ESCRT-III homolog PspA to the membrane with the help of two membrane integral proteins, YdjG/H. In contrast to classical flotillins, YdjI resides in fluid membrane regions and does not enrich in detergent resistant membrane fractions. However, similarly to FloA and FloT from B. subtilis, deletion of YdjI decreases membrane fluidity. Our data reveal a hardwired connection between phage shock response and SPFH proteins.


Genetic analysis of African lions (Panthera leo) in Zambia support movement across anthropogenic and geographical barriers.
The Luangwa Valley in eastern Zambia is a transverse offshoot of the Great Rift Valley system. This region appears to have an isolating effect as evidenced by suspected endemic subspecies, such as the Cookson's wildebeest and Thornicroft's giraffe. Recent mitochondrial DNA studies demonstrated that African lions in Zambia consist of two highly diverse eastern and western sub-populations. Herein, we report nuclear and mitochondrial DNA results from 409 lions that support this population substructure across Zambia but proposes only partial isolation of the Luangwa Valley with more movement between the populations than previously thought. Population assignment analysis identifies two populations with little evidence of admixture assigning lions to either the eastern or western sub-populations. A high occurrence of private alleles and clear evidence for a Wahlund effect further justify the presence of a highly structured population. But, while mitochondrial DNA analysis still shows little to no matrilineal gene flow (FST = 0.53) between sub-populations, microsatellite analysis suggests there is gene flow (FST = 0.04) with low but significant isolation-by-distance and an average of 6 migrants per generation. Evidence of isolation-by-distance is also found in factorial correspondence analysis with the Lower Zambezi National Park and eastern corridor clusters overlapping isolated clusters of the Luangwa Valley and western sub-population. From this evidence, the Luangwa Valley appears separated from the western sub-population with some dispersal through the southern regions of the eastern sub-population. Both the eastern and western sub-populations have high heterozygosity (0.68 and 0.69, respectively) and genetic diversity (0.47 and 0.50, respectively) values, indicative of genetically healthy populations.


Treatment of mycobacterial infections.
Treatment of mycobacterial infections differs from that of other bacterial diseases due to several properties possessed by the mycobacteria and the host. A hallmark of mycobacteria is the complex lipid-rich cell envelope that protects the organism from both the host response and antimycobacterial therapy. In addition, mycobacteria are facultative intracellular parasites which generally cause a more chronic type of disease. These properties add greater constraints to efficient therapy. To be effective, drugs must be able to penetrate the host macrophage and preferably have reduced toxicity and be effective at low doses to allow prolonged therapy. The author presents the general properties of the pathogen/host relationship in mycobacterial infections, in addition to the therapeutic choices available and the mechanisms of action involved in treatment. The evolution of technology for antimycobacterial therapy is illustrated by a discussion of new strategies being developed for the treatment of mycobacterial infections.


Jordanians' willingness to receive heterologous prime-boost COVID-19 vaccination and vaccine boosters.
Coronavirus-2019 (COVID-19) vaccination is the game-changing approach that tops all other strategies to contain the pandemic spread. A growing interest has been raised to heterologous prime-boost and booster COVID-19 vaccination to tackle vaccine shortage and to increase the vaccine's immunogenicity. This study aimed to evaluate the willingness and acceptance of Jordanians to receive heterologous prime-boost COVID-19 vaccination and vaccine boosters. A web-based cross-sectional study was conducted using a validated online questionnaire. Adult Jordanian participants were recruited using several social media platforms. The questionnaire link was randomly posted by researchers on public groups in Jordan. Participant's demographics, medical history, knowledge of mixed and booster COVID-19 vaccination and their willingness to receive them were obtained and analyzed. Approximately 50.5% and 49.3% of the respondents stated former knowledge of the mixed and booster COVID-19 vaccination, respectively. Approximately 50% of respondents acknowledged that the side effects could preclude them from taking mixed and booster vaccines, and 45.3% responded that taking a third dose of the vaccine would increase the side effects. The respondents with previous history of COVID-19 and influenza vaccination were more likely to agree on mixed vaccines compared to those not vaccinated (29.5% vs. 6.5%, p <0.0001; 38.0% vs. 24.5%, p=0.0078, respectively). Moreover, both previous history of COVID-19 and seasonal influenza vaccine was an encouraging response for acceptance of mixed and booster vaccines when compared to those who did not receive the vaccines (54.5% vs. 11.3%; p<0.0001, 69.0% vs. 45.5%; p <0.0001, respectively). The current study showed that nearly half of the respondents were familiar with COVID-19 mixed and booster vaccine programs; however, a high percentage still expressed reticence to receive the mixed vaccines. We consider these results to emphasize the importance and need of awareness campaigns that accentuate the safety profile of such updated vaccination programs.


Severe haemolytic anaemia after replacement of the mitral valve by a St Jude medical prosthesis.
Severe haemolytic anaemia developed in a 33 year old patient after the mitral valve was replaced with a St Jude medical prosthesis. This was the patient's third thoracotomy. She had already had a mitral commissurotomy and a mitral valve bioprosthesis. The patient had an E+ antibody to red blood cells as well as a paraprosthetic leak. The haemolysis became less severe once the population of E+ red cells was completely haemolysed. However, the patient continued to require transfusions to remain out of heart failure. Once the valve was replaced, the haemolysis subsided. Fulminant haemolysis after mitral valve replacement is rare. When it does occur, a paraprosthetic leak should be suspected. Other causes of haemolysis, however, must also be considered and these may contribute to the severity of haemolysis.


A search for apatite crystals in the gap zone of collagen fibrils in bone using dark-field illumination.
Bright-field transmission electron microscope (TEM) images of ion milled or focused ion beam (FIB) sections of cortical bone sectioned parallel to the long axis of collagen fibrils display an electron-dense phase in the gap zones of the fibrils, as well as elongated plates (termed mineral lamellae) comprised of apatite crystals, which surround and lie between the fibrils. Energy dispersive X-ray spectroscopy (EDS) and electron energy loss spectroscopy (EELS) studies by others have shown that the material in the gap zones is calcium phosphate. Dark-field (DF) images are capable of revealing the projected position of crystals of apatite in a section of bone. We obtained bright field (BF) images of ion milled sections of bovine femoral cortical bone cut parallel to fibril axes (longitudinal view), and compared them with DF images obtained using the (002) apatite reflection to test a widely held theory that most of the mineral in bone resides in the gap zones. Most apatite crystals which were illuminated in DF images and which projected onto gap zones were extensions of crystals that also project onto adjacent overlap zones. However, in BF images, overlap zones do not appear to contain significant amounts of mineral, implying that the crystals imaged in DF are actually in the interfibrillar matrix but projected onto images of fibrils. However a small number of "free" illuminated crystals did not extend into the overlap zones; these could be physically located inside the gap zones. We note that projections of gap zones cover 60% of the area of any longitudinal field of view; thus these "free" crystals have a high random probability of appearing to lie on a gap zone, wherever they physically lie in the section. The evidence of this study does not support the notion that most of the mineral of bone consists of crystals in the gap zone. This study leaves uncertain what is the Ca-P containing material present in gap zones; a possible candidate material is amorphous calcium phosphate.


Artemisinin inhibits gastric cancer cell proliferation through upregulation of p53.
Recent population studies suggest that the use of artemisinin is associated with reduced incidence and improved prognosis of certain cancers. In the current study, we assessed the effect of artemisinin on gastric cancer cells (AGS and MKN74 cells). We found that artemisinin inhibited growth and modulated expression of cell-cycle regulators in these cells. Treatment with artemisinin was also associated with induction of p27 kip1 and p21 kip1, two negative cell-cycle regulators. Furthermore, we revealed that artemisinin treatment led to an increased expression of p53. Taken together, these results provide evidence for a mechanism that may contribute to the antineoplastic effects of artemisinin suggested by recent population studies and justify further work to explore potential roles for it in gastric cancer prevention and treatment.


Immune complexes from rheumatoid arthritis synovial fluid induce FcgammaRIIa dependent and rheumatoid factor correlated production of tumour necrosis factor-alpha by peripheral blood mononuclear cells.
Immune complexes (ICs) can induce production of cytokines by peripheral blood mononuclear cells via Fc receptors. Rheumatoid factor (RF) develop in response to ICs in many clinical and experimental settings. We investigated whether and how polyethylene glycol (PEG) precipitated ICs from rheumatoid arthritis (RA) sera and synovial fluid (SF) can influence cytokine production by peripheral blood mononuclear cells. We also examined the relationship between RF and IC induced cytokine production. Parallel sera and SF from 47 RA patients and sera from 15 healthy control individuals were PEG precipitated. The precipitates were added to serum-free peripheral blood mononuclear cell cultures and tumour necrosis factor (TNF)-alpha levels were measured after 20 hours. In separate cell culture experiments FcgammaRIIa and FcgammaRIII were blocked and monocytes were depleted or enriched. RF in serum was determined by nephelometry, and IgG levels in precipitates and anti-cyclic citrullinated peptide antibodies in serum were measured using ELISA. Clinical data were collected from the patients' charts. In two separate investigations, we demonstrated a correlation between RF, PEG-precipitated IgG levels and induction of the proinflammatory cytokine TNF-alpha by PEG-precipitated SF ICs. No such correlation was found for serum ICs. TNF-alpha levels induced by SF precipitates, but not serum precipitates, correlated with the number of swollen and tender joints. Monocytes/macrophages were shown to be the main responder cells, and blockade of FcgammaRIIa, but not blockade of FcgammaRIII, inhibited TNF-alpha production in cultures stimulated with precipitated ICs. Anti-cyclic citrullinated peptide correlated with RF but exhibited no association with IgG content in PEG precipitates or with precipitate-induced TNF-alpha levels. These findings support the hypothesis that SF ICs and correlated RF production are directly linked to cytokine-dependent inflammation in RA. Suppression of monocytes/macrophages in RA joints or blockade of the primate-specific activating FcgammaRIIa receptor might be ways to reduce IC-induced TNF-alpha production in the joints of seropositive RA patients.


Upregulation of IRS1 Enhances IGF1 Response in Y537S and D538G ESR1 Mutant Breast Cancer Cells.
Increased evidence suggests that somatic mutations in the ligand-binding domain of estrogen receptor [ER (ERα/ESR1)] are critical mediators of endocrine-resistant breast cancer progression. Insulinlike growth factor-1 (IGF1) is an essential regulator of breast development and tumorigenesis and also has a role in endocrine resistance. A recent study showed enhanced crosstalk between IGF1 and ERα in ESR1 mutant cells, but detailed mechanisms are incompletely understood. Using genome-edited MCF-7 and T47D cell lines harboring Y537S and D538G ESR1 mutations, we characterized altered IGF1 signaling. RNA sequencing revealed upregulation of multiple genes in the IGF1 pathway, including insulin receptor substrate-1 (IRS1), consistent in both Y537S and D538G ESR1 mutant cell line models. Higher IRS1 expression was confirmed by quantitative reverse transcription polymerase chain reaction and immunoblotting. ESR1 mutant cells also showed increased levels of IGF-regulated genes, reflected by activation of an IGF signature. IGF1 showed increased sensitivity and potency in growth stimulation of ESR1 mutant cells. Analysis of downstream signaling revealed the phosphoinositide 3-kinase (PI3K)-Akt axis as a major pathway mediating the enhanced IGF1 response in ESR1 mutant cells. Decreasing IRS1 expression by small interfering RNA diminished the increased sensitivity to IGF1. Combination treatment with inhibitors against IGF1 receptor (IGF1R; OSI-906) and ER (fulvestrant) showed synergistic growth inhibition in ESR1 mutant cells, particularly at lower effective concentrations. Our study supports a critical role of enhanced IGF1 signaling in ESR1 mutant cell lines, pointing toward a potential for cotargeting IGF1R and ERα in endocrine-resistant breast tumors with mutant ESR1.


Genetic and environmental influences on adiponectin, leptin, and BMI among adolescents in Taiwan: a multivariate twin/sibling analysis.
Circulating levels of leptin and adiponectin are closely associated with obesity. However, it is not known whether there are common shared genes or environment exerting influences on the levels of leptin, adiponectin, and BMI. We aimed to assess the relative contribution of genes and environment to adiponectin, leptin, and BMI individually as well as simultaneously to the three measures. Our subjects included a total of 228 twin/sibling pairs aged 12 to 18 (130 monozygotic twins, 68 dizygotic twins and 30 sibling pairs) were recruited from the middle schools. Multivariate analyses were applied to twin/sibling data using structural equation modeling. The results showed that intraclass correlations for adiponectin, leptin and BMI were higher in the MZ twins than those in the DZ/SP group. The relative contribution of genes to adiponectin (39%) was comparable to those of shared environment (40%). In contrast, leptin and BMI were influenced mostly by genes (74% and 89%, respectively). The multivariate genetic analyses showed that a latent factor underlying the three measures was identified, with BMI being equivalent to this latent factor. The BMI-dependent genetic factor explains only 15% and 34% of variation of adiponectin and leptin, respectively. These data indicate a differential contribution of genetic factors for the variation of adiponectin, leptin and BMI. More importantly, only a small portion of the genetic influences on adiponectin and leptin was attributed to BMI. Our findings provided more insight into the complex regulation of adiponectin and leptin in obesity.


In vivo tribological performance of 231 metal-on-metal hip articulations.
231 cobalt-chromium metal-on-metal (METASUL design) retrieved articulations (297 retrieved components) were examined for their in vivo wear behaviour. A running-in period of about one year is observed where the in vivo wear rate for the whole articulation is approximately 35 m/year. After this running-in period, the measured in vivo wear rate of the whole articulation decreases to about 5 m/year. The metal-on-metal articulation can be considered as a very low wear articulation system. The combination of the specially designed components is mandatory to assure this low wear behaviour. In case of a mismatched bearing (stainless steel head - cobalt-chromium inlay), large amount of wear was measured. (Hip International 2002; 2: 73-6).


Experimental exposure of young pigs using a pathogenic strain of Streptococcus suis serotype 2 and evaluation of this method for disease prevention.
Control of Streptococcus suis infections and associated disease have proven to be a difficult challenge under most farm conditions. The objective of this study was to experimentally expose young pigs with a pathogenic strain of S. suis serotype 2 as a means of controlling the disease in a commercial swine farm. Prior to the start of the study, the pathogenic S. suis strain responsible for mortality in the farm was identified and used to experimentally inoculate baby piglets. Over a 3-week period, groups of pigs were selected (100 pigs/wk) and divided into 2 groups: control (50 pigs/week) and experimentally exposed (50 pigs/week). Pigs in the experimentally exposed group were inoculated at 5 d old by tonsillar swabbing with the pathogenic S. suis farm isolate. The effect of exposure with this pathogenic strain was evaluated during the nursery and finishing stages and was based on: morbidity (pigs with central nervous signs (CNS) and/or lameness), mortality and number of treatments required by pigs that had either CNS or lameness. The relative risk (RR) of acquiring disease due to S. suis infection was also calculated. Results showed that morbidity in the experimentally exposed groups was lower than in the control group and these results were statistically different (P = 0.006). Experimentally exposed pigs also showed a statistically significant reduction in lameness problems (P = 0.012), but not in CNS (P = 0.20) or mortality (P = 0.59). Pigs in the control group had an increased RR of 4.76, 8.77 and 2.7 for morbidity, to have lameness or to have CNS signs, respectively. In conclusion, experimental exposure of young pigs with the farm's pathogenic S. suis strain at a young age, had a positive effect in reducing clinical signs characteristics of S. suis infection. This method constitutes a novel approach to the control of S. suis infections in swine farms.


Small-for-gestational-age babies of low-risk term pregnancies: does antenatal detection matter?
To compare delivery route and admission rate to neonatal intensive care unit between small- and appropriate-for-gestational-age babies among low-risk term pregnancies. A retrospective study was conducted using the database of deliveries in 2014 at a tertiary hospital. Babies delivered at ≥37 weeks with birthweight <10th centile were considered small-for-gestational-age (SGA) and >90th centile were considered large-for-gestational-age. Fetal weight estimation at 30-33 weeks ultrasound <10th centile was considered antenatal detection of SGA. Among 1429 low-risk term pregnancies, 11% (151/1429) had SGA babies and 5% (75/1429) had large-for-gestational-age. SGA babies were associated with higher rate of cesarean sections for nonreassuring fetal status (18/151 versus 8/1202, p < .001) and higher rate of admissions to neonatal intensive care unit (16/151 versus 18/1202, p < .001) compared to appropriate-for-gestational-age. Within SGA group, antepartum detected fetuses were associated with lower rate of operative deliveries for nonreassuring fetal status than undetected group (3/31 versus 39/120, p = .01) Conclusions: In our series, women with SGA term babies were associated with more adverse obstetric and neonatal outcome than appropriate-for-gestational age, especially among those undetected prenatally.


A pyrexic effect of FGF21 independent of energy expenditure and UCP1.
Administration of FGF21 to mice reduces body weight and increases body temperature. The increase in body temperature is generally interpreted as hyperthermia, i.e. a condition secondary to the increase in energy expenditure (heat production). Here, we examine an alternative hypothesis: that FGF21 has a direct pyrexic effect, i.e. FGF21 increases body temperature independently of any effect on energy expenditure. We studied the effects of FGF21 treatment on body temperature and energy expenditure in high-fat-diet-fed and chow-fed mice exposed acutely to various ambient temperatures, in high-fat diet-fed mice housed at 30 °C (i.e. at thermoneutrality), and in mice lacking uncoupling protein 1 (UCP1). In every model studied, FGF21 increased body temperature, but energy expenditure was increased only in some models. The effect of FGF21 on body temperature was more (not less, as expected in hyperthermia) pronounced at lower ambient temperatures. Effects on body temperature and energy expenditure were temporally distinct (daytime versus nighttime). FGF21 enhanced UCP1 protein content in brown adipose tissue (BAT); there was no measurable UCP1 protein in inguinal brite/beige adipose tissue. FGF21 increased energy expenditure through adrenergic stimulation of BAT. In mice lacking UCP1, FGF21 did not increase energy expenditure but increased body temperature by reducing heat loss, e.g. a reduced tail surface temperature. The effect of FGF21 on body temperature is independent of UCP1 and can be achieved in the absence of any change in energy expenditure. Since elevated body temperature is a primary effect of FGF21 and can be achieved without increasing energy expenditure, only limited body weight-lowering effects of FGF21 may be expected.


Lack of nucleophilic addition in the isoxazole and pyrazole diketone modified analogs of curcumin; implications for their antitumor and chemosensitizing activities.
Curcumin (CUR) can be considered as a good lead compound for the design of new anticancer drugs. Further, structure-activity relationship studies may clarify the importance of the redox activities in the antitumor effects of the drug. We have elaborated the alpha,beta-unsaturated 1,3-diketone moiety of CUR into the isoxazole (ISO) and pyrazole (PYR) derivatives. These derivatives should be much less prone to nucleophilic addition than CUR and benzyl mercaptan addition analyses showed that indeed they do not form isolable conjugated products. When compared with CUR, ISO and PYR exhibited increased cell growth inhibitory and pro-apoptotic effects in liver cancer HA22T/VGH cells as well as in other tumor cell types; in contrast to CUR, the antitumor effects of ISO or PYR were not influenced by concomitant administration of N-acetylcysteine, as a source of -SH groups, or buthionine sulfoximine, as an inhibitor of glutathione synthesis. Further, treatment with CUR, but not with ISO or PYR, significantly decreased the content of reduced glutathione in the HA22T/VGH cells. Finally, ISO and PYR lacked the ability of the parent compound to sensitize the HA22T/VGH cells to cisplatin (CIS), an effect which appeared to occur through an interaction of CUR and CIS at the level of the -SH groups. Thus, the ability of interacting with cell thiols might not be requested for the more potent antitumor activities of new diketone modified CUR derivatives, which might rely on other mechanisms, though possibly devoid of chemosensitization capabilities.


Gamete biology of the new world marsupial, the grey short-tailed opossum, Monodelphis domestica.
Mammalian gametes undergo a series of functional and developmental changes that culminate in fertilization. In order to appreciate the necessity for such complex processes as sperm maturation, capacitation and the intimate sperm-egg interactions leading to gamete fusion, it is important to understand how gametes may have evolved. In this respect, marsupials are particularly relevant since they exhibit features reminiscent of both non-mammalian vertebrates and eutherian mammals. The grey short-tailed opossum, Monodelphis domestica, is a New World marsupial from Brazil. It breeds well under laboratory conditions and is an excellent animal model to investigate marsupial gamete biology. As in other American marsupials, the spermatozoa of the opossum form pairs in the epididymis. Here, a number of studies carried out in this laboratory, related to sperm maturation, capacitation and fertilization in M. domestica, are reviewed and the gamete biology in this species is compared with what is known in other marsupials and eutherian mammals.


Coronary blood flow and myocardial segment dimensions during simulated dives in seals.
Three harbor seals Phoca vitulina richardsi and five spotted seals Phoca vitulina largha were used in studies of acute episodes of local myocardial ischemia in open-chest, anesthetized animals and of coronary blood flow and regional function as indicated by left ventricular segment dimensions during experimentally simulated dives of conscious, instrumented animals. We observed that seal myocardium, in which there are few coronary anastomoses, responded to brief local occlusion with prompt local dysfunction and systolic bulging; coronary flow in the nondiving seal oscillated irregularly and declined with spontaneous apnea and related falling heart rate; flow continued to oscillate but was much reduced during dives, frequently ceasing entirely for periods as long as 45 s; ventricular segment dimension shortening was reduced intermittently during dives; and elevated heart rate induced during dives by cardiac pacing or by administration of atropine diminished or eliminated the reductions in coronary blood flow. Responses of seal heart reflect the reduction in cardiac metabolic demand during diving and the seal's myocardial adaptation for enhanced anaerobic glycolysis. The seal heart can maintain mechanical function during dives with minimal coronary perfusion, despite the progressive and ultimately profound hypoxia, hypercapnia, and acidosis. Reduced cardiac metabolism, copious glycolytic reserves, and metabolite washout by intermittent brief bursts of coronary blood flow are apparently sufficient to support continued cardiac function, even though the seal heart has little tolerance for acute localized ischemia.


Addressing the need for an infection prevention and control framework that incorporates the role of surveillance: a discussion paper.
To present a discussion on theoretical frameworks in infection prevention and control. Infection prevention and control programmes have been in place for several years in response to the incidence of healthcare-associated infections and their associated morbidity and mortality. Theoretical frameworks play an important role in formalizing the understanding of infection prevention activities. Discussion paper. A literature search using electronic databases was conducted for published articles in English addressing theoretical frameworks in infection prevention and control between 1980-2012. Nineteen papers that included a reference to frameworks were identified in the review. A narrative analysis of these papers was completed. Two models were identified and neither included the role of surveillance. To reduce the risk of acquiring a healthcare-associated infection, a multifaceted approach to infection prevention is required. One key component in this approach is surveillance. The review identified two infection prevention and control frameworks, yet these are rarely applied in infection prevention and control programmes. Only one framework considered the multifaceted approach required for infection prevention. It did not, however, incorporate the role of surveillance. We present a framework that incorporates the role of surveillance into a biopsychosocial approach to infection prevention and control. Infection prevention and control programmes and associated research are led primarily by nurses. There is a need for an explicit infection prevention and control framework incorporating the important role that surveillance has in infection prevention activities. This study presents one framework for further critique and discussion.


Cellular therapies based on stem cells and their insulin-producing surrogates: a 2015 reality check.
Stem cell technology has recently gained a substantial amount of interest as one method to create a potentially limitless supply of transplantable insulin-producing cells to treat, and possibly cure diabetes mellitus. In this review, we summarize the state-of-the art of stem cell technology and list the potential sources of stem cells that have been shown to be useful as insulin-expressing surrogates. We also discuss the milestones that have been reached and those that remain to be addressed to generate bona fide beta cell-similar, insulin-producing surrogates. The caveats, limitations, and realistic expectations are also considered for current and future technology. In spite of the tremendous technical advances realized in the past decade, especially in the field of reprogramming adult somatic cells to become stem cells, the state-of-the art still relies on lengthy and cumbersome in vitro culture methods that yield cell populations that are not particularly glucose-responsive when transplanted into diabetic hosts. Despite the current impediments toward clinical translation, including the potential for immune rejection, the availability of technology to generate patient-specific reprogrammable stem cells has, and will be critical for, important insights into the genetics, epigenetics, biology, and physiology of insulin-producing cells in normal and pathologic states. This knowledge could accelerate the time to reach the desired breakthrough for safe and efficacious beta cell surrogates.


SCARB1 Gene Variants Are Associated With the Phenotype of Combined High High-Density Lipoprotein Cholesterol and High Lipoprotein (a).
SR-B1 (scavenger receptor class B type 1), encoded by the gene SCARB1, is a lipoprotein receptor that binds both high-density lipoprotein (HDL) and low-density lipoprotein. We reported that SR-B1 is also a receptor for lipoprotein (a) (Lp(a)), mediating cellular uptake of Lp(a) in vitro and promoting clearance of Lp(a) in vivo. Although genetic variants in SCARB1 are associated with variations in HDL level, no SCARB1 variants affecting Lp(a) have been reported. In an index subject with high levels of HDL cholesterol and Lp(a), SCARB1 was sequenced and demonstrated a missense mutation resulting in an S129L substitution in exon 3. To follow up, 2 cohorts (GeneSTAR, the family-based Genetic Study of Atherosclerosis Risk [n=543], and CCHS, the population-based Copenhagen City Heart Study [n=5835]) were screened for combined HDL cholesterol and Lp(a) elevations. Subjects with the extreme phenotype (HDL >80 mg/dL and Lp(a) >100 nmol/L in GeneSTAR, n=8, and >100 mg/dL in CCHS, n=9) underwent sequencing of SCARB1 exons; 15 of 18 from the combined population demonstrated genetic variants, including rare or uncommon missense or splice site mutations in 9 and homozygous synonymous variants in 6. Functional studies with 4 of the SCARB1 variants (c.386C>T, c.631-14T>G, c.4G>A, and c.631-53mC>T & c.726+55mCG>CA) showed decreased receptor function in vitro. Human SCARB1 gene variants are associated with a new lipid phenotype, characterized by high levels of both HDL cholesterol and Lp(a). SCARB1 exonic variants often result in diminished function of translated SR-B1 via reduced binding/intracellular transport of Lp(a).


Policy statement--Physician refusal to provide information or treatment on the basis of claims of conscience.
Health care professionals may have moral objections to particular medical interventions. They may refuse to provide or cooperate in the provision of these interventions. Such objections are referred to as conscientious objections. Although it may be difficult to characterize or validate claims of conscience, respecting the individual physician's moral integrity is important. Conflicts arise when claims of conscience impede a patient's access to medical information or care. A physician's conscientious objection to certain interventions or treatments may be constrained in some situations. Physicians have a duty to disclose to prospective patients treatments they refuse to perform. As part of informed consent, physicians also have a duty to inform their patients of all relevant and legally available treatment options, including options to which they object. They have a moral obligation to refer patients to other health care professionals who are willing to provide those services when failing to do so would cause harm to the patient, and they have a duty to treat patients in emergencies when referral would significantly increase the probability of mortality or serious morbidity. Conversely, the health care system should make reasonable accommodations for physicians with conscientious objections.


The uptake and outcome of prenatal and pre-implantation genetic diagnosis for Huntington's disease in the Netherlands (1998-2008).
We aimed to study reproductive behaviour of couples opting for prenatal diagnosis (PND) and pre-implantation genetic diagnosis (PGD) for Huntington's disease (HD). In the Netherlands, exclusion PND is available for persons at 50% risk, whereas exclusion PGD is not allowed. All 162 couples who underwent PND or PGD for HD between 1998 and 2008 and referrals for exclusion PGD to Belgium were included. Couples' reproductive information was collected until December 2010; 132 couples (81.5%) underwent PND in 262 pregnancies, 54 (33.3%) started PGD, and 25 used both. Sixteen percent of PND couples used exclusion PND and 6% used exclusion PGD. The outcomes were 76.5% of PND couples delivered ≥1 unaffected child(ren) after PND, and 44.4% of PGD couples delivered ≥1 PGD child(ren) (mean 2.5 cycles/couple). Couples opting for PGD secondarily (after a previous pregnancy) had more frequently terminated a pregnancy for HD (87.0%) compared with couples secondarily opting for PND (55.2%; p = 0.015). At-risk or HD expansion carrier males were underrepresented in the group of couples primarily opting for PGD (25%) and overrepresented in the secondary PGD group (64%). We conclude that couples reconsider their choices in every subsequent pregnancy based on their previous experience, personal beliefs and the gender of the at-risk partner.


Implications of Mitral Annular Disjunction in Patients Undergoing Transcatheter Edge-to-Edge Repair for Degenerative Mitral Regurgitation.
Little is known about mitral transcatheter edge-to-edge repair (TEER) in patients with mitral annular disjunction (MAD). The authors sought to explore TEER for degenerative mitral regurgitation (MR) according to MAD status. We retrospectively analyzed 271 consecutive patients (median age 82 [Q1-Q3: 75-88] years, 60.9% men) undergoing an isolated, first-ever TEER for whom there were viewable preprocedural echocardiograms. Stratified by MAD status at baseline, the cohort was evaluated for all-cause mortality, heart failure hospitalizations, and mitral reinterventions-the composite of which constituted the primary outcome-as well as functional capacity and residual MR, all along the first postprocedural year. Individuals with (n = 62, 22.9%) vs without MAD had more extensive prolapse and larger valve dimensions. Although the former's procedures were longer, utilizing more devices per case, technical success rate and residual MR were comparable. MAD presence was associated with higher mortality risk (HR: 2.64; 95% CI: 1.82-5.52; P = 0.014), and increased MAD length-with lower odds of functional class ≤II (OR: 0.65; 95% CI: 0.47-0.88; P = 0.006). Among 47 MAD patients with retrievable 1-month data, MAD regressed in 91.5% and by an overall 50% (Q1-Q3: 22%-100%) compared with baseline (P < 0.001). A greater MAD shortening conferred attenuated risk for the primary outcome. In our experience, TEER for degenerative MR accompanied by MAD was feasible and safe; however, its postprocedural course was somewhat less favorable. MAD shortening following TEER was observed in most patients and proved prognostically beneficial.


Advance Care Planning for African American Caregivers of Relatives With Dementias: Cluster Randomized Controlled Trial.
African-American family caregivers may have insufficient knowledge to make informed end-of-life (EOL) decisions for relatives with dementias. Advance Care Treatment Plan (ACT-Plan) is a community-based education intervention to enhance knowledge of dementia and associated EOL medical treatments, self-efficacy, intentions, and behavior (written EOL care plan). This study evaluated efficacy of the intervention compared to attention control. In a theoretically based, 2-group, cluster randomized controlled trial, 4 similar Midwestern urban megachurches were randomized to experimental or control conditions. Each church recruited African-American caregivers, enrolling concurrent waves of 5 to 9 participants in 4 weekly 1-hour sessions (358 total: ACT-Plan n = 173, control n = 185). Dementia, cardiopulmonary resuscitation (CPR), mechanical ventilation (MV), and tube feeding (TF) treatments were discussed in ACT-Plan classes. Participants completed assessments before the initial class, after the final class (week 4), and at week 20. Repeated measures models were used to test the intervention effect on changes in outcomes across time, adjusting for covariates as needed. Knowledge of CPR, MV, TF, and self-efficacy to make EOL treatment decisions increased significantly more in the ACT-Plan group at weeks 4 and 20. Knowledge of dementia also increased more in the ACT-Plan group at both points, reaching statistical significance only at week 20. Intentions to make EOL treatment decisions and actually an advance care plan were similar between treatment arms. Findings demonstrate promise for ACT-Plan to increase informed EOL treatment decisions for African American caregivers of individuals with dementias.


[Evaluation of the effect of ilaprazole on intragastric pH in patients with duodenal ulcer].
To evaluate the effect of ilaprazole enteric tablets on intragastric pH in duodenal ulcer patients. A randomized, double blind, positive controlled clinical trial was carried out. A total of forty-two patients with duodenal ulcer were randomized into low dose ilaprazole group (5 mg/d), medium dose ilaprazole group (10 mg/d), high dose ilaprazole group (20 mg/d) and omeprazole group (20 mg/d). An ambulatory 24 hour intragastric pH study was performed at the fifth treatment day. Fraction time pH above 3, 4 or 5, median values of 24 hour diurnal pH and 12 hour nocturnal pH, the percentage of patients with total time pH above 3, 4 or 5 at least for 18 hours were evaluated. There were no significant differences of fraction time pH above 3 or 4, median values of 24 hour diurnal pH and 12 hour nocturnal pH and the percentage of patients with total time pH above 3, 4 or 5 at least for 18 hours among all the groups with different doses of ilaprazole and the omeprazole group. The fraction time pH above 5 in medium and high dose ilaprazole groups were (87.96 + or - 12.29)% and (89.86 + or - 15.18)% respectively, which was higher than that in low dose ilaprazole group [(67.17 + or - 30.16)%] and omeprazole group [(76.14 + or - 16.75)%], P < 0.05. Ilaprazole has a strong effect on intragastric acid control with a dose dependent trend.


California Public Opinion On Health Professionals Talking With Patients About Firearms.
Medical and public health organizations have recommended that health professionals discuss firearm safety with patients at risk for gun-related injury, yet few health professionals do so. Concerns that patients may view conversations about firearms as inappropriate have been reported in prior studies. Using state-representative data from the 2018 California Safety and Wellbeing Survey, this study found that most Californians report gun safety conversations with health professionals to be at least sometimes appropriate when these conversations involved a patient who had a known risk factor for firearm-related harm (depending on the risk factor, 83.7-90.2 percent among all respondents and 70.0-91.2 percent among firearm owners). Majorities of respondents also found intervention by health professionals for those at imminent risk to be at least sometimes appropriate (depending on the intervention, 84.0-89.9 percent among all respondents and 82.6-91.0 percent among firearm owners). These findings can inform health policy and education on clinical strategies for preventing firearm-related harm.


Quantitative mineralogical analysis of small samples of china clay using x ray diffractometry.
The quantitative mineralogical analysis of small samples (less than 20 mg) of china clay has been investigated using x ray diffractometry to determine kaolinite, mica, quartz, and feldspar. A method has been developed and applied to the quantitative analysis of airborne dust samples and of other small discrete samples. Determinations were made either on samples after collection on a membrane filter or on samples after deposition from aqueous suspension on to a silver substrate. Quantitative analysis was hindered by preferred orientation of the kaolinite and of the mica particles that occurs when using these methods of specimen preparation. Quartz and feldspar were determined direct from prepared calibration graphs. Preferred orientation of the mica particles leads to serious interference with the most sensitive quartz x ray diffraction peak which, if not recognised, will result in an overestimation of the quartz content. Kaolinite and mica were determined from the ratio of their most intense x ray diffraction peak areas to overcome the preferred orientation effects observed for these two minerals. During the investigation, the opportunity arose for comparative measurements of quartz contents of airborne dust samples with the Occupational Medicine and Hygiene Laboratories of the Health and Safety Executive. The mass of specimen examined varied between 0.8 mg and 20 mg and the quartz contents varied between 0.1% and 1.2%. The comparative results were in good agreement.


A combined therapeutic regimen of buspirone and environmental enrichment is more efficacious than either alone in enhancing spatial learning in brain-injured pediatric rats.
Buspirone, a 5-HT1A receptor agonist, and environmental enrichment (EE) enhance cognition and reduce histopathology after traumatic brain injury (TBI) in adult rats, but have not been fully evaluated after pediatric TBI, which is the leading cause of death in children. Hence, the aims of this study were to assess the efficacy of buspirone alone (Experiment 1) and in combination with EE (Experiment 2) in TBI postnatal day-17 male rats. The hypothesis was that both therapies would confer cognitive and histological benefits when provided singly, but their combination would be more efficacious. Anesthetized rats received a cortical impact or sham injury and then were randomly assigned to receive intraperitoneal injections of buspirone (0.08 mg/kg, 0.1 mg/kg, and 0.3 mg/kg) or saline vehicle (1.0 mL/kg) 24 h after surgery and once daily for 16 days (Experiment 1). Spatial learning and memory were assessed using the Morris water maze (MWM) on post-operative days 11-16, and cortical lesion volume was quantified on day 17. Sham controls for each condition were significantly better than all TBI groups. In the TBI groups, buspirone (0.1 mg/kg) enhanced MWM performance versus vehicle and buspirone (0.08 mg/kg and 0.3 mg/kg) (p<0.05) and reduced lesion volume relative to vehicle (p=0.038). In Experiment 2, buspirone (0.1 mg/kg) or vehicle was combined with EE after TBI, and the data were compared to the standard (STD)-housed groups from Experiment 1. EE lead to a significant enhancement of spatial learning and a reduction in lesion size versus STD. Moreover, the combined treatment group (buspirone+EE) performed markedly better than the buspirone+STD and vehicle+EE groups, which suggests an additive effect and supports the hypothesis. The data replicate previous studies assessing these therapies in adult rats. These novel findings may have important rehabilitation-relevant implications for clinical pediatric TBI.


[Study of the iron-sulfur center N-2 from NADH-dehydrogenase in different metabolic states of the mitochondria from liver and heart].
The structural--equilibrium and nonequilibrium forms of the center N-2 from NADH-dehydrogenase differ in their parametres of the spin-lattice relaxation. The curves of the temperature dependence of the ESR signal intensity become the effective method of the study of the iron-sulphur proteins. The structural nonequilibrium form of the center N-2 was observed in the "4th" metabolic (by Chance) state, but equilibrium form of the center N-2 prevailed in the "3d" state or in the uncoupled state.


Evaluation of subjective assessments and objective diagnostic tests for diagnosing tear-film disorders known to cause ocular irritation.
To determine which subjective assessments and objective tests have clinical utility as diagnostic tools in ocular irritation associated with Sjögren's syndrome-related aqueous tear deficiency (ATD), non-Sjögren ATD, inflammatory meibomian gland disease (MGD) associated with rosacea, and atrophic MGD. Forty adults with ocular irritation and 10 with normal ocular surfaces were enrolled in a nonrandomized, nonblinded clinical trial. Symptoms were evaluated. Tests included biomicroscopy; evaluation of tear-film integrity, production, and clearance; fluorescein and rose bengal staining; and serum autoantibody screening. Symptoms were similar among groups and most severe in the Sjögren's group. Fluorescein tear break-up time was significantly faster in the ATD and MGD groups than that in controls. Schirmer scores were significantly lower in the ATD group than those in MGD and control groups. Tear clearance was delayed in the ATD and atrophic MGD groups. Xeroscope grid distortion was noted only with ATD. The Sjögren's group had greater loss of naso-lacrimal reflex, slower fluorescein clearance, and greater ocular-surface fluorescein and rose bengal staining than did the others. More MGD subjects had meibomian gland orifice metaplasia and acinar dropout than did those with Sjögren-related ATD and controls. Schirmer scores correlated inversely with rose bengal staining, corneal fluorescein staining, and grid distortion. Rose bengal staining correlated with grid distortion and loss of nasal-lacrimal reflex, but not with MGD. Subjective assessments and objective diagnostic tests have clinical utility as diagnostic tools in tear-film disorders. ATD is correlated with ocular-surface disease. An algorithm summarizing the diagnostic utility of these tests is included.


Gender differences in academic surgery, work-life balance, and satisfaction.
An increasing number of women are pursuing a career in surgery. Concurrently, the percentage of surgeons in dual-profession partnerships is increasing. We sought to evaluate the gender differences in professional advancement, work-life balance, and satisfaction at a large academic center. All surgical trainees and faculty at a single academic medical center were surveyed. Collected variables included gender, academic rank, marital status, family size, division of household responsibilities, and career satisfaction. Student t-test, Fisher's exact test, and chi-square test were used to compare results. There were 127 faculty and 116 trainee respondents (>80% response rate). Respondents were mostly male (77% of faculty, 58% of trainees). Women were more likely than men to be married to a professional (90% versus 37%, for faculty; 82% versus 41% for trainees, P < 0.001 for both) who was working full time (P < 0.001) and were less likely to be on tenure track (P = 0.002). Women faculty were more likely to be primarily responsible for childcare planning (P < 0.001), meal planning (P < 0.001), grocery shopping (P < 0.001), and vacation planning (P = 0.003). Gender-neutral responsibilities included financial planning (P = 0.04) and monthly bill payment (P = 0.03). Gender differences in division of household responsibilities were similar in surgical trainees except for childcare planning, which was a shared responsibility. Women surgeons are more likely to be partnered with a full-time working spouse and to be primarily responsible for managing their households. Additional consideration for improvement in recruitment and retention strategies for surgeons might address barriers to equalizing these gender disparities.


Molecular characterization of antibiotic resistant Escherichia coli strains isolated from tap and spring waters in a coastal region in Turkey.
A hundred and seventeen antibiotic-resistant Escherichia coli strains were isolated from public tap and spring waters which were polluted by fecal coliforms. There were no significant differences between two water sources as to the coliform pollution level (p> 0.05). All E. coli isolates were detected to be resistant to one or more antibiotics tested. Nearly 42% of the isolates showed multiresistant phenotype. Three (2.5%) of these isolates contained class 1 integron. Sequencing analysis of variable regions of the class 1 integrons showed two gene cassette arrays, dfr1-aadA1 and dhfrA17-aadA5. Resistance to ampicillin, tetracycline or trimethoprim-sulfamethoxazole was transferable according to the results of conjugation experiments. The rate of tetracycline resistance was 15%. tet(A)-mediated tetracycline resistance was widespread among tetracycline-resistant E. coli isolates. Genotyping by BOX-polymerase chain reaction (BOX-PCR) showed that some of the strains were epidemiologically related. This is the first report on the prevalence and characterization of class 1 integron-containing E. coli isolates of environmental origin in Turkey.


Burden of depression and anxiety among leprosy affected and associated factors-A cross sectional study from India.
Leprosy is a Neglected Tropical Diseases (NTDs) known to cause stigma and discrimination in low-and middle-income countries. It often results in visible impairments, thus pre-disposing to poor mental health. Aim of the study was to estimate the prevalence of depression and anxiety among people affected by Leprosy and to determine the associated factors. A multi-centric, cross-sectional study was carried out in four leprosy endemic states of India-Chhattisgarh, Maharashtra, West Bengal and Tamil Nadu in randomly selected blocks (a sub-unit of district), from one district in each state. From selected blocks those registered for leprosy treatment at public health or referral centres, people above the age of 18 years were interviewed with PHQ-9 and GAD-7 questionnaires for Depression and Anxiety, respectively. Disease profile like leprosy classification, deformity grade, number and site of the patches and socio-economic status were collected along with individual data. Of the total 220 respondents, prevalence of depression and anxiety symptoms was, 33% (73) and 19% (42), respectively. Presence of disability (47%) and Female gender (46%) were significantly associated with depression. Presence of disability (32%), Lower income group (27%) and low education (22%) were significantly associated with symptoms of anxiety. As the severity of disability increased, risk of developing depression and anxiety increased. The study indicates that more than 30% of people affected by leprosy have mental health problems, which emphasizes the importance of mental health care services in leprosy. Women, those who had lower level of education, those belonging to lower socio-economic status and those with any level of disability due to leprosy are at risk of developing depression and/or anxiety. The study concludes more attention to be paid to the categories identified to be at risk.


Factors that Influence the Decision to Seek Help in a Police Population.
Police officers face many competing pressures and demands. Exposure to potentially traumatic incidents and significant job-related stressors can place many at higher risk of developing physical and mental health problems. The police culture exerts a pronounced influence on officers, preventing some from asking for or receiving assistance. The stigma of being perceived as weak or incompetent, concerns about being labelled unfit for duty, and worry that accessing psychological support will impact future career advancement can affect the decision to seek help. The Enhanced Critical Incident Technique was utilized to investigate the following research question: What helps or hinders the decision to access psychological services in a police population? Qualitative interviews were conducted with 20 serving Royal Canadian Mounted Police officers in the lower mainland of British Columbia, Canada. The findings encompass five main themes: the importance of systemic factors, access to information and education, quality and influence of relationships, individual characteristics, and organizational processes that will increase the likelihood of accessing mental health services. The results contribute to the empirical literature by enhancing what is known about elements that influence an officers' decision to seek psychological services, and factors that can enable officers to overcome barriers.


[Effect of delayed application for medical help on the clinical course of myocardial infarction].
This questionnaire study included 203 patients with myocardial infarction (48 men and 24 women at the initial stages of the disease, 50 men and 81 women with a history of coronary heart disease) treated at the city clinical hospital No 50. Data from their medical cards and emergency call records were analyzed for the elucidation of factors influencing timely application for the first aid, the process of hospital treatment, and its final outcome. It was shown that the main cause of late hospitalization is the patients' unawareness of the danger of major clinical symptoms and of the necessity to call an ambulance for their management. Most patients rely on spontaneous recovery in case of moderate pain; those suffering severe pain either try to cope with the diseases by themselves or look for a doctor among their acquaintances. Patients underestimating the risk of further deterioration turn to pressing domesticities instead of seeking medical aid immediately, others are reluctant to stay in a hospital or go through emotional experience associated with hospitalization. Late application for the first aid accounts for the enhanced frequency of complications after discharge from the hospital despite adequate inpatient treatment.


Thrombospondin-1 promotes matrix homeostasis by interacting with collagen and lysyl oxidase precursors and collagen cross-linking sites.
Fibrillar collagens of the extracellular matrix are critical for tissue structure and physiology; however, excessive or abnormal deposition of collagens is a defining feature of fibrosis. Regulatory mechanisms that act on collagen fibril assembly potentially offer new targets for antifibrotic treatments. Tissue weakening, altered collagen fibril morphologies, or both, are shared phenotypes of mice lacking matricellular thrombospondins. Thrombospondin-1 (TSP1) plays an indirect role in collagen homeostasis through interactions with matrix metalloproteinases and transforming growth factor-β1 (TGF-β1). We found that TSP1 also affects collagen fibril formation directly. Compared to skin from wild-type mice, skin from Thbs1-/- mice had reduced collagen cross-linking and reduced prolysyl oxidase (proLOX) abundance with increased conversion to catalytically active LOX. In vitro, TSP1 bound to both the C-propeptide domain of collagen I and the highly conserved KGHR sequences of the collagen triple-helical domain that participate in cross-linking. TSP1 also bound to proLOX and inhibited proLOX processing by bone morphogenetic protein-1. In human dermal fibroblasts (HDFs), TSP1 and collagen I colocalized in intracellular vesicles and on extracellular collagen fibrils, whereas TSP1 and proLOX colocalized only in intracellular vesicles. Inhibition of LOX-mediated collagen cross-linking did not prevent the extracellular association between collagen and TSP1; however, treatment of HDFs with KGHR-containing, TSP1-binding, triple-helical peptides disrupted the collagen-TSP1 association, perturbed the collagen extracellular matrix, and increased myofibroblastic differentiation in a manner that depended on TGF-β receptor 1. Thus, the extracellular KGHR-dependent interaction of TSP1 with fibrillar collagens contributes to fibroblast homeostasis.


Anti-CD20 monoclonal antibodies in Systemic Lupus Erythematosus.
Systemic Lupus Erythematosus (SLE) is an autoimmune inflammatory condition with a wide spectrum of disease manifestations and severities, resulting in significant morbidity and mortality. The aetiopathogenesis of SLE is complex. Young women and certain ethnicities are commonly affected, suggesting a significant hormonal and genetic influence. Diverse immunological abnormalities have been described. A characteristic abnormality is the presence of autoantibodies, implicating a central role for B cells in disease pathogenesis and/or perpetuation. Whilst conventional therapies have improved outcomes, a great unmet need remains. Recently, biological therapies are being explored. B-cell depletion therapy with rituximab has been in use off-label for nearly two decades. Inconsistent results between uncontrolled and controlled studies have raised doubts about its efficacy. In this review, we will focus on B cell abnormalities and the rationale behind B-cell depletion therapy with anti-CD20 monoclonal antibody (mAb), rituximab, will be explored including an evaluation of clinical and trial experience. Finally, we will discuss the mechanistic basis for considering alternative anti-CD20 mAbs.


A descriptive survey of online gaming characteristics and gaming disorder in Ireland.
The aim of this study was to carry out the first ever study of gaming characteristics of individuals engaging in online gaming in Ireland and to ascertain whether features of gaming disorder are present in this population. An online survey (comprising 21 questions - 3 demographic questions and 18 questions related to gaming and gaming disorder) was distributed on numerous Irish online gaming forums and Irish online gaming communities. Participants were self-selected and invited to compete the online survey containing questions related to gaming behaviours (age of onset, hours played on weekdays/weekends, type of device used), mobile gaming, motives for online gaming, use of microtransactions, engagement in esports, and a screening tool for the presence of gaming disorder. A total of 166 participants engaged in the online survey. Among this study population of regular gamers in Ireland, 2.4% of the study population were classified as having gaming disorder, with up to 5.4% showing some evidence of disordered gaming. The main motivation for online gaming in the non-disordered gaming group was recreation (13.3, sd = 2.7) but only the fourth main motivation in the disordered gaming group behind competition (16.3, sd = 3.7), escape (16.2, sd = 4.3), and coping (15.1, sd = 3.7). Increased hours of gameplay on weekdays and weekends were noted in the disordered gaming group compared to non-disordered gamers. A small percentage of gamers in Ireland demonstrate disordered gaming characteristics and gaming disorder, consistent with data from other international studies. Epidemiological studies are required in Ireland to enhance our knowledge of this disorder.


[Manufacture and application of the SJ-1 bolt attachment prosthesis]
OBJECTIVE:This study provided a method of manufacture and using for SJ-1 bolt attachment prostheses clinic application.METHODS:SJ-1 bolt attachment prostheses were applied to restorate 10 cases distal extension edentulous area.The patients had been observed for two years.RESULTS:Patients feel the bolt attachment RPDs comfortable,adaptive.CONCLUSION:This prosthesis was fine retention,masticator efficiency and aesthetics.


Serological tests for celiac disease as indicators of long-term compliance with the gluten-free diet.
The efficacy of celiac disease (CD)-related antibodies in monitoring clinical outcome of patients remains unclear. Our aims were to determine dynamics of antibodies after diagnosis and to assess their performances in monitoring patients' long-term compliance with the gluten-free diet (GFD). We prospectively estimated the performance of seven celiac disease-related antibody tests at diagnosis and at 1 year and more than 4 years after treatment initiation in 53 adults. The ability of antibodies to identify patients partially compliant to treatment was explored by the receiver operating characteristic curve analysis. The derived cut-off values ('compliance' cutoffs) were compared with cut-off values used for diagnosis ('diagnostic' cutoffs). The degree of compliance with the GFD was assessed using a standardized, multidisciplinary approach. Concentrations of all antibodies decreased significantly at 1 year after diagnosis. The decline continued for more than 4 years in strictly compliant patients (P<0.05-0.001). The gap between 'compliance' and 'diagnostic' cut-offs values was wider at 1 year than at more than 4 years. The predictability of partial compliance determined by the area under receiver operating characteristic curves was relevant for most tests examined at 1 year (areas ranging: 0.64-0.72) and more than 4 years (0.58-0.78). Immunoglobulin A antibodies to deamidated gliadin peptides and tissue transglutaminase had the best performance for monitoring long-term compliance. Decreased concentrations of antibodies were significantly associated with the degree of compliance with the GFD. Immunoglobulin A antibodies to deamidated gliadin peptides and tissue transglutaminase had the best and more consistent performances. The serial measurement of antibody levels seems to be more reliable in monitoring compliance than the positive/negative expression of results.


A prospective study of the effect of foot orthoses composition and fabrication on comfort and the incidence of overuse injuries.
Foot orthoses are widely prescribed both to treat existing pathological conditions and to prevent overuse injuries, but little is known about the effect of their material composition and fabrication technique on patient comfort and the incidence of overuse injuries. The acceptance rates and comfort scores of soft custom, soft prefabricated, semirigid biomechanical, and semirigid prefabricated orthoses and their effect on the incidence of stress fractures, ankle sprains, and foot problems were studied in a prospective, randomized, single-blinded clinical trial among 874 infantry recruits during basic training. A statistically significantly lower number of recruits given soft prefabricated orthoses (53%) finished basic training in their assigned devices than in the soft custom group (72%), in the semirigid biomechanical group (75%), and in the semirigid prefabricated group (82%) (p = .003). For recruits who finished training in their assigned orthoses, the soft custom (3.54) and soft prefabricated (3.43) orthoses had significantly higher comfort scores than the semirigid biomechanical (3.23) and prefabricated (3.17) orthoses, (p = .0001). There was no statistically significant difference in the incidence of stress fractures, ankle sprains, or foot problems between recruits using the different types of orthoses. These findings suggest that if a foot orthosis is being dispensed as prophylaxis for overuse injuries in an active, healthy population, there is little justification for prescribing semirigid biomechanical orthoses. Their cost is high compared to other types of orthoses, without an advantage in comfort or a reduction in stress fractures, ankle sprains, and foot problems.