The current format and ongoing advances of medical education in the United States.
The objective of this study was to examine the current system of medical education along with the advances that are being made to support the demands of a changing health care system. American medical education must reform to anticipate the future needs of a changing health care system. Since the dramatic transformations to medical education that followed the publication of the Flexner report in 1910, medical education in the United States has largely remained unaltered. Today, the education of future physicians is undergoing modifications at all levels: premedical education, medical school, and residency training. Advances are being made with respect to curriculum design and content, standardized testing, and accreditation milestones. Fields such as plastic surgery are taking strides toward improving resident training as the next accreditation system is established. To promote more efficacious medical education, the American Medical Association has provided grants for innovations in education. Likewise, the Accreditation Council for Graduate Medical Education outlined 6 core competencies to standardize the educational goals of residency training. Such efforts are likely to improve the education of future physicians so that they are able to meet the future needs of American health care.


[Infanticide in primates and man and the problems of reconstructing the social behavior of the hominids].
The general analysis of infanticide distribution pattern in primate and human populations is given. The possibilities to use the sociobiological, ecological, psycho-analytical and structural-social approaches are considered to explain the infanticide functions in primates. The necessity of exact data concerning the sex, age and social position of both: killers and victims (victim's mothers either) is stressed, as well the estimation of social situation in the group in the period before the infanticide. The qualitative differences in infanticide mechanisms in lower monkeys, anthropoids and man is illustrated. It is proposed to differentiate the infanticide on the individual level and as a group social strategy. The probability of infanticide in hominid societies on the different stages of evolution is discussed.


A proton gradient, not a sodium gradient, is the driving force for active transport of lactate in rabbit intestinal brush-border membrane vesicles.
An inward-directed H+ gradient markedly stimulated lactate uptake in rabbit intestinal brush-border membrane vesicles, and uphill transport against a concentration gradient could be demonstrated under these conditions. Uptake of lactate was many-fold greater in the presence of a H+ gradient than in the presence of a Na+ gradient. Moreover, there was no evidence for uphill transport of lactate in the presence of a Na+ gradient. The H+-gradient-dependent stimulation of lactate uptake was not due to the effect of a H+-diffusion potential. The uptake process in the presence of a H+ gradient was saturable [Kt (concn. giving half-maximal transport) for lactate 12.7 +/- 4.5 mM] and was inhibited by many monocarboxylates. It is concluded that a H+ gradient, not a Na+ gradient, is the driving force for active transport of lactate in rabbit intestinal brush-border membrane vesicles.


Decision support for risk prioritisation of environmental health hazards in a UK city.
There is increasing appreciation of the proportion of the health burden that is attributed to modifiable population exposure to environmental health hazards. To manage this avoidable burden in the United Kingdom (UK), government policies and interventions are implemented. In practice, this procedure is interdisciplinary in action and multi-dimensional in context. Here, we demonstrate how Multi Criteria Decision Analysis (MCDA) can be used as a decision support tool to facilitate priority setting for environmental public health interventions within local authorities. We combine modelling and expert elicitation to gather evidence on the impacts and ranking of interventions. To present the methodology, we consider a hypothetical scenario in a UK city. We use MCDA to evaluate and compare the impact of interventions to reduce the health burden associated with four environmental health hazards and rank them in terms of their overall performance across several criteria. For illustrative purposes, we focus on heavy goods vehicle controls to reduce outdoor air pollution, remediation to control levels of indoor radon, carbon monoxide and fitting alarms, and encouraging cycling to target the obesogenic environment. Regional data was included as model evidence to construct a ratings matrix for the city. When MCDA is performed with uniform weights, the intervention of heavy goods vehicle controls to reduce outdoor air pollution is ranked the highest. Cycling and the obesogenic environment is ranked second. We argue that a MCDA based approach provides a framework to guide environmental public health decision makers. This is demonstrated through an online interactive MCDA tool. We conclude that MCDA is a transparent tool that can be used to compare the impact of alternative interventions on a set of pre-defined criteria. In our illustrative example, we ranked the best intervention across the equally weighted selected criteria out of the four alternatives. Further work is needed to test the tool with decision makers and stakeholders.


Hamartomatous angiolipoma of the parotid gland (sialoangiolipoma).
Mesenchymal tumors of the salivary glands are rare and mostly localized to the parotid gland. We report on the clinico-pathological features of a distinct parotid tumor occurred in a newborn, showing glandular structures admixed with mature lipocytes and blood vessels in variable proportions. This was a well-circumscribed and slowly growing nodule of the superficial parotid lobe, mostly reddish in color with white-yellowish striations. Microscopically, a distinct lobular architecture was evident, along with normal-appearing acinar and ductal structures with interposed loose fibrous stroma. The latter contained aggregates of mature lipocytes and variably sized blood vessels. The morphological features of the lesion reported herein recapitulate those of sialolipoma but also include the presence of a prominent vascular component intimately admixed with both the glandular and the adipose tissues. At variance with salivary lipoadenoma, the glandular component in the current case distinctly showed all the cellular components of normal salivary (serous) glands. In consideration of the young age of the patient, the minimal growth rate and the histological features of the lesion, we hypothesize a hamartomatous origin for this lesion and propose the designation of sialoangiolipoma.


Characterizing subpopulations of neoplastic cells in serous effusions. The role of immunocytochemistry.
To analyze the role of immunochemistry in serous effusions. We analyzed cell blocks of 18 pleural and 18 peritoneal effusions diagnosed as malignant (18), benign (14) and suspicious (4). They were immunostained by the avidin-biotin complex method with a panel of four monoclonal antibodies--CEA, Ber-EP4, LeuM1 (CD15) and p53--and, for lectins (Ulex europaeus) UEA-l, ConA and ConBr. Seventeen of the 18 cases of adenocarcinoma were positive for CEA (95%), 12 (66.6%) for Ber-EP4, 11 (61%) for CD15 and 11 (61%) for p53. Twelve of the 18 (66.6%) were positive for UEA-1, CEA, Ber-EP4 and CD15. UEA-1 did not react with mesothelial cells. p53 Gave a positive reaction in only one case, reactive mesothelial cells. ConA and ConBr reacted indiscriminately with benign and malignant cells; thus, it was not useful in distinguishing between these cells. In this context no antibody used alone is reliable for corroborating a diagnosis, but the selective use of a small panel of three markers (CEA, Ber-EP4 and LeuM1) can be very useful in solving diagnostic difficulties in the cytodiagnosis of serous effusions.


Nuclear proteins. II. Similarity of nonhistone proteins in nuclear sap and chromatin, and essential absence of contractile proteins from mouse liver nuclei.
High resolution SDS slab gel electrophoresis has been used to examine the distribution of nonhistone proteins (NHP) in the saline-EDTA, Tris, and 0.35 M NaCl washes of isolated mouse liver nuclei. These studies led to the following conclusions: (a) all the prominent NHP which remain bound to DNA are also present in somewhat similar proportions in the saline-EDTA, Tris, and 0.35 M NaCl washes of nuclei; (b) a protein comigrating with actin is prominent in the first saline-EDTA wash of nuclei, but present as only a minor band in the subsequent washes and on washed chromatin; (c) the presence of nuclear matrix proteins in all the nuclear washes and cytosol indicates that these proteins are distributed throughout the cell; (d) a histone-binding protein (J2) analogous to the HMG1 protein of K. V. Shooter, G.H. Goodwin, and E.W. Johns (Eur J. Biochem. 47:236-270) is a prominent nucleoplasmic protein; (e) quantitation of the major NHP indicates that they are present in a range of 2.2 X 10(5)-5.2 X 10(6) copies per diploid nucleus. Most of the electrophoretically visible NHP are probably structural rather than regulatory proteins; (f) actin, myosin, tubulin, and tropomyosin, if present at all, constitute a very minor fraction of the nuclear NHP. Contractile proteins constitute a major portion of the NHP only when the chromatin is prepared from crude cell lysates instead of from purified nuclei. These studies support the conclusion that there are no clear differences between many nucleoplasmic and chromatin-bound nonhistone proteins. Except for the histones, many of the intranuclear proteins appear to be in equilibrium between DNA, HnRNA, and the nucleoplasm.


Central nervous system metastasis of a cutaneous epitheliotropic lymphosarcoma in a dog.
This report describes an uncommon case of a cutaneous epitheliotropic T-cell lymphosarcoma with central nervous system (CNS) manifestations in a 9-year-old mixed breed German shepherd dog. The animal had a history of sudden blindness, pyrexia and multifocal areas of hyperaemia in the oral mucosa. A biopsy from the muco-cutaneous junction of the lips led to the diagnosis of an epitheliotropic lymphosarcoma and the animal was humanely destroyed. At necropsy, hyperaemia in the oral mucosa was no longer detectable. In the brain, a mass effacing the optic chiasm and invading the hypothalamic area was found; histological examination revealed lymphoid tumour cell infiltration. In the epithelium of the oral mucosa, intra-epithelial lymphoid tumour cells, sometimes arranged in small clusters (Pautrier's microabscesses), in combination with a mild inflammation in the superficial dermis were observed. Skin and brain tumour cells expressed CD3 antigen, indicating their T-cell origin. This is, to our knowledge, the first report of a cutaneous epitheliotropic lymphosarcoma with CNS metastasis in a dog.


Diagnosis of disseminated alveolar rhabdomyosarcoma using cytogenetics: case report.
The clinical, histologic and cytogenetic features of a patient with the alveolar subtype of rhabdomyosarcoma (RMS) were investigated. The patient presented with a widely disseminated tumour including bone marrow involvement, and was a diagnostic dilemma. The presence of translocation (2;13)(q37;q14), which is strongly associated with alveolar RMS helped make the diagnosis. A review of other published cases confirms the strong association of (2;13) with alveolar RMS. The importance of considering RMS as a differential diagnosis in patients presenting with disseminated tumour as the only finding is stressed. This case also shows how cytogenetic investigation of similar patients may provide a diagnosis.


The Temporal Relationship Between Terrestrial Gamma-Ray Flashes and Associated Optical Pulses From Lightning.
We present 221 Terrestrial Gamma-ray Flashes (TGFs) and associated optical pulses observed by the Atmosphere-Space Interactions Monitor (ASIM) on board the International Space Station. The events were detected between the end of March 2019 and November 2020 and consist of X- and gamma-ray energy detections, as well as photometer data (180-230, 337, and 777 nm) and optical camera data (337 and 777 nm). Using the available ASIM data and applying a consistency check based on TGF characteristics and lightning detections from lightning radio atmospherics close in time, we determine the most likely position of the TGFs in relation to the photometer field of view (FoV), and the association to the observed optical pulses. Out of the 221 events we find 72 events where the TGF and optical data are determined to be associated and inside the photometer FoV. Using the measured TGF durations and the time between the onsets of the TGFs and optical pulses we find: (a) That the TGF onsets are always before or at the same time as the optical pulse onsets (taking into account cloud scattering). (b) A tendency for longer duration TGFs to have longer delays between onsets. (c) Two groups of events: (a) where there is a possible overlap between the TGFs and the optical emissions, as the TGFs last longer than the delay between onsets and (b) where the TGFs and optical emissions do not overlap, as there are long delays between the onsets, which cannot be explained by cloud scattering.


Developmental Stifling: an emerging symptom pattern.
"Developmental Stifling" is a term recently developed by us to denote a symptom pattern observed in a variety of clinical practice sites. The purpose of our paper is to define developmental stifling and compare this recently identified condition with Munchausen Syndrome by Proxy. A case example of developmental stifling is provided, as well as recommendations for early identification and treatment.


Changing epidemiology of Clostridium difficile infection following the introduction of a national ribotyping-based surveillance scheme in England.
Marked increases in Clostridium difficile infection (CDI) incidence, driven by epidemic strain spread, is a global phenomenon. The Clostridium difficile Ribotyping Network (CDRN) was established in 2007 as part of enhanced CDI surveillance in England, to facilitate the recognition and control of epidemic strains. We report on changes in CDI epidemiology in England in the first 3 years of CDRN. CDRN received 12,603 fecal specimens, comprising significantly (P < .05) increasing numbers and proportions of national CDI cases in 2007-2008 (n = 2109, 3.8%), 2008-2009 (n = 4774, 13.2%), and 2009-2010 (n = 5720, 22.3%). The C. difficile recovery rate was 90%, yielding 11,294 isolates for ribotyping. Rates of 9 of the 10 most common ribotypes changed significantly (P < .05) during 2007-2010. Clostridium difficile ribotype 027 predominated, but decreased markedly from 55% to 36% and 21% in 2007-2008, 2008-2009, and 2009-2010, respectively. The largest regional variations in prevalence occurred for ribotypes 027, 002, 015, and 078. Cephalosporin and fluoroquinolone use in CDI cases was reported significantly (P < .05) less frequently during 2007-2010. Mortality data were subject to potential reporting bias, but there was a significant decrease in CDI-associated deaths during 2007-2010, which may have been due to multiple factors, including reduced prevalence of ribotype 027. Access to C. difficile ribotyping was associated with significant changes in the prevalence of epidemic strains, especially ribotype 027. These changes coincided with markedly reduced CDI incidence and related mortality in England. CDI control programs should include prospective access to C. difficile typing and analysis of risk factors for CDI and outcomes.


Independence: the ultimate goal of rehabilitation for spinal cord-injured persons.
During the late 1960s and early 1970s, a new concept related to rehabilitation and improvements in quality of life began to emerge and be expressed by people with spinal cord injuries and other disabilities. This concept, independent living, is the foundation of the independent living movement, which has helped to overcome the barriers to a higher quality of life for disabled people. Of the many organizations and programs set up to provide support for disabled people living in the community, the independent living program seems to be comparatively successful at facilitating independence by people with spinal cord injuries. Independent living programs provide the kind of community-based support services necessary to expand the range of living options for disabled people beyond those traditionally available in most communities. The role of occupational therapists in the independent living stage of the rehabilitation process can be similar in some respects to their role during earlier phases of medical rehabilitation. However, the definition of independence as a "mind process" leads to considerable expansion of the therapist's role beyond the focus on physical skills, which are usually key priorities during medical rehabilitation. Occupational therapists typically possess knowledge and skills that equip them well for assisting clients in the independent living stage of the rehabilitation process.


Exploring supportive care for individuals affected by Huntington disease and their family caregivers in a community setting.
The aim of this research was to identify the needs and coping strategies of individuals with Huntington disease and their family members/carers and to ascertain the extent to which they were supported by the type of specialised service provided in this unit. The duration of the illness may be up to 30 years and there are far reaching implications for the affected person, family members and carers. Services for families need to provide expert psychological and practical support, whilst remaining planned and flexible. The aim of this research was to identify needs and coping strategies of individuals with Huntington disease and their carers and ascertain the extent to which they were supported by a specialised community service. Five focus groups and three individual interviews were used to gather data from affected individuals, family, carers and staff of the unit (n = 33). A semi-structured discussion guide was used in every case. Data were analysed using an inductive coding technique. Three main themes emerged; (i) Transitions and the journey, (ii) Challenges in finding and providing support and (iii) The role of the unit in providing supportive care. While the service was seen as supportive, the need for flexibility was emphasised to facilitate the transition from unaffected to affected status. Affected individuals felt it was important to be known as the person they had been, despite the changes due to the disease. Provision of service in a dedicated unit is an appropriate way to support affected patients and their carers. Enhancing understanding of the disease and allowing the individual to make choices can assist coping with this challenging disease. It is helpful to allow patients control over timing and frequency of contact with professionals. Improving understanding of the condition in the public and health professionals may enable patients to access a greater range of social activities.


Determinants of the natural history of human immunodeficiency virus type 1 infection.
Variation in the time to AIDS and duration of survival of human immunodeficiency virus (HIV)-1-infected persons was recognized early in the epidemic. Recent studies have indicated that the rate of viral replication, as manifest by the number of copies of HIV RNA per milliliter of plasma, is a major determinant of outcome in an infected person. The predictive power of the measurement of plasma HIV RNA copy number is enhanced by combining this result with the CD4 lymphocyte number. The determinants of the rate of viral replication are less clearly defined. Recent studies suggest that polymorphism of the chemokine receptors, required for cellular infection, plays a role in regulating the rate of viral replication. The subsequent adaptive evolution of HIV-1 to the host's immune response is a consequence of this dynamic of the virus. Complicating opportunistic infections also appear to enhance HIV-1 replication, while antiviral therapy, in contrast, can and does suppress viral replication.


Dark-stimulated calcium ion fluxes in the chloroplast stroma and cytosol.
Using transgenic Nicotiana plumbaginifolia seedlings in which the calcium reporter aequorin is targeted to the chloroplast stroma, we found that darkness stimulates a considerable flux of Ca(2+) into the stroma. This Ca(2+) flux did not occur immediately after the light-to-dark transition but began approximately 5 min after lights off and increased to a peak at approximately 20 to 30 min after the onset of darkness. Imaging of aequorin emission confirmed that the dark-stimulated luminescence emanated from chloroplast-containing tissues of the seedling. The magnitude of the Ca(2+) flux was proportional to the duration of light exposure (24 to 120 h) before lights off; the longer the duration of light exposure, the larger the dark-stimulated Ca(2+) flux. On the other hand, the magnitude of the dark-stimulated Ca(2+) flux did not appear to vary as a function of circadian time. When seedlings were maintained on a 24-h light/dark cycle, there was a stromal Ca(2+) burst after lights off every day. Moreover, the waveform of the Ca(2+) spike was different during long-day versus short-day light/dark cycles. The dark-stimulated Ca(2+) flux into the chloroplastidic stroma appeared to affect transient changes in cytosolic Ca(2+) levels. DCMU, an inhibitor of photosynthetic electron transport, caused a significant increase in stromal Ca(2+) levels in the light but did not affect the magnitude of the dark-stimulated Ca(2+) flux. This robust Ca(2+) flux likely plays regulatory roles in the sensing of both light/dark transitions and photoperiod.


The Role of CPNE7 (Copine-7) in Colorectal Cancer Prognosis and Metastasis.
Colorectal cancer (CRC) is one of the most common and deadly cancers in the world. However, no effective treatment for the disease has yet been found. For this reason, several studies are being carried out on the treatment of CRC. Currently, there is limited understanding of the role of CPNE7 (copine-7) in CRC progression and metastasis. The results of this study show that CPNE7 exerts an oncogenic effect in CRC. First, CPNE7 was shown to be significantly up-regulated in CRC patient tissues and CRC cell lines compared to normal tissues according to IHC staining, qRT-PCR, and western blotting. Next, this study used both systems of siRNA and shRNA to suppress CPNE7 gene expression to check the CPNE7 mechanism in CRC. The suppressed CPNE7 significantly inhibited the growth of CRC cells in in vitro experiments, including migration, invasion, and semisolid agar colony-forming assay. Moreover, the modified expression of CPNE7 led to a decrease in the levels of genes associated with epithelial-mesenchymal transition (EMT). The epithelial genes E-cadherin (CDH1) and Collagen A1 were upregulated, and the levels of mesenchymal genes such as N-cadherin (CDH2), ZEB1, ZEB2, and SNAIL (SNAL1) were downregulated after CPNE7 inhibition. This study suggests that CPNE7 may serve as a potential diagnostic biomarker for CRC patients.


The effect of pneumonia on short-term outcomes and cost of care after head and neck cancer surgery.
The Centers for Medicare and Medicaid Services has threatened to discontinue reimbursements for ventilator-associated pneumonia (VAP) as a preventable "never event." We sought to determine the relationship between pneumonia and in-hospital mortality, complications, length of hospitalization and costs in head and neck cancer (HNCA) surgery. Retrospective cross-sectional study. Discharge data from the Nationwide Inpatient Sample for 93,663 patients who underwent an ablative procedure for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm from 2003 to 2008 were analyzed using cross-tabulations and multivariate regression modeling. VAP was rarely coded. Infectious pneumonia was significantly associated with chronic pulmonary disease (odds ratio [OR], 1.5; P < .001), while aspiration pneumonia was associated with dysphagia (OR, 2.0; P < .001). Pneumonia from any cause was associated with weight loss (OR, 3.3; P < .001), age >80 years (OR, 2.0; P = .007), comorbidity (OR, 2.3; P < .001), and major procedures (OR, 1.6; P < .001), with increased in-hospital mortality for infectious (OR, 2.9; P < .001) and aspiration pneumonia (OR, 5.3; P < .001). Both infectious and aspiration pneumonia were associated with postoperative medical and surgical complications, increased length of hospitalization, and hospital-related costs. Postoperative pneumonia is associated with increased mortality, complications, length of hospitalization, and hospital-related costs in HNCA surgical patients. Variables associated with an increased risk of pneumonia are inherent comorbidities in HNCA and known risk factors for VAP, making this a high-risk group for this never event. Caution must be used in the institution of reforms that threaten to inadequately reimburse the provision of care to this vulnerable population. Aggressive preoperative identification and treatment of underlying pulmonary disease, weight loss, and dysphagia may reduce morbidity and mortality.


[Computed and magnetic resonance tomography in the differential diagnosis of osteoarticular tuberculosis].
Due to their high resolving capacity, computerized and magnetic resonance tomographic examinations allow early detection of tuberculosis lesions in vertebral column, large joints and their surrounding soft tissues. They also widen the possibilities for differential diagnosis, help to individualize the choice of adequate treatment, improve the outcomes of this treatment and decrease the period of patients' intrahospital stay.


Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey.
Although many epidemiological studies have suggested that increased serum uric acid levels are a risk factor for cardiovascular mortality, this relationship remains uncertain. To determine the association of serum uric acid levels with cardiovascular mortality. Cross-sectional population-based study of epidemiological follow-up data from the First National Health and Nutrition Examination Survey (NHANES I) from 1971-1975 (baseline) and data from NHANES I Epidemiologic Follow-up Study (NHEFS). A total of 5926 subjects who were aged 25 to 74 years and had serum uric acid level measurements at baseline. Ischemic heart disease mortality, total cardiovascular mortality, and all-cause mortality, compared by quartiles of serum uric acid level. In an average of 16.4 years of follow-up, 1593 deaths occurred, of which 731 (45.9%) were ascribed to cardiovascular disease. Increased serum uric acid levels had a positive relationship to cardiovascular mortality in men and women and in black and white persons. Deaths due to ischemic heart disease in both men and women increased when serum uric acid levels were in the highest quartile compared with the lowest quartile (men, >416 vs <321 micromol/L; risk ratio, 1.77 [95% confidence interval [CI], 1.08-3.98]; women, >333 vs <238 micromol/l; risk ratio, 3.00 [95% CI, 1.45-6.28]). Cox regression analysis showed that for each 59.48-micromol/L increase in uric acid level, cardiovascular mortality and ischemic heart disease mortality increased. Hazard ratios for men were 1.09 (95% CI, 1.02-1.18) and 1.17 (95% CI, 1.06-1.28), and for women were 1.26 (95% CI, 1.16-1.36) and 1.30 (95% CI, 1.17-1.45), respectively, after adjustment for age, race, body mass index, smoking status, alcohol consumption, cholesterol level, history of hypertension and diabetes, and diuretic use. Further analysis, stratifying by cardiovascular risk status, diuretic use, and menopausal status, confirmed a significant association of uric acid and cardiovascular mortality in all subgroups except among men using diuretics (n=79) and men with 1 or more cardiovascular risk factors (n=1140). Our data suggest that increased serum uric acid levels are independently and significantly associated with risk of cardiovascular mortality.


Combining distribution- and anchor-based approaches to determine minimally important differences: the FACIT experience.
Health-related quality of life (HRQOL) is an important endpoint in cancer clinical trials and in cancer treatment in general; however, the meaningfulness of HRQOL scores may not be apparent to clinicians or researchers. Minimally important differences (MIDs) can enhance the interpretability of HRQOL scores by identifying differences likely to be meaningful to patients and clinicians. This article's objective is to describe and provide examples of approaches we have used to identify MIDs for instruments in the Functional Assessment of Chronic Illness Therapy (FACIT) measurement system. Distribution- and anchor-based approaches are described and illustrated. We also discuss the importance of assessing the appropriateness of anchors, and we provide suggestions for combining results into a single range of plausible MIDs. MIDs for FACIT instruments established to date are summarized, and general guidelines that can be used to estimate MIDs for other FACIT instruments are provided. Applications of MIDs in research are illustrated.


Clinical significance of low levels of myeloperoxidase positivity in childhood acute nonlymphoblastic leukemia.
The clinical significance of a low percentage of myeloperoxidase-positive blast cells in childhood acute nonlymphoblastic leukemia was determined. Of 155 consecutive cases studied by cytochemical staining methods, 14 were characterized by 4% to 15% (median 6%) myeloperoxidase-positive blasts. All 14 cases showed reactivity to Sudan black B stain, and 7 had Auer rods. The morphological subtypes of leukemia were M1 (8 cases), M2 (3), M4 (1), and M5 (2). Immunological marker studies disclosed the lymphoid-associated T11 antigen on cells from 8 of the 11 cases tested. Other lymphoid-related findings in these 8 cases included the T3 antigen and E rosette formation in 1 case each. Among cases that were prospectively studied for the expression of lymphoid-associated markers, 6 of 8 with low levels of myeloperoxidase positivity compared with only 1 of 44 with higher levels (greater than 15%) possessed such features (P less than 0.001). We conclude that low levels of myeloperoxidase reactivity distinguish cases of acute leukemia in which the blast cells coexpress lymphoid (T11 antigen) and myeloid markers.


S-Nitrosoglutathione Reductase Is Essential for Protecting the Female Heart From Ischemia-Reperfusion Injury.
Protein S-nitros(yl)ation (SNO) has been implicated as an essential mediator of nitric oxide-dependent cardioprotection. Compared with males, female hearts exhibit higher baseline levels of protein SNO and associated with this, reduced susceptibility to myocardial ischemia-reperfusion injury. Female hearts also exhibit enhanced S-nitrosoglutathione reductase (GSNO-R) activity, which would typically favor decreased SNO levels as GSNO-R mediates SNO catabolism. Because female hearts exhibit higher SNO levels, we hypothesized that GSNO-R is an essential component of sex-dependent cardioprotection in females. Male and female wild-type mouse hearts were subjected to ex vivo ischemia-reperfusion injury with or without GSNO-R inhibition (N6022). Control female hearts exhibited enhanced functional recovery and decreased infarct size versus control males. Interestingly, GSNO-R inhibition reversed this sex disparity, significantly reducing injury in male hearts, and exacerbating injury in females. Similar results were obtained with male and female GSNO-R-/- hearts using ex vivo and in vivo models of ischemia-reperfusion injury. Assessment of SNO levels using SNO-resin assisted capture revealed an increase in total SNO levels with GSNO-R inhibition in males, whereas total SNO levels remained unchanged in females. However, we found that although GSNO-R inhibition significantly increased SNO at the cardioprotective Cys39 residue of nicotinamide adenine dinucleotide (NADH) dehydrogenase subunit 3 in males, SNO-NADH dehydrogenase subunit 3 levels were surprisingly reduced in N6022-treated female hearts. Because GSNO-R also acts as a formaldehyde dehydrogenase, we examined postischemic formaldehyde levels and found that they were nearly 2-fold higher in N6022-treated female hearts compared with nontreated hearts. Importantly, the mitochondrial aldehyde dehydrogenase 2 activator, Alda-1, rescued the phenotype in GSNO-R-/- female hearts, significantly reducing infarct size. These striking findings point to GSNO-R as a critical sex-dependent mediator of myocardial protein SNO and formaldehyde levels and further suggest that different therapeutic strategies may be required to combat ischemic heart disease in males and females.


[Correction of a T-immunodeficit in mice by bone marrow transplantation from donors treated with hydrocortisone].
Adult CBA mice were exposed to thymectomy, lethal irradiation, and protection by syngeneic bone marrow transplantation. In some experiments syngeneic bone marrow of donors, treated with hydrocortisone in a dose of 125 mg/kg for 3 days was used. The bone marrow of these donors contained cells with the Q-marker. Thymectomized and lethally irradiated animals subjected to the transplantation of syngeneic bone marrow from hydrocortisone-treated donors rejected the skin allotransplants, and the lymph node cells of these mice suppressed the endogenous colony-formation in the sublethally-irradiated hybrids (CBA X C57Bl/6) F1.


Evaluation of novel biomarkers for the diagnosis of acute destabilised heart failure in patients with shortness of breath.
The evaluation of novel biomarkers for the diagnosis of acute destabilised heart failure (HF). Prospectively conducted study on diagnostic accuracy. Emergency department of a tertiary care hospital. 251 consecutive patients presenting to the emergency department with dyspnoea as the chief complaint. Index tests were plasma concentrations of 10 biomarkers (BNP, MR-proANP, MR-proADM, copeptin, CT-proET-1, ST2, adiponectin, chromogranin A, proguanylin and prouroguanylin). The reference standard was the diagnosis of acute destabilised HF, which was based on the Framingham score for HF plus echocardiographic evidence of systolic or diastolic dysfunction. Median plasma concentrations of all 10 biomarkers were higher in patients with dyspnoea attributable to acute destabilised HF (n = 137) than in patients with dyspnoea attributable to other reasons (n = 114). Applying receiver operating characteristic curve (ROC) analyses, areas under the curve (AUCs) for BNP (0.92) and MR-proANP (0.88) were significantly higher than the AUCs of the other eight biomarkers (MR-proADM, 0.75; adiponectin, 0.73; CT-proET-1, 0.72; proguanylin, 0.68; ST2, 0.67; prouroguanylin, 0.62; copeptin, 0.62; and chromogranin A, 0.56). In multivariate logistic regression analysis only increased BNP and MR-proANP concentrations remained independent markers for the diagnosis of HF. Both markers alone or in combination added similar diagnostic information besides all clinical information available in the emergency department. The data showed that BNP and MR-proANP were the only independent diagnostic markers of HF. Both markers provided similar diagnostic information and were clinically useful as an aid in the diagnosis of acute destabilised HF in an emergency setting.


Expression of steroid hormone receptors and its prognostic significance in urothelial carcinoma of the upper urinary tract.
To assess the expression status of steroid hormone receptors in upper urinary tract urothelial carcinoma (UUTUC), we immunohistochemically stained for androgen receptor (AR), estrogen receptor-α (ERα), ERβ, glucocorticoid receptor (GR), and progesterone receptor (PR) in 99 UUTUC specimens and paired non-neoplastic urothelial tissues. AR/ERα/ERβ/GR/PR was positive in 20%/18%/62%/63%/16% of tumors, which was significantly lower (except PR) than in benign urothelial tissues [57% (P < 0.001)/40% (P = 0.001)/85% (P = 0.001)/84% (P = 0.002)/13% (P = 0.489)]. There were no significant associations between each receptor expression pattern and histopathological characteristic of the tumors including tumor grade/stage. Kaplan-Meier and log-rank tests revealed no significant prognostic value of each receptor expression in these 99 patients. However, patients with UUTUC positive for either ERα or PR had a significantly higher risk of disease-specific mortality (P = 0.025), compared with those with UUTUC negative for both. PR positivity alone in pT3 or pT4 tumors was also strongly associated with the risk of disease-specific mortality (P = 0.040). Multivariate analysis further identified the expression of ERα and/or PR as a strong predictor for disease-specific mortality in the entire cohort of the patients (hazard ratio, 2.434; P = 0.037). Thus, in accordance with previous observations in bladder specimens, significant decreases in the expression of AR/ERα/ERβ/GR in UUTUC, compared with that in non-neoplastic urothelium, were observed. Meanwhile, the negativity of both ERα and PR in UUTUC as well as the negativity of PR alone in deeply invasive tumor was suggested to serve as a prognosticator.


Expansion of transcatheter aortic valve replacement in the United States.
Patterns of diffusion of TAVR in the United States (U.S.) and its relation to racial disparities in TAVR utilization remain unknown. We identified TAVR hospitals in the continental U.S. from 2012-2017 using Medicare database and mapped them to Hospital Referral Regions (HRR). We calculated driving distance from each residential ZIP code to the nearest TAVR hospital and calculated the proportion of the U.S. population, in general and by race, that lived <100 miles driving distance from the nearest TAVR center. Using a discrete time hazard logistic regression model, we examined the association of hospital and HRR variables with the opening of a TAVR program. The number of TAVR hospitals increased from 230 in 2012 to 540 in 2017. The proportion of the U.S. population living <100 miles from nearest TAVR hospital increased from 89.3% in 2012 to 94.5% in 2017. Geographic access improved for all racial and ethnic subgroups: Whites (84.1%-93.6%), Blacks (90.0%- 97.4%), and Hispanics (84.9%-93.7%). Within a HRR, the odds of opening a new TAVR program were higher among teaching hospitals (OR 1.48, 95% CI 1.16-1.88) and hospital bed size (OR 1.44, 95% CI 1.37-1.52). Market-level factors associated with new TAVR programs were proportion of Black (per 1%, OR 0.78, 95% CI 0.69-0.89) and Hispanic (per 1%, OR 0.82, 95% CI 0.75-0.90) residents, the proportion of hospitals within the HRR that already had a TAVR program (per 10%, OR 1.07, 95% CI 1.03-1.11), P <.01 for all. The expansion of TAVR programs in the U.S. has been accompanied by an increase in geographic coverage for all racial subgroups. Further study is needed to determine reasons for TAVR underutilization in Blacks and Hispanics.


Cellular protection mechanisms against extracellular heme. heme-hemopexin, but not free heme, activates the N-terminal c-jun kinase.
Hemopexin protects cells lacking hemopexin receptors by tightly binding heme abrogating its deleterious effects and preventing nonspecific heme uptake, whereas cells with hemopexin receptors undergo a series of cellular events upon encountering heme-hemopexin. The biochemical responses to heme-hemopexin depend on its extracellular concentration and range from stimulation of cell growth at low levels to cell survival at otherwise toxic levels of heme. High (2-10 microM) but not low (0.01-1 microM) concentrations of heme-hemopexin increase, albeit transiently, the protein carbonyl content of mouse hepatoma (Hepa) cells. This is due to events associated with heme transport since cobalt-protoporphyrin IX-hemopexin, which binds to the receptor and activates signaling pathways without tetrapyrrole transport, does not increase carbonyl content. The N-terminal c-Jun kinase (JNK) is rapidly activated by 2-10 microM heme-hemopexin, yet the increased intracellular heme levels are neither toxic nor apoptotic. After 24 h exposure to 10 microM heme-hemopexin, Hepa cells become refractory to the growth stimulation seen with 0.1-0.75 microM heme-hemopexin but HO-1 remains responsive to induction by heme-hemopexin. Since free heme does not induce JNK, the signaling events, like phosphorylation of c-Jun via activation of JNK as well as the nuclear translocation of NFkappaB, G2/M arrest, and increased expression of p53 and of the cell cycle inhibitor p21(WAF1/CIP1/SDI1) generated by heme-hemopexin appear to be of paramount importance in cellular protection by heme-hemopexin.


Enhancing patient-engaged teamwork in healthcare: an observational case study.
The purpose of this study was to describe how teamwork that effectively engaged patients and families, manifested itself in an acute rural care setting in order to inform the development of teamwork skills. One hundred and forty participants were included in the study representing providers, patients, family, hospital and clinical support personnel, education specialists and students. Using a modified grounded theory approach, and informed by activity theory, observational field notes and interview transcripts were analyzed. Through the analysis of 343 events of providers interacting with, or exchanging information about, patients, three patterns of teamwork emerged that facilitated patient-engaged care: uniprofessional, multiprofessional and interprofessional. The data indicated that providers navigated between these patterns, as well as others, throughout their workday. Providers should be skilled in applying the construct of situation awareness in order to adopt a pattern of teamwork that best facilitates patient-engaged care. Interventions that can enhance teamwork should focus on: valuing the perspectives of others; developing relational competence and resilience; employing reflective learning and shared decision-making skills; and incorporating principles of change theory for both individuals and systems.


Noble Gases in the Murchison Meteorite: Possible Relics of s-Process Nucleosynthesis.
The Murchison carbonaceous chondrite contains a new type of xenon component, enriched by up to 50 percent in five of the nine stable xenon isotopes, mass numbers 128 to 132. This component, comprising 5 x 10(-5) of the total xenon in the meteorite, is released at 1200 degrees to 1600 degrees C from a severely etched mineral fraction, and probably resides in some refractory mineral. Krypton shows a similar but smaller enrichment in the isotopes 80 and 82. Neon and helium released in the same interval also are quite anomalous, being highly enriched in the isotopes 22 and 3. These patterns are strongly suggestive of three nuclear processes believed to take place in red giants: the s process (neutron capture on a slow time scale), helium burning, and hydrogen shell burning. If this interpretation is correct, then primitive meteorites contain yet another kind of alien, presolar material: dust grains ejected from red giants.


Small regulatory RNAs are mediators of the Streptococcus mutans SloR regulon.
Dental caries is among the most prevalent chronic diseases worldwide. Streptococcus mutans, the chief causative agent of caries, uses a 25-kDa manganese-dependent SloR protein to coordinate the uptake of essential manganese with the transcription of its virulence attributes. Small non-coding RNAs (sRNAs) can either enhance or repress gene expression, and reports in the literature ascribe an emerging role for sRNAs in the environmental stress response. Herein, we focused our attention on 18-50 nt sRNAs as mediators of the S. mutans SloR and manganese regulons. Specifically, the results of RNA sequencing revealed 19 sRNAs in S. mutans, which were differentially transcribed in the SloR-proficient UA159 and SloR-deficient GMS584 strains, and 10 sRNAs that were differentially expressed in UA159 cells grown in the presence of low vs high manganese. We describe SmsR1532 and SmsR1785 as SloR- and manganese-responsive sRNAs that are processed from large transcripts and that bind SloR directly in their promoter regions. The predicted targets of these sRNAs include regulators of metal ion transport, growth management via a toxin-antitoxin operon, and oxidative stress tolerance. These findings support a role for sRNAs in coordinating intracellular metal ion homeostasis with virulence gene control in an important oral cariogen. IMPORTANCE Small regulatory RNAs (sRNAs) are critical mediators of environmental signaling, particularly in bacterial cells under stress, but their role in Streptococcus mutans is poorly understood. S. mutans, the principal causative agent of dental caries, uses a 25-kDa manganese-dependent protein, called SloR, to coordinate the regulated uptake of essential metal ions with the transcription of its virulence genes. In the present study, we identified and characterized sRNAs that are both SloR and manganese responsive. Taken together, this research can elucidate the details of regulatory networks that engage sRNAs in an important oral pathogen and that can enable the development of an effective anti-caries therapeutic.


Sequences of topotecan and cisplatin: phase I, pharmacologic, and in vitro studies to examine sequence dependence.
A phase I and pharmacologic study was performed to evaluate the feasibility of administering the topoisomerase I (topo I) inhibitor topotecan (TPT) in combination with cisplatin (CDDP) in minimally pretreated adults with solid tumors. The study was designed to evaluate the magnitude of the toxicologic and pharmacologic differences between the two sequences of drug administration. TPT was administered as a 30-minute infusion daily for 5 days and CDDP was given either before TPT on day 1 or after TPT on day 5. Each patient was treated with both schedules on an alternating basis every 3 weeks. Sequential dose escalation of TPT or CDDP resulted in three dosage permutation of TPT/CDDP (mg/m2): 0.75/50, 1/50, and 0.75/75. After the maximum-tolerated dose (MTD) level was achieved, the feasibility of using granulocyte colony-stimulating factor (G-CSF) to permit further dose escalation was studied. To examine the interaction of TPT and CDDP in vitro, human A549 lung cancer cells were exposed to these agents concurrently and sequentially. Dose-limiting neutropenia and thrombocytopenia resulted after the doses of TPT or CDDP were increased to greater than 0.75 and 50 mg/m2, respectively, without and with G-CSF. The sequence of CDDP before TPT induced significantly worse neutropenia and thrombocytopenia than the alternate sequence. In vitro studies failed to provide any evidence for the differences in the cytotoxicity of these two sequences. Instead, pharmacokinetic studies suggested that the differences in toxicity were due, in part, to lower TPT clearance and exposure when CDDP preceeds TPT, possibly due to subclinical renal tubular toxicity induced by CDDP. The sequence of CDDP before TPT at doses of 50 and 0.75 mg/m2, respectively, is recommended for subsequent clinical trials in tumor types in which both agents have significant single-agent activity. The potential for sequence-dependent cytotoxic, toxicologic, and pharmacologic effects should be evaluated in concurrent clinical and laboratory studies in the course of developing combination chemotherapy regimens that consist of topo I-targeting agents and other antineoplastic agents, particularly DNA-damaging agents.


Neurocognitive Deficits and Effects of Cognitive Reserve in Mild Cognitive Impairment.
Mild cognitive impairment (MCI) is a frequent syndrome in the older population, which involves an increased risk to develop Alzheimer's disease (AD). The latter can be modified by the cognitive reserve, which can be operationalized by the length of school education. MCI can be differentiated into four subtypes according to the cognitive domains involved: amnestic MCI, multiple-domain amnestic MCI, non-amnestic MCI and multiple-domain non-amnestic MCI. While neurocognitive deficits are a constituent of the diagnosis of these subtypes, the question of how they refer to the cognitive reserve still needs to be clarified. We examined neuropsychological deficits in healthy controls, patients with MCI and patients with mild AD (n = 485) derived from a memory clinic. To reduce the number of neuropsychological variables, a factor analysis with varimax rotation was calculated. In a second step, diagnostic groups including MCI subtypes were compared with respect to their clinical and neuropsychological characteristics including cognitive reserve. Most MCI patients showed the amnestic multiple-domain subtype followed by the pure amnestic subtype, while the non-amnestic subtypes were rare. The amnestic subtype displayed a significantly higher level of cognitive reserve and higher MMSE scores than the amnestic multiple-domain subtype, which was in most cases characterized by additional psychomotor and executive deficits. These findings confirm earlier reports revealing that the amnestic multiple-domain subtype is the most frequent one and indicating that a high cognitive reserve may primarily prevent psychomotor and executive deficits in MCI.


Incidence, characteristics and outcomes in very young patients with ST segment elevation myocardial infarction.
ST-segment elevation acute myocardial infarction (STEMI) in very young adults is uncommon. Many studies have focused on the cutoff of 45-50 years old to define young patients with STEMI leaving limited data on the group of very young patients aged less than 35 years old. We investigated the incidence of STEMI in different subgroups of young patients and focused on the characteristics, possible pathogenesis and outcomes in very young patients aged less than 35 years old. We retrospectively studied 792 STEMI patients aged less than 55 years who underwent successful primary PCI. We categorized patients as very young if they were or less 35 years old and as young if they were between 36 and 55 years old. Baseline characteristics, angiographic findings, as well as short- and long-term outcomes were compared between the two groups. There were 46 (6%) very young patients (age ≤ 35 years) and 748 (94%) young patients (36 < age ≤ 55 years). Very young patients had fewer atherosclerotic risk factors than young patients, but there was no difference in short- or long-term outcomes. Overt hypercoagulable state was evident serologically (antiphospholipid antibodies) in 2/7 (29%) of screened patients and clinically (left ventricular thrombus or acute coronary thrombosis without an atherosclerotic plaque) in 6/46 patients (13%). Very young patients with STEMI constitute a distinct subset of young patients with fewer atherosclerotic risk factors yet comparable outcomes. More efforts should be made screening for serologic and clinical evidence of hypercoagulability in this group of patients.


Potassium channels on smooth muscle as a molecular target for plant-derived Resveratrol.
Resveratrol (3,5,4'-trihydroxy-trans-stilbene) is a phytoalexin present in a variety of plant species. Resveratrol has a wide spectrum of pharmacologic properties, and it exhibits versatile biological effects on different human and animal models. The studies have shown that potassium (K) channels can be potential targets in the mechanism of resveratrol action. K channels play a crucial role in maintaining membrane potential. Inhibition of K channels causes membrane depolarization and then contraction of smooth muscles, while the activation leads to membrane hyperpolarization and subsequently, relaxation. Five diverse types of K channels have been identified in smooth muscle cells in different tissue: ATP-sensitive K channels (KATP), voltage-dependent K channels (Kv), Ca2+ - and voltage-dependent K channels (BKCa), inward rectifier K channels (Kir), and tandem two-pore K channels (K2P). The expression and activity of K channels altered in many types of diseases. Aberrant function or expression of K channels can be underlying in pathologies such as cardiac arrhythmia, diabetes mellitus, hypertension, preterm birth, preeclampsia, and various types of cancer. Modulation of K channel activity by molecular approaches and selective drug development may be a novel treatment modality for these dysfunctions in the future. The plant-derived non-toxic polyphenols, such as resveratrol, can alter K channel activity and lead to the desired outcome. This review presents the basic properties, physiological, pathophysiological functions of K channels, and pharmacological roles of resveratrol on the major types of K channels that have been determined in smooth muscle cells.


Density functional theory with van der waals corrections study of the adsorption of alkyl, alkylthiol, alkoxyl, and amino-alkyl chains on the H:Si(111) surface.
Surface modification of silicon with organic monolayers tethered to the surface by different linkers is an important process in realizing future miniaturized electronic and sensor devices. Understanding the roles played by the nature of the linking group and the chain length on the adsorption structures and stabilities of these assemblies is vital to advance this technology. This paper presents a density functional theory (DFT) study of the hydrogen passivated Si(111) surface modified with alkyl chains of the general formula H:Si-(CH2)n-CH2 and H:Si-X-(CH2)n-CH3, where X = NH, O, S and n = (0, 1, 3, 5, 7, 9, 11), at half coverage. For (X)-hexane and (X)-dodecane functionalization, we also examined various coverages up to full monolayer grafting in order to validate the result of half covered surface and the linker effect on the coverage. We find that it is necessary to take into account the van der Waals interaction between the alkyl chains. The strongest binding is for the oxygen linker, followed by S, N, and C, irrespective of chain length. The result revealed that the sequence of the stability is independent of coverage; however, linkers other than carbon can shift the optimum coverage considerably and allow further packing density. For all linkers apart from sulfur, structural properties, in particular, surface-linker-chain angles, saturate to a single value once n > 3. For sulfur, we identify three regimes, namely, n = 0-3, n = 5-7, and n = 9-11, each with its own characteristic adsorption structures. Where possible, our computational results are shown to be consistent with the available experimental data and show how the fundamental structural properties of modified Si surfaces can be controlled by the choice of linking group and chain length.


Chronic granulocytic leukemia and carcinoma of the cervix in situ following renal transplantation.
A 26-year-old white female presented with Philadelphia chromosome positive chronic granulocytic leukemia five years after successful renal transplantation and prolonged therapy with azathioprine and prednisone. This patient represents the seventh case of the chronic granulocytic leukemia reported within the population of immunosuppressed renal transplant recipients. Of further interest in our case is the development of carcinoma in situ of the cervix two years following the transplant. Although multiple malignancies have been recognized in renal homografts, the occurrence of chronic granulocytic leukemia and carcinoma in situ in the same patient has not been previously described. A possible mechanism for the development of chronic granulocytic leukemia is the association of chromosome damage by azathioprine and immunoparalysis of the host, thus setting the stage for the emergency of a malignant clone. The importance of close follow-up of patients on prolonged immunosuppressive therapy is emphasized.


Vericiguat, a novel sGC stimulator: Mechanism of action, clinical, and translational science.
Vericiguat, a novel soluble guanylate cyclase (sGC) stimulator, is approved for the treatment of heart failure (HF) with reduced ejection fraction (HFrEF). Decreased nitric oxide (NO) availability, sGC desensitization to NO, sGC deficiency, and reduced cyclic guanosine monophosphate (cGMP) signaling are potential contributing factors for HF disease progression. Vericiguat works via stimulation of sGC in the critical NO-sGC-cGMP pathway. Vericiguat is primarily metabolized by glucuronidation via uridine diphosphate-glucuronosyltransferase (UGT) isoforms UGT1A1 and UGT1A9. Urinary excretion and renal clearance of vericiguat are low. No intrinsic factor had a clinically relevant effect on vericiguat exposure. Vericiguat has low drug-drug interaction potential with no clinically relevant pharmacokinetic or pharmacodynamic interactions observed with warfarin, digoxin, aspirin, or sacubitril/valsartan. The global phase III study VICTORIA included patients with HFrEF who had a recent HF hospitalization or intravenous diuretic treatment for HF. Treatment with vericiguat on top of standard of care resulted in a 10% relative reduction in the primary composite outcome of death from cardiovascular causes or first hospitalization for HF. Vericiguat was well-tolerated with low incidence of symptomatic hypotension and syncope compared to placebo. Given its positive benefit-risk profile, vericiguat is an important option for high-risk patients with HFrEF who are already on guideline-directed medical therapy and had recent worsening of HF. Future efforts to develop additional effective therapies are needed to further reduce morbidity and mortality in patients with HF.


[Effect of diets with excess protein on nitrogen metabolism in men].
Studies of nitrous metabolism in men aged 30-35 kept for 10 days on isocaloric rations of natural foodstuffs with excess protein content (164 and 233 g daily) have revealed unfavourable effect of increased nitrogen intake with food on the metabolic homeostasis. Even short-term consumption of excess-protein rations results in a sharp increase of urinary excretion of all nitrous metabolites and is attended by functional overstrain of the liver playing the principal role in neutralization of nitrous metabolism. Hyperazotemia and surpassed physiologic thresholds of urea and ammonia content in the blood serum are observed already when the content of protein is increased to 164 g a day in rations for men.


Impact of modem-transferred blood glucose data on clinician work efficiency and patient glycemic control.
Communication of blood glucose (BG) results between patients and health care providers (HCPs) is of established benefit and remains a critical part of the diabetes management process. Currently, HCPs typically receive BG data from patients at the time of clinic visits or by telephone. The Accu-Chek Acculink modem (Roche Diagnostics Corp., Indianapolis, IN) provides an additional and attractive option that can potentially facilitate this communication. To assess the impact of modem transfer of BG, we studied 47 participants with diabetes enrolled in a diabetes education program. Subjects were randomized to weekly communication of BG data to their HCP by either telephone (n = 23) or modem (n = 24) for 4 weeks. Mean age (+/- SD) was 44 +/- 15 years, 62% were female, 74% used insulin, 53% had type 1 diabetes, and mean baseline glycosylated hemoglobin (A1C) was 8.8% (range 5.2-13.2%). There were no differences between groups in the amount of time the HCP spent analyzing BG data and communicating with patients (12.6 +/- 6.1 min/week in the telephone group and 11.5 +/- 5.1 min/week in the modem group) or in the number of patient and HCP attempts needed to make contact. There were similar improvements in A1C between groups (change of -0.4 +/- 0.7% in the telephone group and -0.9 +/- 1.4% in the modem group, P = 0.18). BG data provided by telephone had a 6% error rate, in contrast to modem-sent data, which were transmitted without error. Modem transfer of BG data can provide an accurate and clinically useful option for communication between patients and their HCP and has comparable effects on A1C.


Differential effects of mu and kappa opioid antagonists on Fos-like immunoreactivity in extended amygdala.
It was previously reported that systemic administration of the nonselective opioid antagonist, naltrexone, induces Fos-like immunoreactivity (FLI) within the central nucleus of the amygdala (CeA), bed nucleus of the stria terminalis (lateral-dorsal division; BSTLD), nucleus accumbens shell (NACshell) and ventral tegmental area (VTA) of free-feeding rats. These findings suggest that cellular activity in these brain regions is subject to opioid-mediated inhibitory control under basal conditions. Considering the involvement of mesoaccumbens dopamine neurons and components of the 'extended amygdala' in motivated behavior and reward, it was hypothesized that the induction of c-Fos by naltrexone accounts for the motivational-affective consequences of opioid antagonism. In Experiment 1, naltrexone was administered intracerebroventricularly (i.c.v.; 100 microg) to determine whether results obtained in the prior immunohistochemical studies could be attributed to blockade of opioid receptors in brain as opposed to peripheral tissues that convey visceral sensory inputs to the CeA and BSTLD. Naltrexone produced a marked increase in FLI within the CeA and BSTLD, and a moderate increase in NACshell. In Experiment 2, the kappa opioid antagonist, nor-binaltorphimine (Nor-BNI; 20.0 microg, i.c.v.) reproduced the effect of naltrexone in BSTLD and CeA, suggesting that the induction of c-Fos in these two structures is a consequence of kappa receptor blockade. The selective mu antagonist, CTAP (2.0 microg, i.c.v.), reproduced the effect of naltrexone in NACshell, suggesting that the induction of c-Fos in this structure is a consequence of mu receptor blockade. The functional implications of these results are discussed in terms of the known functions of these brain regions and opioid receptor types, and the prior observation that chronic food restriction eliminates the FLI induced by naltrexone in CeA and BSTLD. It is suggested that tonic mu opioid-mediated inhibition in NACshell has a predisposing effect on goal-approach behavior in general while kappa opioid-mediated inhibition in CeA and BSTLD has a predisposing effect on palatability-driven feeding in particular. Finally, a possible relationship between food restriction-induced suppression of the kappa opioid mechanism in CeA/BSTLD, local CRH function, and sensitization of the neural substrate for incentive-motivating effects of abused drugs is discussed.


[Increase in resistance to UV-light in E. coli bearing the Hly plasmid resistance].
Hly plasmide of wild type and its derepressive (by transmission) mutant communicated to the E. coli cells an increased resistance to the action of ultraviolet rays. Hly plasmide failed to compensate the defects associated with the excision and postreplicative DNA reparation or the reparative DNA synthesis. Hly plasmide increased the resistance to the ultraviolet light in the lon--mutant in which the ultraviolet irradiation disturbed the process of cell division. It is supposed that the resistance to the ultraviolet light connected with Hly plasmide was caused by the influence of the plasmide on some stages of cell division following the ultraviolet irradiation.


Hydrogen exchange of individual amide protons in the E. coli lac repressor DNA-binding domain: a nuclear magnetic resonance study.
Proton exchange in lac repressor headpiece was studied by COSY and 2D NOE spectroscopy. The exchange rates of amide protons, stabilized by the hydrogen bonds of the three alpha-helices of the headpiece, could be determined quantitatively. The exchange rates in these helices showed repetitive patterns of about three to four residues. A correlation with the position of the amide proton in the interior or the exterior of the alpha-helix of the protein was found. The exchange data strongly support the validity of the three-dimensional structure, as determined recently (Kaptein, R. et al., J. Mol. Biol. 182, 179-182 (1985)).


Metabolism of α-linolenic acid during incubations with strained bovine rumen contents: products and mechanisms.
Description of α-linolenic acid (cis-9,cis-12,cis-15-18 : 3, ALA) metabolism in the rumen is incomplete. Ruminal digesta samples were incubated with ALA and buffer containing water or deuterium oxide to investigate the products and mechanisms of ALA biohydrogenation. Geometric Δ9,11,15-18 : 3 isomers were the main intermediates formed from ALA. An increase in the n+1 isotopomers of Δ9,11,15-18 : 3 was due to 2H labelling at C-13. Isomers of Δ9,11,13-18 : 3, cis-7,cis-12,cis-15-18 : 3 and cis-8,cis-12,cis-15-18 : 3 were also formed. No increase in n+1 isotopomers of Δ7,12,15-18 : 3 or Δ8,12,15-18 : 3 was detected. Enrichment in n+2 isotopomers of 18 : 2 products indicated that ALA metabolism continued via the reduction of 18 : 3 intermediates. Isomers of Δ9,11,15-18 : 3 were reduced to Δ11,15-18 : 2 labelled at C-9 and C-13. ALA resulted in the formation of Δ11,13-18 : 2 and Δ12,14-18 : 2 containing multiple 2H labels. Enrichment of the n+3 isotopomer of Δ12,15-18 : 2 was also detected. Metabolism of ALA during incubations with rumen contents occurs by one of three distinct pathways. Formation of Δ9,11,15-18 : 3 appears to be initiated by H abstraction on C-13. Octadecatrienoic intermediates containing cis-12 and cis-15 double bonds are formed without an apparent H exchange with water. Labelling of Δ9,11,13-18 : 3 was inconclusive, suggesting formation by an alternative mechanism. These findings explain the appearance of several bioactive fatty acids in muscle and milk that influence the nutritional value of ruminant-derived foods.


Dissociation and unfolding of the pyruvate dehydrogenase complex by guanidinium chloride.
The effect of guanidinium chloride (GdnHCl) on the pyruvate dehydrogenase complex (PDC) from bovine heart and its constituent enzymes has been studied. The overall activity of the complex is lost reversibly at low levels of GdnHCl (0.2 M) which cause 40-50% inactivation but no loss of overall secondary or tertiary structures of the individual enzymes; the inactivation of the complex is shown to be caused by dissociation of the E1 and E3 components from the E2/X core assembly. This provides an improved procedure for controlled dissociation of the complex and efficient recovery of its component enzymes in their native states. Higher concentrations of GdnHCl (up to 4 M) lead to the unfolding and irreversible inactivation of the separate enzymes of the complex with the E2/X core proving the most resistant to GdnHCl-induced unfolding. Neither the 60-meric E2/X core assembly nor the dimeric E3 component are dissociated into monomers in the presence of 6 M GdnHCl; the latter enzyme forms higher-M(r) aggregates under these conditions.


Applications of Blockchain in the Medical Field: Narrative Review.
As a distributed technology, blockchain has attracted increasing attention from stakeholders in the medical industry. Although previous studies have analyzed blockchain applications from the perspectives of technology, business, or patient care, few studies have focused on actual use-case scenarios of blockchain in health care. In particular, the outbreak of COVID-19 has led to some new ideas for the application of blockchain in medical practice. This paper aims to provide a systematic review of the current and projected uses of blockchain technology in health care, as well as directions for future research. In addition to the framework structure of blockchain and application scenarios, its integration with other emerging technologies in health care is discussed. We searched databases such as PubMed, EMBASE, Scopus, IEEE, and Springer using a combination of terms related to blockchain and health care. Potentially relevant papers were then compared to determine their relevance and reviewed independently for inclusion. Through a literature review, we summarize the key medical scenarios using blockchain technology. We found a total of 1647 relevant studies, 60 of which were unique studies that were included in this review. These studies report a variety of uses for blockchain and their emphasis differs. According to the different technical characteristics and application scenarios of blockchain, we summarize some medical scenarios closely related to blockchain from the perspective of technical classification. Moreover, potential challenges are mentioned, including the confidentiality of privacy, the efficiency of the system, security issues, and regulatory policy. Blockchain technology can improve health care services in a decentralized, tamper-proof, transparent, and secure manner. With the development of this technology and its integration with other emerging technologies, blockchain has the potential to offer long-term benefits. Not only can it be a mechanism to secure electronic health records, but blockchain also provides a powerful tool that can empower users to control their own health data, enabling a foolproof health data history and establishing medical responsibility.


The systematic analysis of ultraconserved genomic regions in the budding yeast.
In the evolution of species, a kind of special sequences, termed ultraconserved sequences (UCSs), have been inherited without any change, which strongly suggests those sequences should be crucial for the species to survive or adapt to the environment. However, the UCSs are still regarded as mysterious genetic sequences so far. Here, we present a systematic study of ultraconserved genomic regions in the budding yeast based on the publicly available genome sequences, in order to reveal their relationship with the adaptability or fitness advantages of the budding yeast. Our results indicate that, in addition to some fundamental biological functions, the UCSs play an important role in the adaptation of Saccharomyces cerevisiae to the acidic environment, which is backed up by the previous observation. Besides that, we also find the highly unchanged genes are enriched in some other pathways, such as the nutrient-sensitive signaling pathway. To facilitate the investigation of unique UCSs, the UCSC Genome Browser was utilized to visualize the chromosomal position and related annotations of UCSs in S.cerevisiae genome. For more details on UCSs, please refer to the Supplementary information online, and the custom code is available on request. firstname.lastname@example.com. Supplementary data are available at Bioinformatics online.


Treatment of rheumatoid arthritis by immunization with mononuclear white blood cells: results of a preliminary trial.
To determine if immunization with alloantigenic blood mononuclear cells (MNC) in active rheumatoid arthritis (RA) can result in objective and subjective improvement in RA. Eleven patients meeting American College of Rheumatology criteria for RA were treated in an open label trial by immunization with allogeneic MNC obtained from donors screened for infectious agents according to American Association of Blood Banks guidelines. MNC (30-250 x 10(6) cells) were given at 6 week intervals. Half the MNC (vol 2 ml) were injected intravenously and half in 4 divided doses subcutaneously (sq, 0.5 ml each). Disease activity assessments were done before entry and at immunotherapy visits thereafter. These included physician global assessment of disease activity, patient global assessment of pain, arthritis impact measurement scales (AIMS), swollen joint count, erythrocyte sedimentation rate (ESR), and/or C-reactive protein (CRP). Statistically significant improvement was noted in all clinical variables measured when pretreatment data were compared to those obtained at the time of injection number 3. MNC dose related improvement was found when the total number of cells given in the first 2 injections were compared to percentage improvement in patient assessment of pain (r = 0.71, p < 0.02), AIMS (r = 0.60, p = 0.05), and improvement in the means of all variables measured (r = 0.70, p < 0.03). When all variables were averaged, 6 of 11 patients experienced > 20% and 3 of 11 experienced > or = 40% improvement. The only side effects noted were transient local pain and swelling at the sq injection sites. MNC immunization may represent a suitable and safe alternative to drug treatment for selected patients with RA. Statistically significant improvement was found in all variables and several of these were cell dose related. A placebo controlled randomized trial immunizing with a standardized number of cells will address efficacy of this biological treatment approach.


Biology of subterranean termites: insights from molecular studies of Reticulitermes and Coptotermes.
Molecular genetic techniques have made contributions to studies on subterranean termites at all levels of biological organization. Most of this work has focused on Reticulitermes and Coptotermes, two ecologically and economically important genera. DNA sequence data have significantly improved our understanding of the systematics and taxonomy of these genera. Techniques of molecular biology have provided important new insights into the process of caste differentiation. Population genetic markers, primarily microsatellites, have furthered our understanding of the life history, population biology, community ecology, and invasion biology of subterranean termites. Recent results on the behavioral ecology of subterranean termites reveal a picture different from long-held views, especially those concerning colony breeding structures and foraging ranges. As additional molecular tools and genomic resources become available, and as more subterranean termite researchers incorporate molecular techniques into their approaches, we can expect accelerating advances in all aspects of the biology of this group.


[Pharmacology and epilepsy : update on the new antiepileptic drugs].
New antiepileptic drugs are regularly approved for treatment and offer large therapeutic opportunities. Efficacy of these drugs is relatively similar on-label with different mechanisms to be combined for a synergic effect. Treatments such as cannabidiol have benefitted from large media coverage despite limited clinical evidence so far. The objective of antiepileptic drugs is to stop the recurrence of epileptic seizures with as few adverse events as possible. When confronted to a difficult-to-treat epilepsy, referral to a specialised centre is strongly advised. The aim is to confirm that the diagnosis is correct, that the treatment is well adapted (indication, pharmacokinetic and compliance) and to evaluate the indication for non-pharmacological treatments such as epilepsy surgery.


Emotional flooding in response to negative affect in couple conflicts: Individual differences and correlates.
This study explored whether individual differences in self-reported emotional flooding were associated with observational behaviors and experienced and displayed anger during a 10-min problem solving discussion. A sample of 233 married or cohabiting couples, comprising 4 groups (distressed with intimate partner violence [IPV], distressed/nonIPV, satisfied/IPV, and satisfied/nonIPV) was recruited via random digit dialing. Consistent with predictions, both men's and women's flooding were positively associated with partners' negative affect variables, including partners' experienced and displayed anger, as well as positively associated with their own anger. A multinomial logistic regression revealed significant differences between flooding in prediction of couples' group status; specifically that higher levels of emotional flooding were reported by distressed and IPV couples compared with other types of couples. Finally, couples that included at least 1 member high on self-reported emotional flooding were less effective in solving problems during the conflict discussion. Implications and future directions are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Chemically functionalized germanene for spintronic devices: a first-principles study.
We have carried out first-principles calculations to explore various chemically functionalized germanene nanomaterials as two-dimensional spintronic devices. The germanene functionalized with O on one side and H on the other side is a ferromagnetic metal, and the phenomenon of negative differential conductance is observed. Moreover, we construct a spin-filter device from it, and about 15% spin filter efficiency is achieved in its ground state by using finite bias. The germanene semi-functionalized with a methyl (-CH3) group is a ferromagnetic semiconductor with a small direct bandgap, and it has highly spin-polarized electronic and transport properties. We proposed that a spin-valve nanodevice with a giant magnetoresistance of up to 10(7)% can be obtained from the semi-methylated germanene nanostructure by introducing an achievable magnetic field to stabilize its metal-like ferromagnetic state. Our findings could be helpful for practical applications of two-dimensional germanane-based nanomaterials in spintronic devices in the future.


Design, Synthesis, Radiosynthesis and Biological Evaluation of Fenretinide Analogues as Anticancer and Metabolic Syndrome-Preventive Agents.
Fenretinide (4-HPR) is a synthetic derivative of all-trans-retinoic acid (ATRA) characterised by improved therapeutic properties and toxicological profile relative to ATRA. 4-HPR has been mostly investigated as an anti-cancer agent, but recent studies showed its promising therapeutic potential for preventing metabolic syndrome. Several biological targets are involved in 4-HPR's activity, leading to the potential use of this molecule for treating different pathologies. However, although 4-HPR displays quite well-understood multitarget promiscuity with regards to pharmacology, interpreting its precise physiological role remains challenging. In addition, despite promising results in vitro, the clinical efficacy of 4-HPR as a chemotherapeutic agent has not been satisfactory so far. Herein, we describe the preparation of a library of 4-HPR analogues, followed by the biological evaluation of their anti-cancer and anti-obesity/diabetic properties. The click-type analogue 3 b showed good capacity to reduce the amount of lipid accumulation in 3T3-L1 adipocytes during differentiation. Furthermore, it showed an IC50 of 0.53±0.8 μM in cell viability tests on breast cancer cell line MCF-7, together with a good selectivity (SI=121) over noncancerous HEK293 cells. Thus, 3 b was selected as a potential PET tracer to study retinoids in vivo, and the radiosynthesis of [18 F]3b was successfully developed. Unfortunately, the stability of [18 F]3b turned out to be insufficient to pursue imaging studies.


A primary role for disulfide formation in the productive folding of prokaryotic Cu,Zn-superoxide dismutase.
Enzymatic activation of Cu,Zn-superoxide dismutase (SOD1) requires not only binding of a catalytic copper ion but also formation of an intramolecular disulfide bond. Indeed, the disulfide bond is completely conserved among all species possessing SOD1; however, it remains obscure how disulfide formation controls the enzymatic activity of SOD1. Here, we show that disulfide formation is a primary event in the folding process of prokaryotic SOD1 (SodC) localized to the periplasmic space. Escherichia coli SodC was found to attain β-sheet structure upon formation of the disulfide bond, whereas disulfide-reduced SodC assumed little secondary structure even in the presence of copper and zinc ions. Moreover, reduction of the disulfide bond made SodC highly susceptible to proteolytic degradation. We thus propose that the thiol-disulfide status in SodC controls the intracellular stability of this antioxidant enzyme and that the oxidizing environment of the periplasm is required for the enzymatic activation of SodC.


Eos Promotes TH2 Differentiation by Interacting with and Propagating the Activity of STAT5.
The Ikaros zinc-finger transcription factor Eos has largely been associated with sustaining the immunosuppressive functions of regulatory T cells. Paradoxically, Eos has more recently been implicated in promoting proinflammatory responses in the dysregulated setting of autoimmunity. However, the precise role of Eos in regulating the differentiation and function of effector CD4+ T cell subsets remains unclear. In this study, we find that Eos is a positive regulator of the differentiation of murine CD4+ TH2 cells, an effector population that has been implicated in both immunity against helminthic parasites and the induction of allergic asthma. Using murine in vitro TH2 polarization and an in vivo house dust mite asthma model, we find that EosKO T cells exhibit reduced expression of key TH2 transcription factors, effector cytokines, and cytokine receptors. Mechanistically, we find that the IL-2/STAT5 axis and its downstream TH2 gene targets are one of the most significantly downregulated pathways in Eos-deficient cells. Consistent with these observations, we find that Eos forms, to our knowledge, a novel complex with and supports the tyrosine phosphorylation of STAT5. Collectively, these data define a regulatory mechanism whereby Eos propagates STAT5 activity to facilitate TH2 cell differentiation.


[Discontinuing of antiepileptic therapy].
The merits of suspending the treatment of children suffering from epilepsy must be evaluated under a number of different headings. It may be justified in the light of side effects brought about by the drugs administered, or on the basis of a favourable prognosis that often characterises these form of epilepsy. The current tendency is to start reducing the dosage of drugs 2-3 years after the complete remission of the seizures, fully suspending treatment 6-12 months thereafter. Greater prudence is called for in cases where the containment of seizures has proved particularly problematic. Despite these precautions, relapses have been found to occur in 15-30% of patients, during both the reduced dosage period and once treatment has been discontinued (normally within the first year). Subjects with brain injury and those effected by particular forms of epilepsy (myoclonic epilepsy, grand and petit mal status, complex epileptic attacks) are more prone to relapse, particularly when seizures have been very frequent. Adolescence and, according to many Authors, persistent EEG alterations, also represent negative factors. In most cases, seizures can be controlled once treatment is resumed. In all cases, the problems associated with the withdrawal of anti-epileptic treatment must be discussed carefully with the patient and his or her family; an attempt should be made to identify the risks involved and the patient must be followed closely during the delicate discontinuance period.


A Rare Case of Vascular Proliferation in the Mandible of a Juvenile Horse.
A fast growing, circumscribed, unilateral swelling of the right mandible of a juvenile horse was observed. Within few weeks, the continuously growing mass reached dimensions ranging from 7 to 10 cm in diameter and resulted in loss of the first deciduous premolar of the affected side. The animal was euthanized due to lesion progression. Histologically the mandibular swelling consisted of numerous variably sized vascular structures, partly filled with erythrocytes and embedded in a loosely arranged fibrous stroma within the medullary cavity of the mandible. Juvenile mandibular angiomatosis was diagnosed. To the authors' knowledge this is the first description of this rare entity in the mandible of a foal.


Methodologic considerations in the study of glomerular ultrafiltration.
Over the past decade numerous studies have detailed the dynamics of glomerular ultrafiltration. Observations in a unique strain of Munich-Wistar rats, which afford the direct measurement of intraglomerular capillary hydrostatic pressure, have determined that under normal physiologic conditions these animals are in a state of filtration equilibrium. Both mathematical models based on this observation and experimental evidence indicate that under these circumstances the primary determinant of glomerular filtration rate (GFR) is the rate of glomerular plasma flow. In addition, this state of filtration equilibrium provides a condition in which changes in the product of glomerular surface area and glomerular capillary hydraulic conductivity (ultrafiltration coefficient) have no influence on glomerular filtration rate. Similarly, changes in glomerular hydrostatic pressure have a relatively small influence on GFR. These conclusions represent a marked alteration of the previously held concepts of the determinants of GFR. Unfortunately, studies in other strains of rats and in other animal species, particularly the dog, have led to the conclusion that filtration disequilibrium is the normal physiologic condition. The validity of this conclusion, however, is made uncertain by methodologic necessities that may lead to erroneous physiologic measurements of the determinants of GFR. In the present Editorial Review we examine the data reflecting on the applicability of filtration equilibrium to mammalian species. In addition, we summarize two new in vitro techniques for the further study of the dynamics of glomerular ultrafiltration.


Amino acids and leucine allow insulin activation of the PKB/mTOR pathway in normal adipocytes treated with wortmannin and in adipocytes from db/db mice.
Amino acids are nutrients responsible for mammalian target of rapamycin (mTOR) regulation in mammalian cells. The mTOR protein is mainly known for its role in regulating cell growth, notably via protein synthesis. In addition to amino acids, mTOR is regulated by insulin via a phosphatidylinositol 3-kinase (PI 3-kinase)-dependent pathway. mTOR mediates crosstalk between amino acids and insulin signaling. We show that in freshly isolated rat adipocytes, insulin stimulates the phosphorylation of mTOR on serine 2448, a protein kinase B (PKB) consensus phosphorylation site. This site is also phosphorylated by amino acids, which in contrast to insulin do not activate PKB. Moreover, insulin and amino acids have an additive effect on mTOR phosphorylation, indicating that they act via two independent pathways. Importantly, amino acids, notably leucine, permit insulin to stimulate PKB when PI 3-kinase is inhibited. They also rescue glucose transport and the mTOR pathway. Further, leucine alone can improve insulin activation of PKB in db/db mice. Our results define the importance of amino acids in insulin signaling and reveal leucine as a key amino acid in disease situations associated with insulin-resistance in adipocytes.


Operant Costs Modulate Dopamine Release to Self-Administered Cocaine.
The costs associated with obtaining illicit drugs can fluctuate depending upon the relative drug availability. As a consequence of the changing costs, the effort that one must exert to obtain drugs is dynamic. Considerable evidence illustrates a critical role for dopamine in the ventral medial striatum in mediating drug reinforcement. However, little is known regarding how dopamine release is affected by changes in the costs associated with earning drugs. We used fast-scan cyclic voltammetry to determine how changes in the operant requirement affected dopamine release to self-administered cocaine in male rats. Dopamine release to cocaine infusions increased across trials during self-administration sessions using a fixed-ratio reinforcement schedule with a low operant requirement. However, increasing the operant requirement abolished the within-session elevation in dopamine release to drug rewards. This effect was not due to underlying changes in preinfusion dopamine levels and was not explained by cocaine levels in the brain. This within-session increase in dopamine release to cocaine infusions reemerged when the operant requirement was lowered. Under a progressive ratio reinforcement schedule, there was no increase in dopamine release to drug rewards across trials, which contrasts with prior studies demonstrating an increase in dopamine release to food rewards. Collectively, these findings illustrate that the influence of operant costs on reward-evoked dopamine release depends upon type of reward that can be earned (e.g., food or drug).SIGNIFICANCE STATEMENT The mesolimbic dopamine system is involved with mediating drug reinforcement. Although the costs associated with earning drugs are dynamic, no studies to date have examined how dopamine release to drug rewards is affected by changing costs. By performing fast-scan cyclic voltammetry recordings in rats self-administering cocaine, the present work demonstrates that changing the operant costs reversibly modulates the dopamine response to cocaine rewards. Furthermore, these findings highlight that the influence of costs on dopamine release to drug rewards differs from the established effect of costs on dopamine release to food rewards.


Dual Networks Based 3D Multi-Person Pose Estimation From Monocular Video.
Monocular 3D human pose estimation has made progress in recent years. Most of the methods focus on single persons, which estimate the poses in the person-centric coordinates, i.e., the coordinates based on the center of the target person. Hence, these methods are inapplicable for multi-person 3D pose estimation, where the absolute coordinates (e.g., the camera coordinates) are required. Moreover, multi-person pose estimation is more challenging than single pose estimation, due to inter-person occlusion and close human interactions. Existing top-down multi-person methods rely on human detection (i.e., top-down approach), and thus suffer from the detection errors and cannot produce reliable pose estimation in multi-person scenes. Meanwhile, existing bottom-up methods that do not use human detection are not affected by detection errors, but since they process all persons in a scene at once, they are prone to errors, particularly for persons in small scales. To address all these challenges, we propose the integration of top-down and bottom-up approaches to exploit their strengths. Our top-down network estimates human joints from all persons instead of one in an image patch, making it robust to possible erroneous bounding boxes. Our bottom-up network incorporates human-detection based normalized heatmaps, allowing the network to be more robust in handling scale variations. Finally, the estimated 3D poses from the top-down and bottom-up networks are fed into our integration network for final 3D poses. To address the common gaps between training and testing data, we do optimization during the test time, by refining the estimated 3D human poses using high-order temporal constraint, re-projection loss, and bone length regularizations. We also introduce a two-person pose discriminator that enforces natural two-person interactions. Finally, we apply a semi-supervised method to overcome the 3D ground-truth data scarcity. Our evaluations demonstrate the effectiveness of the proposed method and its individual components. Our code and pretrained models are available publicly: https://github.com/3dpose/3D-Multi-Person-Pose.


Bird fancier's lung which developed in a pigeon breeder presenting organizing pneumonia.
Bird fancier's lung (BFL) is one of the most common types of hypersensitivity pneumonitis. We report a rare case of acute-on-chronic bird fancier's lung that developed in a pigeon breeder and presented subpleural curvilinear shadow and ground glass opacity on high-resolution computed tomography (HRCT) of the chest. The results of surgical lung biopsy showed mainly intraalveolar organization and alveolitis in addition to the pattern of usual interstitial pneumonia with centrilobular fibrosis. Examination of bronchoalveolar lavage (BAL) fluid revealed an increase in lymphocytes. The results of immunoglobulin (Ig) G and IgA antibodies against pigeon dropping extracts were positive in sera and BAL fluid. Consequently, the patient was diagnosed as having BFL. Avoidance of pigeons and corticosteroid therapy led to rapid improvement.


Echinophora tenuifolia L. branches phytochemical profile and antiproliferative activity on human cancer cell lines.
The methanolic extract of Echinophora tenuifolia L. branches and its fractions were evaluated for their in vitro cell growth inhibitory activity on different human cancer cell lines (C32, LoVo and SKBr3) and the normal BJ fibroblasts. All tested samples were effective against the melanoma cell line C32, with IC50 values ranging from 22.8 ± 0.8 to 78.7 ± 1.2 μg/mL, the antiproliferative activity of the dichloromethane fraction being significantly higher. This fraction was also effective against the LoVo adenocarcinoma cell line, with an IC50 value of 53.0 ± 2.1 μg/mL. The ethyl acetate and dichloromethane fractions showed the highest lipid peroxidation inhibitory activity, verified by means of the β-carotene bleaching test. The phytochemical profiles of E. tenuifolia branches extract were established by means of GC-MS and HPTLC. Overall, branches of E. tenuifolia L. could represent a rich source of bioactive compounds, potentially useful in the pharmaceutical field.


Over-expression of prolyl hydroxylase-1 blocks NF-κB-mediated cyclin D1 expression and proliferation in lung carcinoma cells.
Prolyl hydroxylase-1 (PHD1), a member of the hypoxia inducible factor (HIF)-PHD family, plays an important role in regulating the stability of HIFs. The nuclear factor-κB (NF-κB) pathway consists of a family of transcription factors that play critical roles in inflammation, immunity, cell proliferation, differentiation, and survival. In this study, we demonstrate that PHD1 can inhibit NF-κB activity and its target genes in lung cancer cells based on both over-expression and RNA interference-mediated knockdown of PHD1 in human A549 lung cancer cells and HEK293 T cells. Of medical importance, PHD1 could induce cell cycle arrest in lung cancer cells, resulting in the suppression of cell proliferation. Xenograft tumor growth assays indicate that PHD1 plays a critical role in suppressing lung cancer growth. These findings reveal a new role of PHD1 in lung cancer and provide new treatment perspectives for cancer therapy by characterizing PHD1 as a potential target.


Deriving early single-rosette brain organoids from human pluripotent stem cells.
Brain organoid methods are complicated by multiple rosette structures and morphological variability. We have developed a human brain organoid technique that generates self-organizing, single-rosette cortical organoids (SOSR-COs) with reproducible size and structure at early timepoints. Rather than patterning a 3-dimensional embryoid body, we initiate brain organoid formation from a 2-dimensional monolayer of human pluripotent stem cells patterned with small molecules into neuroepithelium and differentiated to cells of the developing dorsal cerebral cortex. This approach recapitulates the 2D to 3D developmental transition from neural plate to neural tube. Most monolayer fragments form spheres with a single central lumen. Over time, the SOSR-COs develop appropriate progenitor and cortical laminar cell types as shown by immunocytochemistry and single-cell RNA sequencing. At early time points, this method demonstrates robust structural phenotypes after chemical teratogen exposure or when modeling a genetic neurodevelopmental disorder, and should prove useful for studies of human brain development and disease modeling.


Fusion-deficient insertion mutants of herpes simplex virus type 1 glycoprotein B adopt the trimeric postfusion conformation.
Glycoprotein B (gB) enables the fusion of viral and cell membranes during entry of herpesviruses. However, gB alone is insufficient for membrane fusion; the gH/gL heterodimer is also required. The crystal structure of the herpes simplex virus type 1 (HSV-1) gB ectodomain, gB730, has demonstrated similarities between gB and other viral fusion proteins, leading to the hypothesis that gB is a fusogen, presumably directly involved in bringing the membranes together by refolding from its initial or prefusion form to its final or postfusion form. The only available crystal structure likely represents the postfusion form of gB; the prefusion form has not yet been determined. Previously, a panel of HSV-1 gB mutants was generated by using random 5-amino-acid-linker insertion mutagenesis. Several mutants were unable to mediate cell-cell fusion despite being expressed on the cell surface. Mapping of the insertion sites onto the crystal structure of gB730 suggested that several insertions might not be accommodated in the postfusion form. Thus, we hypothesized that some insertion mutants were nonfunctional due to being "trapped" in a prefusion form. Here, we generated five insertion mutants as soluble ectodomains and characterized them biochemically. We show that the ectodomains of all five mutants assume conformations similar to that of the wild-type gB730. Four mutants have biochemical properties and overall structures that are indistinguishable from those of the wild-type gB730. We conclude that these mutants undergo only minor local conformational changes to relieve the steric strain resulting from the presence of 5 extra amino acids. Interestingly, one mutant, while able to adopt the overall postfusion structure, displays significant conformational differences in the vicinity of fusion loops, relative to wild-type gB730. Moreover, this mutant has a diminished ability to associate with liposomes, suggesting that the fusion loops in this mutant have decreased functional activity. We propose that these insertions cause a fusion-deficient phenotype not by preventing conversion of gB to a postfusion-like conformation but rather by interfering with other gB functions.