Characterization of a small round virus associated with the poult enteritis and mortality syndrome.
A small round virus (SRV) identified and isolated in our laboratory from intestinal samples of poults affected with the poult enteritis and mortality syndrome was further characterized. The SRV was propagated in turkey embryos and purified by differential and isopycnic ultracentrifugation. The size of the SRV was 30-32 nm in diameter. The buoyant density of the SRV in cesium chloride was between 1.34 and 1.36 g/cm3. It was resistant to chloroform treatment, stable at pH 3.0, and resistant to heat treatment. Attempts to propagate the SRV in turkey embryo kidney, turkey kidney, Caco-2, Vero, and BGM-70 cells were unsuccessful. Analysis of the SRV capsid proteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed three polypeptides with molecular weights of 34.5, 31, and 28 kD. Genome analysis of the SRV showed that the SRV had a single-strand RNA genome about 7500 nucleotides in length. Reverse transcription-polymerase chain reactions (RT-PCRs) with primers specific to conserved sequences of enteroviruses yielded products with expected sizes. However, sequence analysis of the RT-PCR products showed that there was no similarity between the sequences and that of enteroviruses. RT-PCR with primers specific to the 3' end of a SRV RNA genome yielded products with expected sizes. These products were sequenced and found to contain 669 nucleotides, excluding the polyadenylated tail. Sequence analysis indicated that the SRV shared 38.18% amino acid identity in the C-terminal capsid precursor protein and 41.26% nucleotide identity of the 3' end of turkey astrovirus RNA genome (Genbank accession no. Y15936). We concluded that the SRV is a member of the astrovirus family.


Feedback error learning neural network for trans-femoral prosthesis.
Feedback-error learning (FEL) neural network was developed for control of a powered trans-femoral prosthesis. Nonlinearities and time-variations of the dynamics of the plant, in addition to redundancy and dynamic uncertainty during the double support phase of walking, makes conventional control methods very difficult to use. Rule-based control, which uses a knowledge base determined by machine learning and finite automata method is limited since it does not respond well to perturbations and environmental changes. FEL can be regarded as a hybrid control, because it combines nonparametric identification with parametric modeling and control. This paper presents simulation of a powered trans-femoral prosthesis controlled by a FEL neural network. Results suggest that FEL can be used to identify inverse dynamics of an arbitrary trans-femoral prosthesis during simple single joint movements (e.g., sinusoidal oscillations). The identified inverse dynamics then allows the tracking of an arbitrary trajectory such as a desired walking pattern within a multijoint structure. Simulation shows that the identified controller responds correctly when the leg motion is exposed to a perturbation such as a frequent change of the ground reaction force or the hip joint torque generated by the user. FEL eliminates the need for precise, tedious, and complex identification of model parameters.


Different effect of desipramine on locomotor activity in quinpirole-treated rats after repeated restraint and chronic mild stress.
We have studied the effect of chronic treatment with the tricyclic antidepressant drug desipramine on locomotor activity in rats challenged with the administration of the D2-like dopamine agonist quinpirole, after prolonged exposure to two different stress regimens, repeated restraint stress and chronic mild stress (different stressors randomly presented). These stress schedules have been previously reported to influence in opposite ways the sensitivity to the locomotor response mediated by the stimulation of mesolimbic dopamine receptors. In particular, repeated restraint has been reported to induce an increased response to the locomotor effect of amphetamine, while chronic mild stress has been reported to induce a decreased locomotor response to quinpirole. In the present study, repeated restraint stress failed to influence the locomotor activity after challenge with quinpirole, while chronic mild stress reduced this response. Chronic treatment with desipramine failed to influence this response in the control group, but exerted opposite effects in the two stressed groups. In particular, chronic desipramine reduced locomotor activity in quinpirole-treated rats in the restraint stress group, and increased it in the chronic mild stress group, thus preventing the subsensitivity induced by this stress regimen. The present results, taken together with results from earlier studies, are consistent with the hypothesis that the effect of antidepressants on the sensitivity of the mesolimbic dopamine receptors mediating the locomotor behavioural response tends to be opposite with respect to that exerted by stress, regardless of its direction. However, since we failed to show an increased locomotor activity after quinpirole challenge in the repeated restraint group, this hypothesis remains to be demonstrated. The two stress schedules reduced body weight gain in a similar way, therefore their different effects do not seem to be due to a difference in stress severity. Thus, the observation that both stress schedules reduced body weight gain in a similar way, but only chronic mild stress reduced the sensitivity to the locomotor response to quinpirole, shows that this effect is not an artefact of body weight decrease.


Sodium nitrite-mediated killing of the major cystic fibrosis pathogens Pseudomonas aeruginosa, Staphylococcus aureus, and Burkholderia cepacia under anaerobic planktonic and biofilm conditions.
A hallmark of airways in patients with cystic fibrosis (CF) is highly refractory, chronic infections by several opportunistic bacterial pathogens. A recent study demonstrated that acidified sodium nitrite (A-NO(2)(-)) killed the highly refractory mucoid form of Pseudomonas aeruginosa, a pathogen that significantly compromises lung function in CF patients (S. S. Yoon et al., J. Clin. Invest. 116:436-446, 2006). Therefore, the microbicidal activity of A-NO(2)(-) (pH 6.5) against the following three major CF pathogens was assessed: P. aeruginosa (a mucoid, mucA22 mutant and a sequenced nonmucoid strain, PAO1), Staphylococcus aureus USA300 (methicillin resistant), and Burkholderia cepacia, a notoriously antibiotic-resistant organism. Under planktonic, anaerobic conditions, growth of all strains except for P. aeruginosa PAO1 was inhibited by 7.24 mM (512 μg ml(-1) NO(2)(-)). B. cepacia was particularly sensitive to low concentrations of A-NO(2)(-) (1.81 mM) under planktonic conditions. In antibiotic-resistant communities known as biofilms, which are reminiscent of end-stage CF airway disease, A-NO(2)(-) killed mucoid P. aeruginosa, S. aureus, and B. cepacia; 1 to 2 logs of cells were killed after a 2-day incubation with a single dose of ∼15 mM A-NO(2)(-). Animal toxicology and phase I human trials indicate that these bactericidal levels of A-NO(2)(-) can be easily attained by aerosolization. Thus, in summary, we demonstrate that A-NO(2)(-) is very effective at killing these important CF pathogens and could be effective in other infectious settings, particularly under anaerobic conditions where bacterial defenses against the reduction product of A-NO(2)(-), nitric oxide (NO), are dramatically reduced.


An update on the impact of pre-transplant transfusions and allosensitization on time to renal transplant and on allograft survival.
Blood transfusions have the potential to improve graft survival, induce sensitization, and transmit infections. Current clinical practice is to minimize transfusions in renal transplantation candidates, but it is unclear if the evidence continues to support pre-transplant transfusion avoidance. Changes in the Medicare prospective payment system may increase transfusion rates. Thus there is a need to re-evaluate the literature to improve the management options for renal transplant candidates. A review applying a systematic approach and conducted using MEDLINE(®), Embase(®), and the Cochrane Library for English-language publications (timeframe: 01/1984-03/2011) captured 180 studies and data from publically available registries and assessed the impact of transfusions on allosensitization and graft survival, and the impact of allosensitization on graft survival and wait time. Blood transfusions continued to be a major cause of allosensitization, with allosensitization associated with increased rejection and graft loss, and longer wait times to transplantation. Although older studies showed a beneficial effect of transfusion on graft survival, this benefit has largely disappeared in the post-cyclosporine era due to improved graft outcomes with current practice. Recent data suggested that it may be the donor-specific antibody component of allosensitization that carried the risk to graft outcomes. Results of this review indicated that avoiding transfusions whenever possible is a sound management option that could prevent detrimental effects in patients awaiting kidney transplantation.


A high resolution protein interaction map of the yeast Mediator complex.
Mediator is a large, modular protein complex remotely conserved from yeast to man that conveys regulatory signals from DNA-binding transcription factors to RNA polymerase II. In Saccharomyces cerevisiae, Mediator is thought to be composed of 24 subunits organized in four sub-complexes, termed the head, middle, tail and Cdk8 (Srb8-11) modules. In this work, we have used screening and pair-wise two-hybrid approaches to investigate protein-protein contacts between budding yeast Mediator subunits. The derived interaction map includes the delineation of numerous interaction domains between Mediator subunits, frequently corresponding to segments that have been conserved in evolution, as well as novel connections between the Cdk8 (Srb8-11) and head modules, the head and middle modules, and the middle and tail modules. The two-hybrid analysis, together with co-immunoprecipitation studies and gel filtration experiments revealed that Med31 (Soh1) is associated with the yeast Mediator that therefore comprises 25 subunits. Finally, analysis of the protein interaction network within the Drosophila Mediator middle module indicated that the structural organization of the Mediator complex is conserved from yeast to metazoans. The resulting interaction map provides a framework for delineating Mediator structure-function and investigating how Mediator function is regulated.


Evaluation of Salicornia bigelovii Germplasm for Food Use in Egypt and the United Arab Emirates Based on Agronomic Traits and Nutritional Composition.
Climate change significantly aggravates the quality of soil and water, especially in desert regions such as the United Arab Emirates (UAE) and Egypt concluding in an alarming increase in salinity in the reservoirs of the natural resources. Saline farming rises as a promising solution, utilizing low-quality water and land resources to grow salt-tolerant varieties of conventional crops and halophytes. Samphire (Salicornia spp.) is among the most popular multi-purpose halophytes that are locally consumed in several countries around the world as a vegetable. Six Salicornia bigelovii genotypes (ICBA-2, ICBA-3, ICBA-4, ICBA-8, ICBA-9, ICBA-10) were evaluated for their agronomic performance and nutritional composition in Dubai in UAE and, for the first time, at the Red Sea Governorate in Egypt in the 2019-2020 season using saline groundwater for irrigation (ECw = 26 and 6.6 dS/m, respectively). ICBA-10 performed well in both locations with high green biomass and seed yield (10.9 kgm-2 and 116.3 gm-2, respectively, in UAE; 7.7 kgm-2 and 82.9 gm-2, respectively, in Egypt). ICBA-10 was, overall, also good in ion accumulation, total amino acids and unsaturated fatty acids content in both locations for shoots and seeds. Our results indicated that a lack of a drainage system and leaching fraction, the silt loam texture and the drip irrigation system might have contributed in the gradual accumulation of salts in the soil at Mubarak Valley at the end of the experiment at a higher level than ICBA. Apart from the agronomic parameters, higher salinity levels also affected ion accumulation, the amino acids and the fatty acids content for both shoots and seeds, whereas the proximate composition was affected to a lesser extent. Our findings on the high unsaturated fatty acids content under higher salinity corroborate the nutritional value of S. bigelovii oil. Due to its euhalophyte nature, S. bigelovii is a valuable source of minerals, amino acids and antioxidants that render it the most promising salt-loving plant for food use.


Evaluation of the Effectiveness and Safety of the BNT162b2 COVID-19 Vaccine in the Vaccination Campaign among the Health Workers of Fondazione Policlinico Universitario Agostino Gemelli IRCCS.
Health workers, especially those in patient-facing roles, had a significantly increased risk of COVID-19 infection, having serious outcomes, and risking spreading the virus to patients and staff. Vaccination campaign planning suggests allocating initial supplies of BNT162b2 vaccine to health workers given the importance of early protection to safeguard the continuity of care to patients. The aim of the study is to assess the effectiveness and safety of BNT162b2 vaccine among the health workers of Fondazione Policlinico Universitario Agostino Gemelli IRCCS (FPG). The retrospective cohort study was conducted among health staff working at the FPG. Vaccination data were collected from hospital records. The primary end points were vaccine effectiveness and safety. A total of 6649 health workers were included, of whom 5162 received injections. There were 14 cases of COVID-19 with onset at least 14 days after the second dose among vaccinated health workers and 45 cases among unvaccinated ones. BNT162b2 was 91.5% effective against COVID-19 (95% credible interval, 84.7% to 95.3%). The safety profile of BNT162b2 vaccine consisted of short-term, non-serious events. The promotion and boost of the COVID-19 vaccination campaign represents a key public health measure useful to curb the spread of the pandemic especially in vulnerable contexts, such as hospitals, where health workers carry out a paramount role for the entire community, and requires further protection with a possible booster dose in view of autumn-winter 2021.


Chronic non-bacterial osteomyelitis: a retrospective international study on clinical manifestations and response to treatment.
Chronic non-bacterial osteomyelitis (CNO) is a rare non-infectious bone inflammatory disorder; when multifocal, it is referred to as Chronic Recurrent Multifocal Osteomyelitis (CRMO). This study evaluates the demographic, clinical and radiological characteristics of a multi-centre cohort of patients with CNO/CRMO. Demographic and clinical data of patients with an established diagnosis of CNO/CRMO followed at paediatric rheumatology centres across Europe (Italy, France, Slovenia) and India were retrospectively collected. There were no demographic differences across countries, but time to diagnosis was significantly longer in India (p=0.041). Pain was almost invariably present at disease onset; functional impairment was more frequent among Italian and Slovenian patients (p=0.001). The number of sites of bone involvement was similar between genders and countries, with long bone metaphises being the most common site. Raised acute phase reactants, detected in >50% of patients, were not associated with clinical manifestations or response to treatment. Comorbidities, evinced in 37% of patients, were equally distributed between genders and nationalities. Imaging approach was similar across countries, without any association between radiological findings and clinical manifestations. NSAIDs were almost invariably used as first-line treatment, but response rate was significantly lower in Italy (p=0.02). Methotrexate was used in 28% of case, with an overall rate of response of 82%. Health conditions and rate of permanent deformities were similar across different countries. The differences in clinical presentation, radiological features and response to treatment described in this multinational cohort of CNO/CRMO might provide novel insights into this still elusive disease.


Growth and breastfeeding among low birth weight infants fed with or without protein enrichment of human milk.
The effect of protein enrichment of mother's milk on growth of low birthweight infants needs further exploration in order to optimize feeding strategies. The aim of this study was to describe feeding and growth of infants weighing <1,900 g at birth, up to a corrected age of 18 months, with or without protein-enriched breastmilk. A retrospective, descriptive, non-experimental design was used to describe the growth of 52 low birthweight infants. Data on their growth and feeding were collected from medical records at hospitals and child health care clinics. Despite more severe morbidity, the infants given protein-enriched milk showed similar growth as the other study infants. Standard deviation score for length at birth correlated positively with delta standard deviation score for length, from discharge to 12 and from discharge to 18 months corrected age. Duration of 'full' breastfeeding had a significant impact on subsequent improvement in SDS for weight. At discharge a smaller proportion of singletons fed with protein enriched milk were breastfed 'fully'. Infants who established breastfeeding at an early post-menstrual age were born with more optimal weight standard deviation score and had a better weight gain after discharge. We conclude that protein-enriched breast milk enables low birthweight infants requiring especially intensive care to attain growth at discharge comparable to that of healthier infants not given enriched milk. Low standard deviation score for length at birth may predict poor growth after discharge. However duration of 'full' breastfeeding had a significant impact on subsequent improvement in SDS for weight. Therefore it is important that mothers of LBW infants are given sufficient support of lactation and breastfeeding.


Minimal pair approaches to phonological remediation.
This article considers linguistic approaches to phonological remediation that emphasize the role of the phoneme in language. We discuss the structure and function of the phoneme by outlining procedures for determining contrastive properties of sound systems through evaluation of minimal word pairs. We then illustrate how these may be applied to a case study of a child with phonological delay. The relative effectiveness of treatment approaches that facilitate phonemic acquisition by contrasting pairs of sounds in minimal pairs is described. A hierarchy of minimal pair treatment efficacy emerges, as based on the number of new sounds, the number of featural differences, and the type of featural differences being introduced. These variables are further applied to the case study, yielding a range of possible treatment recommendations that are predicted to vary in their effectiveness.


When failure isn't an option.
Some teams, by the very nature of their work, must consistently perform at the highest levels. How do you--as a team leader, a supervisor, a trainer, or an outside coach--ensure that this happens? To answer this question, Harvard Business Review asked six people who work with high-performance teams to comment on developing and managing these teams. The result is a collection of commentaries from Michael Hillmann, deputy chief of the Los Angeles Police Department and commander of its Special Operations Bureau, which includes the SWAT team; Philippe Dongier, who headed up a joint United Nations/World Bank/Asian Development Bank reconstruction team in Afghanistan after the fall of the Taliban; the National Fire Academy's Robert Murgallis, who trains firefighting teams; Mary Khosh, former career coach for players with the Cleveland Browns; Elizabeth Allen, a planner of society weddings, charity galas, and corporate events; and Ray Evernham, who, as a stock-car-racing crew chief, helped driver Jeff Gordon win three NASCAR championships. The types of teams represented in these commentaries are very different. Some are ad hoc, formed for a specific task, while others are ongoing, typically improving their performance with each task they undertake. For all of them, the stakes are high. Despite their differences, some similarities emerge in the ways they achieve top performance. For example, selection of team members is crucial-as is a willingness to get rid of members who don't consistently deliver. A leader who supports and builds confidence in members is also key, and high-performance teams without such a leader will often informally create one. Finally, the stress that defines the work of these teams helps generate peak short-term performance--and poses the constant risk of members burning out.


Experiences of Infertile Women Seeking Assisted Pregnancy in Iran: A Qualitative Study.
Assisted reproductive technologies (ARTs) are complicated and stressful techniques and the social and cultural norms are major obstacles against their use. Many qualitative studies have been done in the field of women's experiences of infertility, but less is known about the experiences of infertile women seeking assisted pregnancy. The aim of this study was to understand and describe the experience of women who have used assisted reproductive technologies for their current pregnancy. This qualitative study was conducted based on a content analysis approach. With purposive sampling, 12 pregnant women who were using ART were recruited from Avicenna Fertility Center in Tehran. Women were selected purposefully and with maximum variation. Interviews were performed after a positive test of pregnancy and women were introduced to researchers in their first visit of pregnancy in the prenatal clinic. Interviews were recorded, transcribed verbatim and analyzed concurrently. Semi-structured interviews were coded, categorized and the themes were also identified. Four main themes were uncovered which included struggle to achieve pregnancy, fear and uncertainty, escape from stigma and the pursuit to achieve husband satisfaction. It is essential for these women to be counseled and prepared by their health care providers after the use of ARTs. Distress can be reduced for infertile women seeking assisted pregnancy when they are prepared for possible failures, empowered to deal with stigma, and have their partners' involvement in counseling sessions.


Human abilities.
This chapter reviews recent literature, primarily from the 1990s, on human abilities. The review opens with a consideration of the question of what intelligence is, and then considers some of the major definitions of intelligence, as well as implicit theories of intelligence around the world. Next, the chapter considers cognitive approaches to intelligence, and then biological approaches. It proceeds to psychometric or traditional approaches to intelligence, and then to broad, recent approaches. The different approaches raise somewhat different questions, and hence produce somewhat different answers. They have in common, however, the attempt to understand what kinds of mechanisms lead some people to adapt to, select, and shape environments in ways that match particularly well the demands of those environments.


Photobiological characteristics and photosynthetic UV responses in two Ulva species (Chlorophyta) from southern Spain.
The effect of different wavebands of artificial UV (UVB and UVA) and photosynthetically active radiation (PAR) was assessed in two species of the genus Ulva, U. olivascens and U. rotundata, from southern Spain in order to test for possible differences in acclimation of photosynthesis. Both species share similar morphology but are subject to different light environments: U. rotundata is an estuarine alga, inhabiting subtidal locations, while U. olivascens is an intertidal, sun-adapted organism. Algae were exposed to three different UV conditions, PAR+UVA+UVB, PAR+UVA and PAR for 7 d. Short-term exposure (6 h) was also carried out, using two PAR levels, 150 and 700 micromolm(-2)s(-1). Pigment contents and photosynthesis vs. irradiance curves from oxygen evolution were used to contrast sun- and shade adaptation between these species. O2-based net photosynthesis (Pmax) and PAM-chlorophyll fluorescence (optimal quantum yield, Fv/Fm) were used as parameters to evaluate photoinhibition of photosynthesis in the experiments. The results underline different photobiological characteristics among species: the subtidal U. rotundata had higher contents of pigments (Chl a, Chl b and carotenoids) than the sun-adapted U. olivascens, which resulted in higher thallus absorptance and P-I parameters characterized by higher photosynthetic efficiency at limiting irradiances (alpha) and lower saturating points for photosynthesis (Ek). After 7 d exposure, photoinhibition of Fv/Fm was close to 40-45% in both species. Differences between UV treatments were seen in U. rotundata after 5 d and after 7 d in U. olivascens, in which PAR+UVA impaired strongly photosynthesis (80%). Such patterns were correlated with a progressive decrease in pigment contents, specially chlorophylls. In short-term (6 h) exposures, combinations of UVA+UVB and high PAR level resulted in high rates of photoinhibition of chlorophyll fluorescence (68-92%) in U. rotundata, whereas in U. olivascens photoinhibition ranged between 42% and 53%. Photoinhibition under low PAR combined to UV radiation was lower than observed under high PAR. Net O2-Pmax revealed similar response among the species, with maximal photoinhibition rates close to 60% in algae incubated under high PAR+UVA+UVB. In the case of UV exposure in combination with low PAR, the highest photoinhibition rates were measured in U. rotundata.


[Epidemiology of stroke in urban and rural areas, Tianjin, China: a six-year prospective research].
This paper researched the morbidity and mortality rates of stroke in Tianjin by a six-year prospective study. The result showed that there were no significant differences of the stroke morbidity and mortality rates between urban and rural areas in Tianjin. The morbidity and mortality rates of stroke significantly increased parallel with age in two areas, which were 443.86 and 248.20 per 10(5) in urban, 402.05 and 190.22 per 10(5) in rural areas respectively. The difference in type was not found. Mortality rate of cerebral hemorrhage was significant higher than that of cerebral infarction among age group 45 and above in urban and 55-years above in rural areas. October peak was noticed in morbidity and mortality rates of stroke both in urban and rural areas.


Use of perfusional CBCT imaging for intraprocedural evaluation of endovascular treatment in patients with diabetic foot: a concept paper.
Diabetes mellitus (DM) is one of the most common metabolic diseases worldwide; its global burden has increased rapidly over the past decade, enough to be considered a public health emergency in many countries. Diabetic foot disease and, particularly diabetic foot ulceration, is the major complication of DM: through a skin damage of the foot, with a loss of epithelial tissue, it can deepen to muscles and bones and lead to the amputation of the lower limbs. Peripheral arterial disease (PAD) in patients with diabetes, manifests like a diffuse macroangiopathic multi-segmental involvement of the lower limb vessels, also connected to a damage of collateral circulation; it may also display characteristic microaneurysms and tortuosity in distal arteries. As validation method, Bold-MRI is used. The diabetic foot should be handled with a multidisciplinary team approach, as its management requires systemic and localized treatments, pain control, monitoring of cardiovascular risk factors and other comorbidities. CBCT is an emerging medical imaging technique with the original feature of divergent radiation, forming a cone, in contrast with the spiral slicing of conventional CT, and has become increasingly important in treatment planning and diagnosis: from small anatomical areas, such as implantology, to the world of interventional radiology, with a wide range of applications: as guidance for biopsies or ablation treatments. The aim of this project is to evaluate the usefulness of perfusion CBCT imaging, obtained during endovascular revascularization, for intraprocedural evaluation of endovascular treatment in patients with diabetic foot.


IMGs set goals for AMA section.
International medical graduates have become an important part of the American health care structure in recent decades, but too often they remain second-class citizens within the medical community. Increasingly, voices within medicine have called for formal recognition of the unique needs of IMG physicians.


Population genetic analysis of the Plasmodium falciparum circumsporozoite protein in two distinct ecological regions in Ghana.
Extensive genetic diversity in the Plasmodium falciparum circumsporozoite protein (PfCSP) is a major contributing factor to the moderate efficacy of the RTS,S/AS01 vaccine. The transmission intensity and rates of recombination within and between populations influence the extent of its genetic diversity. Understanding the extent and dynamics of PfCSP genetic diversity in different transmission settings will help to interpret the results of current RTS,S efficacy and Phase IV implementation trials conducted within and between populations in malaria-endemic areas such as Ghana. Pfcsp sequences were retrieved from the Illumina-generated paired-end short-read sequences of 101 and 131 malaria samples from children aged 6-59 months presenting with clinical malaria at health facilities in Cape Coast (in the coastal belt) and Navrongo (Guinea savannah region), respectively, in Ghana. The sequences were mapped onto the 3D7 reference strain genome to yield high-quality genome-wide coding sequence data. Following data filtering and quality checks to remove missing data, 220 sequences were retained and analysed for the allele frequency spectrum, genetic diversity both within the host and between populations and signatures of selection. Population genetics tools were used to determine the extent and dynamics of Pfcsp diversity in P. falciparum from the two geographically distinct locations in Ghana. Pfcsp showed extensive diversity at the two sites, with the higher transmission site, Navrongo, exhibiting higher within-host and population-level diversity. The vaccine strain C-terminal epitope of Pfcsp was found in only 5.9% and 45.7% of the Navrongo and Cape Coast sequences, respectively. Between 1 and 6 amino acid variations were observed in the TH2R and TH3R epitope regions of PfCSP. Tajima's D was negatively skewed, especially for the population from Cape Coast, given the expected historical population expansion. In contrast, a positive Tajima's D was observed for the Navrongo P. falciparum population, consistent with balancing selection acting on the immuno-dominant TH2R and TH3R vaccine epitopes. The low frequencies of the Pfcsp vaccine haplotype in the analysed populations indicate a need for additional molecular and immuno-epidemiological studies with broader temporal and geographic sampling in endemic populations targeted for RTS,S application. These results have implications for the efficacy of the vaccine in Ghana and will inform the choice of alleles to be included in future multivalent or chimeric vaccines.


Confined-but-connected quantum solids via controlled ligand displacement.
Confined-but-connected quantum dot solids (QDS) combine the advantages of tunable, quantum-confined energy levels with efficient charge transport through enhanced electronic interdot coupling. We report the fabrication of QDS by treating self-assembled films of colloidal PbSe quantum dots with polar nonsolvents. Treatment with dimethylformamide balances the rates of self-assembly and ligand displacement to yield confined-but-connected QDS structures with cubic ordering and quasi-epitaxial interdot connections through facets of neighboring dots. The QDS structure was analyzed by a combination of transmission electron microscopy and wide-angle and small-angle X-ray scattering. Excitonic absorption signatures in optical spectroscopy confirm that quantum confinement is preserved. Transport measurements show significantly enhanced conductivity in treated films.


[H-graft minimally invasive direct coronary artery bypass for coronary artery disease complicated with Leriche syndrome].
We present a case of Leriche syndrome, requiring coronary revascularization and both lower extremities. Leriche syndrome shows high aortic occlusion, which has occasionally large collateral pathways from the internal thoracic artery (ITA) to the femoral artery via superior and inferior epigastric arteries. Usual usage of ITA may lead to deterioration of blood supply to lower extremities at surgical coronary revascularization. H-graft minimally invasive direct coronary artery bypass (MIDCAB), which puts arterial graft horizontally between in situ left ITA (LITA) and left anterior descending (LAD) through small incision approach, enables surgical LAD revascularization and keeps blood supply to lower extremities. H-graft MIDCAB contributed to two-stage surgery in a patient with Leriche syndrome complicated with coronary artery disease.


The PPARα agonist fenofibrate reduces the cytokine imbalance in a maternal immune activation model of schizophrenia.
Maternal infections during pregnancy may increase the risk of psychiatric disorders in offspring. We recently demonstrated that activation of peroxisome proliferator-activate receptor-α (PPARα), with the clinically available agonist fenofibrate (FEN), attenuates the neurodevelopmental disturbances induced by maternal immune activation (MIA) in rat offspring. We hypothesized that fenofibrate might reduce MIA-induced cytokine imbalance using a MIA model based on the viral mimetic polyriboinosinic-polyribocytidilic acid [poly (I:C)]. By using the Bio-Plex Multiplex-Immunoassay-System, we measured cytokine/chemokine/growth factor levels in maternal serum and in the fetal brain of rats treated with fenofibrate, at 6 and 24 h after poly (I:C). We found that MIA induced time-dependent changes in the levels of several cytokines/chemokines/colony-stimulating factors (CSFs). Specifically, the maternal serum of the poly (I:C)/control (CTRL) group showed increased levels of (i) proinflammatory chemokine macrophage inflammatory protein 1-alpha (MIP-1α), (ii) tumor necrosis factor-alpha (TNF-α), the monocyte chemoattractant protein-1 (MCP-1), the macrophage (M-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF). Conversely, in the fetal brain of the poly (I:C)/CTRL group, interleukin 12p70 and MIP-1α levels were lower than in vehicle (veh)/CTRL group. Notably, MIP-1α, TNF-α, keratinocyte derived chemokine (GRO/KC), GM-CSF, and M-CSF levels were lower in the poly (I:C)/FEN than in poly (I:C)/CTRL rats, suggesting the protective role of the PPARα agonist. PPARα might represent a therapeutic target to attenuate MIA-induced inflammation.


Multifunctional nanomesoporous materials with upconversion (in vivo) and downconversion (in vitro) luminescence imaging based on mesoporous capping UCNPs and linking lanthanide complexes.
A series of new multifunctional nanomesoporous materials based on upconversion nanophosphors NaYF4:Yb,Tm@NaGdF4 (UCNPs) and lanthanide complexes were designed and synthesized through mesoporous capping UCNPs nanophosphors and linking lanthanide (Ln) complexes. The obtained UCNPs@mSiO2-Ln(dbm)4 (Ln = Eu, Sm, Er, Nd, Yb) materials can achieve downconversion and upconversion luminescence to show multicolor emission (covering the spectral region from 450 nm to 1700 nm) under visible-light excitation and 980 nm excitation, respectively. In addition, low cytotoxicity and good biocompatibility was found as determined by methyl thiazolyl tetrazolium assay, and the nanomesoporous materials were successfully applied to cell imaging in vitro based on Eu(3+) luminescence (under 405 nm excitation) and small animal imaging based on Tm(3+) luminescence (under 980 nm excitation). The doped Gd(3+) ion endows the nanomesoporous materials UCNPs@mSiO2-Ln(dbm)4 with effective T1 signal enhancement, which affords them as potential magnetic resonance imaging (MRI) contrast agents. Therefore, our results may provide more exciting opportunities for multimodal bioimaging and multifunctional applications.


Treatment of vaginal intraepithelial neoplasia (VAIN) with the carbon dioxide laser.
The increasing incidence of VAIN especially in young women, the frequent relapses, and renewed interest in maintaining sexual function have prompted gynecologists to a conservative management of the disease. Over the last decades, surgery, 5-fluorouracil, chemosurgery, electrocautery and cryotherapy were used. Carbon dioxide laser ablation therapy of VAIN has been reported from various authors with different results. From June 1991 through December 1998, 39 patients affected by VAIN were treated with laser surgery (35 vaporizations and 4 excisions). To achieve complete elimination of all lesions, seven patients had two vaporizations and one patient three. One patient was submitted to six combined repeated treatments. Five patients were not evaluable and three presented persistence of VAIN. One patient died because of AIDS. The remaining 30 patients, treated with laser surgery, were lesion free: 7 patients were negative at 12-24 months, 10 at 24-36 months and 13 at 37-90 months. No important complications occurred. Sexual function was not compromised. Carbon dioxide laser is a safe and efficacious tool in the treatment of pre-neoplastic lesions of the vagina.


[Chemotherapy in combination with laser coagulation or interstitial hyperthermia--effective combined therapy for disseminated skin melanoma].
Thirty-eight patients with disseminated skin melanoma received chemotherapy in conjunction with laser coagulation or interstitial hyperthermia of intra- or subcutaneous metastases. Use of combination therapy was followed by a rise to 37% in total response and 16%--complete regression, respectively. Most effectiveness was attained when the dacarbazine + cisplatin + BCNU + tamoxifen regime was employed. In this group of 16 patients (46%), total response was 56% and, what is most significant, 31% in complete regression. In all cases of apparent response, polychemotherapy was administered both before and after laser coagulation or interstitial hyperthermia.


Dysfunctional endogenous analgesia during exercise in patients with chronic pain: to exercise or not to exercise?
Exercise is an effective treatment for various chronic pain disorders, including fibromyalgia, chronic neck pain, osteoarthritis, rheumatoid arthritis, and chronic low back pain. Although the clinical benefits of exercise therapy in these populations are well established (i.e. evidence based), it is currently unclear whether exercise has positive effects on the processes involved in chronic pain (e.g. central pain modulation). Reviewing the available evidence addressing the effects of exercise on central pain modulation in patients with chronic pain. Narrative review. Exercise activates endogenous analgesia in healthy individuals. The increased pain threshold following exercise is due to the release of endogenous opioids and activation of (supra)spinal nociceptive inhibitory mechanisms orchestrated by the brain. Exercise triggers the release of beta-endorphins from the pituitary (peripherally) and the hypothalamus (centrally), which in turn enables analgesic effects by activating μ-opioid receptors peripherally and centrally, respectively. The hypothalamus, through its projections on the periaqueductal grey, has the capacity to activate descending nociceptive inhibitory mechanisms. However, several groups have shown dysfunctioning of endogenous analgesia in response to exercise in patients with chronic pain. Muscle contractions activate generalized endogenous analgesia in healthy, pain-free humans and patients with either osteoarthritis or rheumatoid arthritis, but result in increased generalised pain sensitivity in fibromyalgia patients. In patients having local muscular pain (e.g. shoulder myalgia), exercising non-painful muscles activates generalized endogenous analgesia. However, exercising painful muscles does not change pain sensitivity either in the exercising muscle or at distant locations. The reviewed studies examined acute effects of exercise rather than long-term effects of exercise therapy. A dysfunctional response of patients with chronic pain and aberrations in central pain modulation to exercise has been shown, indicating that exercise therapy should be individually tailored with emphasis on prevention of symptom flares. The paper discusses the translation of these findings to rehabilitation practice together with future research avenues.


Phytochemical and Nutraceutical Screening of Ethanol and Ethyl Acetate Phases of Romanian Galium verum Herba (Rubiaceae).
Galium species are used worldwide for their antioxidant, antibacterial, antifungal, and antiparasitic properties. Although this plant has demonstrated its antitumor properties on various types of cancer, its biological activity on cutaneous melanoma has not been established so far. Therefore, the present study was designed to investigate the phytochemical profile of two extracts of G. verum L. herba (ethanolic and ethyl acetate) as well as the biological profile (antioxidant, antimicrobial, and antitumor effects) on human skin cancer. The extracts showed similar FT-IR phenolic profiles (high chlorogenic acid, isoquercitrin, quercitrin, and rutin), with high antioxidant capacity (EC50 of ethyl acetate phase (0.074 ± 0.01 mg/mL) > ethanol phase (0.136 ± 0.03 mg/mL)). Both extracts showed antimicrobial activity, especially against Gram-positive Streptococcus pyogenes and Staphylococcus aureus bacilli strains, the ethyl acetate phase being more active. Regarding the in vitro antitumor test, the results revealed a dose-dependent cytotoxic effect against A375 melanoma cell lines, more pronounced in the case of the ethyl acetate phase. In addition, the ethyl acetate phase stimulated the proliferation of human keratinocytes (HaCaT), while this effect was not evident in the case of the ethanolic phase at 24 h post-stimulation. Consequently, G. verum l. could be considered a promising phytocompound for the antitumor approach of cutaneous melanoma.


Analysis of drug resistance genes of integrons in clinical isolates of Escherichia coli from elderly bloodstream infections.
This experiment was carried out to provide a basis for the treatment of clinical bloodstream infections by analyzing the drug resistance characteristics and integrated gene distribution of Escherichia coli in bloodstream infections in elderly patients. For this aim, E. coli were collected for bacterial identification and drug sensitivity testing from bloodstream infections in elderly patients in the hospital from January 2016 to December 2019. ESBLs positive strains were assayed for genotypes and their integron carriage rates by PCR amplification. The characteristics and differences of various genotype rates were compared and analyzed. Results showed that a total of 230 E. coli strains were isolated. The detection rate of ESBLs-producing bacteria was 37.39 %. ESBLs-producing E. coli showed a high rate of resistance to cefepime, levofloxacin, cotrimoxazole, and ticarcillin/clavulanic acid (>40%). The resistance rate of 230 strains of E. coli to meropenem, minocycline, amikacin, gentamicin and cefoxitin was less than 20%. Among the ESBLs-producing E. coli in bloodstream infections in elderly patients, CTX-M-9 accounted for 27.91%, CTX-M-2 for 17.44%, and SHV for 13.95%. The detection rate of type I integrated genes was 41.30%, and type II and III integrated genes were not detected. ESBLs-producing genotyping-positive bacteria were detected with more than 50% of type I integrated genes. It was concluded that type I integrated genes in ESBLs-producing E. coli isolated from elderly patients carried resistance genes such as CTX-M-9 and CTX-M-2 aggravating multi-drug resistance in bacteria.


How do patients evaluate and make use of online health information?
Increasing numbers of people are turning to the Internet for health advice despite reports that sites vary in terms of their quality. How do they decide whether or not to trust the advice they find online? A staged model of trust development is proposed and tested here in a longitudinal study in which fifteen women faced with decisions concerning the menopause and hormone replacement therapy (HRT) were observed while searching the Internet for information and advice over four consecutive weeks and then kept diaries over a six-month follow-up period. The women were all resident in the North-East of England and were recruited through advertisements in the local media. The study provided general support for a three-stage model of trust in which participants firstly engaged in rapid heuristic processing of information, efficiently sifting and rejecting general sales sites and portals but sometimes rejecting high-quality content because of poor design. Well-designed sites were then effectively interrogated for credible and personalized content before being designated trustworthy. The women appeared to act much like 'scientists' using web material to generate and test hypotheses and theories about HRT, although their capacity to deal with certain forms of risk information was limited. They subsequently reported integrating online advice with offline advice from friends, family and physicians in order to be fully confident in their final decisions. Women felt that the Internet influenced their decision-making and improved communications with physicians. Personalized stories from like-minded others improved trust perceptions. Despite the use of the Internet the physician was still seen as the primary source of information and advice.


Global Transcriptome Analysis Reveals Distinct Phases of the Endothelial Response to TNF.
The vascular endothelium acts as a dynamic interface between blood and tissue. TNF-α, a major regulator of inflammation, induces endothelial cell (EC) transcriptional changes, the overall response dynamics of which have not been fully elucidated. In the present study, we conducted an extended time-course analysis of the human EC response to TNF, from 30 min to 72 h. We identified regulated genes and used weighted gene network correlation analysis to decipher coexpression profiles, uncovering two distinct temporal phases: an acute response (between 1 and 4 h) and a later phase (between 12 and 24 h). Sex-based subset analysis revealed that the response was comparable between female and male cells. Several previously uncharacterized genes were strongly regulated during the acute phase, whereas the majority in the later phase were IFN-stimulated genes. A lack of IFN transcription indicated that this IFN-stimulated gene expression was independent of de novo IFN production. We also observed two groups of genes whose transcription was inhibited by TNF: those that resolved toward baseline levels and those that did not. Our study provides insights into the global dynamics of the EC transcriptional response to TNF, highlighting distinct gene expression patterns during the acute and later phases. Data for all coding and noncoding genes is provided on the Web site (http://www.endothelial-response.org/). These findings may be useful in understanding the role of ECs in inflammation and in developing TNF signaling-targeted therapies.


The capacity of switchgrass (Panicum virgatum) to degrade atrazine in a phytoremediation setting.
Atrazine is a widely used herbicide in agriculture. Non-point source contamination of groundwater and drinking water may pose a significant threat to humans, wildlife, and the environment. Phytoremediation may provide a cost-effective strategy for reducing non-point source contamination of atrazine from agricultural runoff. Previous studies have shown that the rhizosphere of the native prairie grass, switchgrass (Panicum virgatum) is capable of enhancing the degradation of atrazine in soils. Biodegradation also may occur within the plant biomass; however, the extent to which this occurs has not been studied. We hypothesize that switchgrass has the capacity to degrade atrazine in vivo, in addition to the microbial biotransformation that occurs in its rhizosphere. The goals of this study were to characterize the ability of switchgrass to take up atrazine from soils, quantify the amount of biodegradation occurring in the plant, and quantify the amount of degradation occurring in the rhizosphere. Switchgrass seedlings were transplanted into autoclaved and non-autoclaved sand containing 10 µg/g atrazine in sand. Treatments were sacrificed on days 0, 3, and 7. Sand and plant tissue extracts were analyzed by gas chromatography to determine the concentration of atrazine and metabolites in sand and plant tissues. Results demonstrated that leaf biomass is capable of detoxifying atrazine, because metabolites were present in leaf material and not in the sand or root.


Differential activation of vascular smooth muscle Kv7.4, Kv7.5, and Kv7.4/7.5 channels by ML213 and ICA-069673.
Recent research suggests that smooth muscle cells express Kv7.4 and Kv7.5 voltage-activated potassium channels, which contribute to maintenance of their resting membrane voltage. New pharmacologic activators of Kv7 channels, ML213 (N-mesitybicyclo[2.2.1]heptane-2-carboxamide) and ICA-069673 N-(6-chloropyridin-3-yl)-3,4-difluorobenzamide), have been reported to discriminate among channels formed from different Kv7 subtypes. We compared the effects of ML213 and ICA-069673 on homomeric human Kv7.4, Kv7.5, and heteromeric Kv7.4/7.5 channels exogenously expressed in A7r5 vascular smooth muscle cells. We found that, despite its previous description as a selective activator of Kv7.2 and Kv7.4, ML213 significantly increased the maximum conductance of homomeric Kv7.4 and Kv7.5, as well as heteromeric Kv7.4/7.5 channels, and induced a negative shift of their activation curves. Current deactivation rates decreased in the presence of the ML213 (10 μM) for all three channel combinations. Mutants of Kv7.4 (W242L) and Kv7.5 (W235L), previously found to be insensitive to another Kv7 channel activator, retigabine, were also insensitive to ML213 (10 μM). In contrast to ML213, ICA-069673 robustly activated Kv7.4 channels but was significantly less effective on homomeric Kv7.5 channels. Heteromeric Kv7.4/7.5 channels displayed intermediate responses to ICA-069673. In each case, ICA-069673 induced a negative shift of the activation curves without significantly increasing maximal conductance. Current deactivation rates decreased in the presence of ICA-069673 in a subunit-specific manner. Kv7.4 W242L responded to ICA-069673-like wild-type Kv7.4, but a Kv7.4 F143A mutant was much less sensitive to ICA-069673. Based on these results, ML213 and ICA-069673 likely bind to different sites and are differentially selective among Kv7.4, Kv7.5, and Kv7.4/7.5 channel subtypes.


Protection of erythrocytes from sub-hemolytic mechanical damage by nitric oxide mediated inhibition of potassium leakage.
The effects of mechanical stress on red blood cell (RBC) deformability were evaluated by subjecting cells to a uniform fluid shear stress of 120 Pa for 15-120 seconds at 37 degrees C. This level of stress induced significant impairment of RBC deformability as assessed by ektacytometry, with the degree of impairment independent of extracellular calcium concentration. Inhibition of RBC nitric oxide (NO) synthesis by a competitive inhibitor of NO synthases (N-omega-nitro-L-arginine methyl ester, L-NAME) had no effect on deformability after exposure to mechanical stress. The NO donor sodium nitroprusside (SNP) prevented the deterioration of RBC deformability in a dose-dependent manner with 10(-4) M being the most effective concentration. A similar protective effect by the non-selective potassium channel blocker, tetraethylammonium chloride (TEA) suggests that the effect of NO might be mediated by the inhibition of potassium leakage from RBC. These results suggest that NO may prevent mechanical deterioration of RBC exposed to high shear stresses. While RBC are not exposed to such high levels of shear stresses for prolonged periods under normal circulatory conditions, comparable levels of mechanical stress can be encountered under certain situations (i.e., artificial organs, extracorporeal circulation) and may result in subhemolytic damage and hemorheological alterations.


Cheese consumption in relation to cardiovascular risk factors among Iranian adults- IHHP Study.
It is expected that dairy products such as cheeses, which are the main source of cholesterol and saturated fat, may lead to the development or increase the risk of cardiovascular and metabolic diseases; however, the results of different studies are inconsistent. This study was conducted to assess the association between cheese consumption and cardiovascular risk factors in an Iranian adult population. Information from the Isfahan Healthy Heart Program (IHHP) was used for this cross-sectional study with a total of 1,752 participants (782 men and 970 women). Weight, height, waist and hip circumference measurement, as well as fasting blood samples were gathered and biochemical assessments were done. To evaluate the dietary intakes of participants a validated food frequency questionnaire, consists of 49 items, was completed by expert technicians. Consumption of cheese was classified as less than 7 times per week and 7-14 times per week. Higher consumption of cheese was associated with higher C-Reactive Protein (CRP), apolipoprotein A and high density lipoprotein cholesterol (HDL-C) level but not with fasting blood sugar (FBS), total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and apolipoprotein B. Higher consumption of cheese was positively associated with consumption of liquid and solid oil, grain, pulses, fruit, vegetable, meat and dairy, and negatively associated with Global Dietary Index. After control for other potential confounders the association between cheese intake and metabolic syndrome (OR: 0.81; 96%CI: 0.71-0.94), low HDL-C level (OR: 0.87; 96%CI: 0.79-0.96) and dyslipidemia (OR: 0.88; 96%CI: 0.79-0.98) became negatively significant. This study found an inverse association between the frequency of cheese intake and cardiovascular risk factors; however, further prospective studies are required to confirm the present results and to illustrate its mechanisms.


Radioimmunoassay for thymopoietin.
A radioimmunoassay for thymopoietin was developed that detects thymopoietin concentrations greater than 5 ng/ml. A critical point in development of the radioimmunossay was preparation of 125I-labeled thymopoietin by the Bolton-Hunter method, since direct iodination of tyrosyl residues impaired the immunoreactivity of thymopoietin.


Stress of COVID-19 and mental health outcomes in Palestine: the mediating role of well-being and resilience.
We tested the association between the stress of COVID-19 and mental distress manifested by anxiety, depression, and stress, and whether well-being and resilience mediate the relationship between the two variables in a population of Palestinian adults. Namely, we hypothesized that stress of COVID-19 will be positively associated with mental health problems (anxiety, depression, and stress); well-being and resilience will be negatively associated with mental health problems (anxiety, depression, and stress); and well-being and resilience will mediate the association between the stress of COVID-19 and mental health problems (anxiety, depression, and stress). Depression, Anxiety and Stress Scale-21, the Resilience Scale for Adults, the WHO-5 Well-Being Index, and the COVID-19 Stress Scales were administered to 860 participants via online survey. Structural equation modelling (SEM) was applied to address the study hypothesis. Participants recorded a mild level of stress of COVID-19 and high scores for resilience and well-being. A conceptual model depicting COVID-19 stress as a predictor, mental distress as an outcome variable, and resilience and subjective well-being as mediators was confirmed. Palestinians are exposed to mental distress in an environment characterized by ongoing stressors. Conversely, the capability of Palestinians to conserve good levels of well-being and resilience protects them from mental distress even in the wake of the COVID-19 outbreak. On the other hand, COVID-19 can be considered a new critical event demanding and diminishing the people's resiliency recourses in Palestine. Implications for clinical practice and research are discussed.


Iota-carrageenan extracted from red algae is a potent inhibitor of SARS-CoV-2 infection in reconstituted human airway epithelia.
Iota-carrageenan (IC) nasal spray, a medical device approved for treating respiratory viral infections, has previously been shown to inhibit the ability of a variety of respiratory viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), to enter and replicate in the cell by interfering with the virus binding to the cell surface. The aim of this study was to further investigate the efficacy and safety of IC in SARS-CoV-2 infection in advanced in vitro models of the human respiratory epithelium, the primary target and entry port for SARS-CoV-2. We extended the in vitro safety assessment of nebulized IC in a 3-dimensional model of reconstituted human bronchial epithelium, and we demonstrated the efficacy of IC in protecting reconstituted nasal epithelium against viral infection and replication of a patient-derived SARS-CoV-2 strain. The results obtained from these two advanced models of human respiratory tract epithelia confirm previous findings from in vitro SARS-CoV-2 infection assays and demonstrate that topically applied IC can effectively prevent SARS-CoV-2 infection and replication. Moreover, the absence of toxicity and functional and structural impairment of the mucociliary epithelium demonstrates that the nebulized IC is well tolerated.


The Era of Coronavirus: Knowledge, Attitude, Practices, and Barriers to Hand Hygiene Among Makerere University Students and Katanga Community Residents.
The Novel Coronavirus was declared as a pandemic by the WHO at the end of 2019. Proper hand hygiene was identified as one of the simplest most cost-effective Covid-19 control and prevention measures. It is therefore very important to identify gaps in the knowledge, attitude, and practices, and barriers regarding hand hygiene in the community. A descriptive cross-sectional study was conducted using a simple random sampling technique. An interviewer-guided questionnaire with questions on knowledge, attitude, practice, and barriers to hand hygiene was used in data collection. Collected data were analyzed using Microsoft office excel 2016 and STATA 15 software. A 95% confidence interval was used and statistical significance was P<0.05. Only 88 (24.5%) of the participants had adequate knowledge of hand hygiene. 32.8% of the university students had adequate knowledge compared to 6.3% of the Katanga residents. The majority of 336 (93.6%) participants had a good attitude towards hand hygiene. University students had a significantly better knowledge of hand hygiene while Katanga slum residents had a slightly better attitude towards hand hygiene. Only 19.6% accomplished all the seven steps of handwashing. 38.4% of the participants were still greeting by handshaking. Of the participants, 60.1% noted lack of soap as a barrier to hand hygiene and 62.9% reported having more than three barriers to hand hygiene. Participants who had been taught handwashing were more likely to have better hand hygiene knowledge and practice. There was an overall high proportion of participants with a low level of hand hygiene knowledge. There is a need for optimizing hand-hygiene practices through addressing the barriers and promoting public health education.


Differentiation-associated changes in the expression of chondroitin sulfate proteoglycan in induced U-937 cells.
A monoblastic cell line U-937 (clone 4), was induced to differentiate along the monocytoid lineage by 12-O-tetradecanoylphorbol-13-acetate (TPA), retinoic acid (RA), and vitamin D3 (VD3). By immunochemical and morphological criteria the cells were found to differentiate into macrophage-like cells in the presence of all three inducers. The expression of proteoglycans was investigated in control cultures and in cells differentiated in the presence of both TPA, RA, and VD3. The cells were labeled with [35S]sulfate and cell and medium-associated 35S-macromolecules were either solubilized in sodium dodecyl sulfate or subjected to proteolytic digestion. By use of chondroitinase ABC digestions and deaminative cleavage at pH 1.5 it was demonstrated that all cell cultures incorporated [35S]sulfate exclusively into chondroitin sulfate proteoglycan (CSPG). The expression of CSPG was found to decrease with differentiation to 60% in the presence of TPA, 67% in RA, and 40% in VD3 of control cultures on a cellular basis. The CSPG synthesized was consistently recovered from the medium fractions, whereas free glycosaminoglycan (GAG) chains were found in the cell fraction in all the cell cultures. GAG chains from both control and TPA-, RA-, and VD3-induced cultures were found to be exclusively of the chondroitin 4-sulfate type. However, the CSPGs from RA- and VD3-treated cells were found to differ in molecular size from those of control and TPA-induced cultures, as judged by Sepharose CL-6B gel chromatography. This difference in macromolecular properties following the induced differentiation of the monoblastic cells into macrophage-like cells was found to reside in expression of CSPGs (in the presence of RA and VD3) with smaller GAG chains. Control cells and TPA-induced cells synthesized CSPGs with GAG chains of approximate Mr of 30,000, contrasted by approximate Mr of 17,000 and 16,000 in RA- and VD3-induced cells, respectively. Accordingly, all three agents used in this study were found to induce differentiation of the U-937-4 cells and a decrease in the expression of CSPG, but only RA and VD3 were found to influence the structure of the proteoglycans synthesized.


RBD-specific antibody responses after two doses of BBIBP-CorV (Sinopharm, Beijing CNBG) vaccine.
Limited information is available on the effectiveness of the BBIBP-CorV (Sinopharm, Beijing CNBG) vaccine, especially in the elderly, despite the fact that it is approved in more than 50 countries. RBD-specific antibody titres, as a rapidly available and highly predictive surrogate marker, were measured after two doses of the BBIBP-CorV vaccine in 450 subjects. Results were analyzed in a multivariable model accounting for age, sex and time since the administration of the second dose of the vaccine. Sex and time since the second dose had little association with the antibody titres. Age, however, was highly relevant: measurable antibody levels were present in about 90% of individuals below the age of 50, but antibody production after BBIBP-CorV vaccination was strongly reduced with increasing age. A large number of elderly subjects, reaching 25% at 60 years, and up to 50% at ages over 80, were found not to produce any protective antibody. RBD-specific antibody titre, as a correlate of protection for COVID-19 disease susceptibility, should help to evaluate the effectiveness of the BBIBP-CorV vaccine. Results suggest that proper measures should be undertaken to prevent a potential outbreak of COVID-19 in BBIBP-CorV vaccinated but eventually unprotected elderly individuals.


Medication Adherence Interventions for Cardiovascular Disease in Low- and Middle-Income Countries: A Systematic Review.
The burden of cardiovascular diseases (CVD) is high in low- and middle-income countries (LMICs). Medications are integral to the management and control of CVD; however, suboptimal adherence impacts health outcomes. This systematic review aims to critically examine interventions targeted at improving medication adherence among persons with CVD in LMICs. In this systematic review, we searched online databases PubMed, Embase, and CINAHL for studies that evaluated a medication adherence intervention for CVD, reported adherence as an outcome measure, were conducted in LMICs and reported the strategy or tool used to measure adherence. We included articles published in English, available in full text, peer-reviewed, and published between 2010 and 2020. We included 45 articles in this review. The majority of the studies implemented counseling and educational interventions led by nurses, pharmacists, or community health workers. Many of the studies delivered medication-taking reminders in the form of phone calls, text messages, short message services (SMS), and in-phone calendars. Multi-component interventions were more effective than unifocal interventions. Interventions involving technology, such as mobile phone calls, electronic pillboxes, and interactive phone SMS reminders, were more effective than generic reminders. The outcomes reported in the studies varied based on the complexity and combination of strategies. When interventions were implemented at both the patient level, such as reminders, and at the provider level, such as team-based care, the effect on medication adherence was larger. In LMICs, medication adherence interventions among persons with CVD included a combination of patient education, reminders, fixed-dose combination therapy and team-based care approach were generally more effective than singular interventions. Among patients who had CVD, the medication adherence interventions were found to be moderately effective. Future studies focusing on improving medication adherence in LMICs should consider non-physician-led interventions and appropriately adapt the interventions to the local context.


Identification of inhibitors of ribozyme self-cleavage in mammalian cells via high-throughput screening of chemical libraries.
We have recently described an RNA-only gene regulation system for mammalian cells in which inhibition of self-cleavage of an mRNA carrying ribozyme sequences provides the basis for control of gene expression. An important proof of principle for that system was provided by demonstrating the ability of one specific small molecule inhibitor of RNA self-cleavage, toyocamycin, to control gene expression in vitro and vivo. Here, we describe the development of the high-throughput screening (HTS) assay that led to the identification of toyocamycin and other molecules capable of inhibiting RNA self-cleavage in mammalian cells. To identify small molecules that can serve as inhibitors of ribozyme self-cleavage, we established a cell-based assay in which expression of a luciferase (luc) reporter is controlled by ribozyme sequences, and screened 58,076 compounds for their ability to induce luciferase expression. Fifteen compounds able to inhibit ribozyme self-cleavage in cells were identified through this screen. The most potent of the inhibitors identified were toyocamycin and 5-fluorouridine (FUR), nucleoside analogs carrying modifications of the 7-position and 5-position of the purine or pyrimidine bases. Individually, these two compounds were able to induce gene expression of the ribozyme-controlled reporter approximately 365-fold and 110-fold, respectively. Studies of the mechanism of action of the ribozyme inhibitors indicate that the compounds must be incorporated into RNA in order to inhibit RNA self-cleavage.


[The late results of liver resection in repeat operations].
Long-term results after resections of the liver in reoperated patients are described. The operations were performed on 48 patients. Four of them died (8.4%). The patients were followed-up during 1-15 years. The volume of the operations was from segment resections up to wide hemihepatectomies. Good long-term results were obtained in 82.7% of the patients, satisfactory--in 13.9%, unsatisfactory--in 3.4%. The use of cryosurgical methods in palliative resections gives better long-term results of the operations. Recurrences were noted in 17.2% of the patients. Labor rehabilitation after vast resections of the liver in reoperated patients takes place within 1.5-2.5 years.


Women and In-hospital Stroke Code Activation: Age, Ethnicity, and Unique Symptoms Matter.
Women have worse stroke outcomes than men, and almost 17% of all stroke cases have symptom onset when admitted to the hospital for a separate condition. The aim of this study was to investigate the distinctive factors that impact the activation of an in-hospital stroke code and outcomes in women who have a stroke while admitted to the hospital for a separate condition. A retrospective observational propensity score study guided by the model for nursing effectiveness was used. In-hospital stroke code was activated in 46 of 149 or 30.9% of women and 15 of 149 or 10.1% of women received thrombolytic therapy. Activation of an in-hospital stroke code was significant (P < .001) for women receiving thrombolytic therapy and significant to a home discharge status (P = .014). Age (P < .001), ethnicity (P < .001), common (P ≤ .001) and unique (P = .012) stroke symptoms, stroke risk factors (P < .001), comorbid conditions (P < .001), time last known well (P = .041), and diagnostic imaging (P < .001) were all significantly related to activation of an in-hospital stroke code. Activation of an in-hospital stroke is a key indicator for women to receive thrombolytic therapy and be discharged to home. Younger married women from non-Caucasian ethnic groups and women with stroke risk factors and comorbid conditions are at a greater risk for delayed stroke symptom detection and not having an in-hospital stroke code activated. Awareness of these factors that hinder early stroke detection in women is crucial to improving stroke treatment and outcomes in women.


Cervical spine injury from gunshot wounds.
Gunshot wounds (GSWs) to the cervical spine have been examined in a limited number of case series, and operative management of this traumatic disease has been sparsely discussed. The current literature supports and the authors hypothesize that patients without neurological deficit need neither surgical fusion nor decompression. Patients with GSWs and neurological deficits, however, pose a greater management challenge. The authors have compiled the experience of the R Adams Cowley Shock Trauma Center in Baltimore, Maryland, over the past 12 years, creating the largest series of such injuries, with a total number of 40 civilian patients needing neurosurgical evaluation. The current analysis examines presenting bone injury, surgical indication, presenting neurological examination, and neurological outcome. In this study, the authors characterize the incidence, severity, and recovery potential of cervical GSWs. The rate of unstable fractures requiring surgical intervention is documented. A detailed discussion of surgical indications with a treatment algorithm for cervical instability is offered. A total of 144 cervical GSWs were retrospectively reviewed. Of these injuries, 40 had documented neurological deficits. No neurosurgical consultation was requested for patients without deficit. Epidemiological and clinical information was collected on patients with neurological deficit, including age, sex, timing, indication, type of surgery, initial examination after resuscitation, follow-up examination, and imaging data. Twenty-eight patients (70%) presented with complete neurological deficits and 12 patients (30%) presented with incomplete injuries. Fourteen (35%) of the 40 patients underwent neurosurgical intervention. Twelve patients (30%) required intervention for cervical instability. Seven patients required internal fixation involving 4 anterior fusions, 2 posterior fusions, and 1 combined approach. Five patients were managed with halo immobilization. Two patients underwent decompression alone for neurological deterioration and persistent compressive injury, both of whom experienced marked neurological recovery. Follow-up was obtained in 92% of cases. Three patients undergoing stabilization converted at least 1 American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade and the remaining operative cases experienced small ASIA motor score improvement. Eighteen patients underwent inpatient MRI. No patient suffered complications or neurological deterioration related to retained metal. Three of 28 patients presenting with AIS Grade A improved to Grade B. For those 12 patients with incomplete injury, 1 improved from AIS Grade C to D, and 3 improved from Grade D to E. Spinal cord injury from GSWs often results in severe neurological deficits. In this series, 30% of these patients with deficits required intervention for instability. This is the first series that thoroughly documents AIS improvement in this patient population. Adherence to the proposed treatment algorithm may optimize neurological outcome and spine stability.


Risk of falling and hypnotic drugs: retrospective study of inpatients.
Falls and related injuries remain a concern for patient safety in many hospitals and nursing care facilities. In particular, reports examining the relationship between accidents and drugs with a sedative effect have been increasing; however, the analysis of correlation between the background factors of fall accidents and the detailed therapeutic category of drugs is insufficient. Our objective was to estimate fall risk following the administration of hypnotics in inpatients within an acute hospital. We assessed the relationship between falls and hypnotic drugs compared with other medicines. An inpatient population-based study was carried out at Gunma University Hospital, where all inpatients admitted between 1 October and 31 December 2007 were included. Over a 3-month follow-up period, all reports of falling accidents from ward medical staff were investigated. Falls occurred in 1.8% of males and 1.3% of females in the study population (n = 3,683). The mean age of patients who experienced falls (64.7 ± 19.5 years) was significantly higher than that of patients who did not (56.2 ± 20.2 years). Multivariate analysis revealed the following drugs as high-risk factors for falling: hypnotics (odds ratio [OR] 2.17, 95% CI 1.44-3.28), antiepileptics (OR 5.06, 95% CI 2.70-9.46), opioids (OR 3.91, 95% CI 2.16-7.10), anti-Alzheimer's (OR 5.74, 95% CI 1.62-20.3), anti-Parkinson's (OR 5.06, 95% CI 1.58-16.24), antidiabetics (OR 3.08, 95% CI 1.63-5.84), antihypertensives (OR 2.24, 95% CI 1.41-3.56), and antiarrhythmics (OR 2.82, 95% CI 1.36-5.86). Multivariate logistic regression analysis of hypnotics, brotizolam, zopiclone, and estazolam revealed a significant association with an increased risk of inpatient falling accidents, while zolpidem, triazolam, flunitrazepam, and nitrazepam did not. The present findings suggest that the risk of falling accidents in hospitals differs according to the type of hypnotic drug administered. The appropriate selection of hypnotic drugs, therefore, might be important for reducing the number of patient falls.


Phospholipid turnover in isolated rat pancreatic acini. Consideration of the relative roles of phospholipase A2 and phospholipase C.
The purpose of the present study was to explore the interaction of phosphatidylinositol breakdown and the turnover of arachidonic acid in isolated rat pancreatic acini by using receptor agonists and the calcium ionophore ionomycin. Acini prelabelled with myo-[(3)H]inositol in vivo responded to carbachol with a rapid breakdown of phosphatidylinositol. In the presence of [(32)P]P(i), carbachol increased labelling of phosphatidic acid and phosphatidylinositol within 1 and 5 min respectively. Carbachol also rapidly stimulated the incorporation of [(14)C]arachidonic acid into phosphatidylinositol within 2 min, and the peptidergic secretagogue caerulein caused the loss of radioactivity from phospholipids prelabelled with arachidonic acid. Ca(2+) deprivation partially impaired the stimulatory action of carbachol on arachidonic acid turnover. In contrast with its stimulatory effects on [(32)P]P(i) and [(14)C]arachidonate incorporation, carbachol inhibited the incorporation of the saturated fatty acid stearic acid into phosphatidylinositol. Whereas ionomycin stimulation of phosphatidylinositol breakdown and [(32)P]P(i) labelling of phospholipids was slower in onset and less effective than carbachol stimulation, the ionophore effectively promoted (arachidonyl) phosphatidylinositol turnover within 2 min. These results implicate two separate pathways for stimulated phosphatidylinositol degradation in the exocrine pancreas, involving phospholipases A(2) and C. Whereas mobilization of cellular Ca(2+) appears sufficient to cause activation of phospholipase A(2) and amylase secretion, additional events triggered by receptor activation may be required to act in concert with Ca(2+) to optimally stimulate phospholipase C. The nature of the interaction between phospholipases A(2) and C and their specific physiological roles in pancreatic secretion remain to be elucidated.


Adult presentation of ornithine transcarbamylase deficiency: a possible cause of hyperammonemia after high-dose chemotherapy and stem cell transplantation.
Hyperammonemia is a rare and often fatal complication following the conditioning therapy in autologous and allogeneic stem cell transplant recipients. It is characterized by anorexia, vomiting, lethargy and coma without any other apparent cause. The diagnosis is often delayed because symptoms can be subtle and ammonia is usually not included among the routine analyzes. Previous reports have not identified the molecular mechanisms behind hyperammonemia in stem cell transplant recipients. Urea cycle disorders (UCDs) are inborn errors of metabolism leading to hyperammonemia that usually presents in early childhood, whereas first presentation in adults is less common. Here we describe an adult woman with hyperammonemia following autologous stem cell transplantation for multiple myeloma. No apparent cause of hyperammonemia was identified, including portosystemic shunting, liver dysfunction or recent hyperammonemia-inducing chemotherapy. Hyperammonemia, normal blood glucose as well as anion gap and a previous history of two male newborns that died early after birth, prompted biochemical and genetic investigations for a UCD. A heterozygous variant in the X-linked gene encoding ornithine transcarbamylase (OTC) was identified and was regarded as a cause of UCD. The patient improved after treatment with nitrogen scavengers and high caloric intake according to a UCD protocol. This case report suggests that UCD should be considered as a possible cause of hyperammonemia following stem cell transplantation.


Clinical spectrum of hypophosphatasia diagnosed in adults.
The presentation of hypophosphatasia (HPP) diagnosed in adults demonstrates a wide range of clinical manifestations, many of which are nonspecific. We sought to assess clinical characteristics of adult HPP by evaluation of Mayo Clinic Rochester adults diagnosed with HPP from 1976 through 2008. Subjects were identified by diagnostic code or medical records. Inclusion criteria were age ≥18 years at diagnosis; low serum alkaline phosphatase (AP) without bisphosphonate therapy; and one additional element: elevated pyridoxal 5'-phosphate (PLP) or urine phosphoethanolamine (PEA), evidence of osteomalacia, or family history. We were unable to distinguish manifesting carriers from silent unaffected carriers due to lack of a prospective standardized clinical evaluation and the absence of genetic testing. HPP was diagnosed in 22 unrelated adults (median age 49 years; 68% women). Most patients (68%) were symptomatic at presentation with features including musculoskeletal pain (41%) or incident fracture (18%). A history of fracture was present in 54%: hip/femoral neck (23%), feet (23%, all women), wrist (18%), and spine (9%, all men). Nine patients (36%) had multiple fractures while 4 (all women) had subtrochanteric femur fractures. Radiographic chondrocalcinosis (27%) and documented pyrophosphate arthropathy (14%) were only observed in women. Median minimum serum AP was 43% below the lower normal limit. Urine PEA was elevated in 15/16 patients (94%). PLP median was 68 μg/L (normal, 5-50 μg/L) and all (n=8) were above normal. Symptomatic subjects had more fractures and chondrocalcinosis, lower median minimum AP and PLP and higher median PEA levels. Clinical features more common in fracture patients included symptoms at presentation, history of childhood rickets, dental abnormalities, lower median minimum AP and PLP, and higher median urine PEA. Four subjects had iliac crest bone biopsies, with 2/4 specimens consistent with osteomalacia. These results suggest that adult HPP demonstrates a wide spectrum of clinical manifestations including musculoskeletal pain, fractures, chondrocalcinosis and dental anomalies with some overlap in laboratory characteristics in relationship to disease severity. In addition to genetic and environmental factors, gender may influence the clinical expression of HPP.


Support for external validity of radiological anatomy tests using volumetric images.
Radiology practice has become increasingly based on volumetric images (VIs), but tests in medical education still mainly involve two-dimensional (2D) images. We created a novel, digital, VI test and hypothesized that scores on this test would better reflect radiological anatomy skills than scores on a traditional 2D image test. To evaluate external validity we correlated VI and 2D image test scores with anatomy cadaver-based test scores. In 2012, 246 medical students completed one of two comparable versions (A and B) of a digital radiology test, each containing 20 2D image and 20 VI questions. Thirty-three of these participants also took a human cadaver anatomy test. Mean scores and reliabilities of the 2D image and VI subtests were compared and correlated with human cadaver anatomy test scores. Participants received a questionnaire about perceived representativeness and difficulty of the radiology test. Human cadaver test scores were not correlated with 2D image scores, but significantly correlated with VI scores (r = 0.44, P < .05). Cronbach's α reliability was 0.49 (A) and 0.65 (B) for the 2D image subtests and 0.65 (A) and 0.71 (B) for VI subtests. Mean VI scores (74.4%, standard deviation 2.9) were significantly lower than 2D image scores (83.8%, standard deviation 2.4) in version A (P < .001). VI questions were considered more representative of clinical practice and education than 2D image questions and less difficult (both P < .001). VI tests show higher reliability, a significant correlation with human cadaver test scores, and are considered more representative for clinical practice than tests with 2D images.


Growing-rod Graduates With Idiopathic Early-onset Scoliosis Have Comparable Exercise Tolerance to Patients With Surgically Treated Adolescent Idiopathic Scoliosis.
Growing-rod (GR) treatment is the current standard for progressive idiopathic early-onset scoliosis (I-EOS) in young children. Despite good radiographic outcomes, the impact of scoliosis treatment on pulmonary functions is not well-defined in this patient population. The aim of this study was to evaluate pulmonary functions and exercise tolerance in I-EOS patients graduated from GR treatment and to compare them with age-matched, surgically treated adolescent idiopathic scoliosis (AIS) patients and healthy controls. Eight GR graduates with I-EOS with pulmonary function tests and complete radiographic results were compared with a group of 9 thoracic AIS patients at least 2 years out from posterior fusion. Both groups were also compared with a set of 10 healthy individuals. All subjects underwent cardiopulmonary exercise testing and spirometry to evaluate pulmonary function. Age, sex, height, arm span, weight, residual deformity, and level of instrumentation in GR and AIS patients were similar. In the GR group, forced vital capacity % and forced expiratory volume in 1 second % values were reduced compared with the healthy controls and AIS group (P<0.001, <0.001 and 0.036, 0.046, respectively). Breathing reserve index at lactate threshold (BRILT) was higher in GR and AIS patients (P=0.001 and 0.002, respectively), and was similar between GR and AIS patients (P=0.916). Heart rate at lactate threshold was higher in GR and AIS groups compared with controls (P<0.001 and 0.001, respectively). AIS and GR patients demonstrated reduced pulmonary reserve and exercise tolerance compared with their peers with no spinal deformity. However, exercise tolerance of I-EOS patients treated with the GR method was similar to that of operated AIS patients. These results suggest a positive impact of GR treatment in children with I-EOS. Level III-cross-sectional comparative study.


How do red-eyed treefrog embryos sense motion in predator attacks? Assessing the role of vestibular mechanoreception.
The widespread ability to alter timing of hatching in response to environmental cues can serve as a defense against threats to eggs. Arboreal embryos of red-eyed treefrogs, Agalychnis callidryas, can hatch up to 30% prematurely to escape predation. This escape-hatching response is cued by physical disturbance of eggs during attacks, including vibrations or motion, and thus depends critically on mechanosensory ability. Predator-induced hatching appears later in development than flooding-induced, hypoxia-cued hatching; thus, its onset is not constrained by the development of hatching ability. It may, instead, reflect the development of mechanosensor function. We hypothesize that vestibular mechanoreception mediates escape-hatching in snake attacks, and that the developmental period when hatching-competent embryos fail to flee from snakes reflects a sensory constraint. We assessed the ontogenetic congruence of escape-hatching responses and an indicator of vestibular function, the vestibulo-ocular reflex (VOR), in three ways. First, we measured VOR in two developmental series of embryos 3-7 days old to compare with the published ontogeny of escape success in attacks. Second, during the period of greatest variation in VOR and escape success, we compared hatching responses and VOR across sibships. Finally, in developmental series, we compared the response of individual embryos to a simulated attack cue with their VOR. The onset of VOR and hatching responses were largely concurrent at all three scales. Moreover, latency to hatch in simulated attacks decreased with increasing VOR. These results are consistent with a key role of the vestibular system in the escape-hatching response of A. callidryas embryos to attacks.


Blood pressure maintenance in hypertensive sympathectomized rats. I. Adrenal medullary catecholamines.
To assess the role of the sympathetic nervous system in the development of genetic hypertension, blood pressure (BP) was recorded in conscious adult Lyon hypertensive (LH) and normotensive (LN) rats that had received daily injections of saline or guanethidine at 1-13 wk of age. Guanethidine abolished the pressor response to tyramine, decreased plasma norepinephrine by greater than 70% and plasma 3,4-dihydroxyphenylglycol by approximately 90%, and did not change plasma epinephrine. Bilateral adrenalectomy further reduced plasma norepinephrine to 8 and 5% of control levels in LH and LN rats, respectively. BP was lowered (-7%) in sympathectomized rats, but the mean absolute BP difference between LH and LN rats was unaltered. Despite marked supersensitivity to alpha-adrenoreceptor stimulation, phentolamine induced only a small transient depressor response, which was abolished by adrenalectomy in sympathectomized rats. It is concluded that the sympathetic nervous system is not necessary for the development of hypertension in LH rats. After sympathectomy, circulating catecholamines, which mostly derive from the adrenal medulla, play only a minor role in BP maintenance.


Amino acid requirements of Streptococcus mutans and other oral streptococci.
The amino acid requirements of Streptococcus mutans strains AHT, OMZ-61, FA-1, BHT, GS-5, JC-2, Ingbritt, At6T, OMZ-176, 6715, Streptococcus salivarius HHT, Streptococcus sanguis OMZ-9, and strain 72x46 were determined in a chemically defined medium. When grown anaerobically in the presence of sodium carbonate (or bicarbonate for a few strains), few amino acids were required. All strains tested required cystine (or cystine) as a nutrient. Three strains (S. mutans OMZ-176, FA-1, and BHT) required glutamate (and/or glutamine). A third amino acid (lysine for S. mutans FA-1 and histidine for S. mutans OMZ-176) was required by two of the three strains which required glutamate. The amino acids mentioned above were required for all conditions of incubation (and inoculum) tested. The requirements for several other amino acids were conditional, that is, dependent on the incubation conditions and inoculum used. For example, when carbonate was not added, glutamate was required by S. mutans GS-5. Aerobic incubations, with carbonate or bicarbonate added, resluted in requirements for glutamate and leucine by several strains. With these incubation conditions, one strain required isoleucine (S. mutans FA-1), another valine (S. mutans AHT), and a third tyrosine (72x46). Aerobic incubations in the absence of carbonate or bicarbonate further increased the number of amino acids required by several strains. Furthermore, when stationary-phase cultures replaced exponentially growing cultures as an inoculum, several strains required additional amino acids, presumably for the initiation of growth.


Analysis of progression of cervical OPLL using computerized tomography: typical sign of maturation of OPLL mass.
OBJECT The progression of cervical ossification of the posterior longitudinal ligament (OPLL) can lead to increase in the size of the OPLL mass and aggravation of neurological symptoms. In the present study, the authors aimed to analyze the progression of cervical OPLL by using CT imaging, elucidate the morphology of OPLL masses, and evaluate the factors associated with the progression of cervical OPLL. METHODS Sixty patients with cervical OPLL were included. All underwent an initial CT examination and had at least 24 months' follow-up with CT. The mean duration of follow-up was 29.6 months. Fourteen patients (Group A) had CT evidence of OPLL progression, and 46 (Group B) did not show evidence of progression on CT. The 2 groups were compared with respect to the following variables: sex, age, number of involved segments, type of OPLL, and treatment methods. The CT findings, such as the connection of an OPLL mass with the vertebral body and formation of trabeculation in the mass, were evaluated. RESULTS Sex and treatment modality were not associated with OPLL progression. The mean age of the patients in Group A was significantly lower than that in Group B (p = 0.03). The mean number of involved segments was 5.3 in Group A and 3.6 in Group B (p = 0.002). Group A had a higher proportion of cases with the mixed type of OPLL, whereas Group B had a higher proportion of cases with the segmental type (p = 0.02). A connection between the vertebral body and OPLL mass and trabeculation formation were more common in Group B (p < 0.01). CONCLUSIONS Progression of cervical OPLL is associated with younger age, involvement of multiple levels, and mixed-type morphology. OPLL masses that are contiguous with the vertebral body and have trabecular formation are useful findings for identifying masses that are less likely to progress.


Human respiratory tract model for radiological protection: a revision of the ICRP Dosimetric Model for the Respiratory System.
In 1984, the International Commission on Radiological Protection (ICRP) appointed a task group of Committee 2 to review and revise, as necessary, the ICRP Dosimetric Model for the Respiratory System. The model was originally published in 1966, modified slightly in Publication No. 19, and again in Publication No. 30 (in 1979). The task group concluded that research during the past 20 y suggested certain deficiencies in the ICRP Dosimetric Model for the Respiratory System. Research has also provided sufficient information for a revision of the model. The task group's approach has been to review, in depth, morphology and physiology of the respiratory tract; deposition of inhaled particles in the respiratory tract; clearance of deposited materials; and the nature and specific sites of damage to the respiratory tract caused by inhaled radioactive substances. This review has led to a redefinition of the regions of the respiratory tract for dosimetric purposes. The redefinition has a morphologic and physiological basis and is consistent with observed deposition and clearance of particles and with resultant pathology. Regions, as revised, are the extrathoracic (E-T) region, comprising the nasal and oral regions, the pharynx, larynx, and upper part of the trachea; the fast-clearing thoracic region (T[f]), comprising the remainder of the trachea and bronchi; and the slow-clearing thoracic region (T[s]), comprising the bronchioles, alveoli, and thoracic lymph nodes. A task group report will include models for calculating radiation doses to these regions of the respiratory tract following inhalation of representative alpha-, beta-, and gamma-emitting particulate and gaseous radionuclides. The models may be implemented as a package of computer codes available to a wide range of users. This should facilitate application of the revised human respiratory tract model to worldwide radiation protection needs.


Multivocal Didaktik Modelling in Early Childhood Education-For a Sustainable Future in a World of Change.
In times of democratic decline, unanimous choices and approaches and the idea of a singular best practice may be less conducive to democracy and sustainability. Therefore, the aim of this study is to suggest a multivocal approach to education and teaching by studying the question of what may characterise teaching in preschool for a sustainable future. The knowledge contribution and originality of the article is evident in the introduction, method, and results. In abductive analyses, models can summarize what we need to know and teach in pursuit of the creation of open life chances for every child. The results show that didaktik models are open and can provide support for teachers and leaders to consider and base informed decisions on, as well as to motivate their didaktik choices based on scientific foundations and proven experiences. Multivocal didaktik mo-delling intends to open up teaching-cultivating collaboration in preschool for a sustainable future in a world of change. In conclusion, we recommend cultivating an orientation (1) between knowledges, values and didaktik/education/special education in the pursuit of the creation of conditions for good education for all children; (2) between teaching realities and scientific foundations, which are founded in a critical-reflective didaktik, with a choice of direction in relation to an uncertain future; and (3) between continuity, progression and teaching adventures-which can include consolidating, deepening, broadening, raising, and cultivating knowledge and values for multivocality, democracy and sustainability in teaching realities. In the future the concept of multivocal didaktik modelling can be studied in relation to complex teaching realities as in a teaching universe or a teaching multiverse.


Single mechanosensory neurons encode lateral displacements using precise spike timing and thresholds.
During locomotion, animals rely on multiple sensory modalities to maintain stability. External cues may guide behaviour, but they must be interpreted in the context of the animal's own body movements. Mechanosensory cues that can resolve dynamic internal and environmental conditions, like those from vertebrate vestibular systems or other proprioceptors, are essential for guided movement. How do afferent proprioceptor neurons transform movement into a neural code? In flies, modified hindwings known as halteres detect forces produced by body rotations and are essential for flight. However, the mechanisms by which haltere neurons transform forces resulting from three-dimensional body rotations into patterns of neural spikes are unknown. We use intracellular electrodes to record from haltere primary afferent neurons during a range of haltere motions. We find that spike timing activity of individual neurons changes with displacement and propose a mechanism by which single neurons can encode three-dimensional haltere movements during flight.


[Critical comments on the calculation of receptor analyses (author's transl)].
The main literature concerning the processing of binding data is reviewed. Practical conclusions for the measurement of association constants and binding site concentrations are considered from the standpoint of basic binding theory in connection with basic information theory. The theoretical minimum errors in the association constant and the binding site concentration are discussed as a function of the saturation fraction of the most dilute component. Various plotting forms and the error arising from various rearrangements of the basic binding equation are discussed. For fitting procedure several heuristic models are mentioned and it is recommended to start from the most general Adair function. The necessity of well defined criteria for quality of fit in computer programming for iterative curve fitting procedures is emphasized. The most frequent, however avoidable, errors are mentioned.