Haemangioma of the maxilla.
Haemangioma involving the paranasal air sinuses is rare. It presents with severe epistaxis or bleeding due to dental extraction and may mimic malignancy. A case of haemangioma of the maxilla is presented and the diagnostic and operative difficulties together with a review of literature are discussed. Bucy and Capp (1930) described primary haemangioma of bone with special reference to X-ray diagnosis. Wyke (1949) was of the opinion that haemangiomas accounted for only 10 per cent of primary benign neoplasms of skull bones. Batsakis (1979) commented that haemangioma of bone accounted for seven per cent of all osseous neoplasms and that from a review of literature he had found no more than 40 such cases. Dahlin (1967) in a review of 3,947 cases of bone tumours, found 47 cases of osseous haemangioma out of which only three involved the upper jaw. Smith (1959) reported that only 10 cases of haemangioma of the maxilla had been published by 1959 and further isolated cases have been described by Sawhney et al. (1973), Pandhi et al. (1977) and Ahad and Chisti (1977).


Synovial chondromatosis of the distal radioulnar joint.
Synovial chondromatosis is a rare lesion in the wrist and it is extremely uncommon in the distal radioulnar joint. This case presented with wrist pain, swelling and locking secondary to synovial chondromatosis of distal radioulnar joint.


Characterization of antigen recognized by the monoclonal antibody (4F2): different molecular forms on human T and B lymphoblastoid cell lines.
The monoclonal antibody 4F2 recognizes a disulfide-linked ricin-binding glycoprotein complex (Mr congruent to 125,000) composed of a sialylated heavy subunit (Mr congruent to 85,000 on T cell lines) and an unsialylated light subunit (Mr congruent to 41,000). The antigen (T85,41) recognized by 4F2 on T cell lines is structurally distinct from the antigen (B93, 41) on B cell lines. The heavy subunits, but not the light subunits, from all T cell lines examined were uniformly smaller in size than the heavy subunits from several B cell lines. This reflects differences in carbohydrate rather than protein represent in B93,41 compared with T85,41, because both heavy subunits have a common unglycosylated form (p65) and a common partially glycosylated precursor form (p68). Among non-T, non-B hematopoietic cell lines, the monocytoid line U-937 expressed an antigen that resembles B93,41, whereas the erythroleukemic line K-562 expressed an antigen more similar to T85,41. 4F2 recognizes a protein determinant on the heavy subunit (with or without N-linked glycosylation) and also the unglycosylated heavy subunit retains the ability to associate with light subunit. The light subunit itself contains no detectable N-linked carbohydrate. Unlike the transferrin receptor, synthesis of the antigen recognized by 4F2 on the promyelocytic cell line HL-60 did not diminish upon dimethylsulfoxide-induced differentiation, and thus is not tightly correlated with cell proliferation.


Influence of patients' age at implantation on mortality and defibrillator shocks.
Patients have increasing comorbidities and competing causes of death with advancing age, raising questions about the effectiveness of the implantable cardioverter defibrillators (ICD) in older age. We therefore investigated the effect of patients' age at initial device implantation on all-cause mortality and on the risk of ICD shocks in single-chamber (V-ICD), dual-chamber (D-ICD), and cardiac resynchronization therapy defibrillator (CRT-D) recipients. We reviewed de-identified records of 67 128 ICD recipients enrolled in the Boston Scientific ALTITUDE database of remote monitored patients [V-ICD (n = 11 422), D-ICD (n = 23 974), and CRT-D (n = 31 732)]. Over a mean follow-up of 2.3 ± 1.4 years, patients in all ICD groups had increased all-cause mortality but decreased risk of defibrillator shocks and/or anti-tachycardia pacing per 10 year increase in age. Compared with the youngest age group (<50 years), patients in the oldest age group (≥80 years) had a 6.8-fold, 5.9-fold, and 3.4-fold increase in all-cause mortality (P < 0.001 for all comparisons) and a 31, 45, and 53% decrease in the risk of ICD shock (P ≤ 0.002 for all comparisons) for the V-ICD, D-ICD, and CRT-D groups, respectively. Older recipients of standard and CRT defibrillators have higher mortality but fewer ICD shocks and/or therapies compared with younger patients. These data highly suggest less benefit of ICD therapy with increasing age, presumably because of competing risks of non-arrhythmic mortality. The role of defibrillator therapy in older patients may need to be evaluated with randomized controlled trials.


Quantum corrections to fidelity decay in chaotic systems.
By considering correlations between classical orbits we derive semiclassical expressions for the decay of the quantum fidelity amplitude for classically chaotic quantum systems, as well as for its squared modulus, the fidelity or Loschmidt echo. Our semiclassical results for the fidelity amplitude agree with random matrix theory (RMT) and supersymmetry predictions in the universal Fermi-golden rule regime. The calculated quantum corrections can be viewed as arising from a static random perturbation acting on nearly self-retracing interfering paths, and hence will be suppressed for time-varying perturbations. Moreover, using trajectory-based methods we show a relation, recently obtained in RMT, between the fidelity amplitude and the cross-form factor for parametric level correlations. Beyond RMT, we compute Ehrenfest-time effects on the fidelity amplitude. Furthermore our semiclassical approach allows for a unified treatment of the fidelity, both in the Fermi-golden rule and Lyapunov regimes, demonstrating that quantum corrections are suppressed in the latter.


[Value of Two Dimensional Echocardiography for Assessment of Disease Severity in Patients With Pulmonary Hypertension].
To carry out complex assessment of the right ventricular (RV) function with two-dimensional echocardiography (2D-EchoCG) for detection of most informative markers of the disease severity in patients with pulmonary hypertension (PH). We examined 63 patients with PH (38 with idiopathic PH, 7 with corrected congenital heart defects, 6 with systemic scleroderma, 12 with chronic inoperable thromboembolic PY). Examination included right heart catheterization, 2D-EchoCG, and cardiac magnetic resonance tomography (MRT). 2D-EchoCG revealed dilation of right chambers of the heart, hypertrophy of RV anterior wall, increase of ratio of right to left ventricular end-diastolic dimensions (RV:LV), reduction of LV stroke volume, diminution of amplitude and velocity of tricuspid annular plane systolic excursion, and significant increase of myocardial performance index Tei. MRT data evidenced for lowering of RV ejection fraction. Canonical correlation was found between integral characteristic of 2D-EchoCG and integral hemodynamic characteristic (r=0.77; p=0.007). We also determined threshold values of RV: LV to be used for stratification of risk in patients with PH. In patienns with PH calculation of simple 2D-EchoCG parameters provides information important for determination of disease severity, selection of optimal method of treatment, and monitoring of patients condition.


The efficacy of paracetamol versus tenoxicam on postoperative pain and morphine consumption after abdominal hysterectomy: a placebo-controlled, randomized study.
The purpose of this study was to determine the analgesic efficacy and side-effects of paracetamol and tenoxicam in comparison with placebo in patients with postoperative pain after elective abdominal hysterectomy. A total of 120 patients were randomly divided into three groups to receive either paracetamol 1 g, tenoxicam 20 mg or placebo intravenously at the end of surgery, and then morphine was administered by a patient-controlled analgesia device postoperatively. Tenoxicam was associated with lower pain scores at the 2nd, 4th, 6th and 24th hour postoperatively. Total morphine consumption was 44.8 +/- 17.4 mg, 64.6 +/- 19.6 mg, 69.2 +/- 22.1 (tenoxicam, paracetamol and placebo group, respectively) and there was a significant difference in the tenoxicam group compared with the other two groups (p < 0.05). Side-effects except for nausea were similar. A single dose of 20 mg tenoxicam provided effective analgesia and reduced total morphine consumption in comparison with paracetamol and placebo after abdominal hysterectomy.


A young man with recurrent paralysis.
Hypokalemia can cause reactions from mild muscular cramping to life-threatening paralysis and cardiac dysrhythmias. This article describes a patient whose unusual, recurrent muscular symptoms and electrolyte abnormalities were eventually identified as Gitelman syndrome, a rare genetic disorder resulting in severe refractory hypokalemia.


Linking adiponectin expression and kidney dysfunction among Indian patients with and without diabetic nephropathy.
Diabetic kidney disease is a common cause of end stage renal disease has a high incidence rate in population with type 2 diabetes mellitus patients. Adiponectin is an adipocytokine shown to strive anti-diabetic, anti-oxidative as well as anti-inflammatory. The present study aimed to determine the serum adiponectin levels in type 2 diabetes mellitus and explore its association with nephropathy. This cross sectional study recruited 90 type 2 diabetes mellitus patients with (n = 60) and without nephropathy (n = 30). Additionally 30 age, gender, and body mass index matched healthy controls were included. Enzyme linked immunosorbent assay method were used to determine adiponectin concentration. Blood sugars, glycated hemoglobin, body mass index all sounded to be brawny risk factors for nephropathy and microalbumin, e GFR showed a significant association with kidney disease progression in type 2 diabetes mellitus with nephropathy. Both the groups of type 2 diabetes mellitus patients had elevated adiponectin concentrations than controls. Serum adiponectin concentrations were significantly higher in type 2 diabetes mellitus without nephropathy and there was a significant association with nephropathy activity (P<0.0001**). The receiver operating characteristics curve analysis was used to examine the diagnostic performance of adiponectin for nephropathy shown a significant area under the curve 0.998 with sensitivity 100% and specificity 93.33% (P<0.0001**). Hence our study findings concluded that serum adiponectin concentrations considered for the early predictable and prognostic marker for nephropathy.


[The new penicillins].
During recent years, new antibacterial beta-lactams have been identified. The association of beta-lactams and beta-lactamase inhibitors (clavulanic acid or sulbactam) represent a new therapeutic approach. The other drugs are classified into ureodopenicillins (mezlocillin, azlocillin, piperacillin), amidinopenicillins (mecillinam, pivmecillinam), monobactam (aztreonam) and penems (imipenem). Three mechanisms are involved in the bacterial resistance to these beta-lactams: inability to cross the bacterial membrane, inactivation of the antibiotic by a beta-lactamase, modification of the number of porines. The tolerance to these new products is good but they present a high risk for selection of resistant bacteria. These antibiotics markedly improve the treatment of beta-lactamase producing bacterial infections, particularly related to Pseudomonas aeruginosa.


pH-controlled reversible assembly of peptide-functionalized gold nanoparticles.
The assembly/disassembly process of carboxylated peptide-functionalized gold nanoparticles (peptide-GNPs) was studied within the pH interval of 2.5 to 10. The assembly process was not well controlled at pH 2.5, leading to the formation of 3D structures of GNPs, whereas at pH 4 we observed controlled assembly with the formation of only a network of 1D chains. In the pH range of 2.5 to 4, the assembly proceeded with the formation of a combination of two extremes (i.e., having both 1D and 2D nanostructures). The assembly process was reversed on changing the pH of the medium to 10. The assembly/disassembly process was monitored using UV-vis spectroscopy and finally confirmed by TEM analysis. This assembly resulted from the intermolecular H-bonding between two carboxylic acid groups of peptides bound to the two adjacent GNPs and were confirmed by FTIR spectroscopy.


Recurrent stroke and patent foramen ovale: a systematic review and meta-analysis.
Recurrent cerebrovascular events are frequent in medically treated patients with patent foramen ovale (PFO), but it still remains unclear whether PFO is a causal or an incidental finding. Further uncertainty exists on whether the size of functional shunting could represent a potential risk factor. The aim of the present study was to evaluate if the presence of PFO is associated with an increased risk of recurrent stroke or transient ischemic attack and to investigate further if this relationship is related to the shunt size. We conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of all available prospective studies reporting recurrent cerebrovascular events defined as cryptogenic stroke and transient ischemic attacks in medically treated patients with PFO diagnosed by echocardiography or transcranial sonography. We identified 14 eligible studies including a total of 4251 patients. Patients with stroke with PFO did not have a higher risk of the combined outcome of recurrent stroke/transient ischemic attack (risk ratio=1.18; 95% confidence interval=0.78-1.79; P=0.43) or in the incidence of recurrent strokes (risk ratio =0.85; 95% confidence interval=0.59-1.22; P=0.37) in comparison with stroke patients without PFO. In addition, PFO size was not associated with the risk of recurrent stroke or transient ischemic attack. We also documented no evidence of heterogeneity across the included studies. Our findings indicate that medically treated patients with PFO do not have a higher risk for recurrent cryptogenic cerebrovascular events, compared with those without PFO. No relation between the degree of PFO and the risk of future cerebrovascular events was identified.


Altered circadian rhythms regulate growth vigour in hybrids and allopolyploids.
Segregating hybrids and stable allopolyploids display morphological vigour, and Arabidopsis allotetraploids are larger than the parents Arabidopsis thaliana and Arabidopsis arenosa-the mechanisms for this are unknown. Circadian clocks mediate metabolic pathways and increase fitness in animals and plants. Here we report that epigenetic modifications of the circadian clock genes CIRCADIAN CLOCK ASSOCIATED 1 (CCA1) and LATE ELONGATED HYPOCOTYL (LHY) and their reciprocal regulators TIMING OF CAB EXPRESSION 1 (TOC1) and GIGANTEA (GI) mediate expression changes in downstream genes and pathways. During the day, epigenetic repression of CCA1 and LHY induced the expression of TOC1, GI and downstream genes containing evening elements in chlorophyll and starch metabolic pathways in allotetraploids and F(1) hybrids, which produced more chlorophyll and starch than the parents in the same environment. Mutations in cca1 and cca1 lhy and the daily repression of cca1 by RNA interference (RNAi) in TOC1::cca1(RNAi) transgenic plants increased the expression of downstream genes and increased chlorophyll and starch content, whereas constitutively expressing CCA1 or ectopically expressing TOC1::CCA1 had the opposite effect. The causal effects of CCA1 on output traits suggest that hybrids and allopolyploids gain advantages from the control of circadian-mediated physiological and metabolic pathways, leading to growth vigour and increased biomass.


New-onset psychiatric disorders in individuals with autism.
A follow-up study to at least the age of 21 years of 135 individuals with an autism spectrum disorder diagnosed in childhood and an IQ of over 30 was conducted. The study is distinctive in its large size, low attrition rate and use of systematic interviews to obtain clinical information. Questionnaires completed by caregivers asked about the development of new psychiatric disorders. For the 39 individuals with a possible new disorder, a detailed psychiatric assessment was undertaken through parental interview. Of all participants, 16 percent developed a definite new psychiatric disorder. A further 6 percent developed a possible new disorder. Five individuals developed an obsessive-compulsive disorder and/or catatonia; eight an affective disorder with marked obsessional features; three complex affective disorders; four more straightforward affective disorders; one a bipolar disorder; and one an acute anxiety state complicated by alcohol excess. There was no case of schizophrenia.


Mechanisms of TGF-beta action in connective tissue repair of rat mesenteric wounds.
We have recently reported that transforming growth factor-beta stimulates genuine connective tissue repair in the perforated rat mesentery and that this stimulation is not caused by increased macrophage chemotaxis. To further characterize the effect of transforming growth factor-beta(1) on the enhanced rate of wound closure, we performed a series of morphometric analyses with determination of mitotic index, fibroblast labeling index, cellular density, neovascularization, and scar tissue formation. Actin expression close to the wound margin was also evaluated morphologically. Fibroblast cell proliferation was not stimulated by transforming growth factor-beta(1) in either wounded or unwounded tissue. Transforming growth factor-beta(1) did, however, significantly increase the formation of healing tissue postoperative days 5 to 10 (p < 0.05) and angiogenesis was significantly stimulated by transforming growth factor-beta(1) postoperative days 7 and 10 (p < 0.005). The mean cellular density was significantly increased in unperforated, transforming growth factor-beta(1)-treated membranes from days 3 to 10, and increased expression of actin with time was observed close to the wound margin. Transforming growth factor-beta(1) was thus shown to be a potent stimulator of angiogenesis and healing tissue formation in connective tissue repair, but this stimulation mainly occurred after closure of perforations. The increased cellular density in the absence of stimulated proliferation and increased actin expression in wound cells indicate that contraction may be an important mechanism of connective tissue repair in the perforated rat mesentery.


Quantum mechanical model for the anticarcinogenic effect of extremely-low-frequency electromagnetic fields on early chemical hepatocarcinogenesis.
Using the conventional Haberkorn approach, it is evaluated the recombination of the radical pair (RP) singlet spin state to study theoretically the cytoprotective effect of an extremely-low-frequency electromagnetic field (ELF-EMF) on early stages of hepatic cancer chemically induced in rats. The proposal is that ELF-EMF modulates the interconversion rate of singlet and triplet spin states of the RP populations modifying the products from the metabolization of carcinogens. Previously, we found that the daily treatment with ELF-EMF 120 Hz inhibited the number and area of preneoplastic lesions in chemical carcinogenesis. The singlet spin population is evaluated diagonalizing the spin density matrix through the Lanczos method in a radical pair mechanism (RPM). Using four values of the interchange energy, we have studied the variations over the singlet population. The low magnetic field effect as a test of the influence over the enzymatic chemical reaction is evaluated calculating the quantum yield. Through a bootstrap technique the range is found for the singlet decay rate for the process. Applying the quantum measurements concept, we addressed the impact toward hepatic cells. The result contributes to improving our understanding of the chemical carcinogenesis process affected by charged particles that damage the DNA.


Carbamazepine in the treatment of aggression: a case report and a review of the literature.
Aggressive behaviour is an inescapable clinical problem confronting practitioners of medicine, neurology and psychiatry. Several drugs have been used to treat it, with limited success. Successful use of carbamazepine in the treatment of aggressive behaviour in a patient with limbic dysfunction is reported, and varieties of aggressive behaviour that respond to carbamazepine are examined. The authors suggest that carbamazepine may have a specific anti-aggressive effect perhaps due to an anti-kindling effect, but caution that double-blind studies are needed before firm conclusions are drawn.


Inhibitory effect of short-term bile duct ligation on hepatic cytochrome P450 of bile acid-depleted rats.
In this study we analyzed the effect resulting from a short-term (1 h) bile duct obstruction in bile acid-depleted or taurocholate-replenished rats on liver cytochrome P450 enzyme system activity. Rats were depleted of endogenous bile acids and then subjected to a biliary obstruction for 1 h. Some of these depleted-obstructed rats were replenished previously to the obstruction with exogenous taurocholic acid (TC) and the others were treated with the solvent alone. To study the isolated effect of the bile acid, other rats were also previously depleted and then replenished with TC but they were obstructed briefly (20 min). CYP3A2-linked activity was evaluated in vivo with the aminopyrine breath test and in vitro by the measurement of nifedipine oxidase microsomal activity. The results suggested that bile flow suppression per se might inhibit this CYP-linked activity and that bile acid retention is not involved at least as a sole determinant.


Regioselective effect of zwitterionic DNA substitutions on DNA alkylation: evidence for a strong side chain orientational preference.
The incorporation of zwitterionic residues (5-substituted omega-aminoalkyl-2'-deoxypyrimidines) into DNA has been reported to bend DNA as measured by aberrant gel mobility [Strauss et al. (1996) Proc. Natl. Acad. Sci. U.S.A. 93, 9515-9520]. Herein we report that DNA methylation by N-methyl-N-nitrosourea at N7-guanine is regioselectively inhibited by point substitutions of the zwitterionic residues 5-(6-aminohexyl)-2'-deoxycytidine, 5-(6-aminohexyl)-2'-deoxyuridine, or 5-(3-aminopropyl)-2'-deoxyuridine. No inhibition is observed for DNA methylation by dimethyl sulfate. On the basis of inhibition patterns for methylation with the different zwitterionic substitutions and the different length tethers, the omega-aminoalkyl side chains prefer to adopt a conformation that points them toward the 3'-base. Molecular modeling grid searches, coupled with energy minimizations, and simulated annealing molecular dynamics studies indicate that unfavorable steric interactions with the 5'-base and backbone, as well as stabilizing electrostatic interactions with electronegative atoms on the 3'-side, are responsible for the observed conformational preference. No evidence for association of the cationic side chain with the phosphate backbone is observed. The observed bending of DNA induced by the tethered ammonium ions may simply arise from their localization in the major groove.


Detection of Circulating Tumor Cells by Fluorescence Microspheres-Mediated Amplification.
Here we describe a fluorescent microspheres-based separation and analysis that enables the isolation of circulating tumor cells (CTCs) from whole blood of patients with metastatic cancer and the identification of isolated CTCs in situ without immunostaining. This approach uses antibody-functionalized fluorescent polystyrene (PS) microspheres that can selectively bind to CTCs. The binding of CTCs and fluorescent PS microspheres leads to the formation of complexes of CTCs and fluorescent PS microspheres, thereby the CTCs are size-amplified and labeled simultaneously. A pyramidal microcavity array (PMCA) is fabricated using microfabrication technology to create a precise microfilter structure with a high aspect ratio. The PMCA filter device can effectively isolate microspheres-labeled CTCs, while allow hematologic cells to deform and pass through. Using this approach, CTCs are isolated and identified in 15 of 18 patients with metastatic colorectal cancer. This approach will open new possibilities for CTCs isolation and identification and can serve a versatile platform to facilitate CTCs analysis in diverse biomedical applications.


[Effect of laser irradiation of diode laser on healing of surgical wounds in rats].
The aim of this work was to continue in previous study, which concerns biostimulation of skin wound healing evaluated after 24, 48, 120, 168 hours and so complete the chronological continuance of the process during the first seven days. Male, Sprague-Dawley rats (n=21) were used for the experiment. The rats were divided into 3 groups of 7 animals. In general anaesthesia (combination of xylazine, ketamine and tramadol) under aseptic condition two 3,5 cm long parallel skin incisions were performed on the left and right side of the rats spine and immediately sutured. The left wounds were daily stimulated with the diode laser (670 nm). The right wounds were not stimulated and served as control. The specimens of skin wounds were removed for histological evaluation 72, 96 and 144 hours after surgery. The biological specimens were stained with hematoxylin and eosin and histopathologically evaluated. In summary, in our histomorphological study of the influence of laser irradiation on primary wound healing evaluated after 72, 96 and 144 hours was concluded, that the healing of stimulated wounds was accelerated in comparison with controls. The histological evaluation showed earlier regress of inflammatory phase, faster finishing of reepithelization and acceleration in maturation phase. Presented experimental study completes the previous study and achieves the positive effect of biostimulation on all phases of skin wound healing in vivo.


Advances in non-pharmacological management of Parkinson's disease complicated with blood pressure abnormalities.
Parkinson's disease (PD) often presents with autonomic dysregulation, leading to blood pressure irregularities such as neurogenic orthostatic hypotension (nOH), neurogenic supine hypertension (nSH), and postprandial hypotension (PPH). Unfortunately, these conditions remain prevalent and receive insufficient attention in scientific discourse. They not only cause complications like syncope, falls, and fractures but also result in long-term damage to vital organs, diminishing patients' quality of life. Early implementation of appropriate non-pharmacologic management is crucial to prevent severe adverse events later on. This review focuses on the types, clinical characteristics, mechanisms, and common non-pharmacologic management measures for PD complicated by abnormal blood pressure. By promoting early diagnosis, recognizing symptoms of abnormal blood pressure, and employing non-pharmacologic interventions such as health education, dietary adjustments, exercise, and Chinese medicine techniques, we aim to improve patients' symptoms and quality of life while providing practical guidance for managing PD-related blood pressure abnormalities.


Surgical Treatment of Granulomatous Breast Deformities Caused by Injection of Foreign Substances in Transgender Women: A Case Series and Algorithm.
Despite potentially devastating complications, free foreign substance injections for feminizing breast augmentation remain common among transgender women. To date, the literature regarding surgical treatment of these deformities among transgender women remains limited. The authors present a case series of transgender women presenting for surgical management of granulomatous breast deformities secondary to free foreign substance injections between January of 2016 and February of 2020. Seven transgender women presented for surgical management of complications secondary to free foreign substance injections of the breast. These patients ranged in age from 29 to 53 years, all identified as Hispanic/Latinx, and five were primarily Spanish speakers. All were recipients of public insurance. Six of the seven patients received free foreign substance injections outside of the United States, with an average time from initial injections to presentation of 19.3 ± 15.7 years. Three patients presented with a history of prior revisions by other surgeons. Four underwent staged reconstruction at the authors' institutions. Patients were followed for, on average, 10.7 ± 12.6 months after their initial surgery. There were no major complications. The most common minor complication was delayed wound healing. In the present series, the authors illustrate that, with careful consideration and patient selection, it is possible to perform safe and successful breast reconstruction for the management of foreign substance granulomas in transgender women. They also provide an algorithm based on patient-specific factors to guide treatment decisions in this patient population. Further research is needed to determine the generalizability and applicability of this algorithm. Therapeutic, IV.


Increased incidence of isoproterenol-induced ventricular fibrillation in aging rats.
Prolonged beta-adrenergic stimulation obtained by subcutaneous injection of isoproterenol in unanesthetized, unrestrained rats elicited ventricular fibrillation in approximately 80% of animals at 10-12 months of age. Ventricular fibrillation failed to occur in 1-month-old rats and involved only 12% of rats at 2 months. Senescence appeared not to increase the frequency of ventricular fibrillation since a similar incidence was seen in rats at 10-12 and 19-21 months. In all instances, ventricular fibrillation was preceded by ECG changes consistent with acute subendocardial ischemia. To evaluate whether acute beta-adrenergic stimulation elicits comparable cardiovascular effects in animals of different age, a dose-response curve to intravenous injection of isoproterenol was performed in anesthetized rats. Changes in heart rate, systemic arterial pressure, left ventricular pressure, and dP/dt were not different among animal groups. It was concluded that the arrhythmogenic potential of isoproterenol may not be related to differences in cardiac beta-receptor sensitivity with age as suggested by the comparable changes in the inotropic and chronotropic actions of isoproterenol in the animal groups studied.


[Prevalence and association of porcine circovirus type 2 (PCV2), porcine parvovirus (PPV) and porcine reproductive and respiratory syndrome virus (PRRSV) in aborted fetuses, mummified fetuses, stillborn and nonviable neonatal piglets].
Porcine circovirus type 2 (PCV2) seems to cause reproductive failure in sows not only in experimental studies. A retrospective study was made with a total of 252 aborted fetuses, mummified fetuses, stillborn and nonviable neonatal piglets to determine the presence of PCV2, porcine parvovirus (PPV) and porcine respiratory and reproductive syndrome virus (PRRSV) by PCR. PCV2 was found in all stages of gestation in 27.1 percent of samples examined. A statistically significant association could be shown between the detection of PCV2 and PRRSV. However, no significant association was seen between the detection of PCV2 and PPV and between PPV and PRRSV.


Multiple imputation for early stopping of a complex clinical trial.
It is desirable to have procedures available for stopping a clinical trial early if there appears to be no treatment effect. Conditional power procedures allow for early stopping in favor of the null hypothesis if the probability of rejecting H0 at the planned end of the trial given the current data and a value of the parameter of interest is below some threshold level. Lan, Simon, and Halperin (1982, Communications in Statistics C1, 207-219) proposed a stochastic curtailment procedure that calculates the conditional power under the alternative hypothesis. Alternatively, predictive power procedures incorporate information from the observed data by averaging the conditional power over the posterior distribution of the parameter. For complex problems in which explicit evaluation of conditional power is not possible, we propose treating the problem of projecting the outcome of a trial given the current data as a missing data problem. We then complete the data using multiple imputation and thus eliminate the need for explicit calculation of conditional power. We apply this method to AIDS Clinical Trials Group (ACTG) protocol 118 and to several simulated clinical trials.


Moose milk and hair element levels and relationships.
Milk was collected from 21 Alaskan moose (Alces alces gigas) at the Kenai Moose Research Center (MRC), Soldotna, Alaska nad analyzed by atomic absorption spectroscopy for Al, As, Ca, Cd, Co, Cr, Cu, Fe, Hg, K, Mg, Mn, Mo, Na, Ni, Pb, Se and Zn. Hair samples were collected from 100 moose at the MRC to correspond with the lactation period and serve as a metabolic indicator of mineral elements stored in tissue. Published analyses of bovine milk were compared to moose milk; Al, Fe, Se and Zn were higher in moose milk by factors of 1.6 to 290. Elements potentially influenced by nutrition and those determined genetically were also considered. Elements in moose milk and hair values were compared, since mineral element levels in hair potentially reflect the availability and intake of these elements. Calcium and Mg were the only values in hair lower than the values in milk (factors of 4.2 and 1.5 respectively). Moose, as well as domestic cattle, apparently are subjected to lactation stress by the genetically determined levels of Ca and Mg in milk.


Chemical Precipitation Method for the Synthesis of Nb2O5 Modified Bulk Nickel Catalysts with High Specific Surface Area.
We demonstrate a method for the synthesis of NixNb1-xO catalysts with sponge-like and fold-like nanostructures. By varying the Nb:Ni ratio, a series of NixNb1-xO nanoparticles with different atomic compositions (x = 0.03, 0.08, 0.15, and 0.20) have been prepared by chemical precipitation. These NixNb1-xO catalysts are characterized by X-ray diffraction, X-ray photoelectron spectroscopy, and scanning electron microscopy. The study revealed the sponge-like and fold-like appearance of Ni0.97Nb0.03O and Ni0.92Nb0.08O on the NiO surface, and the larger surface area of these NixNb1-xO catalysts, compared with the bulk NiO. Maximum surface area of 173 m2/g can be obtained for Ni0.92Nb0.08O catalysts. In addition, the catalytic hydroconversion of lignin-derived compounds using the synthesized Ni0.92Nb0.08O catalysts have been investigated.


Composition of nasal secretion in patients with cystic fibrosis.
Quantitative examination of nasal secretion in patients with cystic fibrosis revealed a significantly greater than normal concentration of calcium, a finding in keeping with the hypothesized importance of this ion in the pathophysiology of the disease.


Identification of the novel therapeutic targets and biomarkers associated of prostate cancer with cancer-associated fibroblasts (CAFs).
Globally, prostate cancer remains a leading cause of mortality and morbidity despite advances in treatment. Research on prostate cancer has primarily focused on the malignant epithelium, but the tumor microenvironment has recently been recognized as an important factor in the progression of prostate cancer. Cancer-associated fibroblasts (CAFs) play an important role in prostate cancer progression among multiple cell types in the tumor microenvironment. In order to develop new treatments and identify predictive and prognostic biomarkers for CAFs, further research is needed to understand the mechanism of action of prostate cancer and CAF. In this work, we performed the single-cell RNA sequence analysis to obtain the biomarkers for CAFs, and ten genes were finally regarded as the marker genes for CAFs. Based on the ssGSEA algorithm, the prostate cancer cohort was divided into low- and high-CAFs groups. Further analysis revealed that the CAFs-score is associated with many immune-related cells and immune-related pathways. In addition, between the low- and high-CAFs tissues, a total of 127 hub genes were discovered, which is specific in CAFs. After constructing the prognostic prediction model, SLPI, VSIG2, CENPF, SLC7A1, SMC4, and ITPR2 were finally regarded as the key genes in the prognosis of patients with prostate cancer. Each patient was assigned with the risk score as follows: SLPI* 0.000584811158157081 + VSIG2 * -0.01190627068889 + CENPF * -0.317826812875334 + SLC7A1 * -0.0410213995358753 + SMC4 * 0.202544454923637 + ITPR2 * -0.0824652047622673 + TOP2A * 0.140312081524807 + OR51E2 * -0.00136602095885459. The GSVA revealed the biological features of CAFs, many cancer-related pathways, such as the adipocytokine signaling pathway, ERBB signaling pathway, GnRH signaling pathway, insulin signaling pathway, mTOR signaling pathway and PPAR signaling pathway are closely associated with CAFs. As a result of these observations, similar transcriptomics may be involved in the transition from normal fibroblasts to CAFs in adjacent tissues. As one of the biomarkers for CAFs, CENPF can promote the proliferation ability of prostate cancer cells. The overexpress of CENPF could promote the proliferation ability of prostate cancer cells. In conclusion, we discuss the potential prognostic and therapeutic value of CAF-dependent pathways in prostate cancer.


[Cover flaps for loss of substance on the heel. Apropos of 8 cases].
The anatomical and function characteristics of the heel region explain the large number of methods used and the differences of opinion particularly in relation to the repair of weightbearing zones. Our study is based on 28 patients in whom we performed: ten regional flaps, six cross-leg flaps, sixteen microsurgical flaps. The temporal fascia free flap provides good results on the posterior surface with minimal sequelae at the donor site. The medial plantar flap appears to be the most suitable flap for weight-bearing zones. Cross-lep flaps allow satisfactory repair of the weightbearing zone, but the scarred appearance of the donor site is inaesthetic and immobilisation is uncomfortable. The problem of large defects is still not resolved and no really satisfactory method is available among the various distant, skin, myocutaneous, pure muscle or cross-leg flaps. The solution may reside in a combination of two flaps allowing better adaptation to the morphology of the heel. The importance of heel sensation, particularly in the weight-bearing zone, led to the concept of the use of sensitive or resensitised flaps. After a review of the literature and our results, we did not find any correlation between the sensitivity obtained and the success of the reconstruction. It therefore seems useless to perform microscopic nerve sutures in order to resensitise distant heel flaps. The patient's cooperation is essential in every case to compensate for the decreased sensitivity by means of increased visual surveillance and the wearing of suitable shoes.


Validation of a screening test of auditory function using the telephone.
Several European countries have demonstrated successful use of telephone screening tests for auditory function. The screening test consists of spoken three-digit sequences presented in a noise background. The speech-to-noise ratios of the stimuli are determined by an adaptive tracking method that converges on the level required to achieve 50% correct recognition. A version of the three-digit telephone screening protocol for the United States was developed: the US National Hearing Test (NHT). The objective of the current study was to determine the sensitivity and specificity as well as the feasibility of the NHT for use within the Department of Veterans Affairs (VA). Research Design and Study Sample: Using a multisite study design with convenience sampling, we used the NHT to collect data from 693 participants (1379 ears) from three geographical areas of the United States (Florida, Tennessee, and California). The NHT procedures were as follows: the participants (1) called a toll-free telephone number, (2) entered their assigned ear-specific identification code, (3) listened to 40-sets of digit triplets presented in speech-spectrum background noise, and (4) entered in the numbers that they heard on the telephone key pad. The NHT was performed on each ear, either at home or in a VA clinic. In addition to collecting data from the experimental task, we gathered demographic data and the data from other standard-of-care tests (i.e., audiometric thresholds and speech recognition tests in quiet and in noise). A total of 505 participants completed the NHT at a VA clinic, whereas 188 completed the test at home. Although the ear-specific NHT and mean pure-tone threshold all correlated significantly (p < 0.001), there were more modest correlations in the low- and high-frequency ranges with the highest correlation seen with the 2000 Hz mean pure-tone threshold. When the NHT 50% point or threshold was compared with the three-frequency PTA at 500, 1000, and 2000 Hz, the sensitivity was 0.87 and specificity was 0.54. When comparing the NHT with the four-frequency PTA at 500, 1000, 2000, and 4000 Hz, the sensitivity was 0.81 and specificity increased to 0.65. The NHT also correlated strongly with other speech-in-noise measures. The NHT was found to correlate with other audiometric measures, including pure-tone thresholds and speech recognition tests in noise, at sufficiently high correlation values to support its use as a screening test of auditory function.


Aberration in DNA methylation in B-cell lymphomas has a complex origin and increases with disease severity.
Despite mounting evidence that epigenetic abnormalities play a key role in cancer biology, their contributions to the malignant phenotype remain poorly understood. Here we studied genome-wide DNA methylation in normal B-cell populations and subtypes of B-cell non-Hodgkin lymphoma: follicular lymphoma and diffuse large B-cell lymphomas. These lymphomas display striking and progressive intra-tumor heterogeneity and also inter-patient heterogeneity in their cytosine methylation patterns. Epigenetic heterogeneity is initiated in normal germinal center B-cells, increases markedly with disease aggressiveness, and is associated with unfavorable clinical outcome. Moreover, patterns of abnormal methylation vary depending upon chromosomal regions, gene density and the status of neighboring genes. DNA methylation abnormalities arise via two distinct processes: i) lymphomagenic transcriptional regulators perturb promoter DNA methylation in a target gene-specific manner, and ii) aberrant epigenetic states tend to spread to neighboring promoters in the absence of CTCF insulator binding sites.


Mechanism of 3-deazaguanine transport in the rat heart.
The aim of this study was to determine the mechanism of transport of 3-deazaguanine in the rat heart. We used single-pass, paired-tracer dilution method on isolated and retrogradely perfused rat hearts. The maximal cellular uptake (Umax) and total cellular uptake (Utot) of 3-deazaguanine were determined under control conditions and under influence of possible modifiers. Both Umax and Utot were significantly reduced in the presence of unlabeled 3-deazaguanine (from 19.57 +/- 2.02% to 8.14 +/- 1.19% and from 16.49 +/- 3.65% to 4.70 +/- 1.96%, n=6, respectively). The presence of pyrimidine nucleoside thymidine caused the reduction of both Umax and Utot (from 20.03 +/- 3.76% to 13.58 +/- 3.16% and from 16.43 +/- 3.58% to 11.94 +/- 3.13%, n=6, respectively). Also, we tested the effect of the absence of sodium ions in perfusion solution (both Umax and Utot, significantly reduced from 17.95 +/- 2.73% to 16.67 +/- 2.16% and from 16.68 +/- 2.97% to 14.81 +/- 3.04%, n=6, respectively) and the effect of dinitrophenol (both Umax and Utot significantly reduced from 19.09 +/- 3.68% to 10.58 +/- 3.14% and from 16.86 +/- 3.84% to 7.10 +/- 3.11%, n=6, respectively). The results of self- and cross-inhibition studies show that the transport of 3-deazaguanine is saturable, energy- and sodium-dependent and that 3-deazaguanine uses endogenous transport systems for thymidine and adenosine for its own transport.


Detection by paper chromatography of imidazoles, including hydantoin-5-propionic acid, in urine after histidine dosage.
Simple paper chromatography of urine obtained in the Figlu test has been found satisfactory for determining excess excretion of the imidazole metabolites of histidine. It has been confirmed that examination for these in addition to formiminoglutamic acid is necessary for a full assessment of this test. When excretion of the latter is not abnormal in folic-acid and/or vitamin B(12) deficiency, that of urocanic acid, a glycine conjugate of urocanic acid and/or imidazole propionic acid, is usually raised. An abnormally high excretion of hydantoin-5-propionic acid after histidine has also been found in these deficiencies, and its estimation may be of additional use in the evaluation of the Figlu test.


Impact of RASSF1A gene methylation on the metastatic axillary nodal status in breast cancer patients.
Hypermethylation of CpG islands is a hallmark of cancer and occurs at an early stage in breast tumorigenesis. To gain insight into the epigenetic switches that may promote and/or contribute to the initial neoplastic events during breast carcinogenesis, the present study focused on the DNA methylation profile of invasive breast carcinoma. The aim of the study was to evaluate the prognostic significance of Ras association domain family 1 isoform A (RASSF1A) promoter methylation status in operable breast cancer, and to analyze the utility of this biomarker regarding its association with metastatic and nonmetastatic axillary nodal status. For this purpose, formalin-fixed, paraffin-embedded tissue specimens from 116 breast cancer patients with known axillary nodal status were subjected to assessment of RASSF1A promoter methylation status by methylation-specific polymerase chain reaction (MSP) and methylation-sensitive high-resolution melting assay, and the results were subsequently validated by bisulfite sequencing. A multinomial logistic regression model was used to model the dependence of distinct levels of methylation status of the RASSF1A promoter on the nodal status. Promoter region CpG hypermethylation was identified by MSP in 97 (83.6%) of 116 primary breast tumors, while hypermethylation of RASSF1A was confirmed by MS-HRM in 107 (92.2%) of 116 cases of breast cancer. Based on the results of the multinomial logistic regression model, there was no significant difference between the frequency of RASSF1A promoter methylation and axillary lymph node status of patients in general. However, upon adjustment of pN stage, an association was identified between pN0 lymph node-negative status (without axillary metastases) and percentage of RASSF1A methylation in two groups of heterogeneous methylated alleles with ≤50% methylated (P<0.05) and >50% methylated alleles (P<0.0001). If a patients' nodal status changes from pN- to pN+ then the risk of having >50% methylated alleles increases by 7%. The present study revealed a specific phenomenon, suggesting that the presence of heterogeneous methylated alleles in the RASSF1A gene is significantly associated with lymph node-negative status in breast cancer patients. Furthermore, greater significance with negative axillary nodal status was observed with a higher level of heterogeneous methylated alleles in the RASSF1A gene.


Audiovisual speech perception in elderly cochlear implant recipients.
This study examined the speech perception skills of a younger and older group of cochlear implant recipients to determine the benefit that auditory and visual information provides for speech understanding. Retrospective review. Pre- and postimplantation speech perception scores from the Consonant-Nucleus-Consonant (CNC), the Hearing In Noise sentence Test (HINT), and the City University of New York (CUNY) tests were analyzed for 34 postlingually deafened adult cochlear implant recipients. Half were elderly (i.e., >65 y old) and other half were middle aged (i.e., 39-53 y old). The CNC and HINT tests were administered using auditory-only presentation; the CUNY test was administered using auditory-only, vision-only, and audiovisual presentation conditions No differences were observed between the two age groups on the CNC and HINT tests. For a subset of individuals tested with the CUNY sentences, we found that the preimplantation speechreading scores of the younger group correlated negatively with auditory-only postimplant performance. Additionally, older individuals demonstrated a greater reliance on the integration of auditory and visual information to understand sentences than did the younger group On average, the auditory-only speech perception performance of older cochlear implant recipients was similar to the performance of younger adults. However, variability in speech perception abilities was observed within and between both age groups. Differences in speechreading skills between the younger and older individuals suggest that visual speech information is processed in a different manner for elderly individuals than it is for younger adult cochlear implant recipients.


Platelets are versatile cells: New discoveries in hemostasis, thrombosis, immune responses, tumor metastasis and beyond.
Platelets are small anucleate blood cells generated from megakaryocytes in the bone marrow and cleared in the reticuloendothelial system. At the site of vascular injury, platelet adhesion, activation and aggregation constitute the first wave of hemostasis. Blood coagulation, which is initiated by the intrinsic or extrinsic coagulation cascades, is the second wave of hemostasis. Activated platelets can also provide negatively-charged surfaces that harbor coagulation factors and markedly potentiate cell-based thrombin generation. Recently, deposition of plasma fibronectin, and likely other plasma proteins, onto the injured vessel wall has been identified as a new "protein wave of hemostasis" that may occur even earlier than the first wave of hemostasis, platelet accumulation. Although no experimental evidence currently exists, it is conceivable that platelets may also contribute to this protein wave of hemostasis by releasing their granule fibronectin and other proteins that may facilitate fibronectin self- and non-self-assembly on the vessel wall. Thus, platelets may contribute to all three waves of hemostasis and are central players in this critical physiological process to prevent bleeding. Low platelet counts in blood caused by enhanced platelet clearance and/or impaired platelet production are usually associated with hemorrhage. Auto- and allo-immune thrombocytopenias such as idiopathic thrombocytopenic purpura and fetal and neonatal alloimmune thrombocytopenia may cause life-threatening bleeding such as intracranial hemorrhage. When triggered under pathological conditions such as rupture of an atherosclerotic plaque, excessive platelet activation and aggregation may result in thrombosis and vessel occlusion. This may lead to myocardial infarction or ischemic stroke, the major causes of mortality and morbidity worldwide. Platelets are also involved in deep vein thrombosis and thromboembolism, another leading cause of mortality. Although fibrinogen has been documented for more than half a century as essential for platelet aggregation, recent studies demonstrated that fibrinogen-independent platelet aggregation occurs in both gene deficient animals and human patients under physiological and pathological conditions (non-anti-coagulated blood). This indicates that other unidentified platelet ligands may play important roles in thrombosis and might be novel antithrombotic targets. In addition to their critical roles in hemostasis and thrombosis, emerging evidence indicates that platelets are versatile cells involved in many other pathophysiological processes such as innate and adaptive immune responses, atherosclerosis, angiogenesis, lymphatic vessel development, liver regeneration and tumor metastasis. This review summarizes the current knowledge of platelet biology, highlights recent advances in the understanding of platelet production and clearance, molecular and cellular events of thrombosis and hemostasis, and introduces the emerging roles of platelets in the immune system, vascular biology and tumorigenesis. The clinical implications of these basic science and translational research findings will also be discussed.


Serological and Bacteriological Surveillance of Glanders Among Horses in Central Region of Iran.
Glanders is the oldest and very contagious disease among horses caused by Burkholderia mallei. The disease occurs as a chronic form in horses. Hence, because of the prolonged shedding, numerous horses can potentially get infected by one horse with glanders. Glanders is endemic in Iran and this causes occasional occurrence in horse population of the country. The aim of this study was to determine the incidence of B.mallei infection in horses in two central provinces of Iran. A total of 517 serum samples were collected from stable horses in Tehran and Alborz provinces. Among the studied horses, seven presented fever, anorexia, dyspnea, subcutaneous abscesses, nasal and cutaneous discharges, emaciation, and lymphadenopathy. Nasal and ocular discharges and subcutaneous abscesses were sampled for bacterial culture and PCR. The sera were examined by means of complement fixation test (CFT) and indirect enzyme-linked immunosorbent assay (iELISA). Seropositive cases were further examined by Mallein test. The results derived from the present study indicated that only 1.35% of the studied horses were positive in CFT, iELISA and Mallein test, of which only in 42.85% B.mallei was successfully cultured on blood agar and glycerinated nutrient media and confirmed by PCR. Periodic serological tests along with quarantine can benefit reduction of the occurrence of the disease in horses in Iran.


The Development of an Accreditation Framework for Continuing Education Activities for Pharmacists.
Accreditation is the recognition that an educational activity meets certain standards. The processes for accreditation vary considerably depending on the type of activity, and currently there are differing accreditation systems in place for pharmacy continuing education (CE) across different countries. Research was carried out on a selection of these systems with the aim of developing a catalogue of accreditation approaches, and exploring the possibility of developing a common framework for the accreditation of pharmacy CE activities. Accreditation processes from the countries represented by the Global Forum on Quality Assurance of Continuing Education and Continuing Professional Development (GFQACE) were reviewed to explore the themes and patterns in them. This informed the development of a proposed accreditation framework for CE activities for pharmacists. A Delphi method over four rounds involving seven participants from each GFQACE organisation was used as a consensus building technique. Agreement was achieved on including 15 items in the framework within four stages (Input, Process, Output, and Quality Improvement). The GFQACE steering group indicated their intention to use the resultant framework as the basis for the exploration of mutual recognition of accreditation between member countries.


Synthesis and Characterization of Fused-Ring Iridapyrroles.
Treatment of aromatic nitriles with methyllithium produces N-lithiated imine reagents which, when reacted with (η(2)-cyclooctene)(Cl)Ir(PMe(3))(3), generate fused iridaazacycles via ortho-metallation. Mono-protonation of these iridaazacycles produces fused iridapyrrole derivatives, while di-protonation leads to several different pathways.


Atmospheric emission characteristics and control policies of five precedent-controlled toxic heavy metals from anthropogenic sources in China.
A bottom-up inventory of atmospheric emissions of five precedent-controlled toxic heavy metals (HMs), including mercury (Hg), arsenic (As), lead (Pb), cadmium (Cd), and chromium (Cr), from primary anthropogenic sources in China is established for the period 2000–2010. Total emissions of HMs demonstrate a gradually ascending trend along with the increase of coal consumption and industrial production, which are estimated at approximately 842.22 t for Hg, 4196.31 t for As, 29272.14 t for Pb, 795.29 t for Cd, and 13715.33 t for Cr for 2010. Coal combustion is found to be the primary source of HMs emissions. Owing to the dramatic differences of coal use by industrial and power sectors among provinces, spatial allocation performs remarkably uneven characteristics, and spatial distribution features are demonstrated by allocating the emissions into 0.5° × 0.5° grid cells with GDP and population as surrogate indexes. Further, HMs emissions from specified anthropogenic sources under three different control scenarios for the target year 2015 are projected, and collaborative and specialized control strategies are proposed to meet the demand of emission reduction goals of different regions. In the future, a whole processes control management system will be the most effective way for control of HMs.


High-level production of recombinant sulfide-reactive hemoglobin I from Lucina pectinata in Escherichia coli. High yields of fully functional holoprotein synthesis in the BLi5 E. coli strain.
Hemoglobin I (HbI) from Lucina pectinata is a monomeric protein composed of 143 amino acids with high sulfide affinity. Its unique heme pocket contains three residues not commonly found in vertebrate globins: Phe 29 (B10), Gln 64 (E7), and Phe 68 (E11), which are thought to be important for high affinity for hydrogen sulfide. Recombinant HbI (rHbI) and several site-directed mutants were cloned and expressed in Escherichia coli yielding high amounts of protein. The highest rHbI protein yield was obtained when the HbI cDNA was cloned into the pET28 (a+) expression vector, transformed into BLi5 cells, the induction performed with 1 mM IPTG at 30 degrees C and TB medium was supplemented with 30 microg/mL hemin chloride and 1% glucose. The highest yield obtained of HbI was 32 mg/L of culture using Fernbach flasks. UV/Visible spectral analysis showed that rHbI binds heme and ESI-MS shows that its molecular weight corresponds to the expected size. Kinetic studies with H2S confirmed that rHbI and HbI have identical binding properties, where the kON for the clam's Hb is 2.73x10(4)M-1s-1 and for rHbI is 2.43x10(4)M-1s-1.


Asymmetric chelated Claisen rearrangements in the presence of chiral ligands--scope and limitations.
Claisen rearrangements of glycine crotyl ester enolates in the presence of chelating metal salts and chiral ligands provide ,-unsaturated amino acids in a highly stereoselective fashion. Best results are obtained with electron withdrawing protecting groups, isopropylates of aluminum and magnesium, and the cinchona alkaloids as chiral ligands. While the use of quinine gives rise to the (2R)-configured amino acids, quinidine provides the opposite enantiomer. The different enantiomers can also be obtained by using only one of the chiral ligands by simply changing the reaction conditions. A mechanistic rational for the stereochemical outcome of the reaction is given, which is supported by several experiments.


Full-Spectral Fine-Tuning Visible Emissions from Cation Hybrid Cs1-mFAmPbX3 (X = Cl, Br, and I, 0 ≤ m ≤ 1) Quantum Dots.
Full-color visible emissions are particularly crucial for applications in displays and lightings. In this work, we developed a facile room-temperature ligand-assisted supersaturated recrystallization synthesis of monodisperse, cubic structure Cs1-mFAmPbX3 (X = Cl, Br, and I or their mixtures Cl/Br and Br/I, 0 ≤ m ≤ 1) hybrid perovskite quantum dots (QDs). Impressively, cation substitution of Cs+ by FA+ was beneficial in finely tuning the band gap and in exciton recombination kinetics, improving the structural stability, and raising the absolute quantum yields up to 85%. With further assistance of anion replacement, full-spectral visible emissions in the wavelength range of 450-750 nm; narrow full width at half-maxima, and a wide color gamut, encompassing 130% of National Television System Committee television color standard, were achieved. Finally, Cs1-mFAmPbX3-polymer films retaining multicolor luminescence are prepared and a prototype white light-emitting diode device was constructed using green Cs0.1FA0.9PbBr3 and red Cs0.1FA0.9Br1.5I1.5 QDs as color converters, certainly suggesting their potential applications in the optoelectronics field.


Risk factors for postpartum depression among sexual minority and heterosexual parents.
Postpartum depression (PPD), a major depressive episode with postpartum onset, develops in 15% of mothers. Although findings suggest sexual minority parents may be at risk for PPD, research among this population is scarce. We evaluated risk factors for PPD in a sample of sexual minority and heterosexual parents. Four hundred and twenty seven heterosexual and one hundred and eleven sexual minority parents responded to a questionnaire distributed via social media that included demographics, the Edinburgh Postnatal Depression Scale, and the Multidimensional Scale of Perceived Social Support. Sexual minority identity was not associated with increased risk for PPD. Pregnancy had no significant effect on the likelihood for PPD. Social support was negatively and significantly associated with probability for PPD. Our data suggest that sexual minority parents are not at increased risk for PPD, contrary to previous findings. The parental role, a psychosocial factor, is a more dominant risk factor than pregnancy itself, in the development of PPD.


Epidemiology and prevention of renal disease.
More than 40,000 new patients begin treatment for end-stage renal disease in the United States each year. The most frequent causes are diabetes and hypertension. The incidence rates for blacks and Native Americans are six- to sevenfold in excess of those for whites. Studies are seeking to determine the roles of atherosclerotic vascular disease, renal ischemia, and the amount of renal mass on the rate of progressive renal disease. Other studies seek to identify the factors that predict the development of nephropathy in patients with diabetes mellitus. Treatment of hypertension slows the rate of progressive renal disease by 40% to 50%. Meta-analysis of several European studies suggests that dietary protein restriction appears to delay the onset of end-stage renal disease.


Circle of healing: traditional storytelling, part one.
The session began with three presenters - LouAnn Benson, Walter Porter, and Lisa Dolchok - all of whom are or have been affiliated with the Circle of Healing Program at Southcentral Foundation in Anchorage, Alaska. The Southcentral Foundation is a Native Health Corporation that administers what used to be the Indian Health Service Hospital and Medical Center. In the Circle of Healing Program, the Southcentral Foundation has designed and implemented an approach to health care that allows its patients simultaneously to access Western medicine, traditional Native healing, and other alternative approaches to health care, such as acupuncture. An important figure in this effort is Dr. Robert Morgan, a psychologist who has worked with the program for several years, and who helped suggest presenters for this part of the program. Originally, Bob planned to be present in Quebec City, but family priorities meant a change in plans. Bob's absence had a silver lining, however, because in his stead he sent LouAnn Benson, one of his able colleagues, who talked about the program from the perspective of an insider.


Developing Quality and Efficiency of Institutional Review Board Review Under a Human Research Protection Program at a Leading Hospital in Central Southern China: A Descriptive Analysis of the First Three Years.
This study analyzes the Institutional Review Board (IRB) quality and efficiency at a leading hospital in Central Southern China, under the first three years of a Human Research Protection Program (HRPP). We conducted a descriptive, retrospective analysis from 2015 through 2017. We extracted characteristics from the protocol archive in duplicate. Of 396 protocols submitted, 98% were approved. Mean protocol review time decreased from 23 to 15 calendar days, 344 serious adverse events SAEs were reviewed, and 93 conflicts of interest (COIs) were disclosed. IRB quality and efficiency mechanisms improved. Remaining needs include increased monitoring of COIs and unanticipated problem involving risks to subjects or others, distinctions between research types, and cooperation with specialized committees.


Comparative biochemical and morphometric studies on corneal wound healing.
Comparative biochemical and morphological studies were carried out on wounded corneas in order to correlate biochemical findings with morphometric observations during the healing process. Experimental production of corneal wounds, biochemical determinations and quantitative morphometric studies are described in an attempt to correlate corneal matrix macromolecules biosynthesis during the healing process with the morphological modifications of the tissue. The central part and the peripheral part of the corneas were examined separately and compared to the central and peripheral parts of the controlateral corneas. The DNA content of the central portion of the wounded corneas progressively increased and reached after 60 days the same level as the corresponding portion of the controlateral corneas. The DNA contents of the peripheral portions of wounded and controlateral corneas are persistently higher than the DNA contents in the central portion. In peripheral portions of wounded corneas the DNA content is higher than in controlateral corneas and continues to increase steadily during the 60 days of experimentation. Cell density, as determined by morphometry, increased also during that period. The differences between the evolution of the DNA contents and cell density curves may be attributed to variations in cell sizes. The collagen content, estimated from hydroxyproline determinations remained lower in the wounded corneas as compared to the controlateral corneas, even 60 days after operation. This was true for the central as well as for the peripheral portions, suggesting a collagenolytic process as a result of wounding. This is confirmed by morphometric evaluation of fiber density.(ABSTRACT TRUNCATED AT 250 WORDS)


Isolation, identification and pathogenicity of Vibrio harveyi, the causal agent of skin ulcer disease in juvenile hybrid groupers Epinephelus fuscoguttatus × Epinephelus lanceolatus.
The hybrid grouper, Epinephelus fuscoguttatus (♀) × Epinephelus lanceolatus (♂), is a newly bred cultivated marine fish species of high economic value. However, a skin ulcer disease with high mortality has occurred, and the responsible pathogen remains unknown. In this study, we summarized the epidemic status and external signs of this disease. We screened potential pathogens and finally isolated one bacterial strain ML01 from affected fish. We subjected healthy juvenile hybrid groupers to bacterial challenge tests with the isolate by immersion, immersion after dermal abrasion and intraperitoneal injection, respectively. Within 14 days post-infection, the isolate ML01 caused mass mortality of juveniles infected via immersion after dermal abrasion or intraperitoneal injection. Diseased juveniles displayed obvious signs of skin ulcers. The median lethal dose of ML01 by intraperitoneal injection was 1.10 × 105 colony-forming units. ML01 was identified as Vibrio harveyi by bacterial morphology, analytical profile index identification, 16S rDNA sequencing and multilocus sequence analysis. Antibiotic susceptibility tests showed that ML01 was sensitive to ceftriaxone, doxycycline and minocycline. The results of this study suggest that V. harveyi is the causal agent of skin ulcer disease in juvenile hybrid groupers, thus providing a basis for effective control and prevention of this disease.


The effects of the natural antioxidant quercetin and anions of the Hofmeister series on liposomes marked with chlorophyll a.
The unilamellar liposomes of dimyristoylphosphatidylcholine (DMPC), marked with chlorophyll a (Chla), have been chosen as suitable models in studies aimed at determining the effects of natural antioxidant quercetin (QCT) and Hofmeister series anions on lipid bilayers. The variations of steady state fluorescence emission intensity of Chla have been recorded and the values of Chla fluorescence anisotropy, under constant temperature and viscosity, at pH = 7.3-7.4 have been measured. Two types of experiments have been performed. In the first type of experiment, the concentration of anions was maintained constant and the concentration of QCT was varied (from 0 to 100 micromol/l). In the second type of experiment, the concentration of QCT was constant (30 micromol/l) and the concentration of anions was varied (from 0 to 152 mmol/l). The quenching of Chla fluorescence by QCT pleads in favor of QCT insertion at interface water-lipid, in the vicinity of the polar heads of lipids from liposomal bilayer at physiological pH and temperature. Fluorescence anisotropy of Chla in liposomes brought more evidences for QCT localizations at lipid/water interface. Chla is sensing a more rigid microenvironment when QCT is added to the lipid bilayer and specific effects of the Hofmeister series anions.


Treatment of excessive daytime sleepiness in patients with Parkinson's disease with modafinil.
Excessive daytime sleepiness (EDS) may limit the symptomatic treatment of Parkinson's disease and can alter the patient's lifestyle significantly. Ten consecutive patients with Parkinson's disease on various dopaminergic drugs and EDS were recruited to a 4-week open-label trial of modafinil. Patients were evaluated using the Epworth Sleepiness Scale and Unified Parkinson's Disease Rating Scale part III. All but three patients, with previous history of intolerability of a dopamine agonist caused by EDS, remained on their baseline medications. Modafinil was titrated as needed to a maximum of 400 mg/day. The mean Epworth Sleepiness Scale score at baseline of patients completing the study (n = 9) was 14.22 (+/- 3.03). After completing the study on an average dose of 172 mg/day, the Epworth Sleepiness Scale score was 6.0 (+/- 4.87). Unified Parkinson's Disease Rating Scale scores were not affected by this medication. Side effects encountered were headache, generalized paresthesias, and hallucinations (n = 1 each, the patient developing hallucinations dropped out of the trial before completing 4 weeks of the study drug). The three patients who did not tolerate any increments of dopamine agonist before modafinil were able to tolerate further upward titration of the dopamine agonist. Modafinil may be effective in reducing EDS in patients with Parkinson's disease treated with dopaminergic drugs. It does not seem to worsen parkinsonian symptoms and may allow further increase in dopaminergic therapy in patients previously unable to tolerate this because of EDS.


Pesticide exposure on southwestern Taiwanese with MnSOD and NQO1 polymorphisms is associated with increased risk of Parkinson's disease.
Hypothetic mechanism of the individual vulnerability to oxidative stress through metabolism of environmental xenobiotics and genotypic polymorphisms has been considered to promote the development of Parkinson's disease (PD). In this case-control study, we determined the role of manganese-containing superoxide dismutase (MnSOD) and NAD(P)H: quinone oxidoreductase 1 (NQO1) genes in PD risk in a population with high prevalence of pesticide exposure. From southwestern region of Taiwan, we enrolled 153 patients with idiopathic PD and 155 healthy control subjects matched for age, sex and origin. Detailed questionnaires of face-to-face interviews among these subjects were collected. PCR-based restriction fragment length polymorphism (RFLP) assays were used to determine the genotypes of MnSOD (-9 T>C) and NQO1 (609 C>T) genes. Exposure to pesticides associated with PD was significant among patients with an increased odds ratio (OR) of 1.69 (95%CI, 1.07-2.65), and this association remained significant after adjustment for age, sex, and cigarette smoking (aOR=1.68, 95%CI, 1.03-2.76, P=0.023). Considering genetic factors, there were no significant differences in frequencies of both genotypes of MnSOD and NQO1 polymorphisms between PD patients and the control subjects (P>0.05). However, this difference in genotype distribution was significant among subjects who had been exposed to pesticide, with aOR of 2.49 (95%CI, 1.18-5.26, P=0.0072) for MnSOD C allele and aOR of 2.42 (95%CI, 1.16-4.76, P=0.0089) for NQO1 T allele, respectively. Moreover, among subjects exposed to pesticide, the combined MnSOD/NQO1 variant genotype was significantly associated with a 4.09-fold increased risk of PD (95%CI, 1.34-10.64, P=0.0052). Susceptible variants of MnSOD and NQO1 genes may interact with occupational pesticide exposure to increase PD risk in southwestern Taiwanese.


Cellular Interactions of Liposomes and PISA Nanoparticles during Human Blood Flow in a Microvascular Network.
A key concept in nanomedicine is encapsulating therapeutic or diagnostic agents inside nanoparticles to prolong blood circulation time and to enhance interactions with targeted cells. During circulation and depending on the selected application (e.g., cancer drug delivery or immune modulators), nanoparticles are required to possess low or high interactions with cells in human blood and blood vessels to minimize side effects or maximize delivery efficiency. However, analysis of cellular interactions in blood vessels is challenging and is not yet realized due to the diverse components of human blood and hemodynamic flow in blood vessels. Here, the first comprehensive method to analyze cellular interactions of both synthetic and commercially available nanoparticles under human blood flow conditions in a microvascular network is developed. Importantly, this method allows to unravel the complex interplay of size, charge, and type of nanoparticles on their cellular associations under the dynamic flow of human blood. This method offers a unique platform to study complex interactions of any type of nanoparticles in human blood flow conditions and serves as a useful guideline for the rational design of liposomes and polymer nanoparticles for diverse applications in nanomedicine.


Differentiating Mouse Embryonic Stem Cells into Embryoid Bodies in AggreWell Plates.
Embryonic stem (ES) cells can develop into many types of differentiated tissues if they are placed into a differentiating environment. This can occur in vivo when the ES cells are injected into or aggregated with an embryo, or in vitro if their culture conditions are modified to induce differentiation. Many times ES cell differentiation proceeds through an intermediate stage called the embryoid body (EB). EBs are round structures composed of ES cells that have undergone some of the initial stages of differentiation. EBs can then be manipulated further to generate more specific cell types. The method described here makes use of commercially available AggreWell 400 plates with prefabricated indentations that cradle each EB. Although these plates are relatively expensive, they may be suitable for some high-throughput experiments. This protocol describes the preparation of embryoid bodies of defined size and shape in a large-scale format (approximately 1200 embryoid bodies per preparation).


Slow oscillations during sleep coordinate interregional communication in cortical networks.
Large-amplitude sleep slow oscillations group faster neuronal oscillations and are of functional relevance for memory performance. However, relatively little is known about the impact of slow oscillations on functionally coupled networks. Here, we provide a comprehensive view on how human slow oscillatory dynamics influence various measures of brain processing. We demonstrate that slow oscillations coordinate interregional cortical communication, as assessed by phase synchrony in the sleep spindle frequency range and cross-frequency coupling between spindle and beta activity. Furthermore, we show that the organizing role of slow oscillations is restricted to circumscribed topographical areas. These findings add importantly to our basic understanding of the orchestrating role of slow oscillations. In addition, they are of considerable relevance for accounts of sleep-dependent memory reprocessing and consolidation.


The Role of Magnetic Resonance Imaging in the Pre-operative Evaluation of Women Diagnosed With Atypical Endometrial Hyperplasia.
To evaluate the role of MRI in patients with atypical endometrial hyperplasia (AEH) and incorporate MRI findings in predictive models estimating the risk of co-existent endometrial cancer (EC). Data from 189 women diagnosed with AEH and had MRI scan prior to operation, over nine years, were retrospectively collected. Histology showed EC in 51 (27%) cases. Presence of myometrial invasion on MRI was more commonly detected in patients with EC compared to those with benign pathology (37.3% versus 10.9%, p<0.001). The sensitivity and specificity of MRI in identifying cancer were 37% and 89%, respectively. Age, menopausal status and presence of invasion on MRI were the best predictors for the presence of malignancy. Myometrial invasion on MRI is associated with increased risk of EC in women with AEH. Its accuracy in detecting malignancy improves when combined with clinical parameters. This could be of value for conservative-management candidates.


The effects of magnesium sulphate-pretreatment on suxamethonium-induced complications during induction of general endotracheal anaesthesia.
To determine the effects of Magnesium-Sulphate-pretreatment on Suxamethonium-induced complications (serum potassium rise, fasciculations and apnea). Eighty-four adult patients were selected and randomly allocated into two study groups during induction of general endotracheal anaesthesia. Endotracheal intubation was facilitated with suxamethonium in group A, while in group B magnesium sulphate pretreatment and suxamethonium. Blood sample for serum potassium estimation was taken before induction and at 5 min after induction. Degree of fasciculations and duration of apnea were assessed clinically. Anaesthetic technique and monitoring of patient was standardized. This study showed statistically significant increase in serum potassium of Group A patients {average 0.34 mmol/L} from baseline value p value 0.00. Magnesium sulphate pretreatment significantly reduced suxamethonium-induced hyperkalaemia by an average of 0.3 mmol/L (p-value 0.01). The severity of fasciculations was also significantly reduced (p-value 0.00). There was no significant effect of magnesium pretreatment on duration of apnea during endotracheal intubation (p-value 0.41). Fourteen point six percent (14.6%) of patients that received magnesium pretreatment complained of feeling of heat or warmth but there was no life threatening dysrrhythmias observed in any of the eighteen patients that had continuous ECG monitoring. The study shows that magnesium sulphate pretreatment has significantly reduced suxamethonium-induced hyperkalaemia and severity of fasciculations during induction of general endotracheal anaesthesia, however there was no significant effect on the duration of apnea. The average of 0.034 mmol/L in Group B was not significant {p value 0.06}. We advocate the use of magnesium pretreatment in all patients at risk of these complications.


Isolation and Structural Characterization of Er@ C2 v(9)-C82 and Er@ C s(6)-C82: Regioselective Dimerization of a Pristine Endohedral Metallofullerene Induced by Cage Symmetry.
Two Er@C82 isomers have been isolated and unambiguously characterized as Er@ C2 v(9)-C82 and Er@ C s(6)-C82, respectively, by single-crystal X-ray diffraction. Er@ C s(6)-C82 is identified as a dimeric structure in the crystalline state, but dimerization does not occur for Er@ C2 v(9)-C82 under identical crystallization conditions, indicating a cage-symmetry-induced dimerization process. Density functional theory calculations reveal that the major unpaired spin resides on a special C atom of Er@ C s(6)-C82, which leads to regioselective dimerization. Calculations also found that the dimeric structure of Er@ C s(6)-C82·Ni(OEP) is much more stable than the two monomers, suggesting a thermodynamically favorable dimerization process. Vis-near-IR spectrometric and electrochemical results demonstrate that the electronic structure of Er@C82 isomers is Er3+@C823-, instead of the theoretically proposed Er2+@C822-.


TextNetTopics Pro, a topic model-based text classification for short text by integration of semantic and document-topic distribution information.
With the exponential growth in the daily publication of scientific articles, automatic classification and categorization can assist in assigning articles to a predefined category. Article titles are concise descriptions of the articles' content with valuable information that can be useful in document classification and categorization. However, shortness, data sparseness, limited word occurrences, and the inadequate contextual information of scientific document titles hinder the direct application of conventional text mining and machine learning algorithms on these short texts, making their classification a challenging task. This study firstly explores the performance of our earlier study, TextNetTopics on the short text. Secondly, here we propose an advanced version called TextNetTopics Pro, which is a novel short-text classification framework that utilizes a promising combination of lexical features organized in topics of words and topic distribution extracted by a topic model to alleviate the data-sparseness problem when classifying short texts. We evaluate our proposed approach using nine state-of-the-art short-text topic models on two publicly available datasets of scientific article titles as short-text documents. The first dataset is related to the Biomedical field, and the other one is related to Computer Science publications. Additionally, we comparatively evaluate the predictive performance of the models generated with and without using the abstracts. Finally, we demonstrate the robustness and effectiveness of the proposed approach in handling the imbalanced data, particularly in the classification of Drug-Induced Liver Injury articles as part of the CAMDA challenge. Taking advantage of the semantic information detected by topic models proved to be a reliable way to improve the overall performance of ML classifiers.


New sphingolipids from marine sponge Iotrochota baculifera.
Chemical examination of the marine sponge Iotrochota baculifera of the Indian Ocean furnished a sphingolipid (1), a new glycosphingolipid (iotroridoside-B, 2) and a four-component mixture of sphingolipids (3a-d) with two new components. Structure elucidation was carried out by spectral and chemical methods.


Understanding of statistical terms routinely used in meta-analyses: an international survey among researchers.
Biomedical literature is increasingly enriched with literature reviews and meta-analyses. We sought to assess the understanding of statistical terms routinely used in such studies, among researchers. An online survey posing 4 clinically-oriented multiple-choice questions was conducted in an international sample of randomly selected corresponding authors of articles indexed by PubMed. A total of 315 unique complete forms were analyzed (participation rate 39.4%), mostly from Europe (48%), North America (31%), and Asia/Pacific (17%). Only 10.5% of the participants answered correctly all 4 "interpretation" questions while 9.2% answered all questions incorrectly. Regarding each question, 51.1%, 71.4%, and 40.6% of the participants correctly interpreted statistical significance of a given odds ratio, risk ratio, and weighted mean difference with 95% confidence intervals respectively, while 43.5% correctly replied that no statistical model can adjust for clinical heterogeneity. Clinicians had more correct answers than non-clinicians (mean score ± standard deviation: 2.27±1.06 versus 1.83±1.14, p<0.001); among clinicians, there was a trend towards a higher score in medical specialists (2.37±1.07 versus 2.04±1.04, p = 0.06) and a lower score in clinical laboratory specialists (1.7±0.95 versus 2.3±1.06, p = 0.08). No association was observed between the respondents' region or questionnaire completion time and participants' score. A considerable proportion of researchers, randomly selected from a diverse international sample of biomedical scientists, misinterpreted statistical terms commonly reported in meta-analyses. Authors could be prompted to explicitly interpret their findings to prevent misunderstandings and readers are encouraged to keep up with basic biostatistics.


The Gluten-Free Frenzy: Fad or Fitting?
Although the gluten-free diet has been recognized as therapeutic for individuals suffering from celiac disease, it has been promoted recently for other indications, such as autism, chronic fatigue syn- drome, and irritable bowel syndrome, or simply as a healthy dietary choice for anyone. The basics of the gluten-free diet are explored, with evidence-based indications and nursing implications when patients choose gluten-free.


Phase diagram and glass transition of confined benzene.
We used differential scanning calorimetry, neutron scattering, and proton NMR to investigate the phase behavior, the structure, and the dynamics of benzene confined in a series of cylindrical mesoporous materials MCM-41 and SBA-15 with pore diameters, d, between 2.4 and 14 nm. With this multitechnique approach, it was possible to determine the structure and, for the first time to our knowledge, the density of confined benzene as a function of temperature and pore size. Under standard cooling rates, benzene partially crystallizes in SBA-15 matrixes (4.7 <or= d <or= 14 nm) but not in MCM-41 (2.4 <or= d <or= 3.5 nm). Structure factors of the confined phases were recorded at different temperatures and compare to those of the bulk. The confined liquid has the same structure as the bulk above the bulk melting point. In SBA-15, the confined crystals are defective and have the same structure as the bulk. In MCM-41, the liquid undergoes a glass transition at low temperature regardless of the cooling rate or the thermal history of the sample. The density as a function of temperature was measured by neutron scattering contrast matching, and the glass transition temperatures were determined from the density versus temperature curves. The pore size dependence of T(g) does not show any evidence of finite size effects. A temperature versus pore diameter phase diagram of confined benzene is proposed combining liquid, supercooled liquid, crystal states, and glassy states. NMR relaxation time measurements showed that the dynamics of the confined liquids are slower than those of the bulk above its melting point. In the partially crystallized samples, the liquid and the crystal have the same relaxation times. The activation energies of reorientation motions in the confined phases, determined from spin lattice relaxation times, are smaller than the bulk ones.


Factors associated with the recruitment and retention of social workers in Wales: employer and employee perspectives.
Despite acute staffing shortages in social work, workforce planning within the UK social care sector is compromised by poor workforce intelligence. This study aimed to inform the evidence base providing new data on recruitment and retention in Wales, examining what personal and organizational characteristics are associated with intentions to leave, and what initiatives or incentives might mediate that effect. A multi-method design facilitated comparisons between two data sources--a census of all 22 Welsh local authority employers about recruitment and retention practices and a survey of all social workers and senior practitioners employed in social services (n = 998; response rate 45.9%) about demography, workforce characteristics, working patterns, morale and plans and reasons for leaving one's job. Vacancy (mean 14.4%) and turnover (mean 15%) rates were statistically significantly higher in children's services than in adult services; vacancy rates were also higher in authorities that offered higher starting salaries. The provision of certain types of traineeship might also be associated with higher vacancy rates but these results should be treated with some caution. There was little evidence that recruitment and retention initiatives were associated with lower vacancy or turnover rates, despite employers' perceptions about their effectiveness. Social workers derived a lot of satisfaction from their work, but more than a quarter wanted to leave their job within 6 months, and almost as many were actively seeking alternative employment. Intention to leave was explained by job and employer satisfaction, and negative feelings about pay. Senior practitioners and staff members with longer lengths of service were less likely to want to leave, even if they were dissatisfied with their job or employer. Job and employer dissatisfaction was associated with retention initiatives related to facilities, good caseload management and home-working, suggesting that dissatisfied staff might remain in employment for longer if these initiatives were in place.


Chimaeribacter arupi a new member of the Yersineacea family has the characteristics of a human pathogen.
Chimaeribacter arupi (heterotypic synonym: "Nissabacter archeti") is a facultative anaerobic, newly described Gram-negative rod and belongs to the Yersineacea family. Here, we report the case of a 19-month-old female infant patient who presented to the emergency unit with somnolence and fever. C. arupi was isolated from a positive blood culture, taken via an implanted Broviac catheter, proving a bloodstream infection by the pathogen. The objective of this study was to utilize whole genome sequencing to assess the genes encoding potential virulence associated factors, which may play a role in host tropism, tissue invasion and the subsequent stages in the pathogenesis of a bloodstream infection with C. arupi. The genome of the isolate was completely sequenced employing Illumina MiSeq and Nanopore MinION sequencing and the presumptive virulence associated factors and antimicrobial resistance genes were investigated in more detail. Additionally, we performed metabolic profiling and susceptibility testing by microdilution. The presence of predicted TcfC-like α-Pili suggests that C. arupi is highly adapted to humans as a host. It utilizes flagellar and type IV pili-mediated motility, as well as a number of γ1-pili and a σ-pilus, which may be used to facilitate biofilm formation and adherence to host epithelia. Additionally, long polar fimbriae may aid in tissue invasion. The bacterium possesses antioxidant factors, which may enable temporary survival in phagolysosomes, and a capsule that potentially provides protection from phagocytosis. It may acquire iron ions from erythrocytes through the type 6 secretion system and hemolysins. Furthermore, the isolate exhibits beta-lactamase-mediated penicillin and aminopenicillin resistance. Based on the analysis of the whole genome, we conclude that C. arupi possesses virulence factors associated with tissue invasion and may thus be a potential opportunistic pathogen of bloodstream infections.


[Combination chemotherapy (modified CHOP-Bleo) in non-Hodgkin's lymphoma].
Twenty-six adults with advanced non-Hodgkin's lymphoma (73% in clinical stage IV) were treated with a combination of cyclophosphamide, hydroxyldaunorubicin, vincristine, prednisolone and bleomycin (modified CHOP-Bleo), from May 1978 to July 1987. Complete remission (CR) was obtained in 12 of 26 patients (46%). The median survival time was 19.5 months (2-77 + months), Median duration of CR was 30.5 months (2-76 + months). The survival of patients with diffuse lymphoma large cell type (DL) was better than those with other diffuse lymphomas. The 50% of patients with DL are projected to be free of disease. The survival of patients with clinical stage III was significantly better than those with clinical stage IV. Major complications during chemotherapy with modified CHOP-Bleo were myelosuppression, constipation and peripheral neuropathy. These toxicities were generally mild and well tolerated.


Significance of circulating endothelial progenitor cells in hepatocellular carcinoma.
This study evaluated the significance of circulating bone marrow-derived endothelial progenitor cells (EPCs) in patients with hepatocellular carcinoma (HCC), a solid tumor with rich neovasculature. Eighty patients with HCC were recruited for the study, and 16 patients with liver cirrhosis and 14 healthy subjects were also included for comparison. Blood samples were taken before treatment. Total mononuclear cells were isolated from peripheral blood, preplated to eliminate mature circulating endothelial cells, and colony-forming units (CFUs) formed by circulating EPCs were counted. To validate the CFU scores, FACS quantification of EPCs using CD133, VEGFR2, and CD34 as markers was performed in 30 cases. Our study showed significantly higher mean CFU scores in patients with HCC compared to patients with cirrhosis and healthy controls (P = .001 and .009, respectively). Furthermore, the CFU scores of patients with HCC positively correlated with levels of serum alpha-fetoprotein (r = .303, P = .017), plasma VEGF (r = .242, P = .035), and plasma interleukin-8 (IL-8) (r = .258, P = .025). Patients with unresectable HCC had higher CFU scores than patients with resectable tumors (P = .027). Furthermore, for those who underwent curative surgery, higher preoperative CFU scores were observed in patients with recurrence within 1 year compared with those who were disease-free after 1 year (P = .013). In conclusion, higher circulating levels of EPCs are seen in patients with advanced unresectable HCC as compared to patients with resectable HCC or those with liver cirrhosis. Our evidence supports the potential use of circulating level of EPCs as a prognostic marker in patients with HCC.


Severe airway hyperresponsiveness was not predictable with the use of current tools in asthmatic children in general practice.
To evaluate whether moderate to severe airway hyperresponsiveness (AHR) could be suspected with the use of routinely available clinical and environmental information. Cross-sectional study of asthma in 526 asthmatics aged 7-17 years and treated in general practice. Moderate to severe AHR was present in 48% (n=253) of the participants. The presence of inhalation allergy, nocturnal symptoms, and usage of beta2-mimetics were significantly associated with moderate to severe AHR. If all three factors were present, the probability of the presence of moderate to severe and severe AHR was 76% and 36%, respectively. If all three were absent, the probability decreased to 11% and 5%, respectively. In 319 subjects (64%) AHR could not be adequately predicted with routinely available information. Moderate and severe AHR could not be suspected with the use of routinely available clinical and environmental information in the majority of children. Except for a subgroup of children, our models were not helpful in deciding in which child an inhaled corticosteroid should be started or whether the dose should be increased or decreased. We recommend measuring the severity of AHR in these children by means of an inhalation challenge test.


Binding of wheat gliadin in vitro to reticulum in normal and dermatitis herpetiformis skin.
We have demonstrated by indirect immunofluorescence that wheat gliadin binds in vitro to reticulin-like fibrils present in cryostat sections of human skin, and rat liver, kidney and stomach. Gliadin was seen to bind to fibrils throughout the dermis of both normal and dermatitis herpetiformis skin, and this was particularly striking in the dermal papillae. Serum from 2 dermatitis herpetiformis patients who did not have antireticulin antibody gave reticulin staining when retested by immunofluorescence on cryostat sections of rat tissue pretreated with gliadin. Gliadin treated sections may prove useful in screening patients with gluten sensitive enteropathy for anti-gliadin antibody. Binding of gliadin to skin sites in dermatitis herpetiformis patients and subsequent deposition of antigliadin antibody at these sites may be involved in the development of skin lesions.


[Ectopic mediastinal parathyroid adenoma resected by video-assisted thoracic surgery with intraoperative methylene blue infusion].
We report a case of 26-year-old man treated for ectopic mediastinal parathyroid adenoma with videoassisted thoracic surgery and perioperative methylene blue intravenous injection. The patient had elevated serum calcium levels, and a history of recurrent urinary stone seizures from 8 years ago. Hypercalcemiadue to the hyperparathyroidism was suspected and am ectopic parathyroid adenoma in the mediastinum was identified by computed tomography (CT) and magnetic resonance imaging(MRI).Thoracoscopic extirpation of mediastinal parathyroid adenoma was scheduled with the help of tumor staining by methylene blue intravenous injection. The lesion was identified easily during surgery, andthe thoracoscopic surgery could be safely performed. The postoperative course is well, and hypercalcemia was improved. The ureteral stone seizures did not occur subsequently.