Prenatal diagnosis of aortopulmonary window associated with aberrant subclavian artery.
Aortopulmonary window is a rare cardiac developmental anomaly characterised by a communication between the ascending aorta and the pulmonary artery. Aortopulmonary window may be isolated or associated with cardiac defects such as ventricular septal defect, atrial septal defect, interrupted aortic arch, and tetralogy of Fallot. We report a case of aortopulmonary window associated with aberrant subclavian artery based on fetal two-dimensional echocardiogram. The mother was referred for fetal echocardiography because of multiple fetal anomalies. Prenatal echocardiography at 30 weeks of gestation revealed a defect between the main and right pulmonary arteries and the ascending aorta (type III). The patient was born at 38 weeks of gestation via caesarean delivery, and was admitted to the neonatal intensive care unit because of respiratory failure and multiple congenital anomalies. Postnatal echocardiogram and cardiac MRI confirmed the prenatal findings. In addition, this patient had severe Dandy-Walker malformation and renal anomalies with poor prognosis. The family decided to withdraw respiratory care support on day of life 4, and the neonate passed away shortly after.


Groundwater management by watershed agencies: an evaluation of the capacity of Ontario's conservation authorities.
Watershed-based resource management organizations around the world are becoming more involved in groundwater management. This reflects, among other considerations, growing awareness of the critical role that these local agencies can and should play in the management of groundwater resources. Ontario's conservation authorities (CAs) are an important example. CAs are taking on new responsibilities for groundwater data collection, monitoring and planning. Unfortunately, not all local organizations are equally capable of participating effectively in groundwater management. This certainly is the case among Ontario's 38 CAs, which have highly variable levels of financial and staff resources. Local capacity for water management can be explored from the perspective of the institutional environment, the watershed community, and the financial, technical and staff resources of the organizations. This paper presents an evaluation of the groundwater management capacity of Ontario's conservation authorities, drawing on two detailed case studies (the Upper Thames River CA and the Ganaraska Region CA), and additional data gathered from all 38 CAs. Institutional issues, such as the clarity of management roles and senior government commitment to local management, as well as resourcing concerns, local working relationships, and public support, largely determine the capacity of CAs to expand their involvement in groundwater management. Strengthening the capacity of watershed-based agencies to participate in groundwater management is an important challenge in all jurisdictions, as these agencies are well placed to reinforce municipal groundwater management by identifying local needs and trends, facilitating communication and cooperation, and promoting best management practices.


Molecular mechanism of specific ion interactions between alkali cations and acetate anion in aqueous solution: a molecular dynamics study.
Specific ion interactions between alkali cations (i.e., Li(+), Na(+), and K(+)) and an acetate anion in aqueous solution were studied using molecular dynamics simulation techniques and polarizable potential models. The ions-acetate systems were used as a model for understanding the interactions between ions and protein surfaces. We computed free energy profiles for different ion pairs using constrained mean force methods. Upon analyzing the computed free energy profiles for the Na(+)/K(+)-acetate ion-pairs, we observed a deeper contact ion minimum and also a larger association constant for the Na(+)-acetate pair as compared to the corresponding K(+)-acetate pair. These observations help to demonstrate the preferential binding of Na(+) over K(+) to protein surfaces. We also applied various rate theories to study the kinetics of ion pair interconversion.


Presence of lithium ions in MgO lattice: surface characterization by infrared spectroscopy and reactivity towards oxidative conversion of propane.
The surface morphology of Li-promoted MgO catalysts prepared using the sol-gel method (sg) and wet impregnation procedure (imp), respectively, has been studied by low-temperature infrared spectroscopy of adsorbed CO molecules. The results show that step sites, as unselective catalytic centers, are the major features existing on the surface of pure MgO, and those are active toward the oxidative conversion of propane. However, the concentration of these sites is drastically reduced by the incorporation of lithium ions in the MgO lattice. In fact, the incorporated Li (+) ions tend to move into the surface region and occupy sites associated with lower coordination number (e.g., step sites). Li/MgO-sg catalysts are characterized by a higher concentration of incorporation of lithium compared to Li/MgO-imp. In the case of oxidative dehydrogenation/cracking of propane, Li/MgO-sg catalysts show higher activity and selectivity to olefins compared to materials prepared using wet impregnation. Catalytic performance differs strongly regarding (i) the amount of olefins formed, and (ii) the ratio of C(3)H(6)/C(2)H(4). It is shown that high density of active sites is essential for further oxidative dehydrogenation of propyl radicals to propylene and suppression of cracking reactions pathway.


Interstitial cystitis: unexplained associations with other chronic disease and pain syndromes.
To determine the prevalence of concomitant disease in individuals with interstitial cystitis and to compare these results to the general population. We used a questionnaire-based study evaluating 12 disease processes and a survey of interstitial cystitis characteristics. The population was 2,405 individuals with interstitial cystitis who responded to the initial survey and an additional 277 individuals who were randomly selected and individually contacted. Allergies, irritable bowel syndrome, and sensitive skin were the most common diseases in the interstitial cystitis population. In comparison to the general population, individuals with interstitial cystitis are 100 times more likely to have inflammatory bowel disease and 30 times more likely to have systemic lupus erythematosus. In addition, allergies, irritable bowel syndrome, sensitive skin, and fibromyalgia have an increased association with interstitial cystitis. Interstitial cystitis has, as yet, an unexplained association with certain other chronic disease and pain syndromes.


Response of patients and physicians to mass screening for coronary risk factors.
Qestionnaires were sent to 1,817 adults screened twice for coronary risk factors 10 to 11 months apart and to their physicians. Physician questionnaires returned on 1,764 persons indicated that 359 (20.4%) of the total group and 227 of 1,191 persons (19.1%) with one or more abnormal risk factors during the first screen did not return for follow-up care. Only persons with one or more risk factors were given advice or medication. When the 227 patients that did not return for follow-up are removed from the group with one or more risk factors, the 239 patients who received advice or treatment comprise 24.8% of those who could have been treated. Of the total 1,764 patients, 13.5% recieved treatment or advice. Qestionnaires returned by 1,396 persons who received follow-up care by their physicians confirmed that only those who had one or more risk factors received advice or treatment. Results of the patient questionnaires show that 223 persons received advice or treatment (23.2% of all with risk factors who returned for follow-up; 16.0% of the 1,396 persons). Furthermore, of 116 persons prescribed medication for risk factor control, 60 (51.7%) were not taking this medication. Of 20, persons given advice for reduction of risk factors, 162 (78.9%) were not following this advice. These data indicate physician indifference and patient apathy to reduction of coronary risk factors in asymptomatic individuals.


The impact of in utero HIV exposure on gut microbiota, inflammation, and microbial translocation.
HIV-exposed but uninfected (HEU) children represent a growing population and show a significantly higher number of infectious diseases, several immune alterations, compromised growth, and increased mortality rates when compared to HIV-unexposed children. Considering the impact that the gut microbiota has on general host homeostasis and immune system development and modulation, we hypothesized that HEU children present altered gut microbiota that is linked to the increased morbidity and the immune system disorders faced by them. Our experiments revealed no differences in beta and alpha diversity of the gut microbiota between HEU and unexposed children or between HIV-infected and uninfected mothers. However, there were differences in the abundance of several taxa from the gut microbiota between HEU and unexposed children and between HIV-infected and uninfected mothers. Functional prediction based on 16S rRNA sequences also indicated differences between HEU and unexposed children and between infected and uninfected mothers. In addition, we detected no differences between HEU and unexposed children in relation to weight, weight-for-age z scores, albumin serum levels, or microbial translocation and inflammation markers. In summary, HIV-infected mothers and their HIV-exposed children present alterations in the abundance of several taxa in the gut microbiome and the predicted functional metagenome when compared to uninfected mothers and unexposed children. Knowledge about the gut microbiome of HEU children in different settings is essential in order to determine better treatments for this susceptible population.


The neuroprotective effects of β-hydroxybutyrate on Aβ-injected rat hippocampus in vivo and in Aβ-treated PC-12 cells in vitro.
Alzheimer's disease is a neurodegenerative disorder associated with the deposition of the peptide amyloid-beta (Aβ) in senile plaques and cerebral vasculature. The neurotoxic mechanisms of this condition have been linked to oxidative-stress-induced apoptosis leading to widespread neuronal loss. Herein, we demonstrate the neuroprotective effects of a ketone body D-β-hydroxybutyrate (β-HB) in neural cell lines and an animal model induced by injecting Aβ into the hippocampus. Using histological examination and the TUNEL assay, we show that administration of exogenous β-HB effectively prevents Aβ deposition and neuron apoptosis in this rat model. β-HB pretreatment also relieves the oxidative stress in Aβ-induced PC-12 cells, as shown by decreased intracellular reactive oxygen species and Ca(2+) levels, activated Nrf2 and recovered superoxide dismutase and catalase activities. Consequently, the apoptotic pathway is also inhibited in these cells, with decreased levels of p53, caspase-12, caspase-9, caspase-3; a decreased Bax/Bcl-2 ratio; and decreased cytochrome c release. Taken together, our study provides a molecular basis for the neuroprotective effects of β-HB in line with the suppression of oxidative stress and the inhibition of apoptotic protein activation.


Effects of different antihypertensive treatments on morphologic progression of diabetic nephropathy in uninephrectomized dogs.
We previously reported the renal hemodynamic effects of different antihypertensive regimens in uninephrectomized, alloxan-induced, diabetic (DM) beagle dogs following one year of treatment. Dogs were prospectively randomized to one of five groups (N = 26): nondiabetic controls, Group I; dogs with DM on no antihypertensive drugs, Group II; dogs on a converting enzyme inhibitor, lisinopril (L), Group III; dogs on a calcium antagonist, TA3090 (diltiazem-like), Group IV; and dogs on a combination of each drug, in reduced doses, Group V. The current paper extends our previous studies by describing the morphologic changes that occurred within each group of dogs studied. More than 100 glomeruli from the renal cortex of each dog were evaluated for increases in mesangial volume fraction (Vv), glomerulosclerosis (GS) and ateriolar hyalinosis. The interstitium was also evaluated for associated changes. Increases in Vv were attenuated in all treated groups (0.28 +/- 0.04, DM alone versus 0.16 +/- 0.05 L; 0.21 +/- 0.07, TA-3090; 0.19 +/- 0.06 micron 2/micron 2, L+TA 3090; P < 0.05) compared to untreated DM. An attenuated increase in Vv also correlated with a blunted rise in proteinuria in Groups III (r = 0.79) and V (r = 0.81) but not Group IV (r = 0.29). Development of focal GS was blunted in all treated groups; however, global GS was fourfold greater in Group IV compared to untreated DM. The degree of interstitial fibrosis also correlated with the degree of global GS. These data support the concept that both a converting enzyme inhibitor and heart rate lowering calcium antagonist attenuate morphologic progression of diabetic renal disease.(ABSTRACT TRUNCATED AT 250 WORDS)


Variations in pectoral girdle muscles in dogs.
Muscle variations take the form of additional muscle bundle or belly, unusual muscle origin or termination, as well as complete muscle absence. Knowledge of such variations not only has clinical importance for guiding surgery, but also can help reveal phylogenetic relationships. To improve our understanding of muscle variations in dogs, 57 medium-sized, cross-breed male and female adult animals were dissected as part of a gross anatomy course between 2005 and 2011. Variations in pectoral girdle muscles were observed in 7 (12.3%) dogs and took the form of an additional muscle bundle in the brachiocephalicus muscle (n = 2), in the omotransversarius muscle (n = 2), in the cervical part of the rhomboideus muscle (n = 2) and in the cervical part of the serratus ventralis muscle (n = 1). Muscle variation was bilateral in only one dog; it involved the omotransversarius muscle. The variations did not seem to be sex dependent. Such variations can appear regularly in dogs and should be taken into consideration during anatomical dissection.


Bias in the design of studies which examine genetic and environmental influences on behaviour.
Genetic and environmental factors may interact to influence the development of complex disorders such as schizophrenia, depression and alcoholism. Twin and adoption studies are used to examine the relative influence of these factors on such behaviours. We propose a set of guidelines for critiquing these studies. Results of the methodologically sound studies may be useful in identifying high risk populations and designing and implementing prevention and treatment programs.


Electronic structure of organic diradicals: Evaluation of the performance of coupled-cluster methods.
The performance of (i) the reduced multireference (RMR) coupled-cluster (CC) method with singles and doubles (RMR CCSD) that employs a modest-size MR CISD wave function as an external source for the most important (primary) triples and quadruples in order to account for the nondynamic correlation effects in the presence of quasidegeneracy, (ii) the RMR CCSD(T) method that adds a perturbative correction for the remaining (secondary) triples to the RMR CCSD energy, and (iii) the recently developed partially linearized MR CCSD method, which determines primary triples and quadruples using a subset of linear CC equations projected onto the corresponding higher-than-doubly excited configurations, are tested by considering the singlet-triplet splitting for several diradicals, ranging from a prototypical methylene radical to trimethylenemethane, and benzyne and pyridynium cation isomers. Both RHF and multiconfigurational self-consistent field molecular orbitals are employed. The equilibrium geometries for the lowest-lying singlet and triplet states are determined using both the density functional theory (DFT) and various CC approaches, and a comparison with both the experiment and other theoretical results, wherever available, is made. The RMR CCSD(T) results provide the most satisfactory description in all cases. The dependence of the MR diradical character on a spatial separation of radical centers, as well as the artifactual DFT geometry in the case of benzyne and pyridynium meta-isomers, is also pointed out.


Effect of fenoterol on secretions of an isolated single submucosal gland from the trachea.
The mechanism of secretion of airway submucosal glands is not known. Although the existence of cyclic AMP in the submucosal gland has been reported, the effect of stimulation of the gland by exogenous cyclic AMP has been denied. We hypothesize that the negative effect of exogenous cyclic AMP is due to the modified influence of ciliated epithelium on the submucosal gland, because epithelium releases chemical mediators. We isolated a single submucosal gland from a cat trachea. We measured mucous glycoprotein labeled with [3H]-glucosamine from the isolated submucosal glands. With stimulation of dibutyryl cyclic AMP, a percent increase of the secretion above control was about 3 times in isolated glands. Methacholine and fenoterol secreted mucus largely in isolated glands. We suggest that cyclic AMP increased the secretion in the glands. The difference of quantity of secretions between methacholine and fenoterol has been investigated further.


Thermal and cold neutron phase-contrast radiography.
In this paper, we will discuss a phase-contrast imaging method that avoids the complications of interferometry to provide phase contrast in weakly absorbing samples. A transversely coherent neutron beam is used with the traditional radiography scheme. Images taken with this scheme show dramatic intensity variations due to sharp changes in the neutron wave refractive index. With some numerical processing these images may be used to reconstruct a quantitative phase radiograph of specimens imaged with this technique.


[The Ca(2+)-pump in erythrocytes is inhibited by glucose: a possible role in the pathogenesis of chronic complications in diabetes].
An animal model in vitro condition was used in experiments, the aim of which was to test the effect of typical diabetes glucose concentration on the purified and reactivated Ca(2+)-ATPase with a defined phospholipid composition. Inhibition of Ca(2+)-ATPase activity depends on glucose concentration in a time-dependent manner. It does not depend on phospholipid content, which suggests direct glycation of the enzyme. The altered activity of erythrocyte Ca(2+)-ATPase by glycation may lead in vivo to imbalance in the ionic transport and may contribute to the development of chronic complications of diabetes. (Tab. 2, Fig. 2, Ref. 16.)


Role of lysine during protein modification by HOCl and HOBr: halogen-transfer agent or sacrificial antioxidant?
Although protein degradation by neutrophil-derived hypochlorous acid (HOCl) and eosinophil-derived hypobromous acid (HOBr) can contribute to the inactivation of pathogens, collateral damage to host proteins can also occur and has been associated with inflammatory diseases ranging from arthritis to atherosclerosis. Though previous research suggested halotyrosines as biomarkers of protein damage and lysine as a mediator of the transfer of a halogen to tyrosine, these reactions within whole proteins are poorly understood. Herein, reactions of HOCl and HOBr with three well-characterized proteins [adenylate kinase (ADK), ribose binding protein, and bovine serum albumin] were characterized. Three assessments of oxidative modifications were evaluated for each of the proteins: (1) covalent modification of electron-rich amino acids (assessed via liquid chromatography and tandem mass spectrometry), (2) attenuation of secondary structure (via circular dichroism), and (3) fragmentation of protein backbones (via sodium dodecyl sulfate-polyacrylamide gel electrophoresis). In addition to forming halotyrosines, HOCl and HOBr converted lysine into lysine nitrile (2-amino-5-cyanopentanoic acid), a relatively stable and largely overlooked product, in yields of up to 80%. At uniform oxidant levels, fragmentation and loss of secondary structure correlated with protein size. To further examine the role of lysine, a lysine-free ADK variant was rationally designed. The absence of lysine increased yields of chlorinated tyrosines and decreased yields of brominated tyrosines following treatments with HOCl and HOBr, respectively, without influencing the susceptibility of ADK to HOX-mediated losses of secondary structure. These findings suggest that lysine serves predominantly as a sacrificial antioxidant (via formation of lysine nitrile) toward HOCl and as a halogen-transfer mediator [via reactions involving ε-N-(di)haloamines] with HOBr.


Noticing of cannabis health warning labels in Canada and the US.
Product labelling and health warnings are important components of regulatory frameworks for consumer products such as tobacco, alcohol and food. However, evidence in the cannabis domain is limited. This study aimed to examine the reach of mandated health warnings on cannabis products using a natural experimental design. Data are from the online International Cannabis Policy Study 2018 and 2019 surveys. Respondents were men and women aged 16 to 65 years in Canada and US states with illegal and legal nonmedical cannabis ("illegal" and "legal" states, respectively) (n = 72 549). Regression models tested differences in noticing health warnings on cannabis packages pre- and post-legalization in Canada, with comparisons to US states, adjusting for cannabis use, cannabis source and sociodemographics. Respondents in Canada showed a greater increase in noticing warnings (+8.9%) in 2019 (14.7%) versus 2018 (5.8%) than respondents in US "illegal" states (+2.8%) and "legal" states (+3.2%). In 2019, consumers residing in jurisdictions with legal recreational cannabis who purchased from legal retail sources were more likely to report noticing warnings than consumers who obtained cannabis from illegal/unstated sources (Canada: 40.4% vs. 15.3%; US "legal" states: 35.3% vs. 17.0%). Regular cannabis consumers were more likely to notice warnings than less frequent consumers. Mandating warning labels on cannabis products may increase exposure to messages communicating the health risks of cannabis, especially among frequent consumers and those who access the legal market.


Diabetic Macular Edema Treatment with Bevacizumab Does Not Depend on the Retinal Nonperfusion Presence.
This study evaluated the relationship between the retinal nonperfusion area (NPA) presence and the effectiveness of bevacizumab treatment (IVB) in patients with diabetic macular edema (DME). It also tested the prognostic usefulness of ultra-wide-field fluorescein angiography (UWFFA) and OptosAdvance software for diabetic retinopathy monitoring. Eighty-nine patients with DME with a macular central subfield thickness (CST) ≥ 250 μm, with (N = 49 eyes) and without (N = 49 eyes) retinal NPA, underwent nine bevacizumab injections over 12 months. NPA distribution, leakage area distribution, microaneurysm (MA) count, macular CST, diabetic retinopathy severity, and best-corrected visual acuity (BCVA) were assessed. The results show that bevacizumab reduced the macular CST from 420 to 280 μm (p < 0.001) and improved BCVA (p < 0.001) by about 10 ETDRS letters in both groups of patients. Additionally, the therapy reduced total retinal NPA from 29 (14-36) mm2 to 12 (4-18) mm2 (Me (Q1-Q3); p < 0.001) in patients with diagnosed nonperfusion. The effect of the therapy measured with vascular leakage, MA count, BCVArelative, and CSTrelative strongly depended on the zone of the retina and the NPA distribution. We conclude that the bevacizumab treatment had a positive effect on DME and BCVA in both study groups and on the size of retinal NPA in patients with retinal nonperfusion.


[The correlation between interleukin-10 and interferon-gamma produced by peripheral blood mononuclear cells stimulated by house dust mite antigen in atopic dermatitis].
The production of interleukin (IL)-10 and interferon (IFN)-gamma by peripheral blood mononuclear cells (PBMC) stimulated by house dust mite (HDM)antigen and concanavaln A (Con A) was measured in patients with atopic dermatitis (AD). The HDM-stimulated PBMC from AD patients revealed to produce significantly higher levels of IL-10 (12 h: 918.4 +/- 206.5, 24 h: 1252.5 +/- 145.8, 72 h: 1332.7 +/- 123.9 pg/ml) than those from normal control subjects (12 h: 231.1 +/- 139.0, 24 h: 585.7 +/- 196.2, 72 h: 813.5 +/- 181.8 pg/ml). Con A-stimulated AD-PBMC also showed significantly higher levels of IL-10 production than those from normal controls, although they were lower than the productions induced by HDM antigen. By contrast, the levels of IFN-gamma from AD PBMC stimulated with HDM or Con A, were significantly lower than those from normal controls. IFN-gamm production might be down-regulated by IL-10 in AD-PBMC. The overproduction of IL-10 seems to show that helper T type 2 (Th2) cells are rather dominantly activated than Th1 cells and Th2 cells might contribute to produce the cytokines in response to HDM antigen in AD patients.


[Disturbance of lipid metabolism].
The disturbance of lipid metabolism is seen in some inherited diseases and also in patients with some kinds of underlying diseases. The presence of its disturbance can be detected by measuring the concentrations of cholesterol and triglyceride in serum. Although hyperlipidemia or hypolipidemia is the result of abnormal lipid metabolism, hyperlipidemia is of more concern to physicians because of the close association with atherosclerosis. Responsible genes for some primary (or hereditary) hyperlipidemic diseases have been confirmed as follows; LPL or apo C-II for primary chylomicronemia, LDL receptor for familial hypercholesterolemia and apo B-100 for familial defective apo B-100. However, the responsible gene remains controversial for familial combined hyperlipidemia, though AI/CIII/AIV cluster is one of the possible candidate genes. Secondary hyperlipidemia is caused by various diseases such as diabetes mellitus, renal diseases and cholestasis. This type of hyperlipidemia is improved by therapy for the underlying diseases. To date, the mechanism of lipid metabolism has been defined in a molecular basis. In fact, sterol regulatory element-binding protein (SREBP), peroxisome proliferator-activated receptor (PPAR) and ATP-binding cassette transporter subfamily A, member 1(ABCA1) were recently identified and it was demonstrated that these regulate lipid metabolism.


Surface and Electrochemical Studies on Silicon Diphosphide as Easy-to-Handle Anode Material for Lithium-Based Batteries-the Phosphorus Path.
The electrochemical characteristics of silicon diphosphide (SiP2) as a new anode material for future lithium-ion batteries (LIBs) are evaluated. The high theoretical capacity of about 3900 mA h g-1 (fully lithiated state: Li15Si4 + Li3P) renders silicon diphosphide as a highly promising candidate to replace graphite (372 mA h g-1) as the standard anode to significantly increase the specific energy density of LIBs. The proposed mechanism of SiP2 is divided into a conversion reaction of phosphorus species, followed by an alloying reaction forming lithium silicide phases. In this study, we focus on the conversion mechanism during cycling and report on the phase transitions of SiP2 during lithiation and delithiation. By using ex situ analysis techniques such as X-ray powder diffraction, formed reaction products are identified. Magic angle spinning nuclear magnetic resonance spectroscopy is applied for the characterization of long-range ordered compounds, whereas X-ray photoelectron spectroscopy gives information of the surface-layer species at the interface of active material and electrolyte. Our SiP2 anode material shows a high initial capacity of about 2700 mA h g-1, whereas a fast capacity fading during the first few cycles occurs which is not necessarily expected. On the basis of our results, we conclude that besides other degradation effects, such as electrolyte decomposition and electrical contact loss, the rapid capacity fading originates from the formation of a low ion-conductive layer of LiP. This insulating layer hinders lithium-ion diffusion during lithiation and thereby mainly contributes to fast capacity fading.


A case of gross haematuria due to an ureteric-iliac artery fistula.
A case of gross haematuria due to an ureteric-iliac artery fistula We report a case of a 75-year-old man presented with gross haematuria and left hydronephrosis due to an ureteric iliac- artery fistula . Medical history included a previous positioning of aorto-bisiliac graft and an iliac artery stent placed to exclude an hypogastric aneurysm. A retrograde pyelography revealed a compression of the middle ureter and an extravasation of contrast at that level, for this reason a double J stent was inserted. Contrast-enhanced computed tomography showed the presence of a fistula between the left ureter and the internal iliac. The patient underwent endovascular treatment using a stent-graft with the subsequent patient's recovery. Ureteric iliac-artery fistula is a rare condition and it generally manifests with life threatening gross bleeding. We suggest a multidisciplinary clinical approach in order to achieve the best results for the patient and to avoid severe complications. Endovascular techniques have been demonstrated to be effective and rapid in the treatment of this emergency condition; ureteral stenting is also recommended.


P3b Does Not Reflect Perceived Contrasts.
It has been shown that P3b is not a signature of perceptual awareness per se but is instead more closely associated with postperceptual processing (Cohen et al., 2020). Here, we seek to investigate whether human participants' attentional states are different in the report and the no-report conditions. This difference in attentional states, if exists, may lead to degraded consciousness of the stimuli in the no-report condition, and it therefore remains unknown whether the disappearance of P3b is because of a lack of reportability or degraded consciousness. Results of our experiment 1 showed that participants did experience degraded contents of consciousness in the no-report condition. However, results of experiment 2 showed that the degraded contents of consciousness did not influence the amplitude of P3b. These findings strengthen the claim that P3b is not a signature of perceptual awareness but is associated with postperceptual processing.


Complete Genome Sequences of Five Bacteriophages That Infect Enterobacteriales Hosts.
Full genome sequences of five bacteriophages that were isolated from raw sewage samples and infect Enterobacteriales hosts are presented. Brookers is a P22-like Proteus phage, OddieOddie is a 9g-like Escherichia coli phage, Diencephelon is a Kp3-like Klebsiella phage, and Rgz1 and Lilpapawes are classic T4-like and T7-like virulent Proteus phages, respectively.


Effect of viscoelasticity on the flow pattern and the volumetric flow rate in electroosmotic flows through a microchannel.
Many lab-on-a-chip based microsystems process biofluids such as blood and DNA solutions. These fluids are viscoelastic and show extraordinary flow behaviors, not existing in Newtonian fluids. Adopting appropriate constitutive equations these exotic flow behaviors can be modeled and predicted reasonably using various numerical methods. In the present paper, we investigate viscoelastic electroosmotic flows through a rectangular straight microchannel with and without pressure gradient. It is shown that the volumetric flow rates of viscoelastic fluids are significantly different from those of Newtonian fluids under the same external electric field and pressure gradient. Moreover, when pressure gradient is imposed on the microchannel there appear appreciable secondary flows in the viscoelastic fluids, which is never possible for Newtonian laminar flows through straight microchannels. The retarded or enhanced volumetric flow rates and secondary flows affect dispersion of solutes in the microchannel nontrivially.


A nationwide survey of 20 legacy brominated flame retardants in indoor dust from China: continuing occurrence, national distribution, and implication for human exposure.
Despite the restrictions on polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDDs), these chemicals are still ubiquitous environmental pollutants. In this study, we measured the concentrations and profiles of 17 PBDE congeners and 3 HBCDD isomers in indoor dust samples collected from 23 provinces and cities across China. The summed concentrations of PBDEs (Σ17PBDEs) ranged from 4.19 to 817 ng/g, with an average of 171 ± 184 ng/g. BDE-209 was the most abundant congener. The concentrations of HBCDDs ranged from 6.65 to 1335 ng/g, with an average of 236 ± 324 ng/g. Unlike commercial HBCDD formulations, α-HBCDD was the predominant isomer in the indoor dust samples analyzed. Geographical distributions showed that the concentrations of PBDEs and HBCDDs varied significantly among different regions. Higher PBDE and HBCDD levels were observed in samples from eastern coastal and economically developed regions. Further, we estimated the daily intakes of PBDEs and HBCDDs through the routes of dust ingestion and dust dermal absorption for different age groups. Dust dermal absorption is an unneglectable exposure pathway to PBDEs and HBCDs for the Chinese population. Among the age groups, infants had the highest exposure via dust dermal absorption, and toddlers had the highest exposure via dust ingestion. Compared with the threshold values, the exposure doses of PBDEs and HBCDDs are unlikely to pose significant health concerns for both infants and adults in China. This is the first national survey of PBDEs and HBCDDs in indoor dust samples across China after the restriction.


Relativistic quantum corrections to laser wakefield acceleration.
The influence of quantum effects on the interaction of intense laser fields with plasmas is investigated by using a hydrodynamic model based on the framework of the relativistic quantum theory. Starting from the covariant Wigner function and Dirac equation, the hydrodynamic equations for relativistic quantum plasmas are derived. Based on the relativistic quantum hydrodynamic equations and Poisson equation, the perturbations of electron number densities and the electric field of the laser wakefield containing quantum effects are deduced. It is found that the corrections generated by the quantum effects to the perturbations of electron number densities and the accelerating field of the laser wakefield cannot be neglected. Quantum effects will suppress laser wakefields, which is a classical manifestation of quantum decoherence effects, however, the contribution of quantum effects for the laser wakefield correction will been partially counteracted by the relativistic effects. The analysis also reveals that quantum effects enlarge the effective frequencies of plasmas, and the quantum behavior appears a screening effect for plasma electrons.


Sucking improvement following blood transfusion for anemia of prematurity.
To determine whether correction of anemia of prematurity by packed red blood cell transfusion improves sucking. Nonexperimental intervention study. Neonatal intensive care unit of Shaare Zedek Medical Center, Jerusalem, Israel, between July 23, 2006, and December 16, 2007. Thirty-six neonates at a gestational age of 34 weeks or younger, feeding orally, who developed anemia of prematurity. Packed red blood cell transfusion, 15 mL/kg. Change in sucking parameters recorded with the Kron Nutritive Sucking Apparatus for 5 minutes and ingested volume, prior to and 1 to 2 days after intervention. The mean (SD) gestational age was 30.1 (2.1) weeks, and the mean (SD) birth weight was 1436 (45) g. At the time of the study, the mean (SD) postnatal age was 46 (26) days, the mean (SD) weight was 2311 (36) g, and the mean (SD) hematocrit was 26.7% (2.6%). Overall, there was no change in the number of sucks, number of bursts, or maximum negative pressure generated. Daily weight gain increased after transfusion (mean [SD] weight gain, 30.9 [10.0] g before transfusion vs 36.5 [13.0] g after transfusion; P=.02). The babies were then stratified into those below the median number of sucks (109 sucks) before transfusion (poor feeders) and those at or above the median (better feeders). In the former subgroup only, changes from before transfusion to after transfusion were found in the number of sucks (mean [SD] sucks, 73.4 [29.5] vs 108.9 [53.3], respectively; P=.006; mean [SD] sucks per burst, 3.4 [1.4] vs 4.9 [2.8], respectively; P=.01) and volume consumed (mean [SD] volume, 17.1 [9.8] mL vs 23.2 [12.8] mL, respectively; P=.004). Correction of anemia of prematurity with blood transfusion improved sucking and volume ingested in premature infants who were poor feeders prior to the transfusion. It also enhanced overall weight gain.


Zebrafish as an experimental model for the simulation of neurological and craniofacial disorders.
Zebrafish have gained momentum as a leading experimental model in recent years. At present, the zebrafish vertebrate model is increasingly used due to its multifactorial similarities to humans that include genetic, organ, and cellular factors. With the emergence of novel research techniques that are very expensive, it is necessary to develop affordable and valid experimental models. This review aimed to highlight some of the most important similarities between zebrafish and humans by emphasizing the relevance of the first in simulating neurological disorders and craniofacial deformity.


Inter-segmental motions of the foot: differences between younger and older healthy adult females.
Although accumulative evidence exists that support the applicability of multi-segmental foot models (MFMs) in evaluating foot motion in various pathologic conditions, little is known of the effect of aging on inter-segmental foot motion. The objective of this study was to evaluate differences in inter-segmental motion of the foot between older and younger adult healthy females during gait using a MFM with 15-marker set. One hundred symptom-free females, who had no radiographic evidence of osteoarthritis, were evaluated using MFM with 15-marker set. They were divided into young (n = 50, 20-35 years old) and old (n = 50, 60-69 years old) groups. Coefficients of multiple correlations were evaluated to assess the similarity of kinematic curve. Inter-segmental angles (hindfoot, forefoot, and hallux) were calculated at each gait phase. To evaluate the effect of gait speed on intersegmental foot motion, subgroup analysis was performed according to the similar speed of walking. Kinematic curves showed good or excellent similarity in most parameters. Range of motion in the sagittal (p < 0.001) and transverse (p = 0.001) plane of the hallux, and sagittal (p = 0.023) plane of the forefoot was lower in older females. The dorsiflexion (p = 0.001) of the hallux at terminal stance and pre-swing phases was significantly lower in older females. When we compared young and older females with similar speed, these differences remained. Although the overall kinematic pattern was similar between young and older females, reduced range of inter-segmental motion was observed in the older group. Our results suggest that age-related changes need to be considered in studies evaluating inter-segmental motion of the foot.


Multi-Level 3D Surgery for Obstructive Sleep Apnea: Could It Be the Future?
(1) Background: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder and is characterized by recurrent episodes of complete or partial obstruction of the upper airway, leading to reduced or absent breathing during sleep. A nocturnal upper airway collapse is often multi-levelled. The aim of this communication is to describe a 3D multi-level surgery setting in OSA pathology, introducing new surgical approaches, such as 4K-3D endoscopic visualization for the tongue base approach with the aid of a coblator and exoscopic visualization in the palatal approach. (2) Methods: Seven patients affected by OSA underwent 3D Barbed Reposition Pharyngoplasty (BRP) surgery associated with transoral coblation tongue base reduction and nose surgery. (3) Results: No patients experienced intra-operative, post-operative or delayed complications. For OSA multi-level 3D surgery, it took less than 2 h: the median 3D system setting time was 12.5 ± 2.3 min; the overall procedure time was 59.3 ± 26 min. (4) Conclusions: The use of the 4K-3D endoscope and coblator for tongue base resectioning and of the 3D exoscope for lateral pharyngoplasty represents an excellent system in multi-level OSA related surgery that could reduce the time and the costs compared to those of robotic surgery.


Hierarchical disruption in the Bayesian brain: Focal epilepsy and brain networks.
In this opinion paper, we describe a combined view of functional and effective brain connectivity along with the free-energy principle for investigating persistent disruptions in brain networks of patients with focal epilepsy. These changes are likely reflected in effective connectivity along the cortical hierarchy and construct the basis of increased local functional connectivity in focal epilepsy. We propose a testable framework based on dynamic causal modelling and functional connectivity analysis with the capacity of explaining commonly observed connectivity changes during interictal periods. We then hypothesise their possible relation with disrupted free-energy minimisation in the Bayesian brain. This may offer a new approach for neuroimaging to specifically develop and address hypotheses regarding the network pathomechanisms underlying epileptic phenotypes.


Immunohistochemical localization of metabotropic glutamate receptors, mGluR7a and mGluR7b, in the central nervous system of the adult rat and mouse: a light and electron microscopic study.
The distributions of two alternative splicing variants of metabotropic glutamate receptor mGluR7, mGluR7a and mGluR7b, were examined immunohistochemically in the rat and mouse by using variant-specific antibodies raised against C-terminal portions of rat mGluR7a and human mGluR7b. Many regions throughout the central nervous system (CNS) showed mGluR7-like immunoreactivities (LI). The distribution patterns of mGluR7-LI in the rat were substantially the same as those in the mouse, although some species differences were observed in a few regions. Intense mGluR7a-LI was seen in the main and accessory olfactory bulbs, anterior olfactory nucleus, islands of Calleja, superficial layers of the olfactory tubercle, piriform cortex and entorhinal cortex, periamygdaloid cortex, amygdalohippocampal area, hippocampus, layer I of the neocortical regions, globus pallidus, superficial layers of the superior colliculus, locus coeruleus, and superficial layers of the medullary and spinal dorsal horns. The distribution of mGluR7b was more restricted. It was intense in the islands of Calleja, substantia innominata, hippocampus, ventral pallidum, and globus pallidus. The medial habenular nucleus also showed intense mGluR7a-LI in the rat but not in the mouse. For both mGluR7a- and mGluR7b-LI, localization in the active zones of presynaptic axon terminals was confirmed electron microscopically at synapses of both the asymmetrical and symmetrical types. It is noteworthy that mGluR7a-LI is seen preferentially in relay nuclei of the sensory pathways and that both mGluR7a- and mGluR7b-LI are observed not only in presumed glutamatergic axon terminals, but also in non-glutamatergic axon terminals including presumed inhibitory ones. Thus, mGluR7 may play roles not only as an autoreceptor in glutamatergic axon terminals, but also as a presynaptic heteroreceptor in non-glutamatergic axon terminals in various CNS regions.


The evolving (epi)genetic landscape of pancreatic neuroendocrine tumours.
Neuroendocrine neoplasms (NENs) are a relatively rare group of heterogeneous tumours originating from neuroendocrine cells found throughout the body. Pancreatic NENs (PanNENs) are the second most common pancreatic malignancy accounting for 1-3% of all neoplasms developing in the pancreas. Despite having a low background mutation rate, driver mutations in MEN1, DAXX/ATRX and mTOR pathway genes (PTEN, TSC1/2) are implicated in disease development and progression. Their increased incidence coupled with advances in sequencing technologies has reignited the interest in PanNEN research and has accelerated the acquisition of molecular data. Studies utilising such technological advances have further enriched our knowledge of PanNENs' biology through novel findings, including higher-than-expected presence of germline mutations in 17% of sporadic tumours of no familial background, identification of novel mutational signatures and complex chromosomal rearrangements and a dysregulated epigenetic machinery. Integrated genomic studies have progressed the field by identifying the synergistic action between different molecular mechanisms, while holding the promise for deciphering disease heterogeneity. Although our understanding is far from being complete, these novel findings have provided the optimism of shaping the future of PanNEN research, ultimately leading to an era of precision medicine for NETs. Here, we recapitulate the existing knowledge on pancreatic neuroendocrine tumours (PanNETs) and discuss how recent, novel findings have furthered our understanding of these complex tumours.


The Role of Propolis in Oxidative Stress and Lipid Metabolism: A Randomized Controlled Trial.
Although there is evidence of the benefits of propolis on human health, the vast majority of studies have been conducted using animal models. The present study includes the chemical characterization and clinical evaluation of the effects of the oral administration of propolis solution on the oxidative status and modulation of lipids in a human population in Talca, Chile. Chemical characterization of propolis, total phenol, flavonoids, and total antioxidant capacity were determined by ORAC. Identification of phenols and flavonoids in propolis was assessed by HPLC-DAD. A double-blind, placebo-controlled clinical trial was conducted. Subjects provided informed consent form and the Bioethics Committee of the Universidad de Talca approved protocol. Eligible subjects (n = 67) were randomized in two groups: propolis (n = 35) and placebo (n = 32). All subjects were evaluated at 0 (baseline), 45, and 90 days. In the propolis group, we observed that increases in HDL-c went from 53.9 ± 11.9 to 65.8 ± 16.7 mg/dL (p < 0.001) from baseline to 90 days. Compared to placebo subjects, consumption of propolis induced a net increase in GSH levels (p < 0.0001) and a decrease (p < 0.001) in TBARS levels for the propolis group. Our findings indicate potential benefits of propolis use in human health. The use of propolis appears to have positive effects on oxidative status and improvement of HDL-c, both of which contribute to a reduced risk of cardiovascular disease.


Context, evidence and attitude: the case for photography in medical examinations of asylum seekers in the Netherlands.
Can photographs of scars serve as evidence of torture? Amnesty International's Medical Examination Group in the Netherlands (AI-MEG) has, for more than a decade, been photographing torture scars to supplement the testimonies of asylum seekers who have been denied refuge. AI-MEG only intervenes at this point, when asylum seekers face extradition. Proving allegations of torture is of vital importance, as asylum seekers face rising anti-immigrant sentiment in European countries. All victims examined by AI-MEG present a combination of mental, physical and emotional scars. We summarize five cases where AI-MEG used photography in their medical examinations, and consider the ethical role physicians play in helping asylum seekers obtain refuge. Though photographs cannot capture all forms of trauma, as visual documents, they are a compelling form of concrete evidence of torture. In this way, photographs complement verbal testimonies and help doctors and immigration authorities to see and understand physical scars left by various forms of torture. AI-MEG explains in medical terms the connections between the visible late sequelae of torture and victims' testimonies. They then assess whether or not the physical scars are consistent with the forms of torture recounted by victims, using the terminology of the Istanbul Protocol (1999), the United Nations-adopted manual of guidelines that explains how to document torture. This paper outlines the medical examination process and argues for the use of photography as medical evidence on behalf of asylum seekers.


DNA sequence and functional analysis of Lactobacillus delbrueckii subsp. lactis plasmids pN42 and pJBL2.
The plasmids pN42 and pJBL2 were isolated from the Lactobacillus delbrueckii subsp. lactis strains NCC88 and JCL414. DNA sequence determination and bioinformatic analysis revealed a strikingly conserved genetic organization containing five major, highly conserved open reading frames (ORFs). Transformation studies indicated that ORF2 (consisting of a primase fused to a replicative DNA helicase), ori, and ORF3 constitute the minimal requirements for replication of pN42 in the heterologous host Lactococcus lactis. The ORF1's are predicted to encode type I restriction-modification (R-M) system HsdS subunits with different specificities on either plasmid, suggesting that these plasmids may be involved in host defense by expanding their host R-M system repertoire. These plasmids constitute the basis for the construction of novel L. delbrueckii vectors.


Prospective trial of catheter irrigation and muscle flaps for sternal wound infection.
Sternal wound infection is a relatively rare but potentially devastating complication of open heart operations. The most common treatments after debridement are rewiring with antibiotic irrigation and muscle flaps. Here we present the results of a prospective trial to determine the appropriate roles of closed-chest catheter irrigation and muscle flap closure for sternotomy infection and to assess the effect of internal mammary artery bypass grafting on the outcome of each treatment modality. Between 1990 and 1994, 5,658 sternotomies were performed at the University of Washington Medical Center. Sternal dehiscence occurred in 43 patients, 25 of whom had infection (overall incidence, 0.44%). Because of the infrequency of this complication, a prospective, randomized trial was developed in which the initial approach to sternal dehiscence was rewiring and catheter irrigation. Muscle flaps were used as the primary treatment if the sternum could not be restabilized or as secondary treatment if catheter irrigation failed. Wound resolution, length of hospital stay, and complications were evaluated. Sterile dehiscences were successfully closed with irrigation in 17 of 18 patients; the other patient required flap closure. Of the 25 patients with infection, 19 had irrigation and 6, closure with flaps primarily. In the group of infected patients, 17 of the 19 who received irrigation also had internal mammary artery bypass grafting. Irrigation failed in 15 (88.2%) of these 17 patients, and salvage was accomplished with muscle flap closure. All 6 patients with infection who were closed primarily with muscle flaps had a successful outcome. Hospitalization averaged 10.2 days when muscle flaps were used primarily and 14.3 additional days for unsuccessful irrigation. When irrigation was successful, the hospital stay averaged 11.2 days. Catheter irrigation should be reserved for patients without infection or patients with infection but without internal mammary artery bypass grafts in whom dehiscence occurs less than 1 month after sternotomy. All others should have closure with muscle flaps.


Inference and quantile regression for the unit-exponentiated Lomax distribution.
In probability theory and statistics, it is customary to employ unit distributions to explain practical variables having values between zero and one. This study suggests a brand-new distribution for modelling data on the unit interval called the unit-exponentiated Lomax (UEL) distribution. The statistical aspects of the UEL distribution are shown. The parameters corresponding to the proposed distribution are estimated using widely recognized estimation techniques, such as Bayesian, maximum product of spacing, and maximum likelihood. The effectiveness of the various estimators is assessed through a simulated scenario. Using mock jurors and food spending data sets, the UEL regression model is demonstrated as an alternative to unit-Weibull regression, beta regression, and the original linear regression models. Using Covid-19 data, the novel model outperforms certain other unit distributions according to different comparison criteria.


Grandpa's radical neck surgery: a historical memory.
This article is a professional and personal stroll down memory lane. The sister authors investigated one of the first radical neck procedures for cancer, performed in the early 1950s on their grandfather. The historical Operating Room Nurse role is briefly reviewed, and some of the effects of the surgery on the family are discussed. The surgeries today on ears, nose, and throat would not be possible without the brave pioneer patients, physicians, and nurses of the past.


Contribution of Crk adaptor proteins to host cell and bacteria interactions.
The Crk adaptor family of proteins comprises the alternatively spliced CrkI and CrkII isoforms, as well as the paralog Crk-like (CrkL) protein, which is encoded by a different gene. Initially thought to be involved in signaling during apoptosis and cell adhesion, this ubiquitously expressed family of proteins is now known to play essential roles in integrating signals from a wide range of stimuli. In this review, we describe the structure and function of the different Crk proteins. We then focus on the emerging roles of Crk adaptors during Enterobacteriaceae pathogenesis, with special emphasis on the important human pathogens Salmonella, Shigella, Yersinia, and enteropathogenic Escherichia coli. Throughout, we remark on opportunities for future research into this intriguing family of proteins.


Advocacy and hope for the patient with pityriasis rubra pilaris.
Pityriasis rubra pilaris (PRP) is a rare skin disease that can cause severe physical and psychological manifestations. A short case study of an adult with PRP who was denied access to medications and his journey towards improved health is discussed. Through advocacy and support, health care providers can make a difference in the care of patients with PRP and improve their quality of life.


Neutrophils promote T-cell activation through the regulated release of CD44-bound Galectin-9 from the cell surface during HIV infection.
The interaction of neutrophils with T cells has been the subject of debate and controversies. Previous studies have suggested that neutrophils may suppress or activate T cells. Despite these studies, the interaction between neutrophils and T cells has remained a largely unexplored field. Here, based on our RNA sequencing (RNA-seq) analysis, we found that neutrophils have differential transcriptional and functional profiling depending on the CD4 T-cell count of the HIV-infected individual. In particular, we identified that neutrophils in healthy individuals express surface Galectin-9 (Gal-9), which is down-regulated upon activation, and is consistently down-regulated in HIV-infected individuals. However, down-regulation of Gal-9 was associated with CD4 T-cell count of patients. Unstimulated neutrophils express high levels of surface Gal-9 that is bound to CD44, and, upon stimulation, neutrophils depalmitoylate CD44 and induce its movement out of the lipid raft. This process causes the release of Gal-9 from the surface of neutrophils. In addition, we found that neutrophil-derived exogenous Gal-9 binds to cell surface CD44 on T cells, which promotes LCK activation and subsequently enhances T-cell activation. Furthermore, this process was regulated by glycolysis and can be inhibited by interleukin (IL)-10. Together, our data reveal a novel mechanism of Gal-9 shedding from the surface of neutrophils. This could explain elevated plasma Gal-9 levels in HIV-infected individuals as an underlying mechanism of the well-characterized chronic immune activation in HIV infection. This study provides a novel role for the Gal-9 shedding from neutrophils. We anticipate that our results will spark renewed investigation into the role of neutrophils in T-cell activation in other acute and chronic conditions, as well as improved strategies for modulating Gal-9 shedding.


Lesions of the posterior limb of the internal capsule in neuromyelitis optica spectrum disorder.
Posterior limb of the internal capsule lesions (PLICL) are one of the MRI features of neuromyelitis optica spectrum disorder (NMOSD). However, there is no evidence that such lesions are pathogenically related to NMOSD. We retrospectively analyzed features of PLICL in NMOSD, and other central nervous system inflammatory disorders, in 561 patients. We also examined the pathological samples of six patients. Of the 561 patients investigated, PLICL were found in 65 patients (11.6%). Lesions were bilateral in 26 cases (40%) and unilateral in 39 cases (60%). Unilateral lesions were mainly located on the left side (74.3%, 29/39). Of the 65 patients with PLICL, 46 patients had NMOSD (70.8%) and were positive for anti-aquaporin (AQP4-IgG), four had NMOSD (6.2%) and were AQP4-IgG negative, 10 patients had multiple sclerosis (MS), three patients had NMDAR encephalitis, and two had autoimmune meningoencephalitis. Of the six patients whose pathological samples were evaluated, all had PLICL and were negative for AQP4-IgG, and none had pathological NMOSD lesion features. These cases included three patients with multiple sclerosis, one with anti-N-methyl-D-aspartate receptor encephalitis, and two with autoimmune meningoencephalitis. In conclusion, PLICL are found not only in patients with NMOSD, but also in MS and other disorders.


Recombinant expression of porcine lactoferrin peptide LF-6 with intein technology and its immunomodulatory function in ETEC K88-infected mice.
LF-6 is a modified antibacterial peptide derived from LFP-20, a major active ingredient of porcine lactoferrin, whose antibacterial activity is 200 times higher than its native protein counterpart. Moreover, LF-6 displays even higher antibacterial activity than LFP-20 and negligible toxic adverse effects, make it a potential therapeutic agent for antibacterial purposes. Escherichia coli expression system has been a preferred choice and workhorse for most recombinant proteins. However, LF-6 must be coexpressed with a fusion partner to avoid its potentially fatal toxicity which would threat E. coli expression system. In this study, we successfully introduced intein system to solve this problem, which LF-6 was N-terminally fused to dithiothreitol (DTT)-induced self-cleavable intein, and it conduct cleavage when the intein-fusion peptide passing through a chromatography column filled with chitin, then the spliced peptide was purified with RP-HPLC and identified with mass spectroscopy. A bacteriostatic test showed that the recombinant LF-6 displayed nearly the same antibacterial activity as the chemically synthetized LF-6, and an in vivo immunoprotection analysis showed that the recombinant LF-6 exerted protective effects on Escherichia coli (ETEC)-K88-infected mice, which significantly reduced the pro-inflammatory cytokines level in plasma and intestine, and resistant to intestinal mucosal injury compared to the infective alone groups. Our study indicates that the intein system allows a safe and efficient method to produce recombinant LF-6, which not only has antibacterial activity, but more importantly, has an immunomodulatory function.


Does the third molar position influence periodontal status and overall condition of patients with acute pericoronitis? A cross-sectional study.
The teeth positioning may be an important associated factor for the pericoronitis' clinical signs. Our objective was to verify the association between lower third molar position according to the Pell and Gregory classification and clinical variables in patients with pericoronitis. Cross-sectional analysis of panoramic radiographs and medical records of patients with pericoronitis. Primary outcomes: pain and oral health-related quality of life (OHRQoL); secondary outcomes: mouth opening, edema/erythema extension, visible plaque index, bleeding on probing index, periodontal pocket probing depth, and distal alveolar bone crest height of the adjacent second molar. The edema/erythema extension was higher in the IIA position compared with the IA position (p = 0.03). Regarding the OHRQoL, the OHIP-14 score was 21.0 (± 9.26, range from 4 to 44). The most scored domain was physical pain (5.24), followed by psychological discomfort (4.43). Third molars in IIA position are associated with worse OHRQoL than IB and IIB positions (p = 0.03). There was a higher extension of edema/erythema and worse OHRQoL when the third molar was in IIA position. Prophylactic removal of mandibular third molar in position IIA may avoid the onset of mucosal edema/erythema and prevent pericoronitis from promoting impairment of individuals' quality of life.


Clinicians' Need for an Ecological Approach to Violence Reduction.
We now know that harmful social policies, such as those that deny health care to some people, can generate structural violence and be far more harmful than any type of direct violence. A health professional who engages in public health promotion must thus consider the adverse effects of structural violence generated by bad policies. On this view, the dictum, "first, do no harm," can be interpreted as a mandate to protect patients from injustice. Health care professionals' responsibilities extend to motivating policies that prevent avoidable deaths and disabilities. As we exist within an ecology, we must each recognize our responsibility to care for one another and for the larger human community.


Expanding color gamut of reflective liquid crystal displays from filtering undesirable wavelengths of a light source by an embedded etalon.
This work demonstrates a method to reduce the intensity of the undesirable wavelengths of blue (B-) and green (G-) ambient lights to expand the color gamut of reflective liquid crystal displays (LCDs) by an embedded etalon. The built-in reflector of the reflective LCDs is replaced by the blue-green overlapping wavelengths filtering etalon, which is used to reduce the intensity of undesirable B- and G-primaries, thereby decreasing the color cross talk of B- and G-color filters. After etalon adoption, the color gamut can be expanded from 105.96% to 121.81% of National Television System Committee (NTSC) in International Commission on Illumination (CIE) 1976 color space. Compared with the color gamut of the display without the blue-green overlapping wavelength etalon, the maximum expansion of color gamut is ∼15.85%. Moreover, the balance between light loss and color gamut expansion should be taken into consideration.


[Cigarette smoking. A pilot project of dehabituation and experimental research].
An interdisciplinary approach was adopted in a pilot programme research project as the most effective way to obtain concrete results in curing tobacco-addiction. The various stages and effects of the treatment are analysed as a means of identifying the most appropriate techniques. The early results are reported under separate headings according to treatment type (psychological, neurophysiological, dietary, clinical, chemical).


CD4+CD25+FOXP3+ regulatory T cells: a potential "armor" to shield "transplanted allografts" in the war against ischemia reperfusion injury.
Despite the advances in therapeutic interventions, solid organ transplantation (SOT) remains the "gold standard" treatment for patients with end-stage organ failure. Recently, vascularized composite allotransplantation (VCA) has reemerged as a feasible treatment option for patients with complex composite tissue defects. In both SOT and VCA, ischemia reperfusion injury (IRI) is inevitable and is a predominant factor that can adversely affect transplant outcome by potentiating early graft dysfunction and/or graft rejection. Restoration of oxygenated blood supply to an organ which was previously hypoxic or ischemic for a period of time triggers cellular oxidative stress, production of both, pro-inflammatory cytokines and chemokines, infiltration of innate immune cells and amplifies adaptive alloimmune responses in the affected allograft. Currently, Food and Drug Administration (FDA) approved drugs for the treatment of IRI are unavailable, therefore an efficacious therapeutic modality to prevent, reduce and/or alleviate allograft damages caused by IRI induced inflammation is warranted to achieve the best-possible transplant outcome among recipients. The tolerogenic capacity of CD4+CD25+FOXP3+ regulatory T cells (Tregs), have been extensively studied in the context of transplant rejection, autoimmunity, and cancer. It was not until recently that Tregs have been recognized as a potential cell therapeutic candidate to be exploited for the prevention and/or treatment of IRI, owing to their immunomodulatory potential. Tregs can mitigate cellular oxidative stress, produce anti-inflammatory cytokines, promote wound healing, and tissue repair and prevent the infiltration of pro-inflammatory immune cells in injured tissues. By using strategic approaches to increase the number of Tregs and to promote targeted delivery, the outcome of SOT and VCA can be improved. This review focuses on two sections: (a) the therapeutic potential of Tregs in preventing and mitigating IRI in the context of SOT and VCA and (b) novel strategies on how Tregs could be utilized for the prevention and/or treatment of IRI.


An ambient stable core-substituted perylene bisimide dianion: isolation and single crystal structure analysis.
Here we report the first example of an isolable, ambient stable perylene bisimide (PBI) dianion which was synthesized by catalytic reduction of a highly electron deficient PBI derivative. The remarkable stability of this unprecedented dianion in air for months facilitated its complete characterization by different methods, including single crystal X-ray analysis. Furthermore, solvent dependent cyclic and square wave voltammetry studies revealed that the formation of PBI dianions is preferred in more polar solvents, whereas the generation of PBI radical anions should be favoured in less polar solvents.


Single coronary artery and sick sinus syndrome.
We report 2 patients with recurrent syncope and dizziness, later noted to have single coronary arteries. Both had right heart strain, one having pulmonary hypertension and the other having right ventricular outflow obstruction, which resulted in sinus node dysfunction. Patients were refractory to medical therapy and improved after pacemaker implantation.


The physicochemical properties of infectious hepatitis A virions.
The propagation of hepatitis A virus (HAV) in the cell line PLC/PRF/5 made possible the radiolabelling in vivo of mature, infectious hepatitis A virions and the determination of their physicochemical properties. In contrast to poliovirus type 2 (160S, 1.340 g/ml), HAV had a sedimentation coefficient of 156 +/- 2S and a buoyant density of 1.332 g/ml in CsCl. The genome of HAV consisted of linear single-stranded RNA which sedimented at 32.5S under non-denaturing conditions. Compared to the size and sedimentation behaviour of poliovirus RNA (2.6 X 10(6) mol. wt., 35S) this corresponds to a mol. wt. of 2.3 X 10(6). Electrophoresis under fully denaturing conditions, however, revealed a mol. wt. of 2.8 X 10(6) and indicates the existence of relatively extended regions with secondary structure. The purified virus genome, containing a poly(A) sequence, served as a messenger for the synthesis of virus antigen in PLC/PRF/5 cells. Finally, in accordance with previous observations, the capsid of the virion was found to be constructed of three major polypeptides (VP1, 31 X 10(3); VP2, 26 X 10(3); VP3, 21 X 10(3) mol. wt.) and of two less readily demonstrable components probably corresponding to VP4 (8 X 10(3) to 10 X 10(3) mol. wt.) and the precursor polypeptide VP0 (40 X 10(3) mol. wt.).


Rare Clinical Presentation of Tuberculous Meningitis: A Case Report.
Tuberculosis is the second leading cause of death under the category of infectious diseases, after the human immunodeficiency virus (HIV). Tuberculous meningitis (TBM) constitutes about 5% of all extrapulmonary disease worldwide. This report describes a case of Tuberculous meningitis with rare presentation in a 28-year-old woman, who was treated based on a collection of her social background, clinical findings and Multiplex PCR of tuberculosis. A 28-year-old Malay woman with no significant medical history presented to HUSM with one month history of on and off fever, two weeks history of generalised limbs weakness and one week history of dysphagia. She was reported to have experienced visual hallucination and significant weight loss. Her laboratory result is significant for leukocytosis, elevated ESR and hypernatremia. Non-enhanced and contrast CT scan of the brain showed severe bilateral frontal cerebral atrophy. Cerebral spinal fluid (CSF) for multiplex PCR for Mycobacterium tuberculosis complex was positive. She was promptly started on anti-TB regime combined with dexamethasone. Subsequent follow-up showed significant improvement. This is a rare clinical manifestation of Tuberculous meningitis that demonstrates the importance of recognising and initiating the treatment early to reduce disabilities and improve clinical outcome.


Migration Energy Barriers for the Surface and Bulk of Self-Assembly ZnO Nanorods.
Post-annealing treatment is a necessary process to create/eliminate/repair defects in self⁻assembly (SA) metal oxide by providing enough thermal energy to the O atoms to overcome the migration energy barrier in ZnO. The height of migration energy barrier is dependent on the depth from the surface, which is hard to be estimated by theoretical calculations, as well as the optical analyses. SA ZnO nanorods (ZNRs) have high surface-to-volume ratio to provide complete picture between the optical and surface properties obtained by photoluminescence (PL) and ultraviolet/X-ray photoemission spectroscopy (UPS/XPS), which is used to investigate the evolution of structure and chemical states of the surface layers to reveal mutual agreement on all observations in PL, XPS, and UPS. We demonstrate variation of the surface structure of SA-ZNRs by scanning over a range of annealing temperatures and time to regulate the structure variation of SA-ZNRs, and their optical analyses agrees well with PL, XPS and UPS, which indicates the dependence of migration energy barriers on the depth from the surface of ZNR. The results reveal the well ZNRs formed at 570 °C and the further oxidation process and the formation of hydroperoxide on the Zn-rich surface of ZNRs at 640 °C.


The effect of fluperlapine in acute psychotic patients.
Fluperlapine (NB 106 689), a dibenzazepine chemically and pharmacologically similar to clozapine, was investigated in 28 patients with regard to antipsychotic efficacy and occurrence of adverse effects. In an open early phase II study patients were given fluperlapine over a period of 26 days. The average daily dosage was 300 mg. Five patients had to be withdrawn from the trial during the first week due to side effects or therapeutic inefficacy, 23 patients were examined during the period planned. The substance proved to have fast-acting antipsychotic effect with few adverse effects and no extrapyramidal motor disturbances.


A practical comparison of algorithms for the measurement of multiscale entropy in neural time series data.
There is a broad family of statistical methods for capturing time series regularity, with increasingly widespread adoption by the neuroscientific community. A common feature of these methods is that they permit investigators to quantify the entropy of brain signals - an index of unpredictability/complexity. Despite the proliferation of algorithms for computing entropy from neural time series data there is scant evidence concerning their relative stability and efficiency. Here we evaluated several different algorithmic implementations (sample, fuzzy, dispersion and permutation) of multiscale entropy in terms of their stability across sessions, internal consistency and computational speed, accuracy and precision using a combination of electroencephalogram (EEG) and synthetic 1/ƒ noise signals. Overall, we report fair to excellent internal consistency and longitudinal stability over a one-week period for the majority of entropy estimates, with several caveats. Computational timing estimates suggest distinct advantages for dispersion and permutation entropy over other entropy estimates. Considered alongside the psychometric evidence, we suggest several ways in which researchers can maximize computational resources (without sacrificing reliability), especially when working with high-density M/EEG data or multivoxel BOLD time series signals.


Quantum noise ciphered optical stealth communication based on equivalent spectral encoding.
To provide secure and covert transmission for optical communication system at the same time, a quantum-noise stream ciphered optical stealth communication approach is proposed for the first time. In the proposed system, the optical pulses are time spread by a chromatic dispersion device and then phase modulated with optical codes at chip rate to realize an equivalent spectral encoding. Binary optical codes are converted to multiple level phase-shift keying signal according to Y-00 protocol. The encoded optical signals are attenuated to mesoscopic coherent states and sent to a public channel. The ciphered signals are stealthy transmitted under public channel noise. The availability and covertness of the optical stealth channel is verified by system simulations.


Diversity Profile and Dynamics of Peptaibols Produced by Green Mould Trichoderma Species in Interactions with Their Hosts Agaricus bisporus and Pleurotus ostreatus.
Certain Trichoderma species are causing serious losses in mushroom production worldwide. Trichoderma aggressivum and Trichoderma pleuroti are among the major causal agents of the green mould diseases affecting Agaricus bisporus and Pleurotus ostreatus, respectively. The genus Trichoderma is well-known for the production of bioactive secondary metabolites, including peptaibols, which are short, linear peptides containing unusual amino acid residues and being synthesised via non-ribosomal peptide synthetases (NRPSs). The aim of this study was to get more insight into the peptaibol production of T. aggressivum and T. pleuroti. HPLC/MS-based methods revealed the production of peptaibols closely related to hypomurocins B by T. aggressivum, while tripleurins representing a new group of 18-residue peptaibols were identified in T. pleuroti. Putative NRPS genes enabling the biosynthesis of the detected peptaibols could be found in the genomes of both Trichoderma species. In vitro experiments revealed that peptaibols are potential growth inhibitors of mushroom mycelia, and that the host mushrooms may have an influence on the peptaibol profiles of green mould agents.


OBSERVATIONS ON THE BIOLOGICAL VALUE OF A MIXTURE OF ESSENTIAL AMINO ACIDS.
(1) A mixture of "essential" amino acids, fed to rats, was found to be inferior from a nutritional point of view to enzymatic or acid casein hydrolysates or casein fed at comparable levels. (2) Evidence is presented which suggests that the nutritive inadequacy of the essential amino-acid diet may be due in part to toxic effects of unnatural forms of certain amino acids that can not be utilized.


Matrix-Assisted Laser Desorption/Ionization-Mass Spectrometry Imaging of Metabolites during Sorghum Germination.
Dhurrin is the most abundant cyanogenic glucoside found in sorghum (Sorghum bicolor) where it plays a key role in chemical defense by releasing toxic hydrogen cyanide upon tissue disruption. Besides this well-established function, there is strong evidence that dhurrin plays additional roles, e.g. as a transport and storage form of nitrogen, released via endogenous recycling pathways. However, knowledge about how, when and why dhurrin is endogenously metabolized is limited. We combined targeted metabolite profiling with matrix-assisted laser desorption/ionization-mass spectrometry imaging to investigate accumulation of dhurrin, its recycling products and key general metabolites in four different sorghum lines during 72 h of grain imbibition, germination and early seedling development, as well as the spatial distribution of these metabolites in two of the lines. Little or no dhurrin or recycling products were present in the dry grain, but their de novo biosynthesis started immediately after water uptake. Dhurrin accumulation increased rapidly within the first 24 h in parallel with an increase in free amino acids, a key event in seed germination. The trajectories and final concentrations of dhurrin, the recycling products and free amino acids reached within the experimental period were dependent on genotype. Matrix-assisted laser desorption/ionization-mass spectrometry imaging demonstrated that dhurrin primarily accumulated in the germinating embryo, confirming its function in protecting the emerging tissue against herbivory. The dhurrin recycling products, however, were mainly located in the scutellum and/or pericarp/seed coat region, suggesting unknown key functions in germination.


ASSOCIATION BETWEEN QUANTITATIVE TRAITS AND ALLOZYME HETEROZYGOSITY IN A TETRASOMIC SPECIES: DACTYLIS GLOMERATA.
Tetraploid individuals of orchardgrass (Dactylis glomerata L. subsp. hispanica Roth.) sampled from a natural population were used to evaluate the correlation between both single and multilocus heterozygosity at 7 enzyme loci, and several quantitative traits (plant size at time of collection, leaf weight, and panicle number in experimental trials). Four hundred and forty-eight plants were studied at the 7 loci and 288 of these individuals were scored for an additional eighth locus. Five genotype classes (monogenic, simplex, and duplex digenic, trigenic, and tetragenic) were distinguished according to their heterozygosity level. Multilocus heterozygosity showed a significant positive correlation with both leaf and panicle yield in experimental conditions, but not with original plant size, which was found to be markedly influenced by environmental microheterogeneity. Multilocus heterozygosity, estimated from both the number of heterozygous loci and the number of distinct alleles per locus, had a significant influence on plant performance. Individual locus effects were positive and significant at two loci (GOT1 and PX1). Panicle number increased regularly with heterozygosity level (from monogenics to tetragenics) at the GOT1 locus, as did leaf weight and panicle number at the PX1 locus. Such variation would be predicted by overdominance at these loci or at linked loci. Significant relationships between leaf yield and heterozygosity level at the GOT1 locus distinguished the homozygotes from the heterozygotes (of any class) and was thus more consistent with inbreeding effects. No significant differences were observed among the five genotype classes for any quantitative trait at the six remaining loci. At both the GOT1 and PX1 loci, heterozygosity had a significant independent effect on leaf weight and panicle number even when the correlation between these traits was removed by analysis of covariance.


Comparing efficacies of neurocognitive treatment and homework assistance programs for children with learning difficulties.
The purpose of the study was to analyze the relative efficacies of two treatments for children with learning difficulties. The first treatment consisted of multiple training components targeting specific cognitive and behavioral factors; the second treatment provided emotional support and supervision of school tasks. The participants were 94 Chilean schoolchildren (6 to 11 years of age). The efficacies were compared on (a) neurocognitive tests, (b) school achievement tests, and (c) behavior in school and at home. The results indicated that both groups improved on most of the outcome measures. The first group showed best results in parents' rating of home behavior, and the second group in reading. The findings also emphasized the importance of emotional support and the inclusion of a parents' group in treatment for children with learning difficulties.


Pathological manifestations in lymphatic filariasis correlate with lack of inhibitory properties of IgG4 antibodies on IgE-activated granulocytes.
Helminth parasites are known to be efficient modulators of their host's immune system. To guarantee their own survival, they induce alongside the classical Th2 a strong regulatory response with high levels of anti-inflammatory cytokines and elevated plasma levels of IgG4. This particular antibody was shown in different models to exhibit immunosuppressive properties. How IgG4 affects the etiopathology of lymphatic filariasis (LF) is however not well characterized. Here we investigate the impact of plasma and affinity-purified IgG/IgG4 fractions from endemic normals (EN) and LF infected pathology patients (CP), asymptomatic microfilaraemic (Mf+) and amicrofilaraemic (Mf-) individuals on IgE/IL3 activated granulocytes. The activation and degranulation states were investigated by monitoring the expression of CD63/HLADR and the release of granule contents (neutrophil elastase (NE), eosinophil cationic protein (ECP) and histamine) respectively by flow cytometry and ELISA. We could show that the activation of granulocytes was inhibited in the presence of plasma from EN and Mf+ individuals whereas those of Mf- and CP presented no effect. This inhibitory capacity was impaired upon depletion of IgG in Mf+ individuals but persisted in IgG-depleted plasma from EN, where it strongly correlated with the expression of IgA. In addition, IgA-depleted fractions failed to suppress granulocyte activation. Strikingly, affinity-purified IgG4 antibodies from EN, Mf+ and Mf- individuals bound granulocytes and inhibited activation and the release of ECP, NE and histamine. In contrast, IgG4 from CP could not bind granulocytes and presented no suppressive capacity. Reduction of both the affinity to, and the suppressive properties of anti-inflammatory IgG4 on granulocytes was reached only when FcγRI and II were blocked simultaneously. These data indicate that IgG4 antibodies from Mf+, Mf- and EN, in contrast to those of CP, natively exhibit FcγRI/II-dependent suppressive properties on granulocytes. Our findings suggest that quantitative and qualitative alterations in IgG4 molecules are associated with the different clinical phenotypes in LF endemic regions.


Pre and post treatment mucociliary function in allergic rhinitis in three different treatment modalities.
Allergic rhinitis causes an impairment of the mucociliary function in the nose. It is hoped that treatment of perennial allergic rhinitis would be able to revert mucociliary function to normal. This study aims to compare pre and post treatment mucociliary transport time in 3 different treatment modalities. Ninety-two newly diagnosed patients with allergic rhinitis were randomised into 3 groups and started on different treatment regimes. At the end of 8 weeks, the group treated with only intranasal beclomethasone showed some, though not significant, improvement in the mucociliary function. There were no changes in the mucociliary function in the other two groups treated with beclomethasone and loratidine or loratidine alone.


Unveiling the mechanisms behind surface degradation of dental resin composites in simulated oral environments.
Dental resin composites are widely used as restorative materials due to their natural aesthetic and versatile properties. However, there has been limited research on the degradation mechanisms of these composites in gastric acid environments, which would be common in patients with gastroesophageal reflux. This study aims to investigate the degradation behavior of dental composites immersed in simulated oral environments, including acid, saliva, and water. Mechanical and morphological properties of the composites, upon immersion in the simulated environments, were thoroughly examined using hardness testing and SEM imaging. Qualitative analyses of the ions leached from the polymer matrix and fillers were conducted using XPS and ICP-MS. In addition, the thermodynamic stability of the inorganic fillers of the composites in aqueous solutions across a wide range of pH values was theoretically studied through construction of Pourbaix diagrams. This study proposed a mechanism for composite leaching involving interactions between the matrix's hydrophilic groups and the aqueous immersion media, leading to swelling and chemical degradation of the composites. Furthermore, it was demonstrated that filler leaching was followed by ion exchange with Ca and P, resulting in the formation of hard calcified layers on the composite surface. The current findings provide valuable insights into the development of new composite materials with improved durability and resistance to degradation, especially for patients suffering from gastroesophageal reflux.


Measurement of |V{ub}| from inclusive charmless semileptonic B decays.
We present the partial branching fraction for inclusive charmless semileptonic B decays and the corresponding value of the Cabibbo-Kobayashi-Maskawa matrix element |V{ub}|, using a multivariate analysis method to access approximately 90% of the B-->X{u}lnu phase space. This approach dramatically reduces the theoretical uncertainties from the b-quark mass and nonperturbative QCD compared to all previous inclusive measurements. The results are based on a sample of 657x10{6} BB[over ] pairs collected with the Belle detector. We find that DeltaB(B-->X{u}lnu;p(l){*B}>1.0 GeV/c)=1.963x(1+/-0.088{stat}+/-0.081{syst})x10{-3}. Corresponding values of |V{ub}| are extracted using several theoretical calculations.


Inflammatory cytokines are associated with the development of symptom burden in patients with NSCLC undergoing concurrent chemoradiation therapy.
Elevations in cancer treatment-induced circulating inflammatory cytokines may be partially responsible for the development of significant symptom burden (e.g., pain, fatigue, distress, disturbed sleep) during concurrent chemoradiation therapy (CXRT). Sixty-two patients undergoing CXRT for locally advanced non-small cell lung cancer (NSCLC) reported symptoms weekly for 15 weeks via the M. D. Anderson Symptom Inventory (MDASI). Serum inflammatory cytokines were assessed weekly during therapy via enzyme-linked immunosorbent assay. Dynamic changes in cytokines and associated symptom profiles were estimated using mixed-effect models. MDASI symptom severity increased gradually as CXRT dose accumulated and peaked at week 8. Serum concentrations of interleukin (IL)-6, IL-10, and serum soluble receptor 1 for tumor necrosis factor (sTNF-R1) increased significantly by week 8 (all p<.05). During CXRT, controlled for age, sex, race, body mass index, cancer recurrence, previous treatment status, total radiotherapy dose, and CXRT delivery technique, an increase in sTNF-R1 was significantly related to an increase in the mean score for all 15 MDASI symptoms (estimate, 1.74; SE, 0.69; p<.05) and to a larger radiation dose to normal lung volume (estimate, 1.77; SE, 0.71; p<.01); an increase in serum IL-6 was significantly related to increased mean severity for the five most severe symptoms (pain, fatigue, disturbed sleep, lack of appetite, sore throat) (estimate, 0.32; SE, 0.16; p<.05). These results suggest a role for over-expressed pro-inflammatory cytokines in significant worsening of symptoms in NSCLC patients undergoing CXRT, and warrant further study to identify biological targets for ameliorating treatment-related symptom burden.


Bis(mu-4-carboxy-2-sulfonatobenzoato)bis[aqua(2,2'-bipyridyl)manganese(II)].
In the title compound, [Mn(2)(C(8)H(4)O(7)S)(2)(C(10)H(8)N(2))(2)(H(2)O)(2)], pairs of hexacoordinated manganese(II) centres are bridged by 2-sulfonatoterephthalate(2-) anions to form cyclic centrosymmetric dimers, which are linked into sheets by O-H...O hydrogen bonds.


Integrated ambulatory care resource scheduling in oncology.
In a modern managed-care environment, the scheduling of ambulatory care activities must be viewed as a series of closely related activities rather than a group of unique and independent events. These activities must be sequenced in a logical manner, and linked with a variety of information on other clinical, operational, and administrative activities. This article focuses on such an integrated scheduling system which supports the ambulatory care services at the Johns Hopkins Oncology Center.


Likert or Rasch? Nothing is more applicable than good theory.
In nursing research many concepts are measured by questionnaires. Respondents are asked to respond to a set of related statements or questions. In unidimensional scaling these statements or questions are indicants of the same concept. Scaling means to assign numbers to respondents, according to their position on the continuum underlying the concept. It is very common to use the summative Likert scaling procedure. The sumscore of the responses to the items is the estimator of the position of the patient on the continuum. The rationale behind this procedure is classical test theory. The main assumption in this theory is that all items are parallel instruments. The Rasch model offers an alternative scaling procedure. With Rasch both respondents and items are scaled on the same continuum. Whereas in Likert scaling all items have the same weight in the summating procedure, in the Rasch model items are differentiated from each other by 'difficulty'. The model holds that the probability of a positive response to an item is dependent on the difference between the difficulty of the item and the value of the person on the latent trait. The rationale behind this procedure is item response theory. In this paper both scaling procedures and their rationales are discussed.


Pain distribution and predictors of widespread pain in the immediate aftermath of motor vehicle collision.
Musculoskeletal pain is common after motor vehicle collision (MVC). The study objective was to evaluate distribution of pain and predictors of widespread musculoskeletal pain in the early aftermath (within 48 h) of collision. European American adults aged 18-65 years presenting to the emergency department (ED) after collision who were discharged to home after evaluation were eligible. Evaluation included an assessment of reported pre-collision psychological characteristics, crash characteristics, current pain severity and location, and current psychological symptoms. Adjusted risk ratios were estimated using generalized linear models. Among 890 participants included in the study, 589/890 (66%) had pain in three or more regions, and 192/890 (22%) had widespread musculoskeletal pain (pain in seven or more regions). In adjusted analyses, the presence of widespread pain was strongly associated with depressive and somatic symptoms prior to collision, pain catastrophizing, and acute psychological symptoms, and was not associated with most collision characteristics (road speed limit, extent of vehicle damage, collision type, driver vs. passenger, airbag deployment). The reported number of body regions that struck an object during the collision was associated with both reported pre-collision depressive symptoms and with widespread pain. More than one in five individuals presenting to the ED in the hours after MVC have widespread pain. Widespread pain is strongly associated with patient characteristics known to be modulated by supraspinal mechanisms, suggesting that stress-induced hyperalgesia may influence acute widespread pain after collision.


Socioeconomic factors, country of birth, and years in Sweden are associated with first birth fertility trends during the 1990s: a national cohort study.
Decreasing fertility rates and postponement of first birth are of considerable public health concern in many industrialized countries. Previous studies suggest that this will increase involuntary childlessness in the population. The general aim was to examine the association between sociodemographic factors and first birth fertility trends in Sweden during the 1990s. This Swedish national study examined changes in first birth rates and mean age at first birth between 1991 and 1992 (n = 452,000) and 1997-98 (n = 495,756). The impact of socioeconomic factors and years in Sweden on first birth fertility was examined among Swedish-born and 19 subgroups of foreign-born women aged 20-41 years. Poisson regression was used in the analysis. First birth rates decreased and mean age at first birth increased between the two periods among the Swedish-born and most foreign-born women. Non-employment and low income were associated with decreased first birth fertility, and low educational status was associated with slightly increased first birth fertility. Interaction tests revealed that, in contrast to Swedish-born women, several groups of foreign-born women increased their first birth fertility even if they were non-employed or had a low income. Among foreign-born women fewer years in Sweden was significantly associated with increased first birth fertility. Public health information should emphasize that postponement of first birth could lead to involuntary childlessness. Health care workers need to consider the woman's socioeconomic characteristics, country of birth, and years in Sweden when such information is given.


[Determination of the galactokinase activity of erythrocytes of swine of various ages].
In view of the fact that the ability of pig erythrocytes to use galactose will decrease with growing age, the galactokinase activity in pig erythrocytes of different age was determined by means of a spectrophotometrical method. A total of 5 pig fetuses (112th day of gestation) and 45 piglets at the age of 8 hours to 35 days belonging to different broods as well as 10 pigs for slaughter whose blood was collected after slaughtering out were included in the examination. In 5 piglets of one brood a progress examination was made during the suckling period. In the erythrocytes of all examined animals of different age groups the activity of the enzyme could be identified. There are great differences in the galactokinase activity of haemolysates of pig erythrocytes in different broods irrespective of their age. Therefore, an enzyme age dependence can only be recognized as a tendency from the comparison of the enzyme activities in erythrocytes of animals taken from different broods. In the erythrocyte haemolysate of 5 piglets of one brood the age dependence on galactokinase activity during the suckling period was determined in such a way that newborn piglets show a 30% higher enzyme activity than piglets at an age of 35 days. The enzyme activity in them, however, is still 1.6 times higher than in pigs for slaughtering. Thus, it may be concluded tht a postnatal decrease of galactokinase activity will occur in pig erythrocytes similarly to human erythrocytes. However, it is not responsible for a decrease of galactose utilization because no direct relations exist between both procedures. Parallel to glucose the decrease of galactose membrane permeability is assumed to play the decisive role here.


Cutaneous late phase responses--an allergic inflammatory response.
Cutaneous late phase responses have been demonstrated to occur secondary to either immune or nonimmune mast cell activation. In this article I will review studies from our laboratory that support the concept that inflammatory cells, migrating into the allergic reaction secondary to mast cell activation, are themselves activated. These activated cells release mediators that then can induce edematous, indurated cutaneous responses occurring hours after mast cell activation that have been termed "late phase cutaneous responses."


Case report: Isolated dissection of the left gastric artery: an unusual cause of acute abdominal pain.
Spontaneous and isolated dissection of the left gastric artery is a rare occurrence, with only a handful of cases reported in the medical literature. Clinical presentation may mimic more common intra-abdominal pathologies; however, it is imperative to identify this condition promptly due to its potential serious consequences. This underscores the importance of maintaining a high level of clinical suspicion and including this pathology in the differential diagnosis of patients presenting with acute abdominal symptoms. Hence, this case report aims to increase awareness among clinicians about the importance of identifying and treating this rare condition promptly. A 69-year-old female experienced severe epigastric pain while attending a yoga class, prompting her admission to the emergency department 24 h later due to the persistence of her symptoms. Following imaging work-up utilizing computed tomography angiography (CTA), she was diagnosed with a dissection of the left gastric artery. Notably, there was no associated aneurysm or any evidence of ischemia in the esophageal or gastric wall. Conservative management, including low-dose aspirin and blood pressure control, was implemented. After 6 months of follow-up, CTA demonstrated expansion of the true lumen and the absence of secondary aneurysm formation, leading to discontinuation of aspirin. The management of spontaneous dissection of visceral arteries is primarily determined by the presence of complications and organ ischemia. In the case of uncomplicated visceral artery dissections, first-line treatment comprises surveillance and antiaggregation. Nevertheless, the optimal duration of antiplatelet therapy and the necessity for long-term follow-up remain unclear. Endovascular or surgical interventions should be reserved for patients exhibiting deteriorating symptoms or complications, and the decision to pursue these interventions should be made on a case-by-case basis.