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Prostaglandin E2 inhibits vasotocin-induced osmotic water permeability in the frog urinary bladder by EP1-receptor-mediated activation of NO/cGMP pathway. PGE(2) is a well-known inhibitor of the antidiuretic hormone-induced increase of osmotic water permeability (OWP) in different osmoregulatory epithelia; however, the mechanisms underlying this effect of PGE(2) are not completely understood. Here, we report that, in the frog Rana temporaria urinary bladder, EP(1)-receptor-mediated inhibition of arginine-vasotocin (AVT)-induced OWP by PGE(2) is attributed to increased generation of nitric oxide (NO) in epithelial cells. It was shown that the inhibitory effect of 17-phenyl-trinor-PGE(2) (17-ph-PGE(2)), an EP(1) agonist, on AVT-induced OWP was significantly reduced in the presence of 7-nitroindazole (7-NI), a neuronal NO synthase (nNOS) inhibitor. NO synthase (NOS) activity in both lysed and intact epithelial cells measured as a rate of conversion of l-[(3)H]arginine to l-[(3)H]citrulline was Ca(2+) dependent and inhibited by 7-NI. PGE(2) and 17-ph-PGE(2), but not M&B-28767 (EP(3) agonist) or butaprost (EP(2) agonist), stimulated NOS activity in epithelial cells. The above effect of PGE(2) was abolished in the presence of SC-19220, an EP(1) antagonist. 7-NI reduced the stimulatory effect of 17-ph-PGE(2) on NOS activity. 17-ph-PGE(2) increased intracellular Ca(2+) concentration and cGMP in epithelial cells. Western blot analysis revealed an nNOS expression in epithelial cells. These results show that the inhibitory effect of PGE(2) on AVT-induced OWP in the frog urinary bladder is based at least partly on EP(1)-receptor-mediated activation of the NO/cGMP pathway, suggesting a novel cross talk between AVT, PGE(2), and nNOS that may be important in the regulation of water transport.

The post-NSAID era: what to use now for the pharmacologic treatment of pain and inflammation in osteoarthritis. Traditionally, clinicians have relied heavily on the use of NSAIDs to treat the pain of osteoarthritis, as numerous studies have proven these agents effective. However, controversy has arisen regarding their use as first-line therapy, due to increasing awareness of their cardiovascular risks. One of these agents, rofecoxib, was withdrawn from the market in 2004 due to these concerns. Since that time, numerous studies have illustrated that many of the NSAIDs, both the selective cyclooxygenase-2 inhibitors and the traditional non-selective agents, may confer similar risks of cardiovascular toxicity. Although these agents may still be useful in many patients, concerns over side effects have begun to limit their use, and patients and clinicians are reaching for alternate agents. This review highlights the evidence behind the effectiveness of other, non-NSAID pharmacologic options in the treatment of pain and inflammation in osteoarthritis.

Methodological requirements for clinical trials in refractory epilepsies--our experience with zonisamide. 1. The guidelines for clinical evaluation of antiepileptic drugs (AEDs), proposed by the International League Against Epilepsy in 1989, were scrutinized through our clinical experiences with zonisamide. 2. Seizure type, seizure frequency, number of concomitant AEDs, and type of epilepsy were found to be essential factors in quantitatively determining the efficacy of a new drug. 3. The majority of patients selected according to the guidelines consist inevitably of those with complex partial seizures with or without secondary generalization. Consequently, the efficacy of new AEDs is evaluated mainly in patients with partial seizures, and it is difficult to evaluate their efficacy in those with refractory generalized seizures, either convulsive or nonconvulsive. 4. In order to avoid such predilection, patients with various types of generalized seizures who are taking one or two conventional AEDs should account for 30 to 40% of the total patient population selected for clinical drug trials.

[Perfluorinated Compounds in Snow from Downtown Hangzhou, China]. Snow samples were collected from the snow event on January 20-22, 2016 from 11 sites in downtown Hangzhou to explore the occurrence of sixteen perfluorinated compounds (PFCs) in the atmosphere. All samples were prepared by solid-phase extraction with Oasis WAX cartridges and analyzed using ultra performance liquid chromatography interfaced with tandem mass spectrometry (UPLC-MS/MS). The results showed that seven medium- and short-chain PFCs including C4 and C8 perfluorinated sulfonates (PFSAs) and C4-C6, C8, and C9 perfluorinated carboxylic acids (PFCAs) were detected in the snow samples. Total PFC concentrations ranged from 2.85 to 35.1 ng·L-1, whereas perfluorooctanoic acid (PFOA) dominated, with ranges of 2.15-23.0 ng·L-1, and perfluorooctane sulfonate (PFOS) was detected at lower levels, ranging from 0 to 0.46 ng·L-1. As compared to the results from other studies, the PFOA concentrations of the study region were at mid-level and the PFOS concentrations were relatively low. The spatial distribution of PFCs varied, and the pollutant concentrations of the snow samples from the sampling sites located in the urban areas were higher than those in the rural areas. The greatest total PFC concentrations were detected in Fuyang, whereas the lowest concentrations were detected in Jiande and Chun'an. In this study, the high concentrations of PFCs dominated by PFOA that were measured in the Hangzhou snow samples emphasize the importance of atmospheric wet deposition as one of the sources of PFC contamination in this ecological system and should be addressed. The occurrence of PFCs in the air, indicated by their presence in the snow, suggests that the atmospheric environment may be an important contributor in human and ecological exposure to PFCs by local residents.

Breastfeeding duration is a risk factor for atopic eczema. The results of numerous studies on the influence of breastfeeding in the prevention of atopic disorders are often contradictory. One of the most important problems is confounding by other lifestyle factors. The aim of the present study was to analyse the effect of any breastfeeding duration on the prevalence of atopic eczema in the first seven years of life taking into account other risk factors. In an observational birth cohort study 1314 infants born in 1990 were followed-up for seven years. At 3, 6, 12, 18, 24 months and every year thereafter, parents were interviewed and filled in questionnaires, children were examined and blood was taken for in vitro allergy tests. Generalized Estimation Equations (GEE)-models were used to model risk factors for the prevalence of atopic eczema and for confounder adjustment Breastfeeding was carried out for longer if at least one parent had eczema, the mother was older, did not smoke in pregnancy, and the family had a high social status. The prevalence of atopic eczema in the first seven years increased with each year of age (OR 1.05; 95% CI 1.01-1.09 for each year), with each additional month of breastfeeding (1.03; 1.00-1.06 for each additional month), with a history of parental atopic eczema (2.06; 1.38-3.08), and if other atopic signs and symptoms appeared, especially specific sensitization (1.53; 1.25-1.88), and asthma (1.41; 1.07-1.85). Although breastfeeding should be recommended for all infants, it does not prevent eczema in children with a genetic risk. Parental eczema is the major risk factor for eczema. But in this study, each month of breastfeeding also increased the risk.

Parasitofauna of the nine-spined stickleback from the Gulf of Gdańsk and the mouth of Dead Vistula. Four species, one subspecies and one parasite marked to the genus were collected from the nine-spined stickleback Pungitius pungitius L. from the Gulf of Gdańsk and the mouth of Dead Vistula. Nine-spined stickleback was noted as a new host in Polish coastal water for five parasites: Glugea anomala (Microsporidia), Diplostomum spathaceum (Digenea-metacercariae) and Apatemon sp. (Digenea-incysted metacercariae), Hysterothylacium aduncum (Nematoda-third stage larvae) and Thersitina gasterostci (Copepoda). Earlier in this area have been obserwd only ciliates Tnchodina domerguei.

Metal binding ability of hypermodified nucleosides of t-RNA. Potentiometric and spectroscopic studies on the metal complexes of N-[(9-beta-D-ribofuranosylpurin-6-yl)-carbamoyl] threonine. Copper(II), nickel(II), zinc(II), manganese(II), and magnesium(II) complexes of t6A (N-[9-beta-D-ribofuranosylpurin-6-yl)carbamoyl] threonine and t6Ade (N6(threoninocarbonyl)adenine) were studied by potentiometric and spectroscopic methods. It was found that t6Ade has three dissociable protons in the accessible pH range (N1 and N9 of purine and carboxylate), while only two pK values are characteristic of t6A. Magnesium(II) and manganese(II) do not interact effectively with these ligands, but copper(II) and nickel(II) ions form very stable complexes with the coordination of purine N1, deprotonated amide nitrogen, and carboxylate oxygen donors.

Genetic variation of metabolite and hormone concentration in UK Holstein-Friesian calves and the genetic relationship with economically important traits. The decline of dairy cattle fertility worldwide remains a major concern, with conception rates to first service commonly below 40%. The length and severity of negative energy balance postpartum are unfavorably correlated with fertility, suggesting that the length and severity of negative energy balance and fertility are linked via several hormones or metabolites. These compounds therefore have the potential to predict fertility at a genetic level. The addition of a predictor trait for fertility into present fertility indices would accelerate genetic gain, particularly if it was expressed before adulthood. The objective of this work was to estimate the genetic variation in several metabolites and hormones in calves, and to determine their genetic relationships with fertility and production through sire predicted transmitting abilities (PTA; sires of calves sampled). Circulating concentrations of free fatty acids (FFA), glucose, growth hormone (GH), insulin, and insulin-like growth factor 1 (IGF-1) in male and female UK Holstein-Friesian dairy calves (average age +/- SD; 126 +/- 12.7 d) were analyzed during 2 studies: data set 1 (n = 496 females; 1996-2001; 7 commercial dairy herds) and data set 2 (n = 326 females, n = 256 males; 2002-2006; multiple ovulation and embryo transfer breeding scheme). Univariate mixed models were fitted to the data using ASREML. Basal concentrations of FFA, glucose, GH, insulin and total IGF-1 were all moderately heritable in both sexes (heritability range +/- SE; 0.09 +/- 0.05 to 0.66 +/- 0.14). The sire PTA for protein percentage had significant regression coefficients and approximate genetic correlations with FFA and insulin, and the sire PTA for calving interval had significant regression coefficients and approximate genetic correlations with GH. Additive genetic variance seems responsible for a moderate proportion of the phenotypic variation in important metabolites and regulatory hormones in male and female UK Holstein-Friesian dairy calves, therefore supporting further investigation into their use as juvenile predictors for fertility in the mature female.

The use of gastric ultrasonography in the evaluation of a new antiflatulent preparation in human volunteers. A method is described for inducing experimental aerogastria (flatulence) in human volunteers by the ingestion of "whipped" egg-white. Abdominal ultrasonography was used to measure the distension of the stomach and its interference with the visualization of organs such as gall bladder, pancreas and left kidney lying behind the stomach. A double-blind crossover comparison of Flatoril, a mixture of dimethicone (200 mg) and clebopride (0.5 mg) against placebo clearly demonstrated the superior antifoaming activity of the former both in terms of reduced gastric distension and of improved visualization of organs otherwise hidden by the foam-filled stomach.

A general theory of chemical cytotoxicity based on a molecular model of the living cell, the Bhopalator. To define the molecular processes underlying toxicological manifestations experimentally measured on the cellular level, it is essential to have available a molecular model of the living cell itself. The Bhopalator is a molecular model of the living cell formulated by integrating the three major branches of biology within a coherent theoretical framework - the Watson-Crick molecular genetics, the conformon theory of enzymic catalysis, and the theory of dissipative structures developed by I. Prigogine. According to this model, the living cell is a self-moving, self-thinking and self-reproducing machine (automaton) that receives information and energy from its environment, processes them according to the genetic programs stored in DNA, and generates output signals to environment in order to realize teleonomically designed functions. The Bhopalator suggests a set of general statements useful in toxicological research, and these statements have been utilized to provide possible answers to several fundamental questions raised by recent experimental findings on chemically-induced cell injury and death.

Neurons of the periaqueductal gray matter as revealed by Golgi study. Neurons of the periaqueductal gray matter of the normal adult cat are classified into seven general types, Ia, Ib, II, IIIa, IIIb, IIIc, and IIId, based on the Golgi-Cox impregnated materials. Types Ia and Ib are spindle shaped bipolar neurons with one straight dendritic process forming varicosities and short stemmed spines. Type Ia is small in size and Ib is larger. The axon of each neuron emerges from another pole and projects beyond the PAG region. Occasionally it may share the origin with a dendrite or a tuft of dendrites. Type II, triangular shaped, had an apical dendrite that traverses a long distance within the PAG and an axon emerging from the basal portion and projecting beyond the PAG. Type IIIa, b, c, and d are pleomorphic multipolar neurons. Type IIIa has a rhomboid-shaped soma and dichotomically branching dendrites. Type IIIb has a spheroidal soma and short axons that terminate within the PAG. Type IIIc has a piriform soma and spiny dendrites that ramify perfusely and an axon which terminates within the PAG. Type IIId has the largest soma of all these neurons and the structure resembles an undifferentiated motor neuron of the CNS. Axons of the types IIIa and IIId are projecting in nature. Type Ia is found exclusively in the area immediately surrounding the aqueduct, the nucleus medialis. Types IIIc and IIId are found exclusively in the lateral region of the PAG which corresponds to the nucleus lateralis while the remaining cell types are found mostly in nuclei lateralis and dorsalis.

The isolated RNase H domain of murine leukemia virus reverse transcriptase. Retention of activity with concomitant loss of specificity. Retroviral RNases H are similar in sequence and structure to Escherichia coli RNase HI and yet have differences in substrate specificities, metal ion requirements, and specific activities. Separation of reverse transcriptase (RT) into polymerase and RNase H domains yields an active RNase H from murine leukemia virus (MuLV) but an inactive human immunodeficiency virus (HIV) RNase H. The "handle region" present in E. coli RNase HI but absent in HIV RNase H contributes to the binding to its substrate and when inserted into HIV RNase H results in an active enzyme retaining some degree of specificity. Here, we show MuLV protein containing the C-terminal 175 amino acids with its own handle region or that of E. coli RNase HI has the same specific activity as the RNase H of RT, retains a preference for Mn2+ as the cation required for activity, and has association rate (KA) 10% that of E. coli RNase HI. However, with model substrates, specificities for removal of the tRNAPro primer and polypurine tract stability are lost, indicating specificity of RNase H of MuLV requires the remainder of the RT. Differences in KA, while significant, appear insufficient to account for the differences in specific activities of the bacterial and viral RNases H.

Use of cessation methods among smokers aged 16-24 years--United States, 2003. Smoking cessation among adolescent smokers is relatively rare, with approximately 15.6% of smokers aged 12-19 years quitting smoking in a 4-year period (approximately 4% per year). Rates for failed quitting attempts among younger smokers are higher than those for adults (43%), with approximately 58% of high-school smokers having tried to quit at least once for 1 day or longer in the preceding year. To track the history of quitting behavior among smokers aged 16-24 years, Roswell Park Cancer Institute (Buffalo, New York) initiated the 2-year longitudinal National Youth Smoking Cessation Survey (NYSCS) in 2003. This report summarizes key findings from the survey regarding lifetime use of smoking-cessation methods. The findings indicated that smokers aged 16-24 years who had tried to quit were more likely to use unassisted quitting methods than assisted quitting methods; none of the unassisted methods are recommended by the Public Health Service (PHS) clinical guidelines for treatment of tobacco use and dependence, whereas most of the assisted methods are recommended for adults and have been determined to be effective. Many youths aged 16-24 years are trying to quit smoking but often underestimate the rapid progression to tobacco dependence; therefore, PHS clinical practice guidelines for treating tobacco use and dependence recommend that certain clinical interventions proven to be effective among adults be used in youth-based approaches to cessation. In addition, other components of comprehensive tobacco-control programs also increase smoking cessation and should be implemented at CDC-recommended levels to lower tobacco use among youths and adults.

Spinal neurenteric cyst presenting as burning feet syndrome. Spinal neurenteric cysts are rare congenital cysts of endodermal origin. A 34 years old man presented with burning feet syndrome of two years duration. Magnetic resonance imaging (MRI) revealed an intradural extramedullary cystic mass lesion extending from L2 to L5 vertebrae causing severe compression and displacement of terminal portion of conus medullaris and filum terminale to the right side. Additionally, tethered cord and filar lipoma were also present. Cystic mass and filar lipoma were resected along with release of tethered cord. Histopathology confirmed a neurenteric cyst. This case is reported in view of rare occurrence and peculiar presentation.

Crystal structure of the secreted form of antigen 85C reveals potential targets for mycobacterial drugs and vaccines. The antigen 85 (ag85) complex, composed of three proteins (ag85A, B and C), is a major protein component of the Mycobacterium tuberculosis cell wall. Each protein possesses a mycolyltransferase activity required for the biogenesis of trehalose dimycolate (cord factor), a dominant structure necessary for maintaining cell wall integrity. The crystal structure of recombinant ag85C from M. tuberculosis, refined to a resolution of 1.5 A, reveals an alpha/beta-hydrolase polypeptide fold, and a catalytic triad formed by Ser 124, Glu 228 and His 260. ag85C complexed with a covalent inhibitor implicates residues Leu 40 and Met 125 as components of the oxyanion hole. A hydrophobic pocket and tunnel extending 21 A into the core of the protein indicates the location of a probable trehalose monomycolate binding site. Also, a large region of conserved surface residues among ag85A, B and C is a probable site for the interaction of ag85 proteins with human fibronectin.

Surgical specialty, surgical unit volume and mortality after oesophageal cancer surgery. Mortality after oesophagectomy is lower in high-volume than in low-volume surgical units. Case series from cardiothoracic surgeons report lower mortality rates than those from general surgeons. We therefore used a national data set to investigate the effects of surgical specialty and volume on mortality after oesophagectomy. We analysed Hospital Episode Statistics for oesophagectomy for cancer (n=9034 cases), linked to data from death certificates, in England from 1998 to 2003. After adjustment for patients' age, sex and deprivation score, the odds ratio (OR) for death of general surgeons' (GS) patients, compared with cardiothoracic surgeons' (CTS) patients, was significantly high: 1.62 [95% CI 1.34-1.96] at 30 days and 1.38 [1.18-1.61] at 90 days. The odds ratio for high-volume GS patients was not significantly different from that for high-volume CTS patients. However, the odds ratio for low-volume GS patients compared with high-volume CTS patients was significantly high: 1.72 (1.40-2.11) at 30 days and 1.48 (1.26-1.74) at 90 days. Patients treated by general surgeons in low-volume hospitals had worse mortality outcomes than those treated by general surgeons in high-volume hospitals or by cardiothoracic surgeons. This is important because a majority of patients who underwent oesophagectomy for cancer were in this high-mortality risk group.

Is orphan drug status beneficial to tropical disease control? Comparison of the American and future European orphan drug acts. OBJECTIVES To quantify past outcomes of tropical pharmacology research and development (R & D) and to assess past benefits of the American orphan drug act and potential benefits of the future European orphan drug regulation on tropical diseases. This paper presents two analyses: a 1983-97 retrospective study of the United States Orphan Drug Act concerning rare diseases and a prospective study of the European Proposal for a Regulation Concerning Orphan Drugs and its possible impact on tropical diseases. Different programmes have in the past tried to stimulate R & D in this area, but results remain limited. Of 1450 new chemical entities marketed between 1972 and 1997, 13 were specifically for tropical diseases and considered as essential drugs. Between 1983 & 1997, the US Orphan Drug Act approved 837 drugs and marketing of 152 new molecular entities (NMEs). Three NMEs have been designated for malaria and human African trypanosomiasis. Seven others, already commonly used in tropical diseases, received either orphan designation or an orphan approval for another indication. Pharmaceutical companies benefit from the US framework only when the US market exclusivity clause was applicable. Future European orphan drug regulation appears to be similar to the US Orphan Drug Act. CONCLUSION The orphan drug programmes relating to rare diseases have met with some success. Considering tropical diseases rare diseases seems inadequate to boost pharmaceutical R & D. However, some provisions of the European text may be relevant to tropical diseases, admitting the need for a more specific rule for evaluations of this kind of drug and recognizing the existence of 'diseases of exception'.

Multiple response optimization for high efficiency energy saving treatment of rhodamine B wastewater in a three-dimensional electrochemical reactor. The removal of high-concentration rhodamine B (RhB) wastewater was investigated in a three-dimensional electrochemical reactor (3DER) packed with granular activated carbon (GAC) particle electrodes. Response surface methodology (RSM) coupled with grey relational analysis (GRA) was used to evaluate the effects of voltage, initial pH, aeration rate and NaCl dosage on RhB removal and energy consumption of the 3DER. The optimal conditions were determined as voltage 7.25 V, pH 5.99, aeration rate 151.13 mL/min, and NaCl concentration 0.11 mol/L. After 30 min electrolysis, COD removal rate could arrive at 60.13% with an extremely low energy consumption of 6.22 kWh/kg COD. The voltage and NaCl were demonstrated to be the most significant factors affecting the COD removal and energy consumption of 3DER. The intermediates generated during the treatment process were identified and the possible degradation pathway of RhB was proposed. It is worth noting that 3DER also showed an excellent performance in total nitrogen (TN) removal under the optimal condition. The activated chlorine generated from chloride had great contributions to eliminate carbon and nitrogen of RhB wastewater. The treatment effluent had a good biodegradability, which was suitable for subsequent biological treatment.

An analysis of automatic teller machine usage by older adults: a structured interview approach. It is often assumed that automatic teller machines (ATMs) are inherently easy to use and require no training. However, there is evidence to suggest that ATM users do experience difficulty when learning to use the system. The purpose of the present study was to conduct an in-depth analysis of ATM usage by older adults. Our approach consisted of telephone interviews followed by structured individual interviews. The goals were to understand the problems encountered by ATM users, to determine how ATMs might be better designed and to assess the training needs of older individuals. The phone interview data provide information about the relationships between age, sex and ATM usage within the adult sample, as well as information about why some people choose not to use ATMs. The structured interview data provide a more in-depth view of the concerns of both users and non-users, and information about training needs. The training and design implications of the results are discussed.

Energy sources identify metabolic phenotypes in pancreatic cancer. Metabolic reprogramming is one of the emerging hallmarks of cancers. As a highly malignant tumor, pancreatic ductal adenocarcinoma (PDA) is not only a metabolic disease but also a heterogeneous disease. Heterogeneity induces PDA dependence on distinct nutritive substrates, thereby inducing different metabolic phenotypes. We stratified PDA into four phenotypes with distinct types of energy metabolism, including a Warburg phenotype, a reverse Warburg phenotype, a glutaminolysis phenotype, and a lipid-dependent phenotype. The four phenotypes possess distinct metabolic features and reprogram their metabolic pathways to adapt to stress. The metabolic type present in PDA should prompt differential imaging and serologic metabolite detection for diagnosis and prognosis. The targeting of an individual metabolic phenotype with corresponding metabolic inhibitors is considered a promising therapeutic approach and, in combination with chemotherapy, is expected to be a novel strategy for PDA treatment.

A nondestructive method for the measurement of radioactive 14CO2 in blood. A method for estimation of 14CO2 present in blood and tissular samples is described. It is basically based on the introduction of large amounts of a gas mixture (95% O2, 5% CO2) in the samples which serves to remove the CO2 label by gas dilution. The gas phase is later captured in scintillation vials containing an organic-soluble base that retains the carbon label. The results obtained by means of this methodology show much better recoveries for blood samples than those obtained when the classic acid-diffusion method is used. In addition, it is a very fast procedure which does not alter the pH or protein integrity of the biological sample.

Risk factors for silent myocardial ischemia in patients with well-controlled essential hypertension. Silent myocardial ischemia (SMI) is frequently observed in patients with essential hypertension (EH). The major risk factor for SMI is uncontrolled blood pressure (BP), but SMI is also observed in patients with well-controlled BP. To evaluate the prevalence of SMI and the factors associated with SMI in EH patients with well-controlled BP. The medical records of 859 EH patients who underwent simultaneous 24-h ambulatory blood pressure monitoring (ABPM) and 24-h ambulatory electrocardiogram recording (AECG) were retrospectively evaluated. Each SMI episode was characterized by: (a) ST segment depression ≥0.5 mm; (b) duration of ST segment depression >60 s; and (c) reversibility of the ST segment depression. Overall 126 EH patients (14.7 %) had at least one episode of SMI. The SMI events were more frequent among patients with poorly controlled compared to those with well-controlled BP [86/479 (17.95 %) vs. 40/380 (10.52 %), p < 0.01]. Among EH patients with well-controlled BP, current and past smoking as well as the presence of an additional metabolic syndrome (MetS) constitutive element (obesity, impaired fasting glucose level or dyslipidemia) were significantly associated with the occurrence of SMI. In all EH patients with well-controlled BP and AECG evidence of SMI, there were one or more coronary artery stenotic lesions greater than 50 % found at coronary angiography. In EH patients who are current smokers, or have one or more additional components of a MetS there is markedly reduced benefit associated with good BP control with regard to the occurrence of myocardial ischemia: in this patient category, an AECG may help detect this condition.

[Conservative surgery for renal cell carcinoma]. During the nine years period from April 1984 through March 1993, we performed conservative surgery on 26 kidneys in 25 patients with renal cell carcinoma. Of these 25 patients the indication was imperative in 8 patients (the imperative group) and elective in 17 patients (the elective group). Eight patients of imperative group consisted of 5 patients with bilateral renal cell carcinoma (3 synchronous and 2 asynchronous), 1 patient who had renal cell carcinoma on one side and renal pelvic carcinoma on the other side, and 2 patients with renal cell carcinoma in a solitary kidney. In these 8 patients of the imperative group, conservative surgery was performed on 9 kidneys since 1 of 3 patients with synchronous bilateral renal cell carcinoma underwent the conservative surgery for both kidneys. In the elective group, all 17 patients had a small renal cell carcinoma, with the contralateral kidney normal in all. Enucleation was conducted on 4 kidneys out of 9 kidneys in 8 patients of the imperative group. On a total of 22 kidneys consisting of the remaining 5 kidneys and 17 kidneys of the elective group partial nephrectomy was done. The tumor size ranged from 0.9 to 7.0 cm (mean: 3.5 cm) for the imperative group and from 0.8 to 3.0 cm (mean: 2.3 cm) for the elective group. Thus, the tumor size was less than 3.0 cm in all of these 17 cases. As to the histologic atypia, 12 patients were classified as grade 1 and 14 patients as grade 2. None of the patients were classified as grade 3.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationship between the use of gay mobile phone applications and HIV infection among men who have sex with men in Ningbo, China: a cross-sectional study. In recent years, there has been a significant increase in the use of gay mobile phone applications (gay apps) and HIV prevalence among men who have sex with men (MSM) in China. The aim of this study was to investigate whether there was a relationship between the use of gay apps and HIV infection and provide a targeted intervention to MSM. A cross-sectional study was conducted. Chinese MSM who were over 18 years old and had self-reported homosexual intercourse in the past six months were interviewed in 2016. Proportions were used for categorical variables and determinants of HIV infection were assessed using univariate and multivariate regression. Of the 403 participants, nearly 66.0% reported having used gay apps to seek sexual partners in the past six months. A higher proportion of the gay app users were younger than 19 years old, single, had high school education, were earning less than 115 GBP income per month, and identified themselves as homosexual. Compared to app non-users, a greater proportion of app users reported a higher frequency of male-male sexual contact (≥1 time/week: 57.5% versus 39.4%, p < 0.01), multiple male sex partners (34.2% versus 11.7%, p < 0.001), and unprotected sex with men (51.5% versus 36.5%, p < 0.01) in the past six months. The prevalence of HIV among app users was 7.9%. HIV infection was significantly associated with being an app user (adjusted odds ratio = 5.2, 95% CI = 1.1-24.3). It is suggested that the use of gay apps, especially Blued, is popular among Chinese MSM and is associated with high-risk sexual behaviors and HIV infection. Therefore, there is an urgent need to promote HIV testing and HIV prevention through gay apps to decrease the risk of HIV infection among Chinese MSM.

[The management of adolescents and adults with congenital heart defects: 3 years experiences with interdisciplinary consultation]. Since September 1991, 204 patients (pts), 109 male and 95 female, mean age 27.3 +/- 10.6 years, were followed in a newly established interdisciplinary outpatient clinic combining both adult and pediatric cardiologists. 61 pts predominantly presented with left-to-right shunt congenital heart disease (CHD), 32 with valvar CHD, 20 with aortic coarctation, 23 with complex acyanotic, and 49 with cyanotic CHD. The population included 19 pts with Marfan syndrome. 106 pts had had previous cardiac surgery, 32 of them with up to three reoperations. Deficits and needs in medical and social care were analyzed in 100 pts using a standardized questionnaire at the time of first examination: One-third of pts were not or only incompletely informed about their CHD, previous surgical procedures and need for antibiotic prophylaxis of endocarditis. Only a minority of pts had had vocational advice (34%) or counseling concerning contraception (40%) or pregnancy (30%). Cardiac catheterization was performed in 37 pts (18%) after being first seen in our outpatient clinic, followed by a primary surgical intervention in 19 and reoperation in eight cases. Overall, 30 pts (15%) underwent surgery (28) or interventional procedures (one closure of the arterial duct, one AV node ablation after Mustard-operation) as a consequence of admission to our unit. Successful late Fontan operations were performed in four adults aged 21 to 35 years. There was 1/30 postoperative death (M. Ebstein, thrombosis of the mechanical prosthesis). The population includes five pts with severe pulmonary vascular disease (one waiting for lung transplantation) and two pts with pulmonary artery arborisation malformations not amenable to surgery. In a population of 204 adolescents and adults with CHD, we clearly found deficits in medical and social care and, in addition, an unexpected high percentage of necessary invasive investigations (18%) and surgical or interventional procedures (15%). Interdisciplinary management of these patients is mandatory combining the special facilities of adult and pediatric cardiologists.

Vasoactive intestinal polypeptide as possible mediator of relaxation in the rat gastric fundus. Relaxations were induced in longitudinal muscle strips of the rat gastric fundus by stimulation of non-adrenergic non-cholinergic (NANC) neurons and by administration of vasoactive intestinal polypeptide (VIP) or isoprenaline. The effect of antiserum against vasoactive intestinal polypeptide (VIP antiserum) and of control serum on these relaxations was investigated. Incubation with VIP antiserum (dilution 1/50) for 1 h almost completely prevented the relaxation by VIP. It partially prevented the relaxation evoked by electrical stimulation while the relaxation induced by isoprenaline was not influenced. Control serum decreased the VIP- and stimulation-induced relaxations much less than did VIP antiserum. In addition, the effect of the putative VIP antagonist (4Cl-D-Phe6, Leu17) VIP was studied on the relaxations induced by NANC neuron stimulation and by VIP. The VIP antagonist (3 x 10(-5) M, incubation time 10 min) had a relaxatory effect itself but had no influence on either VIP- or stimulation-induced relaxations. The results with VIP antiserum confirm the involvement of VIP in the inhibitory NANC neurotransmission of the rat gastric fundus.

Lipid content and response to insulin are not invariably linked in human muscle cells. In type 2 diabetes, a strong correlation between intramyocellular lipid accumulation and insulin resistance exists but whether intramyocellular accumulation is a cause or a consequence of insulin resistance is not clear. Lipid accumulation and response to insulin were evaluated in primary human myotubes derived from non-diabetic subjects and type 2 diabetic patients. Myotubes derived from type 2 diabetic patients had a defective response to insulin without showing a significant increase in lipid accumulation compared to myotubes derived from non-diabetic subjects. In myotubes derived from non-diabetic subjects, response to insulin stimulation (Akt phosphorylation) was abrogated and lipid content was increased after palmitate treatment. However, chronic exposure to insulin or inhibition of mitochondrial activity by antimycin led to independent changes of lipid content and response to insulin in myotubes derived from non-diabetic subjects. Altogether these results suggest that lipid accumulation and response to insulin are not invariably linked.

PTRAJ and CPPTRAJ: Software for Processing and Analysis of Molecular Dynamics Trajectory Data. We describe PTRAJ and its successor CPPTRAJ, two complementary, portable, and freely available computer programs for the analysis and processing of time series of three-dimensional atomic positions (i.e., coordinate trajectories) and the data therein derived. Common tools include the ability to manipulate the data to convert among trajectory formats, process groups of trajectories generated with ensemble methods (e.g., replica exchange molecular dynamics), image with periodic boundary conditions, create average structures, strip subsets of the system, and perform calculations such as RMS fitting, measuring distances, B-factors, radii of gyration, radial distribution functions, and time correlations, among other actions and analyses. Both the PTRAJ and CPPTRAJ programs and source code are freely available under the GNU General Public License version 3 and are currently distributed within the AmberTools 12 suite of support programs that make up part of the Amber package of computer programs (see http://ambermd.org ). This overview describes the general design, features, and history of these two programs, as well as algorithmic improvements and new features available in CPPTRAJ.

Acute toxicity studies of ebrotidine. The acute toxicity of two formulations of ebrotidine (N-[N-[(E)-[[2-[[[2-[(diaminomethylene)amino]-4-thiazolyl] methyl]thio]ethyl]amino]methylene]-4-bromo-benzenesulfonamide, CAS 100981-43-9, FI-3542) was studied in rats and mice by different routes of dosing: oral and intraperitoneal routes in rats and mice (suspension), intravenous and oral routes in mice and intravenous route in rats (injectable solution). LD50 values for the oral route were indeterminable in all cases. For the intraperitoneal route. LD50 values were 316 mg/kg (rat) and 366 mg/kg (mouse), and for the intravenous route LD50 values were 100 mg/kg (rat) and 107 mg/kg (mouse).

[FI-KR non-separated method coupled with FAAS for the determination of Fe(II) and Fe(III) in water]. An FI-KR non-separated method coupled with FAAS for the determination of Fe(II) and Fe(III) was developed. With 60 s of sampling at a flow rate of 6.0 mL x min(-1), EF of 41 for Fe(III) and 9 for Fe(II) were obtained. The precision (RSD, n = 11) for Fe(III) and Fe(II) was 2.3% and 3.1% at the 0.04 mg x L(-1) level respectively. When 0.1 per thousand phi TEA was used as masking reagent, the recovery rate for Fe(III) and Fe(II) was from 97% to 101% and from 96% to 100% respectively.

[Abuse and neglect--a challenge for the dentist]. The article defines five types of abuse; physical abuse, neglect, failure-to-thrive, emotional and sexual abuse. Problems related to incidence is discussed. There is no national survey of the first four types. But results from a few quantitative and qualitative studies in limited geographical areas are referred to. The need for integrating several theoretical frame of references such as the psychodynamic model, the sociological model, the interaction model as well as others to be able to understand and handle the problem is stressed. The need for interprofessional cooperation and for the dentists to engage themselves in this is argued.

Reaction paths of phosphine dissociation on silicon (001). Using density functional theory and guided by extensive scanning tunneling microscopy (STM) image data, we formulate a detailed mechanism for the dissociation of phosphine (PH3) molecules on the Si(001) surface at room temperature. We distinguish between a main sequence of dissociation that involves PH2+H, PH+2H, and P+3H as observable intermediates, and a secondary sequence that gives rise to PH+H, P+2H, and isolated phosphorus adatoms. The latter sequence arises because PH2 fragments are surprisingly mobile on Si(001) and can diffuse away from the third hydrogen atom that makes up the PH3 stoichiometry. Our calculated activation energies describe the competition between diffusion and dissociation pathways and hence provide a comprehensive model for the numerous adsorbate species observed in STM experiments.

Induction of protective immunity in mice using a 62-kDa recombinant fragment of a Schistosoma mansoni surface antigen. Mice exposed to radiation-attenuated cercariae of Schistosoma mansoni are highly resistant to challenge infection, and sera from these mice can confer partial resistance when transferred to naive recipients. These sera recognize Ag present in schistosomular and adult worms, among them an Ag of 200 kDa. A cDNA encoding a 62-kDa portion of this Ag was cloned; the deduced amino acid sequence of this cDNA clone shares homology with myosins of other species. To assess the immunoprophylactic potential, we carried out vaccination trials in mice using the recombinant polypeptide expressed as a fusion protein with beta-galactosidase presented in the form of proteosome complexes with the outer membrane protein of meningococcus. The level of protection achieved was 32%, and this level could be increased to 75% by removal of those amino acids included in the fusion protein that were derived from the vector to yield a polypeptide, designated rIrV-5. A similar level of protection was achieved when mice were immunized with the same dose of rIrV-5 in the form of protein complexes but without outer membrane protein, suggesting that protection did not require the use of adjuvant. However, at least three immunizations were necessary to achieve protection. Using mAb and sera from mice vaccinated with rIrV-5, we demonstrated that the native protein recognized by antibodies against rIrV-5 is a 200-kDa protein that is expressed on the surface of newly transformed schistosomula. The protection achieved with rIrV-5 in mice encourages additional studies of its potential as a vaccine candidate for the prevention of schistosomiasis.

Traceability of 'Mozzarella di Bufala Campana' production chain by means of carbon, nitrogen and oxygen stable isotope ratios. New techniques are required to guarantee the authenticity of food, especially for PDO (Protected Designation of Origin) trademarks. The genuineness of a product is directly related to the raw material and to the production process used. In this article, the traceability of the Mozzarella di Bufala Campana PDO was investigated, using carbon, nitrogen and oxygen stable isotopes ratios, measured on buffalo feeding, milk and mozzarella, from Caserta and Salerno farms. Furthermore, 37 mozzarella brands were analyzed (carbon, nitrogen and oxygen isotopes) from the different production areas, to characterize their origin. The results of this work showed no changes in carbon and nitrogen isotopic ratios of milk and mozzarella, indicating no fractionation in the production process. The δ13 C of milk was influenced by feeding signal; while, milk δ15 N was regulated by fractionation occurring during ruminant metabolism. Mozzarella oxygen isotopic signal depleted with respect to the milk one. Regarding brand samples, it was found that the geographical differentiation is based more on carbon isotopes than on the nitrogen and oxygen ones. This work gives an important contribution to the knowledge regarding the traceability of such a particular cheese as mozzarella. © 2019 Society of Chemical Industry.

X-Point-Position-Dependent Intrinsic Toroidal Rotation in the Edge of the TCV Tokamak. Edge intrinsic rotation was investigated in Ohmic L-mode discharges on the Tokamak à Configuration Variable, scanning the major radial position of the X point, R(X). Edge rotation decreased linearly with increasing R(X), vanishing or becoming countercurrent for an outboard X point, in agreement with theoretical expectations. The core rotation profile shifted fairly rigidly with the edge rotation, changing the central rotation speed by more than a factor of two. Core rotation reversals had little effect on the edge rotation velocity. Edge rotation was modestly more countercurrent in unfavorable than favorable ∇B shots.

Surface-hopping dynamics simulations of malachite green: a triphenylmethane dye. Malachite green is a typical triphenylmethane dye widely used in fundamental and industrial research; however, its excited-state relaxation dynamics remains elusive. In this work we simulate its photodynamics from the S2 and S1 states using the fewest-switches surface-hopping scheme. In the S2 photodynamics, the system first relaxes to the S2 minimum, which immediately hops to the S1 state via an S2/S1 conical intersection. In the S1 state, 90% trajectories evolve into a structurally symmetric S1 minimum; the remaining ones proceed toward two propeller-like S1 minima. Two kinds of S1 minima then decay to the S0 state via the S1/S0 conical intersections. The S1 photodynamics is overall similar to the S1 excited-state dynamics as a result of the ultrafast S2 → S1 internal conversion in the S2 photodynamics, but the weights of the trajectories that decay to the S0 state via three different S1/S0 conical intersections are variational. Moreover, the S2 relaxation dynamics mainly happens in a concerted synchronous rotation of three phenyl rings. In comparison, in the S1 relaxation dynamics, the rotations of two aminophenyl rings can proceed in the same and opposite directions. In certain trajectories, only the rotation of an aminophenyl ring is active. On the basis of the results, the S2 and S1 excited-state lifetimes of malachite green in vacuo are calculated to be 424 fs and 1.2 ps, respectively. The present work provides important mechanistic insights for similar triphenylmethane dyes.

Effects of nonylphenol on hepatic testosterone metabolism and the expression of acute phase proteins in winter flounder (Pleuronectes americanus): comparison to the effects of Saint John's Wort. 4-Nonylphenol (4-NP), a major by-product of alkylphenol ethoxylates, is used in several industries and as a consequence is quite common in rivers, estuaries and other aquatic environments that receive sewage discharges or are near offshore oil platforms. 4-NP is an environmental estrogen that also binds human and rodent Pregnane X-receptor (PXR), the orphan nuclear receptor that controls the expression of several detoxication genes in mammals, including several CYP3A and CYP2B family members. These P450s preferentially hydroxylate testosterone in the 6beta- and 16beta-positions, respectively. In this study, the effects of 4-NP on testosterone metabolism and hepatic CYP3A induction were compared to the effects of St. John's Wort (SJW), a well established mammalian PXR agonist, in winter flounder. Male winter flounder (Pleuronectes americanus) were injected with 100 mg/kg/day 4-NP or 500 mg/kg/day SJW or both (S and N) every 24 h. Forty-eight hours after the initial injections, flounder were euthanized. Western blots and testosterone 6beta-hydroxylation indicated that CYP3A was increased 50% by 4-NP, but was not affected by SJW. Testosterone 16beta-hydroxylase activity was also significantly increased in flounder treated with 4-NP (2.8 x), but not with SJW. This is not consistent with our hypothesis that both SJW and 4-NP would induce CYP3A. Subtractive hybridization was performed between control and 4-NP treated hepatic mRNA samples to isolate differentially expressed genes. Subtractive hybridization indicated that several acute phase proteins were altered by 4-NP. Quantitative real-time PCR (Q-PCR) confirmed 4-NP altered the expression of complement components C8b, cathepsin L, C-type lectin domain, FK506 binding protein 2 precursor (FKBP2) and an EST (expressed sequence tag). SJW and 4-NP treated flounder demonstrated similar induction profiles for the EST, cathepsin L and FKBP2, suggesting that SJW was at a sufficient dose to alter gene expression but not induce P450s. In conclusion, testosterone hydroxylase activity and Western blots indicate that SJW did not activate detoxication pathways in a similar manner to 4-NP.

Complementary and conventional cancer care: the integration of two cultures. There is now increasing evidence that many cancer patients are seeking unorthodox forms of support and treatment. These range from measures to enhance the quality of life, such as counselling and relaxation therapy, through to alternative cancer remedies, such as extreme diets with detoxification by coffee enemas. Much of complementary care is provided outside the hospital setting, often without the knowledge of the health care professionals involved in a patient's treatment. The Bristol Cancer Help Centre was founded in 1980 to provide an alternative approach to cancer treatment. It became the leading British centre for such therapies, although, from its outset, it had an uneasy relationship with conventional medicine. Some clinicians were highly critical of its perceived methods even though very few actually visited the centre to examine the evolving programmes of care offered. In 1988, a group of oncologists from Hammersmith Hospital visited the Bristol Centre. A joint development programme was conceived in which the lessons from Bristol were integrated into a busy academic oncology unit prior to the design and construction of a new cancer centre. Many problems emerged in trying to merge the two cultures, one driven by technology, the other by human need. Several other oncology units are adopting complementary strategies within their services. Here we describe our joint experience and outline the Hammersmith supportive care model currently in use.

A new approach for enhanced multiplication of arbuscular mycorrhizal fungi and isolation of ITS regions from Glomus deserticola and Laccaria fraterna. Rootlets induced from the petiole base of L. purpureus, using IAA and kinetin was used for enhanced multiplication of arbuscular mycorrhizal (AM) fungus, G. deserticula. Using conserved short arbitrary oligonucleotides, as specific primers, we amplified the ITS-region, a molecular marker for fungal identification, from the genomic DNA extracted from cultured spores of G. deserticola, and genomic DNA extracted from the mycelium of L. fraterna. The capacity of fungal colonization and subsequent spore formation of G. deserticola, compared with the natural root system was evaluated. This technology would provide a simple way to multiply AM fungi and to produce spores without microbial contamination useful for further molecular characterization.

[The effect of spinal anesthesia on pulmonary function tests in old patients]. Pulmonary function test (PFT) results are mainly dependent on age, sex, height, weight, pulmonary mechanics disturbances and cooperation of the subjects. The position and anesthesia type may also influence the PFT results. In this study we aimed to evaluate spirometric changes in old and young patients who performed spinal anesthesia. Fifty patients performed spinal anesthesia were randomized in two groups: Group 1 (n= 25) aged 60-85 years old and group 2 (n= 25) aged 20-59 years old. After electrocardiography, noninvasive blood pressure and peripheral oxygen saturation (SpO2) monitorization, spinal anesthesia using 0.5% hyperbaric bupivacain from L 3-4 intervertebral space was applied. Sensory block levels, hemodynamics and PFT such as forced vital capacity (FVC), forced expiratory volume/1 second (FEV(1)), peak expiratory flow (PEF), and forced expiratory flow at the 25 and 75% of the pulmonary volume (FEF(25-75)) were performed before and after spinal anesthesia in 10th, 40th and 100th minutes in supine and 30 degrees head position using hand type spirometry. Wilcoxon paired two tests statistical analysis was used to compare PFT changes of the subjects. Mean arterial blood pressure levels and spirometric measurements of FVC, FEV(1) and FEF25-75 decrease with respect to basal values in 40th minutes was significant in old patients whom spinal anesthesia was over Th6 level but in young patients the changes were not significant. PFT decrement probabilities should be taken in account in old patients supposing for spinal anesthesia and be paid attention for high level spinal blocks in risk group patients.

[Everted intestinal sac method for quick finding absorption ingredients of Wuzhuyu decoction]. To establish a method for quick finding the absorption ingredients of Wuzhuyu decoction in order to select the index to control its quality. The absorption of three concentration of Wuzhuyu decotion was investigated with the in vitro-everted intestinal sac model. The intestinal bag fluid of jejunum and ileum were collected in different time and the eight ingredients, which were evodiamine (Ev), rutaecarpine (Ru), limonin (Li), ginsenoside-Rb1, -Rg1, -Re (Rb1, Rg1, Re), isorhamnetin-3-O-beta-D-glucosyl(6''-->1'")-alpha-L-rhamnoside (Irs)and 6-gingerol (6-Gi), were detected by HPLC as the represent constituents in samples. Eight ingredients except Ru in samples could be detected, but Ev could not be detected in high concentration samples. The ratios between absorption ingredients were different from in Wuzhuyu decotion. The in vitro-everted intestinal sac canc absorb the ingredients of Wuzhuyu decotion selectivity. Compare with the ileum, the jejunum can provide the more absorption information and faster, the best test time is 60-90 min.

Integrating local environmental management and federal/state interests through governance: the case of the Garden Island Environmental Advisory Committee. The apparently unresolvable differences between managing national defense and local conservation, public recreation, and scientific research can be overcome through an advisory committee, with a strong and dedicated entity to drive the processes of governance and change. The case of the Garden Island Environmental Advisory Committee shows how the organizational and political difficulties of integrating state interests and federal concerns were met. Garden Island, off the coast of Perth, the capital of the State of Western Australia, is a base for the Royal Australian Navy which is administered by the federal Department of Defence. Examples are given of the committee's approach to integrated environmental management and the implementation of the Navy's environmental policy.

A 5-ms Error, 22-μA Photoplethysmography Sensor using Current Integration Circuit and Correlated Double Sampling. This paper presents a low-power Photoplethysmography (PPG) sensing method. The PPG is commonly used in recent wearable devices to detect cardiovascular information including heartbeat. The heartbeat is useful for physical activity and stress monitoring. However, the PPG circuit consumes large power because it consists of LED and photodiode. To reduce its power consumption without accuracy degradation, a cooperative design of circuits and algorithms is proposed in this work. A straightforward way to reduce the power is intermittent driving of LED, but there is a disadvantage that the signal is contaminated by a noise while circuit switching. To overcome this problem, we introduce correlated double sampling (CDS) method, which samples an integration circuit output twice with short intervals after the LED turns on and uses the difference of these voltage. Furthermore, an up-conversion method using linear interpolation, and an error correction using autocorrelation are introduced. The proposed PPG sensor, which consists of the LED, the photodiode, the current integration circuit, a CMOS switch, an A/D converter, and an MCU, is prototyped. It is evaluated by actual measurement with 22-year-old subject. The measurement results show that 22-μA total current consumption is achieved with 5-ms mean absolute error.

Alginate-polymer-caged, C(18)-functionalized magnetic titanate nanotubes for fast and efficient extraction of phthalate esters from water samples with complex matrix. The magnetic titanate nanotube (Fe(3)O(4)-TN composite) was prepared and functionalized with C(18) groups and then coated by a hydrophilic alginate polymer cage. This material (ALG@C(18)-Fe(3)O(4)-TN) exhibited the properties of large surface area, superparamagnetism, high adsorption ability, and good dispersibility in water. ALG@C(18)-Fe(3)O(4)-TNs possessed high extraction efficiency to phthalate esters di-n-propyl-phthalate (DPP), di-n-butyl-phthalate (DBP), dicyclohexyl-phthalate (DCP), and di-n-octyl-phthalate (DOP). The dispersed adsorbents in solution could be collected with an external magnetic field within 10 min. The extraction could be conducted under some extreme conditions such as high salinity, acid or alkali solution or humic acid-rich samples without the decrease in extraction efficiency. In the presence of 100 mg L(-1) humic acid (HAs), the recoveries of analytes were not affected at pH >6, and decreased recoveries of DPP and DCP were observed only in acid solution. Potential analysis and comparison study with the biphthalate acid or n-decanoic acid-rich matrix indicated that the anti-interference ability of adsorbents to HAs mainly resulted from the repulsion interaction and size exclusion provided by alginate cage to HAs. Under the optimized conditions, ALG@C(18)-Fe(3)O(4)-TNs were used to analyze several environmental water samples, a concentration factor of 1000 and detection limits of phthalate esters ranging in 11-46 ng L(-1) were achieved, and the recoveries of analytes were in the range of 84-109% for all samples.

Did the pleistocene glaciations promote divergence? Tests of explicit refugial models in montane grasshopprers. There is a long-standing debate over whether or not the Pleistocene glaciations promoted speciation. While some models predict that extensive mixing of populations during interglacial expansion would have inhibited divergence, others postulate that divergence among allopatric glacial refuges or founder events during recolonization of previously glaciated areas would have promoted differentiation. Using a combination of traditional and coalescent based population genetic approaches, this study finds that the glaciations did not inhibit divergence among populations of the grasshopper Melanoplus oregonensis. Instead, drift associated with recolonization of previously glaciated areas, as well as divergence among multiple allopatric glacial refugia, have both contributed to differentiation in this montane grasshopper from the 'sky islands' of the northern Rocky Mountains. Significant population structure was detected by phylogenetic and FST analyses, including significant FST values among individual pairs of sky-island populations. In addition to clustering of haplotypes within populations, there is some evidence of regional phylogeographic structure, although none of the 'regional groups' form a monophyletic clade and there is a lack of concordance between the genealogical and geographical positions of some haplotypes. However, coalescent simulations confirm there is significant regional phylogeographic structure that most likely reflects divergence among multiple ancestral refugial populations, and indicate that it is very unlikely that the observed gene tree could have been produced by the fragmentation of a single widespread ancestral population. Thus, rather than inhibiting differentiation, the glaciations appear to have promoted population divergence in M. oregonensis, suggesting that they may have contributed to the radiation of Melanoplus species during the Pleistocene.

Electron and phonon cooling in a superconductor-normal-metal-superconductor tunnel junction. We present evidence for the cooling of normal-metal phonons, in addition to the well-known electron cooling, by electron tunneling in a superconductor-normal-metal-superconductor tunnel junction. The normal-metal electron temperature is extracted by comparing the device current-voltage characteristics to the theoretical prediction. We use a quantitative model for the heat transfer that includes the electron-phonon coupling in the normal metal and the Kapitza resistance between the substrate and the metal. It gives a very good fit to the data and enables us to extract an effective phonon temperature in the normal metal.

Millennium development goals and oral health in cities in Southern Brazil. To investigate social determinants of oral health, analysing the occurrence of associations between millennium development goals (MDG) indicators and oral health (OH) indicators. An ecological study was performed in two distinct phases. In Phase 1, MDG indicators and related covariates were obtained from the demographic census of the Brazilian Institute of Geography and Statistics, the Ministry of Health database and the 2000 Human Development Atlas, making up the whole set of independent variables. Principal component analysis was carried out for the independent variables showing the correlations among the variables comprising the main components, and generating a synthetic index allowing the performance of the cities to be known with regard to the MDG (MDG index). In Phase 2, the DMFT index (mean number of decay, missing or filled permanent teeth) and the CF index (prevalence of caries-free individuals), in 12 years old were obtained from the epidemiological survey undertaken in 2002-2003, in 49 cities in southern Brazil, and were analysed in relation to the MDG index using Spearman's correlation. A statistically significant correlation was found for the DMFT and CF indices, respectively, with: the MDG index (R(2)=0.49 and 0.48; P = 0.00); the socioeconomic status of the population (R(2)= 0.12 and 0.12; P = 0.02); the socioenvironmental characteristics (R(2)=0.41 and 0.46; P= 0.00). The MDG synthetic index of the cities analysed and the respective components relating to their socioeconomic and socioenvironmental status demonstrated a positive correlation with OH indicators. As such, intersectoral public policies based on population strategies that act on social determinants of general and oral health need to be integrated so as to impact on the MDG and OH outcomes.

Diagnosis of Nonischemic Stage B Heart Failure in Type 2 Diabetes Mellitus: Optimal Parameters for Prediction of Heart Failure. This study sought to identify whether impaired global longitudinal strain (GLS), diastolic dysfunction (DD), or left atrial enlargement (LAE) should be added to stage B heart failure (SBHF) criteria in asymptomatic patients with type 2 diabetes mellitus. SBHF is a precursor to clinical heart failure (HF), and its recognition justifies initiation of cardioprotective therapy. However, original definitions of SBHF were based on LV hypertrophy and impaired ejection fraction. Patients with asymptomatic type 2 diabetes mellitus ≥65 years of age (age 71 ± 4 years; 55% men) with preserved ejection fraction and no ischemic heart disease were recruited from a community-based population. All underwent a standard clinical evaluation, and a comprehensive echocardiogram, including assessment of left ventricular hypertrophy (LVH), LAE, DD (abnormal E/e'), and GLS (<16%). Over a median follow-up of 1.5 years (range 0.5 to 3), 20 patients were lost to follow-up, and 290 individuals were entered into the final analyses. In this asymptomatic group, LV dysfunction was identified in 30 (10%) by DD, 68 (23%) by LVH, 102 (35%) by LAE, and 68 (23%) by impaired GLS. New-onset HF developed in 45 patients and 4 died, giving an event rate of 112/1,000 person-years. Survival free of the composite endpoint (HF and death) was about 1.5-fold higher in patients without a normal, compared with an abnormal echocardiogram. LVH, LAE, and GLS <16% were associated with increased risk of the composite endpoint, independent of ARIC risk score and glycosylated hemoglobin, but abnormal E/e' was not. The addition of left atrial volume and GLS provided incremental value to the current standard of clinical risk (ARIC score) and LVH. In a competing-risks regression analysis, LVH (hazard ratio: 2.90; p < 0.001) and GLS <16% (hazard ratio: 2.26; p = 0.008), but not DD and LAE were associated with incident HF. Subclinical left ventricular systolic dysfunction is prevalent in asymptomatic elderly patients with type 2 diabetes mellitus, and impaired GLS is independent and incremental to LVH in the prediction of incident HF.

The meiotic pairing behaviour in human spermatocytes carrier of chromosome anomalies and their repercussions on reproductive fitness. I: Inversions and insertions. A European collaborative study. The synaptic behavior of pachytene chromosomes was studied in men heterozygous for inversions and one inversion-insertion by analysis of synaptonemal complexes at the electron microscopy level. The human meiotic data were collected from European laboratories in order to test the current theories and to link the arrest of spermatogenesis and the risk of chromosome imbalance to the mode of pairing and their consequences. The breakpoint location would allow to predict the synaptic and recombinational behavior of chromosome aberrations and particularly the risk of aneusomie de recombinaison in the progeny of inversion carriers.

Microchromatographic quantitation of fetal hemoglobin in patients with sickle cell disease. A microchromatographic procedure (Isolab Fast Hb Test System) which was developed for the quantitation of Hb AI (10) has been found useful for the quantitation of Hb F in samples that contain Hb S and/or Hb C but no Hb A (% Fmicro). This method has been evaluated through analyses of known mixtures of Hb F and Hb S. The Hb Fmicro levels in patients with sickle cell anemia and related conditions were compared with results obtained by alkali denaturation (% FAD) and conventional DEAE-cellulose chromatography (% FDE). This microchromatographic technique is a fast, simple, and sensitive method for Hb F quantitation in patients with Sickle cell disease.

Agreement between fragility fracture risk assessment algorithms as applied to adults with chronic spinal cord injury. Cross-sectional. The objective of the study was to determine and report agreement in fracture risk stratification of adults with spinal cord injury (SCI) using (1) Canadian Association of Radiologists and Osteoporosis Canada (CAROC) and Canadian Fracture Risk Assessment (FRAX) tools with and without areal bone mineral density (aBMD) and (2) SCI-specific fracture thresholds. Tertiary rehabilitation center, Ontario, Canada. Community-dwelling adults with chronic SCI (n=90, C2-T12, AIS A-D) consented to participation. Femoral neck aBMD values determined 10-year fracture risk (CAROC and FRAX). Knee-region aBMD and distal tibia volumetric BMD values were compared to SCI-specific fracture thresholds. Agreements between CAROC and FRAX risk stratifications, and between fracture threshold risk stratification, were assessed using prevalence- and bias-adjusted Kappa statistics (PABAK). CAROC and FRAX assessment tools showed moderate agreement for post-menopausal women (PABAK=0.56, 95% confidence interval (CI): 0.27, 0.84) and men aged ⩾50 years (PABAK=0.51, 95% CI: 0.34, 0.67), with poor agreement for young men and pre-menopausal women (PABAK⩽0). Excellent agreement was evident between FRAX with and without aBMD in young adults and in those with motor incomplete injury (PABAK=0.86-0.92). In other subgroups, agreement ranged from moderate to substantial (PABAK=0.41-0.73). SCI-specific fracture thresholds (Eser versus Garland) showed poor agreement (PABAK⩽0). Fracture risk estimates among individuals with SCI vary substantially with the risk assessment tool. Use of SCI-specific risk factors to identify patients with high fracture risk is recommended until a validated SCI-specific tool for predicting fracture risk is developed.

Clinically significant skeletal variations of the shoulder and the wrist: role of MR imaging. Several skeletal variations of the upper extremity may cause painful conditions or precipitate early degenerative changes, either spontaneously or in response to overuse and trauma. Magnetic resonance imaging has proved particularly useful for accurate interpretation of many of these clinically significant skeletal variations; however, the widespread use of MR imaging may have contributed to over-emphasizing their clinical importance, which is still controversial in many cases. We review, illustrate, and discuss clinically significant skeletal variations of the upper extremity as seen on MR images, particularly those involving the shoulder and the wrist. In the shoulder region, we evaluate variations of acromial and coracoid processes as well as variations and minor dysplastic deformities of the glenoid fossa. We also review different skeletal variations of the carpal region, including ulnar variance, ulnar styloid, lunate morphology, carpal coalition, and carpal accessory ossicles. The role of MR imaging in assessing the clinical importance of such conditions, whether potential, controversial, or well established, is emphasized in this review.

Phagocyte priming as a prognostic indicator in the intensive care unit. The purpose of this study was to study the temporal changes in circulating phagocyte respiratory burst activity and its relationship to mortality in intensive care unit (ICU) patients. Thirty-seven consecutive patients over a 3-week period were studied on their first, third, and seventh day of admission to the regional ICU in Northern Ireland. Blood samples were assayed for respiratory burst activity using luminol-enhanced whole blood chemiluminescence. Compared with survivors, nonsurvivors exhibited significantly higher Acute Physiology and Chronic Health Evaluation II scores, a base deficit, and reduced phagocyte activity (median [interquartile range]) (24.00% [18.00%, 56.00%] vs. 38.00% [30.00%, 63.50%], p = 0.047, Mann-Whitney U test) on day 3 of admission to the ICU. Temporal changes in phagocyte activation dependent on the underlying insult were seen in ICU patients. Furthermore, the degree of phagocyte activation was able to distinguish between survivors and nonsurvivors on day 3 of admission to the ICU. Nonsurvivors exhibited reduced phagocyte activation, suggesting patients at risk of mortality exhibit systemic anergy.

Mechanisms and rehabilitation of discoordination following stroke using a cortical imaging method. Mechanisms underlying discoordination, expressed in the form of obligatory coupling between the shoulder and the elbow muscles following stroke, are probed by simultaneously recording 163-channel EEG together with elbow/shoulder torques and EMGs from the upper arm. With this unique experimental protocol, we were able to have strict post hoc control of a subject's motor performance. Using this novel approach, this paper provides the first evidence of a linear relationship between an overlap in the cortical activities and obligatory shoulder/elbow torque coupling. Furthermore, results obtained from an 8 weeks multi-degree of freedom isometric training protocol showed that a well-designed treatment intervention could reduce obligatory torque coupling following stroke. Preliminary data indicates that this change in torque coupling appears to be associated with brain reorganization. Other potential rehabilitation methods based on an increased understanding of the mechanisms underlying discoordination following stroke are discussed.

Peripheral vascular smooth muscle responsiveness to tumour-promoting phorbol esters in pacing-induced heart failure. Contractions of the dorsal pedal artery and saphenous vein to phorbol 12,13-dibutyrate (PDBu), 12-O-tetradecanoylphorbol 13-acetate (TPA), and 4 alpha-phorbol 12,13-didecanoate (4 alpha-phorbol) were measured from dogs with and without pacing-induced heart failure. The effects of polymyxin B (a relatively selective protein kinase C inhibitor), nifedipine (calcium channel blocker), and prazosin (alpha 1-adrenoceptor antagonist) were examined on the contractions developed to PDBu before heart failure, after 1 week of pacing, and at end-stage heart failure. PDBu and TPA, but not 4 alpha-phorbol, produced concentration-dependent increases in contractile force in both the artery and the vein. In the dorsal pedal artery, efficacy of and sensitivity to PDBu and TPA were enhanced after 1 week of pacing, but returned to control level at end-stage heart failure. In the saphenous vein, the concentration-effect curve to PDBu was displaced to the left after 1 week of pacing; EC50 values for PDBu were 3.2 x 10(-9) and 3.2 x 10(-8) M for 1 week paced and control, respectively. Polymyxin B significantly decreased the efficacy of PDBu in the dorsal pedal artery at all time points, but was less effective with advancing heart failure. In contrast, in the vein, there was a significant increase in inhibitory potential at end-stage heart failure. In all cases, nifedipine inhibited PDBu in a concentration-dependent manner. With the progression of heart failure, the contractions of the saphenous vein, developed to PDBu, became more sensitive to inhibition by nifedipine. Prazosin failed to inhibit vascular effects of PDBu. These results are discussed in terms of protein kinase C involvement in vascular contractions and its role in the pathogenesis of heart failure.

[Combination chemotherapy concurrent with small-dose radiation therapy of small cell carcinoma of the lung]. Forty consecutive patients with small cell carcinoma of the lung were treated with chemotherapy, radiotherapy or both. Of 34 patients treated with chemotherapy, 24 were treated with combination chemotherapy, containing cyclophosphamide vincristine methotrexate and procarbazine, concurrent with small dose radiation therapy (500cGy/5 fraction) as a chemosensitizer (COMPrt). The response rate to this regimen was 81% (29% complete) and the 2 year survival rate was 28.6%. These results have been superior to other regimens and the toxicity was not see to be any higher. After completion of COMPrt regimen, 10 patients were treated with intrathoracic radiation therapy (average dose 3000cGy) and 3 received surgical treatment. Radiation therapy improved the 2-year survival rate (42.2%) when compared with those patients who received no radiation therapy (18.2%). Three patients received surgical treatment were considered to be disease-free for 23, 17, and 9 months respectively, after induction of chemotherapy.

Characteristics of mesenteric lymph node cells homing to gut-associated lymphoid tissue in syngeneic mice. A subpopulation of cells in murine mesenteric lymph nodes, about 15% of those synthesizing DNA at any given time, homes specifically to the gut and mesenteric nodes of syngeneic recipients within 1 day of i.v. transfer. In contrast, cells from Oeyer's patches or peripheral lymph nodes do not. A large proportion of the B blasts which home to the small intestine has surface Ig, but lacks complement receptors. Thy-1-positive T blasts home to the gut to a lesser extent than B blasts. However, it is probable that equal fractions of B and T blasts home to mesenteric nodes. Homing is not affected by measures calculated to interfere with the combination of cell surface IgA and secretory component.

The role of executive function and social-emotional skills in the development of literacy and numeracy during preschool: a cross-lagged longitudinal study. The majority of evidence on the interplay between academic and non-academic skills comes from high-income countries. The aim of this study was to examine the bidirectional associations between Ghanaian children's executive function, social-emotional, literacy, and numeracy skills longitudinally. Children (N = 3,862; M age = 5.2 years at time 1) were assessed using direct assessment at three time points over the course of two school years. Controlling for earlier levels of the same skill, early executive function predicted higher subsequent literacy and numeracy skills, and early literacy and numeracy skills predicted higher subsequent executive function, indicating that the development of executive function and academic skills is inter-related and complementary over time. Early literacy and numeracy predicted subsequent social-emotional skills, but early social-emotional skills did not predict subsequent literacy and numeracy skills. The findings provide longitudinal evidence on children's learning and development in West Africa and contribute to a global understanding of the relations between various developmental skills over time.

Breastfeeding in Women on Opioid Maintenance Therapy: A Review of Policy and Practice. Opioid use is epidemic in the United States. Opioid use disorder (OUD) in pregnancy, as well as neonatal abstinence syndrome, has quadrupled in the last decade, and opioid maintenance therapy is recommended for pregnant women with OUD. Breastfeeding is an important means of improving outcomes for these vulnerable women and newborns. The purpose of this study was to review current policy on breastfeeding and opioid maintenance therapy, the rates of breastfeeding among women in this population, and facilitators and barriers to implementing policy recommendations. CINAHL, PubMed, the Cochrane Database of Systematic Reviews, Embase, and Web of Science were searched. Inclusion criteria included publication between 2013 and 2018, English language, human only, and original data (except for policy statements). Studies were excluded if they did not report original data and did not examine breastfeeding for women on opioid maintenance therapy. Eight policy statements and 17 original research studies were identified that met the search criteria. All the policy statements support breastfeeding for women who are stable on opioid maintenance therapy and do not have HIV. Despite this, rates of breastfeeding among women receiving opioid maintenance therapy remain low compared with women in the general population. Results of qualitative research indicates that women on opioid maintenance therapy face numerous barriers to breastfeeding, including misinformation from health care professionals. Quantitative research has only begun to identify interventions to improve breastfeeding outcomes in this population. Research was conducted primarily with white women receiving care at urban health care centers. Practice lags behind policy in terms of supporting breastfeeding in women receiving opioid maintenance therapy. There is a need for more research that includes African American and rural women on opioid maintenance therapy, as well as quantitative research that uses findings from qualitative research to identify the best possible interventions for improving breastfeeding outcomes for women on opioid maintenance therapy and their newborns. One significant need is for health care provider education regarding these policies as well as best practices for providing breastfeeding education and support to this population.

[Prevalence of hepatitis C virus markers in Polish blood donors in 1994-2003]. The results of serological and molecular screening tests for HCV performed by Polish Blood Transfusion Service between 1994 and 2003 are presented. Serological tests were performed in 4,233,119 donors. The average frequency of anti-HCV was 0,48%. The frequency of anti-HCV was higher in first time donors (0,86%) than in repeat donors (0,23%). In both groups a decreasing trend in anti-HCV frequency was observed--4% annually in the group of candidates for donors and 21% annually in repeat donors. Molecular methods for identification of HCV infection in serologic window period were introduced in 2000. RNA HCV was detected in 51 out of 2,915,299 (0,002%) anti-HCV negative plasma samples. The frequency of HCV infection markers is in Poland higher than in most European countries. However, a decreasing tendency of HCV markers detection, especially in repeat donors is observed.

Detection of Borrelia afzelii, Borrelia burgdorferi sensu stricto, Borrelia garinii and group VS116 by PCR in skin biopsies of patients with erythema migrans and acrodermatitis chronica atrophicans. OBJECTIVE: To evaluate the diagnostic performance of two polymerase chain reaction (PCR) procedures using skin biopsies of 20 erythema migrans (EM) and 24 acrodermatitis chronica atrophicans (ACA) patients. METHODS: One assay amplified a fragment of the outer surface protein (Osp) A gene. The second method amplified the spacer region between the 5S and 23S rRNA genes; hybridization of this fragment allowed identification of Borrelia burgdorferi sensu lato species. RESULTS: Among EM patients, both assays detected Borrelia DNA in 15 samples. Among ACA patients, the ospA PCR detected 15 positives and 10 samples were positive by 5S-23S PCR. In 19 samples one species was detected, 15 skin biopsies contained Borrelia afzelii, and Borrelia garinii was found in two patients. Group VS116 was detected in two EM patients, and therefore this group has pathogenic potential. Mixed infections of B. afzelii and B. garinii, group VS116 or B. burgdorferi sensu stricto were found in three EM and three ACA patients. CONCLUSIONS: Diagnosis of EM and ACA by PCR is useful and knowledge of the presence of species may be used to predict the course of disease or the need for further antibiotics.

The effect of subject awareness and prior slip experience on tribometer-based predictions of slip probability. Prior knowledge of potentially slippery conditions has been shown to alter normal human gait in slip and fall experiments. We sought to quantify how the empirical relationship between slip probability and available floor friction was affected by subject awareness and prior slip experience. Sixty-eight subjects (40 females, 28 males) walked over three different low-friction surfaces inserted periodically between non-slip control trials. Three increasing levels of prior knowledge were used: deceived (unaware of the slippery surface), aware (20% chance of a slippery surface, but no prior slip experience) and experienced (aware with prior slip experience). Available friction was measured using a drag sled and a variable incidence tribometer. Of 620 low-friction trials, 124 generated slips greater than 27mm. The proportion of slips, the slip distance and the required friction (taken from the control trial immediately before a low-friction trial) generally decreased with increasing levels of prior knowledge. These adaptations were accommodated by logistically regressing slip outcome (yes/no) against the normalized friction (available friction minus required friction) rather than against available friction alone. The regressions showed that subject awareness biased the slip probability curve toward a lower slip risk for a given normalized friction, but that the subsequent addition of slip experience generated a slip risk curve that was not significantly different from that of deceived (and presumably unprepared) subjects. These findings suggest that data to validate a tribometer's ability to predict the risk of slipping (but not falling) can be acquired from subjects with prior slip experience.

Heterogeneity in the conformation of valine in the elastin mimetic (LGGVG)6 as shown by solid-state 13C NMR SPEctroscopy. Elastin is an abundant protein found in vertebrates and is the source of elasticity in connective tissues and blood vessels. The repeating polypeptide sequences found in the hydrophobic domains of elastin have been the focus of many studies that attempt to understand the function of the native protein on a molecular scale. In this communication, the (LGGVG)6 elastin mimetic is characterized by solid-state 13C NMR spectroscopy. Through the use of a combination of a statistical analysis based on the Protein Data Bank, one-dimensional cross-polarization magic-angle-spinning NMR spectroscopy, and two-dimensional off-magic-angle-spinning spin-diffusion experiments, it is determined that this tandem repeat does not form a regular, highly ordered structure. Instead, like the poly(VPGVG) elastin mimetics, the valine has a twofold heterogeneity, although the conformations of these two populations differ from one peptide to the other.

Salting out of chemicals in estuaries: implications for contaminant partitioning and modelling. Many neutral chemicals are salted out of aqueous solution via electrostriction and exhibit increased sorption with increasing concentration of dissolved salt. Salting out has significant implications for the reactivity, transport and fate of chemicals discharged to estuaries, but attempts to define or model the effect in such environments have been limited. This paper examines new and existing data on the sorption of neutral chemicals (specifically, a tetrachlorinated biphenyl, a phthalic acid ester, and neutral species of tributyltin) to estuarine suspended particles in order to evaluate the potential application and limitations of salting theory to estuarine chemical modelling. It is shown that the salinity dependence of sorption may be empirically modelled using a salting equation, but salting constants derived from data-fitting are often significantly greater than those derived by calculation or from conventional aqueous solubility studies. This suggests that the hydrophobicity of sediment organic matter is modified by interactions with dissolved seawater ions, and (or) chemical solubility is enhanced in river water via hydrophobic interactions with dissolved organic matter. In some estuaries, trace metals also appear to be salted out, suggesting that stable neutral complexes are formed between transition metals and a specific, but undefined pool of dissolved organic ligands. Despite successful empirical modelling of the effect in estuaries, predictive modelling of salting out is currently hampered by a lack of understanding or definition of the precise interactions between (i) neutral solute (or trace metal) and dissolved and sediment organic matter, and (ii) sediment organic matter and dissolved seawater ions.

The association of early computed tomography scan findings and ambulation, self-care, and supervision needs at rehabilitation discharge and at 1 year after traumatic brain injury. To ascertain the association between early computed tomography (CT) scan findings and the need for assistance with ambulation, activities of daily living (ADLs), and supervision at rehabilitation discharge and at 1 year after traumatic brain injury (TBI). Prospective longitudinal design. Seventeen Traumatic Brain Injury Model Systems (TBIMS) centers. A total of 1,839 adults with TBI admitted to TBIMS trauma centers with subsequent acute rehabilitation; 849 were followed to 1 year after injury. Not applicable. Accumulated CT scan pathology from the first week after injury; FIM instrument and Disability Rating Scale at rehabilitation discharge and 1 year after injury; and Supervision Rating Scale at 1 year. Chi-square analyses showed that individuals with a midline shift greater than 5mm (lateral compression) were more likely to require the assistance of another person at discharge from acute rehabilitation with ambulation (29% vs 17%-19%, P=.02), toileting (47% vs 33%-38%, P=.05), lower-body dressing (57% vs 39%-46%, P=.015), bladder continence (32% vs 19%-23%, P=.03), and overall supervision (53% vs 44%, P=.0006) than patients with a midline shift of lesser degree. At 1 year, 57% of patients with a midline shift greater than 5mm on acute CT scans were being supervised in the home versus 30% to 39% of those with a shift of lesser degree (P=.003); there were no significant differences in the percentages of those needing assistance for ambulation or ADLs. The association of subdural hematoma with ambulation, self-care, and supervision needs was related to the degree of midline shift but not to the presence of subdural hematoma. Individuals with subcortical contusions were more likely to require assistance at rehabilitation discharge for ambulation (32% vs 18%, P<.0001), lower-body dressing (61% vs 44%), toileting (52% vs 35%), bladder continence (34% vs 22%), and overall supervision (61% vs 44%) than those without subcortical contusions (P<.0001). At 1 year, individuals with acute subcortical contusions were more likely to need assistance with ambulation (15% vs 8%, P=.004) and stair climbing (15% vs 9%, P=.03). Those with bilateral frontal (54% vs 46%, P=.009) or bilateral temporal (58% vs 46%, P=.03) contusions were more likely to need assistance with overall supervision at rehabilitation discharge, compared with those with unilateral or no cortical contusions. The presence of either a midline shift greater than 5mm or a subcortical contusion on acute CT scans is associated with a greater need of assistance with ambulation, ADLs, and global supervision at rehabilitation discharge. Patients with bilateral cortical contusions require more global supervision at rehabilitation discharge but no more supervision for ambulation and ADLs. These findings may aid health care professionals and potential caregivers in planning for rehabilitation and supervision needs after rehabilitation discharge and, to a lesser extent, at 1 year after TBI.

Effects of acute olanzapine exposure on central insulin-mediated regulation of whole body fuel selection and feeding. The use of antipsychotics is associated with severe disruptions in whole body glucose and lipid metabolism which may in part occur through the central nervous system and impaired insulin action at the brain. Here we investigated whether olanzapine treatment might also affect the ability of central insulin treatment to regulate food intake and fuel preference in the light and dark cycle. Male Sprague-Dawley rats were treated with olanzapine (or vehicle solution; 3 mg/kg, subcutaneous) and a simultaneous acute intracerebral ventricular (ICV) infusion of insulin (or vehicle; 3 μL at 10mU; ICV) at the beginning of the 12-h light and dark cycles. Olanzapine treatment reduced RER in the dark and light phases (most consistently in the 4-hours post-treatment), while ICV insulin reduced average RER predominantly in the dark phase, but also at the end of the light cycle. The RER lowering effect of ICV-insulin during the light cycle was absent in the group co-administered olanzapine. The reduction in RER during the dark phase was mirrored by decreased food intake with ICV insulin, but not olanzapine treated rats. The reduction in food intake by ICV-insulin was abolished in rats co-administered olanzapine suggesting rapid induction of central insulin resistance. A combination of ICV-insulin and olanzapine similarly reduced RER in the dark phase, independent of changes in food intake. Olanzapine treatment, alone or in combination with ICV-insulin, significantly reduced VCO2 at regular intervals in the dark phase (specifically 3 h post-treatment), while VO2 was not significantly altered by either treatment. Finally, heat production was increased by olanzapine treatment in the light phase, though this effect was not consistent. The findings confirm that acute olanzapine treatment directly reduces RER and suggest that treatment with this drug may also override central insulin-mediated reductions in food intake at the hypothalamus (while still independently favoring fatty acid oxidation). Acute central insulin similarly reduces RER, but in contrast to olanzapine, this may represent a physiologically appropriate response to reduction in food intake.

Transcript heterogeneity of the human gene for Ca2+-binding protein regucalcin. Regucalcin is a Ca2+-binding protein which plays a regulatory role in liver cell functions related to Ca2+. In this study we have cloned and characterized cDNA for regucalcin from human liver and human hepatoma cell line Hep G2 by screening and rapid amplification of cDNA ends (RACE). The nucleotide sequences of the clones revealed that they were identical in their coding region and differed only in their 5' untranslated regions (UTRs). Northern blot analysis showed that regucalcin mRNA in the Hep G2 was longer than that of the liver. The present study demonstrates the existence of transcript heterogeneity of the human gene for regucalcin.

Segmental hypersensitivity and spinothalamic function in spinal cord injury pain. The mechanisms underlying central pain following spinal cord injury (SCI) are unsettled. The purpose of the present study was to examine differences in spinothalamic tract function below injury level and evoked pain in incomplete SCI patients with neuropathic pain below injury level (central pain) versus those without such pain. A clinical examination, quantitative sensory testing and magnetic resonance imaging (MRI) were performed in 10 SCI patients with below-level pain and in 11 SCI patients without neuropathic pain. Patients with and without pain had similar reductions of mechanical and thermal detection thresholds below injury level. SCI patients with central pain had sensory hypersensitivity in dermatomes corresponding to the lesion level more frequently than SCI patients without pain, but this may in part be explained by the exclusion of at-level spontaneous pain in the pain-free group. The rostral-caudal extent of the lesion measured by MRI did not differ between the two patient groups, and there were no statistically significant differences in any of the predefined areas of interest on the axial plane images. This study suggests that neuronal hyperexcitability plays a key role in central SCI pain and furthermore - in contrast to previous findings - that loss of spinothalamic functions does not appear to be a predictor for central neuropathic pain in spinal cord injury.

Health maintenance strategies for women of different ages. An overview. Preventive health strategies for screening for specific illnesses, counseling, and immunization are discussed. Emphasis is given to cardiovascular screening and risk reduction, screening for malignancies, and immunization practices. A framework for designing periodic health examinations for patients is detailed.

FOXO3a: a novel player in thyroid carcinogenesis? The forkhead box transcription factor FOXO3a has recently been identified as central mediator of the cellular response to oxidative stress inducing cell cycle arrest or apoptosis. The aim of our study was to investigate the regulation of FOXO3a in the thyroid and to determine whether alterations in FOXO3a activity occur in thyroid carcinogenesis. In vitro, we demonstrate that FOXO3a activity is negatively regulated by the PI3K/Akt cascade promoting increased phosphorylation and cytoplasmatic accumulation of FOXO3a with decreased transcription of the target genes p27kip (CDKN1B) and Bim (BCL2L11), but increased expression of GADD45A. By contrast, we show that H(2)O(2) exposure activates FOXO3a in thyrocytes with JNK (MAPK8)-mediated nuclear accumulation of FOXO3a and increased expression of the cell cycle arrest genes p27kip and GADD45A. In vivo, we observed a marked cytoplasmatic accumulation of FOXO3a in differentiated thyroid cancers versus an exclusive nuclear accumulation in follicular adenoma and normal thyroid tissue. Moreover, this cytosolic accumulation of FOXO3a correlated with an increased phospho-Akt expression in thyroid malignancies and was accompanied by decreased expression of the FOXO targets p27kip and Bim and an increase in GADD45A mRNA expression in the thyroid cancers. Our data suggest FOXO3a as a novel player of cellular stress response in the thyroid, mediating the thyrocyte's fate either to survive or to undergo apoptosis. Furthermore, PI3K-dependent FOXO3a inactivation may be a novel pathomechanism for the escape from apoptosis in thyroid cancer cells, in particular in follicular thyroid carcinoma.

Transantral-ethmoidal decompression of optic canal fracture. A case of indirect trauma to the optic nerve was successfully treated with transethmoidal decompression. The literature was reviewed, and reports of poor results from neurosurgical procedures are cited. Improved results from transethmoidal decompression of the optic nerve have been reported by Japanese authors but, in our opinion, without proper selection of cases. Early diagnosis of traumatic compression of the intracanalicular optic nerve as evidenced by delayed and/or progressive vision loss following injury, coupled with prompt transantral-ethmoidal surgical decompression, should yield gratifying results in the treatment of this uncommon condition.

Regulation of chitinase production by the 5'-untranslated region of the ybfM in Serratia marcescens 2170. Serratia marcescens 2170 produces three chitinases and the chitin-binding protein CBP21, and efficiently degrades insoluble and crystalline chitin. The three chitinases and CBP21 are induced by N,N'-diacetylchitobiose [(GlcNAc)₂], the major product of chitin hydrolysis by S. marcescens chitinases. We have found that uptake of both (GlcNAc)₂ and N-acetylglucosamine (GlcNAc) is important for the efficient utilization of (GlcNAc)₂ because (GlcNAc)₂ is less efficiently fermented by S. marcescens 2170 in the absence of chitobiase. In order to determine the mechanism of utilization of the degradation products of chitin by S. marcescens, chitobiase deficient transposon mutants were screened. A transposon present in chitobiase-deficient mutants was inserted into the ybfMN-ctb cluster. The mutants produced chitinases, except for TT327, in which a transposon was inserted into the 5'-untranslated region (5'-UTR) of ybfM. Ectopic expression of this region in TT327 restored chitinase production. These results indicate that the 5'-UTR of ybfM is important for chitinase induction in S. marcescens.

In vitro strain-induced endothelial cell dysfunction determined by DNA synthesis. Rapid re-endothelialization following balloon angioplasty can reduce restenosis by inhibiting smooth muscle cell migration and proliferation. However, formation of a neointima following angioplasty can be inhibited due to endothelial cell dysfunction and denudation. The purpose of this study was to evaluate mechanical tensile stress as a cause of endothelial cell dysfunction. The Flexercell strain unit was utilized to generate both short-term cyclic and static tensile strain on cultured bovine aortic endothelial cells (BAECs). Before analysis of this loading on BAECs, strain behaviour of the Flexercell system and DNA assay conditions were optimized. This paper demonstrates that, when compared with unloaded controls, 4-h cyclic loading at 4 per cent elongation and 0.1 Hz, and static loading at 4 per cent elongation cause a 44 and 70 per cent decrease in DNA synthesis respectively. In a companion paper, it is demonstrated that low DNA synthesis levels in mechanically loaded cells can be increased by incubation with Ap4A and/or NO donors.

ERCC1 (excision repair cross-complementing 1) expression in pT2 gallbladder cancer is a prognostic factor. Gallbladder cancer (GBC) is the main cause of death by malignant tumour in women in Chile. There is no information regarding the role of excision repair cross-complementing group 1 (ERCC1) in GBC. Our aim is to determine the expression and significance of ERCC1 as a prognostic factor in GBC. Tissue microarrays were prepared using 200 surgically resected GBCs and 50 non-malignant gallbladders as controls. In 190 cases, ERCC1 was determined by immunohistochemistry. The correlation between ERCC1 expression and GBC pathological characteristics and patient survival were analysed. Ninety-five percent of the non-malignant gallbladder epithelia showed intense and diffuse ERCC1 expression. GBC cases showed ERCC1 expression in the tumour cells in 100/190 (53%) cases. The best differentiated tumours showed significantly greater expression than the less differentiated (p<0.05). Patients with ERCC1-positive status with subserosal carcinomas (pT2) had significantly better survival than ERCC1-negative patients at 20 and 60 months of follow-up (p=0.005), and the probability of dying was 6 times lower for ERCC1-positive than for ERCC1-negative patients. Our preliminary results show that chole-cystectomised patients with GBC in stage pT2 and with ERCC1 expression have significantly better survival than patients at the same stage that did not present ERCC1 expression.

Skeletal muscle mass: evaluation of neutron activation and dual-energy X-ray absorptiometry methods. Although skeletal muscle (SM) is a major body component, whole body measurement methods remain limited and inadequately investigated. The aim of the present study was to evaluate the Burkinshaw in vivo neutron activation analysis (IVNA)-whole body 40K-counting and dual-energy X-ray absorptiometry (DXA) methods of estimating SM by comparison to adipose tissue-free SM measured using multiscan computerized axial tomography (CT). In the Burkinshaw method the potassium-to-nitrogen ratios of SM and non-SM lean tissue are assumed constant; in the DXA method the ratio of appendicular SM to total SM is assumed constant at 0.75. Seventeen healthy men [77.5 +/- 13.8 (SD) kg body wt] and eight men with acquired immunodeficiency syndrome (AIDS; 65.5 +/- 7.6 kg) completed CT, IVNA, and DXA studies. SM measured by CT was 34.4 +/- 6.2 kg for the healthy subjects and 27.2 +/- 4.0 kg for the AIDS patients. Compared with CT, the Burkinshaw method underestimated SM by an average of 6.9 kg (20.1%, P = 0.0001) and 6.3 kg (23.2%, P = 0.01) in the healthy men and the men with AIDS, respectively. The DXA method minimally overestimated SM in both groups (2.0 kg and 5.8% in healthy men, P = 0.001; 1.4 kg and 5.1% in men with AIDS, P = 0.16). This overestimate could be explained by a higher actual than assumed ratio of DXA-measured appendicular SM to total body SM (actual = 0.79 +/- 0.05, assumed = 0.75). The current study results reveal that large errors are present in the Burkinshaw SM method and that substantial refinements in the models that form the basis of this IVNA approach are needed. The model on which the DXA-SM method is based also needs further minor refinements, but this is a promising in vivo approach because of less radiation exposure and lower cost than the IVNA and CT methods.

Comparison of glucose and insulin concentrations in macaque sera and plasma. The glucose and insulin concentrations in blood from Macaca nigra and M. mulatta were determined after an overnight fast and 3 min after a glucose infusion. Blood treatment included clotting for serum or additions of fluoride, heparin, or heparin plus fluoride. Samples were centrifuged at 0 min or after being held at 22 degrees C for 20, 40, or 60 min. Levels of glucose and insulin generally agreed within 1 SD at all times examined for samples removed at 0 or 3 min.

Comparison of flexible sigmoidoscopy with other diagnostic techniques in the diagnosis of rectocolon neoplasia. Flexible sigmoidoscopy was compared to rigid sigmoidoscopy in the detection of colorectal neoplasia in a select group of patients. A distance of 30 cm or greater was obtained by flexible sigmoidoscopy in 94% of patients and a distance of 50 cm or greater in 46% of patients. A significant number of cancers and adenomas detected by flexible sigmoidoscopy were not detected by rigid sigmoidoscopy. Flexible sigmoidoscopy was tolerated better than rigid sigmoidoscopy but required twice the time. Flexible sigmoidoscopy could be combined with air-contrast barium enema the same day with the one preparation and did not interfere with the x-ray examination. All cancers and a significant number of adenomas detected subsequently on colonoscopy were detected by the combination of flexible sigmoidoscopy and air-contrast barium enema. Although the combination of flexible sigmoidoscopy and air-contrast barium enema is not adequate for thorough diagnostic evaluation of patients with a positive screening test, it may be of value in other select clinical situations. Flexible sigmoidoscopy has the potential for higher yield and better patient tolerance as compared to rigid sigmoidoscopy. This warrants further evaluation.

The handicapped child and child abuse. For a group of children with handicaps, growth and development are also affected by abuse or neglect. Our understanding of the problems of the abused, handicapped child emerges from experience with 37 children with cerebral palsy who have been maltreated, coupled with a review of the literature in related areas. We identify the following four problems as crucial to the study of abuse and neglect to the child with handicaps: (1) abuse that causes handicaps, (2) abuse that occurs to the handicapped child, (3) compromises in care that can occur when the handicapped child becomes involved with the medical and legal systems, and (4) arrangements for foster care or other out-of-home placement for the child with handicaps. We conclude that the very systems designed to protect and care for the child often fail, leaving the handicapped child without opportunity to reach developmental potential. In light of our observations, we recommend that the pediatrician not only be aware of the existence of abuse and neglect in the population of handicapped children, but also serve in the dual role of coordinator of services and advocate for these children.

Colloidal Gold Nanocups with Orientation-Dependent Plasmonic Properties. Colloidal gold nanocups are synthesized through single-vertex-initiated gold deposition on PbS nanooctahedrons and subsequent selective dissolution of the PbS component. They possess strong magnetic plasmon resonance and exhibit remarkable orientation-dependent plasmonic properties when deposited on flat substrates. They can also effectively couple s-polarized light into the interfacial region between the nanocup and substrate.

The physiological basis of psychological disgust and moral judgments. To address ongoing debates about whether feelings of disgust are causally related to moral judgments, we pharmacologically inhibited spontaneous disgust responses to moral infractions and examined effects on moral thinking. Findings demonstrated, first, that the antiemetic ginger (Zingiber officinale), known to inhibit nausea, reduces feelings of disgust toward nonmoral purity-offending stimuli (e.g., bodily fluids), providing the first experimental evidence that disgust is causally rooted in physiological nausea (Study 1). Second, this same physiological experience was causally related to moral thinking: ginger reduced the severity of judgments toward purity-based moral violations (Studies 2 and 4) or eliminated the tendency for people higher in bodily sensation awareness to make harsher moral judgments than those low in this dispositional tendency (Study 3). In all studies, effects were restricted to moderately severe purity-offending stimuli, consistent with preregistered predictions. Together, findings provide the first evidence that psychological disgust can be disrupted by an antiemetic and that doing so has consequences for moral judgments. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Increased nuchal translucency: results from microarray and RASopathy disorders testing. To determine the incidence of chromosome abnormalities, submicroscopic chromosomal microarray (CMA) abnormalities and RASopathy Disorders (RD) pathogenic variants in a cohort of pregnant patients with a nuchal translucency (NT) ≥3.5mm. We propose a clinical protocol for surveillance of this group of patients. A retrospective chart review was performed on patients seen at The Prenatal Diagnosis and Medical Genetics Program between January 2013 - December 2015 for NT ≥3.5mm that had chorionic villus sampling or amniocentesis. Patients underwent extensive genetic counselling prior to invasive procedures and testing. Initial genetic testing included qualitative fluorescence polymerase chain reaction (QF-PCR) for aneuploidies. If negative, patients underwent karyotype testing, CMA and DNA analysis for RD pathogenic variants which included 9 known genes. Patients also underwent detailed fetal ultrasounds and echocardiograms completed by experts in the fields. A total of 226 eligible patients were identified. In 116/226 (51.3%) patients, QF-PCR identified a chromosomal aneuploidy. The remaining 110/226 (48.7%) patients had further genetic testing. Abnormal/pathogenic cytogenetic results (karyotyping and CMA) were detected in 9/110 (8.2%) of the patients along with 5 variants of unknown significance (VUS). RD testing yielded 3 pathogenic variants (3/110) for a detection rate of 2.7 % and 1 VUS. The optimal NT cut off for RD screening was 7.9 mm in this population. This article is protected by copyright. All rights reserved.

Pattern production through a chiral chasing mechanism. Recent experiments on zebrafish pigmentation suggests that their typical black and white striped skin pattern is made up of a number of interacting chromatophore families. Specifically, two of these cell families have been shown to interact through a nonlocal chasing mechanism, which has previously been modeled using integro-differential equations. We extend this framework to include the experimentally observed fact that the cells often exhibit chiral movement, in that the cells chase, and run away, at angles different to the line connecting their centers. This framework is simplified through the use of multiple small limits leading to a coupled set of partial differential equations which are amenable to Fourier analysis. This analysis results in the production of dispersion relations and necessary conditions for a patterning instability to occur. Beyond the theoretical development and the production of new pattern planiforms we are able to corroborate the experimental hypothesis that the global pigmentation patterns can be dependent on the chirality of the chromatophores.

Detection and quantized conductance of neutral atoms near a charged carbon nanotube. We describe a novel single atom detector that uses the high electric field surrounding a charged single-walled carbon nanotube to attract and subsequently field-ionize neutral atoms. A theoretical study of the field-ionization tunneling rates for atomic trajectories in the attractive potential near a nanowire shows that a broadly applicable, high spatial resolution, low-power, neutral-atom detector with nearly 100% efficiency is realizable with present-day technology. Calculations also show that the system can provide the first opportunity to study quantized conductance phenomena when detecting cold neutral atoms with mean velocities less than 15 m/s.

Large and Uniform Optical Emission Shifts in Quantum Dots Strained along Their Growth Axis. We introduce a calibration method to quantify the impact of external mechanical stress on the emission wavelength of distinct quantum dots (QDs). Specifically, these emitters are integrated in a cross-section of a semiconductor core wire and experience a longitudinal strain that is induced by an amorphous capping shell. Detailed numerical simulations show that, thanks to the shell mechanical isotropy, the strain in the core is uniform, which enables a direct comparison of the QD responses. Moreover, the core strain is determined in situ by an optical measurement, yielding reliable values for the QD emission tuning slope. This calibration technique is applied to self-assembled InAs QDs submitted to incremental elongation along their growth axis. In contrast to recent studies conducted on similar QDs submitted to a uniaxial stress perpendicular to the growth direction, optical spectroscopy reveals up to ten times larger tuning slopes, with a moderate dispersion. These results highlight the importance of the stress direction to optimize the QD optical shift, with general implications, both in static and dynamic regimes. As such, they are in particular relevant for the development of wavelength-tunable single-photon sources or hybrid QD opto-mechanical systems.

The benefits of estrogen or selective estrogen receptor modulator on kidney and its related disease-chronic kidney disease-mineral and bone disorder: osteoporosis. An umbrella concept addressing the relationship between chronic kidney disease (CKD) and mineral and bone disorders has been developed in recent years. Given the high prevalence of osteoporosis-related fractures in postmenopausal women with CKD, especially those undergoing chronic hemodialysis, the strategy used in the prevention and management of CKD and its associated osteoporosis in these postmenopausal women has become a topic of substantial debate. This controversy has ongoing relevance because osteoporosis results in a significant economic burden secondary to increased morbidity and mortality. The perfect goal of treatment and prevention includes both bone protection and renal protection, or at least protection of one disease without compromising the other disease. Both CKD and osteoporosis are frequently observed in the same patients, and often have parallel progression in postmenopausal women. Estrogen, the main female hormone during reproductive age, has been reported to have a protective effect on kidney fibrosis in several animal models, and is also considered one of the most effective drugs in the management of postmenopausal women with osteoporosis and prevention of osteoporosis. However, due to the many adverse events associated with the use of estrogen with and without progestin, some of which have contributed to significant morbidity and mortality, drug modification, which has had fewer reported incidences of adverse events without compromising the protective effect on both the kidney and bone, may have an easier road to acceptance. Therapeutic alternatives, such as the selective estrogen receptor modulators (SERMs), have shown the benefits of estrogen on bone, serum lipid levels, and renal protection, without any adverse effects on the breast and endometrium. The Multiple Outcomes of Raloxifene Evaluation trial (MORE) and its extension-Continuing Outcomes Relevant to Evista (CORE), a double-blind, randomized clinical trial encompassing postmenopausal women with osteoporosis, showed promising results in both bone and renal studies. Raloxifene increased bone mineral density (BMD) in the spine and femoral neck and reduced the risk of vertebral fracture. In addition, raloxifene slowed the increase in the rate of serum creatinine and also significantly slowed the decrease in the estimated glomerular filtration rate; of most importance, raloxifene use was associated with significantly fewer kidney-related adverse events. Hemodialyzed women on raloxifene treatment demonstrated increased trabecular BMD, a decrease in bone resorption markers, and a decrease in the low-density lipoprotein-cholesterol value. Thus, raloxifene and, most likely, other SERMs could be better in place of estrogen in the management of postmenopausal women with CKD and its associated osteoporosis, although much evidence should be provided in the advanced-stage CKD, especially in the Stage 5 CKD patients on dialysis.

Rapid Down-Regulation of Glucocorticoid Receptor Gene Expression in the Dentate Gyrus after Acute Stress in vivo: Role of DNA Methylation and MicroRNA Activity. Although glucocorticoid receptors (GRs) in the hippocampus play a vital role in the regulation of physiological and behavioural responses to stress, the regulation of receptor expression remains unclear. This work investigates the molecular mechanisms underpinning stress-induced changes in hippocampal GR mRNA levels in vivo. Male Wistar rats were killed either under baseline conditions or after forced swim stress (FSS; 15 min in 25°C water). Rat hippocampi were micro-dissected (for mRNA, microRNA, and DNA methylation analysis) or frozen whole (for chromatin immunoprecipitation). In an additional experiment, rats were pre-treated with RU486 (a GR antagonist) or vehicle. FSS evoked a dentate gyrus-specific reduction in GR mRNA levels. This was related to an increased DNMT3a protein association with a discreet region of the Nr3c1 (GR gene) promoter, shown here to undergo increased DNA methylation after FSS. FSS also caused a time-dependent increase in the expression of miR-124a, a microRNA known to reduce GR mRNA expression, which was inversely correlated with a reduction in GR mRNA levels 30 min after FSS. FSS did not affect GR binding to a putative negative glucocorticoid response element within the Nr3c1 gene. Acute stress results in decreased GR mRNA expression specifically in the dentate gyrus. Our results indicate that a complex interplay of multiple molecular mechanisms - including increased DNA methylation of discrete CpG residues within the Nr3c1 gene, most likely facilitated by DNMT3a, and increased expression of miR-124a - could be responsible for these changes.

Acute theophylline toxicity and the use of esmolol to reverse cardiovascular instability. Theophylline overdoses are frequent conditions that may require emergency treatment. Clinical features common to severe theophylline toxicity include nausea and vomiting, tachydysrhythmias, metabolic disturbances, seizures, and cardiovascular collapse. Several reports have described these manifestations and their treatments. We report the case of a patient suffering from an acute, intentional theophylline overdose who exhibited the classic features of a toxic ingestion and describe the first reported use of IV esmolol in the treatment of accompanying cardiovascular manifestations.

[Transcription factor comr acts as a direct activator in the genetic program controlling spermatogenesis in D. melanogaster]. Cardiff University, Cardiff CF10 3AX, UK). In Drosophila melanogaster differentiation of the male germ cells is accompanied by chromatin rearrangement and activation of the specific genes. These processes are regulated by few transcription factors that belong to two classes, can and aly that form distinct functional complexes. Mechanisms of action of aly and can class transcription factors on gene expression and chromatin state remain unclear. To investigate this question we have built the whole genome binding profile of transcription factor Comr belonging to aly class using the tissue-specific DamID method. Resulting datawere correlated with gene expression in comr (aly class) and can (can class) mutant testes. It was shown that Comr is a direct activator for about 300 testis-specific genes. Furthermore a set of genes revealed decreased expression in comr mutants but did not bind Comr protein, suggesting the existence of secondary regulation. Indeed, among the Comr gene targets we found a gene coding an uncharacterized transcription factor that could be a secondary participant in the genetic pathway in spermatocytes. These date allowed us to advance a model of gene activation needed for male gametes differentiation in D. melanogaster.

Aquatic Activities During Pregnancy Prevent Excessive Maternal Weight Gain and Preserve Birth Weight: A Randomized Clinical Trial. The aim of the present study was to examine the influence of a supervised and regular program of aquatic activities throughout gestation on maternal weight gain and birth weight. A randomized clinical trial. Instituto de Obstetricia, Ginecología y Fertilidad Ghisoni (Buenos Aires, Argentina). One hundred eleven pregnant women were analyzed (31.6 ± 3.8 years). All women had uncomplicated and singleton pregnancies; 49 were allocated to the exercise group (EG) and 62 to the control group (CG). The intervention program consisted of 3 weekly sessions of aerobic and resistance aquatic activities from weeks 10 to 12 until weeks 38 to 39 of gestation. Maternal weight gain, birth weight, and other maternal and fetal outcomes were obtained by hospital records. Student unpaired t test and χ2 test were used; P values ≤.05 indicated statistical significance. Cohen's d was used to determinate the effect size. There was a higher percentage of women with excessive maternal weight gain in the CG (45.2%; n = 28) than in the EG (24.5%; n = 12; odds ratio = 0.39; 95% confidence interval: 0.17-0.89; P = .02). Birth weight and other pregnancy outcomes showed no differences between groups. Three weekly sessions of water activities throughout pregnancy prevents excessive maternal weight gain and preserves birth weight. The clinicaltrial.gov identifier: NCT 02602106.

Central nervous system disease in a child with primary Sjögren syndrome. A 9-year-old girl had hemiparesis, and a diagnosis of primary Sjögren syndrome was made. The neurologic dysfunction was multifocal, involving both the brain and spinal cord, and was recurrent; the findings mimicked multiple sclerosis. Corticosteroid treatment during episodes of acute neurologic dysfunction appeared to be beneficial.

Entrapment of the external iliac vein in a both-column acetabular fracture. We present a patient with an associated both-column acetabular fracture with entrapment of the external iliac vein in the fracture. This complication was not recognized until fracture manipulation during open reduction and fixation. This case report demonstrates that an acetabular fracture can have an associated vascular injury without any obvious clinical signs. This can be especially dangerous during percutaneous manipulation and fixation of these fractures as an obstruction or injury to the external iliac vein may occur and remain unrecognized. We feel that any surgeon involved in treating patients with acetabular or pelvic fractures should be aware of this potentially serious complication.

Aspects of constitutive and acquired antibioresistance in Aeromonas hydrophila strains isolated from water sources. Over the last three decades, the literature pointed out the implications of Aeromonas species in human pathology. These species were described as being involved in intestinal (several outbreaks of acute gastroenteritis of choleric/dysenteric form or chronic diarrhoea, ulcerative colitis, etc.) in normal adults or children, as well as in extraintestinal infections in immunocompromised hosts. This last aspect included a large range of cutaneous injuries (micronecrosis, abscesses, bums, cellulites, furunculosis), joint, bones, respiratory, urinary tract, ocular infections up to meningitis, endocarditis, peritonitis, hepatobilliary disease, endotoxic shock and septicemia (as consequence of leech microvascular surgery). During the last decade, the literature reported a high mortality in Aeromonas infections determined by certain phenospecies (A. hydrophila and A. veronii) especially in extraintestinal infections in immunocompromised patients. In microbiologists' opinion this high rate of mortality was probably due to poor knowledge concerning the aspects of antibioresistance in Aeromonas strains, to empiric treatments with antibiotics to which these bacteria exhibiting constitutive resistance lead to insuccessful results, and at last to the increasing trend of aeromonads resistance to certain antibiotics after 1996. The literature mentioned also that for a great number of Beta-lactamase producing Aeromonas strains, the use of microdilution method (by comparison to disk diffusion in agar medium) giving false results made more difficult the true knowledge of Aeromonas antibioresistance patterns. At the same time, in 2002, the literature mentioned 4 ecological compartments considered as "reservoirs for dissemination and transfer of microbial antibioresistance i.e. humans, animals, plants and natural soil and water. In the last time, more and more data of the literature revealed that some bacteria with role of reservoir of antibioresistance in the natural environment, even without a direct medical impact, however they could play an indirect one remaining permanent sources of R genes for bacterial strains with pathogenic abilities implicated in human pathology (i.e. Aeromonas infections in man related to different professional activities such as fishing, surfing, swimming, diving, etc.). The purpose of this work was to determine the aspects related to constitutive and acquired antibioresistance in 35 A. hydrophila strains isolated in aquatic environment of Danube Delta (10 salmaster waters, 5 aquatic plants, 5 fish intestinal content, 5 fish sapling, 5 snake and oyster shells). The strains were biochemically identified by using API20E and API20NE kits. The antibioresistance spectrum was determined by disk diffusion method following NCCLS 2000 recommendations. The choice and disposal of antibiotics on the Mueller Hinton plate was done to allow the interpretive reading and the phenotypic detection of different antibioresistance mechanisms, as follows: beta-lactamases (PEN, ME, AMX, AMC, CAZ) and carbapenemase (IMP) production; porin deficiency (FOX); efflux mechanism (C, TE, NOR). All tested strains exhibited high resistance to penicillin, aspect pleading for constitutive penicillinase production in Aeromonas strains. With reference to other penicillins (ME, AMX, AMC) and cephalosporins (CAZ, FOX) the tested strains exhibited 2 different antibioresistance patterns: AMX-R, AMC-S, CAZ-S (65%) indicating the presence of beta-lactamase sensitive to inhibitors and AMX-R, AMC-R, CAZ-S (22%) indicating the presence of beta-lactamase resistant to inhibitors. Resistance to FOX in 8% of strains signifies a phenotypical marker for the presence of porin deficiency. Only one Aeromonas strain (2.8%) was resistant to IMP. Three strains (8%) were simultaneous resistant to TE and TMP/SMX, NOR and CHL probably due to the presence of a resistance plasmid (codifying an efflux/ enzymatic mechanism). These aspects are pleading for the necessity to investigate the bacterial antibioresistance patterns of bacterial strains isolated from the environment, in the purpose to identify the factors responsible for the spreading of certain antibioresistance mechanisms in the external medium as risk factors for the colonization process with possible impact upon the human pathology.

[The return of anthrax. From bioterrorism to the zoonotic cluster of Sciacca district]. Anthrax is a disease caused by Bacillus anthracis which affects herbivorous animals. Humans acquire the disease incidentally by exposure to infected animals, animal products or spores on soil. The infection is still endemic in many regions in developing countries. In Italy animal clusters are very rare and human cases are exceptional. Bacillus anthrax is also a potential source for acts of bioterrorism. In the natural human infection, cutaneous anthrax is the most widespread, while the other two, pulmonary and gastrointestinal anthrax, are very rare forms. We describe the first case of human anthrax occurring in western Sicily in the last twenty years. The cutaneous lesion healed without significant scarring after antibiotic treatment with tigecycline, rifampin and ciprofloxacin. Following our diagnosis, a cluster of bovine anthrax was detected in the district of Sciacca, causing the death of 13 animals. A larger outbreak was avoided by the vaccination of over 5000 herbivores.

Matricellular proteins in the heart: possible role during stress and remodeling. Matricellular proteins are extracellular matrix proteins that modulate cell-matrix interactions and cell function, and do not seem to have a direct structural role. The family includes tenascin-C (TN-C), tenascin-X (TN-X), osteonectin, osteopontin, thrombospondin-1 (TSP1) and thrombospondin-2 (TSP2). Expression of matricellular proteins is high during embryogenesis, but almost absent during normal postnatal life. Interestingly, it re-appears in response to injury. Left ventricular remodeling is a complicated process that occurs in the stressed heart, and is still not completely understood. Several members of the matricellular protein family, like tenascin-C, osteopontin, and osteonectin are up-regulated after cardiac injury. Therefore, this group of proteins may have crucial functions in the heart coping with stress. This review will focus on the expression, regulation and function of these matricellular proteins, and will discuss the crucial functions that these proteins might exert during remodeling of the stressed heart.

Influence of standard RF coil materials on surface and buildup dose from a 6 MV photon beam in magnetic field. Magnetic resonance guided teletherapy systems aspire to image the patient concurrently with the radiation delivery. Thus, the radiofrequency (RF) coils used for magnetic resonance imaging, placed on or close to patient skin and in close proximity to the treatment volume, would be irradiated leading to modifications of radiation dose to the skin and in the buildup region. The purpose of this work is to measure and assess these dose modifications due to standard off-the-shelf RF coil materials. A typical surface coil was approximated as layered sheets of polycarbonate, copper tape, and Teflon to emulate the base, conductor, and cover, respectively. A separate investigation used additional coil materials, such as copper pipe, plastic coil housing, a typical coil padding material, and a thin copper conductor. The materials were placed in the path of a 6 MV photon beam at various distances from polystyrene phantoms in which the surface and buildup doses were measured. The experiments were performed on a clinical Varian linac with no magnetic field and with a 0.21 T electromagnet producing a magnetic field parallel to the beam central axis. The authors repeated similar experiments in the presence of a 0.22 T magnetic field oriented perpendicular to the beam central axis using an earlier linac-MR prototype, with a biplanar permanent magnet. The radiation detectors used for the measurements were two different parallel plate ion chambers and GAFChromic films. A typical open beam surface dose of 20% (relative to open beam Dmax) was increased to 63% by the coil padding material and to >74% by all other materials when placed in direct contact with the phantom, irrespective of magnetic field presence or orientation. Without a magnetic field, the surface dose decreased as the test materials were moved away from the phantom surface toward the radiation source, reaching between 30% and 40% at 10 cm gap between the phantom and the test materials. In the presence of the transverse magnetic field, the surface dose reduction was more rapid reaching a dose level of 30%-40% with only 3-4 cm gap. In the presence of the parallel magnetic field, as expected, the surface dose did not decrease considerably as the gap between the phantom surface and test materials was increased; the surface dose remained >60% at 10 cm gap for all tested materials except for the thin copper conductor. As expected, placing coil materials in direct contact with the phantom surface increases the surface dose considerably. The surface dose is reduced by creating a gap between the coil materials and phantom surface. This dose reduction happens more rapidly in the presence of a transverse magnetic field. However, the surface dose stays relatively large irrespective of the gap in the presence of a parallel magnetic field. Thus, the standard, off-the-shelf RF coils should be used with caution in integrated linac-MR systems, especially those using a parallel magnetic field orientation in which case the RF coils will probably need to be reconfigured to create open ports for the radiation beam.

The ending of menstruation: perspectives and experiences of lesbian and heterosexual women. This article aims to theorize how a sample of menopausal women, lesbian and heterosexual, construct the ending of their periods, and what the experience means for them. Findings indicate that for most of the lesbian participants (who were in a sizeable minority), emotions of loss at the ending of periods were simultaneously expressed alongside positive feelings, and they engaged in greater introspection around the issue than did heterosexual women. However, lesbians did not all take up a singular subject position in relation to menstruation, indicating that there is fragmentation and plurality in how the body is experienced across a group.

Adiposity and gingival crevicular fluid tumour necrosis factor-alpha levels in children. To investigate whether adiposity is associated with gingival crevicular fluid (GCF) tumour necrosis factor-alpha (TNF-alpha) levels in children. We also examined whether this relationship is mediated through plasma fasting insulin. This preliminary study used cross-sectional data from the baseline-visit of the Quebec Adipose and Lifestyle InvesTigation in Youth cohort, which is an ongoing longitudinal study investigating the natural history of obesity in Quebec children. Study participants (76 girls and 102 boys) include children aged 8-10 years and their families, living in the Montreal and Quebec City areas. TNF-alpha level was measured in pooled samples (N=4) for each child by enzyme-linked immunosorbant assay. Height and weight were measured. Body mass index (BMI) was calculated as weight/height(2) (kg/m(2)). Sex/age-specific BMI was categorized into normal (<85th percentile), overweight (85th-95th percentile) and obese (>or=95th percentile) defined by the 2000 US-CDC growth charts. Insulin resistance was measured using fasting plasma insulin in children. Data analysis involved descriptive and multiple linear regression analyses. Our results suggest that obesity in boys was associated with a 37% increase of GCF-TNF-alpha level. However, when accounting for insulin resistance this association was reduced and disappeared while the model's goodness of fit improved. These findings provide support for the link between adiposity in children and GCF-TNF-alpha level, which appears to be mediated by insulin resistance.

More tetanic contractions are required for activating glucose transport maximally in trained muscle. Exercise training increases contraction-stimulated maximal glucose transport and muscle glycogen level in skeletal muscle. However, there is a possibility that more muscle contractions are required to maximally activate glucose transport in trained than in untrained muscle, because increased glycogen level after training may inhibit glucose transport. Therefore, the purpose of this study was to investigate the relationship between the increase in glucose transport and the number of tetanic contractions in trained and untrained muscle. Male rats swam 2 h/day for 15 days. In untrained epitrochlearis muscle, resting glycogen was 26.6 micromol glucose/g muscle. Ten, 10-s-long tetani at a rate of 1 contraction/min decreased glycogen level to 15.4 micromol glucose/g muscle and maximally increased 2-deoxy-D-glucose (2-DG) transport. Training increased contraction-stimulated maximal 2-DG transport (+71%; P < 0.01), GLUT-4 protein content (+78%; P < 0.01), and resting glycogen level (to 39.3 micromol glucose/g muscle; P < 0.01) on the next day after the training ended, although this training effect might be due, at least in part, to last bout of exercise. In trained muscle, 20 tetani were necessary to maximally activate glucose transport. Twenty tetani decreased muscle glycogen to a lower level than 10 tetani (18.9 vs. 24.0 micromol glucose/g muscle; P < 0.01). Contraction-stimulated 2-DG transport was negatively correlated with postcontraction muscle glycogen level in trained (r = -0.60; P < 0.01) and untrained muscle (r = -0.57; P < 0.01).

Effects of sulfate on the acute toxicity of selenate to freshwater organisms. This study evaluated the relationship between ambient sulfate concentrations and acute selenate toxicity to freshwater aquatic life. Previous studies indicated that increasing sulfate concentrations reduced selenate bioconcentration and toxicity. However, these studies generally were not conducted in a manner that was conducive to their use in deriving a water quality criterion. We compiled results from previous studies and generated additional data to help define a selenate-sulfate relationship for acute toxicity. Selenate toxicity was determined in standardized test waters with varying sulfate concentrations using Ceriodaphnia dubia, Gammarus pseudolimnaeus, Hyalella azteca, and Pimephales promelas as the test organisms. Analysis of test results indicated that a significant relationship does exist between acute selenate toxicity and ambient sulfate concentrations. Data from these tests and previous studies were combined to develop a statistical relationship sufficiently robust to derive a sulfate-dependent water quality criterion for selenate. The relationship is similar to those commonly derived between divalent metals and hardness to adjust water quality criteria.

Peer mentoring is associated with positive change in physical activity and aerobic fitness of grades 4, 5, and 6 students in the heart healthy kids program. Only 7% of Canadian children achieve activity recommendations, contributing to obesity and preventable disease. The Heart Healthy Kids (H2K) program was designed to test the relationship between peer mentoring, physical activity, and cardiovascular fitness. Participants from 10 schools (5 control, 5 intervention) were enrolled in the program. In control schools, H2K included a physical activity challenge and education sessions. Intervention schools included the addition of a peer-mentoring component. Physical activity was measured through daily pedometer recording. Cardiovascular fitness was evaluated using the PACER (Progressive Aerobic Cardiovascular Endurance Run) protocol to calculate maximal oxygen uptake (VO2 max). Participants included 808 children (average age 9.9 ± 1.0 years). Although control and intervention schools did not differ at baseline, participants with peer mentoring logged significantly more steps per school day, on average, than those in control schools (6,785 ± 3,011 vs. 5,630 ± 2,586; p < .001). Male participants logged significantly more steps per school day than female participants. A significant improvement in VO2 max was also noted in intervention schools, with an average increase of 1.72 ml/mg/min. H2K was associated with positive change in physical activity and cardiovascular fitness, suggesting that peer mentoring shows promise for application in health promotion interventions.