Tenascin-C is expressed in macrophage-rich human coronary atherosclerotic plaque.
Tenascin is a large extracellular matrix glycoprotein generally found in adult tissues undergoing active remodeling such as healing wounds and tumors. To determine the potential role of tenascin-C (TN-C) in the pathophysiology of atherosclerosis, we investigated the pattern of expression of TN-C in human coronary atherosclerotic plaques. Immunohistochemical staining and in situ hybridization demonstrated minimal and random expression of TN-C in fibrotic but lipid-poor atherosclerotic plaques. In contrast, all plaques with an organized lipid core or ruptured intimal surface strongly expressed TN-C, which was preferentially concentrated around the lipid core, shoulder regions, and ruptured area of the plaques but not in the fibrous cap. TN-C was not detected in normal arterial tissue. To identify the cellular source of TN-C, the plaques were stained with smooth muscle cell- and macrophage-specific antibodies. TN-C expression correlated with the infiltration of macrophages. Northern blot and immunoprecipitation analysis showed that macrophages expressed 7. 0-kb TN-C mRNA and 220-kDa protein. Reverse transcription-polymerase chain reaction of total RNA derived from macrophages showed that they express the small isoform of TN-C. Zymogram analysis revealed that macrophages markedly increased MMP-9 expression. This study demonstrates that the level of TN-C expression correlates with the degree of inflammation present, not with plaque size. In addition, cultured macrophages have the capacity to express the TN-C gene. These findings suggest the significance of macrophages in the remodeling of atherosclerotic plaque matrix composition.


Blindness and glaucoma: a comparison of patients progressing to blindness from glaucoma with patients maintaining vision.
To compare patients becoming legally blind from glaucoma with those who did not go blind. Retrospective, cohort, and case-control study. A retrospective community-based longitudinal study of residents of Olmsted County, Minnesota, who were newly diagnosed with open-angle glaucoma between 1965 and 1980 and followed through 1998. A case-control study was performed comparing patients progressing to legal blindness from glaucoma with aged-matched and visual field-matched patients not progressing to blindness. Fifty-six of 290 patients progressed to legal blindness in at least one eye over the 34-year period of the study. Most who progressed to blindness had moderate to advanced visual field loss at the time of diagnosis of glaucoma. Those becoming legally blind had mean intraocular pressures (IOP) on therapy lower than or similar to patients who did not go blind, although the variability of IOP was higher in the blind group. Different susceptibilities to IOP were apparent, as some eyes with initially normal disks and visual fields became blind at an IOP of 20 mm, while others did not worsen. Changes in medical therapy after progression of visual field damage were less effective in lowering IOP in the group becoming blind than in the nonblind group. Patients at greatest risk of blindness had visual field loss at the time of diagnosis of glaucoma. Different susceptibilities to IOP were apparent, with some patients becoming blind at pressures that others tolerated without significant progression. This suggests that continued monitoring of visual fields and reassessment of target IOP levels when field damage occurs are fundamental in the management of glaucoma.


Substrate profile variation and drug resistance patterns of â - lactamase producing Shigella species isolated from diarrhoeal patients in Lagos, Nigeria.
The number and trend of antibiotic resistance by Shigella species recovered from food and diarrhoeal stools are on the increase in Nigeria and has resulted in a high frequency of hospitalisation. Increased cost of disease management, and higher mortality in children. This study exposes 51 â-lactamase producing Shigella isolates from Lagos to some newly introduced drugs in the country. The drugs include â-lactam - â-actamase inhibitor antibiotics. â-lctam substrate hydrolysis and inhibitory effects of clavulanate were also investigated in-vitro. Results obtained revealed that all the isolates showed high level resistance to tetracycline, ampicillin, streptomycin, co-trimoxazole and amoxicillin with an MIC range of 128 - 1024 microg/ml. The isolates were susceptible to piperacillin, tobramycin, aztreonam and ofloxacin (0.03 - 8 microg/ ml). 18.2 - 40.9% of S. flexneri and S. dysenteriae showed low level resistance to cefuroxime and cefotaxime (MIC = 4 - 16 microg/ ml). Among the â-lactam - â- lctamase inhibitors tested, only piperacillin-tazobactam showed 100% resistance. Hydrolysis of â -lctam substrate was found to be species dependent in decreasing order of S. flexneri, S. dysenteriae, S. sonnei and S.boydii. An IC50 range of 0.8-2.4 mM was also observed in these isolates. Our data indicate that the incidence of multidrug resistance is high among â-lactamase producing Shigella isolates in Lagos, Nigeria. While the third generation cephalosporins should be used with cautions, some of the newly introduced drugs have the prospects of being used in the future control and management of shigellosis in the country.


Auditory and visual confusions: Evidence against simple modality encoding hypotheses.
Using both recognition and recall responses, confusion and intrusion errors were obtained for briefly exposed 11-letter strings. The patterns of errors were sharply dependent upon experimental variables. In Experiment I Ss made auditory and visual intrusions with recall, but neither with recognition. In Experiment II increasing exposure time and eliminating a poststimulus cue primarily increased auditory confusions. This suggests that auditory and visual confusions reflect strategy-contingentrecoding rather than modality-specificencoding.


Intraarticular corticosteroids for chronic arthritis in children: efficacy and effects on cartilage and growth.
To assess the efficacy and effects on cartilage and statural growth of intraarticular corticosteroid (IAS) therapy for chronic arthritis in children and adolescents. We examined 21 children and adolescents with chronic arthritis (median duration, 8 months) that did not respond to nonsteroidal antiinflammatory drugs. The 21 joints injected with triamcinolone-hexacetonide were examined before and 7 weeks after IAS therapy by gadolinium-enhanced magnetic resonance imaging; 14 joints were also examined 13 months after IAS therapy. All joints treated with IAS had improvement. Magnetic resonance imaging showed long-lasting suppression of inflammation and pannus without evidence of toxic effects on cartilage. Statural growth was not affected. In experienced hands, IAS therapy may be a safe and effective tool in the treatment of chronic arthritis in childhood. Long-term follow-up is mandatory.


Elution characteristics of doxorubicin-loaded microspheres differ by drug-loading method and microsphere size.
To examine the loading and elution behavior of doxorubicin and superabsorbent polymer microspheres (SAP-MS) as they relate to particle size and loading techniques. SAP-MS, 30-60 μm and 50-100 μm, were subject to loading 50 mg of doxorubicin from a dry lyophilized state. Doxorubicin loading was performed after prehydration of SAP-MS (one-step method) or serially in two divided administrations (two-step method). Loading rate and elution characteristics were determined after doxorubicin analysis using a high-pressure liquid chromatography (HPLC) assay. All experiments were performed in triplicate. All systems showed the ability to load and elute doxorubicin effectively in the specified time frame (loading 15 minutes to 2 hours and elution 1 hour to 14 days). For the two loading methods, 30-60 μm SAP-MS showed no statistically significant difference in loading rate but a statistically significant difference in cumulative elution at 14 days (19.13 mg vs 17.83 mg, one-step vs two-step; P = .02). For the two loading methods, 50-100 μm SAP-MS showed no statistically significant difference in loading rate and no statistically significant difference in cumulative elution at 14 days (14.87 mg vs 12.77 mg, one-step vs two-step; P = .20). SAP-MS exhibit the ability to load and release doxorubicin. In comparing particle size and loading methods, higher cumulative elution rates were associated with smaller (30-60 μm) particle size and one-step loading. Higher elution from the one-step loading method may be due to release of unbound doxorubicin. Differences in the loading and elution of doxorubicin may depend on the increased surface area of smaller SAP-MS resulting in alterations of behavior of doxorubicin and its interactions with the polymer microspheres.


Easy technique to overcome the undesirable catheterization of the profunda femoral artery during antegrade femoral access.
We describe a simple method to avoid favored passage of the wire into the profunda femoral artery (PFA) after antegrade puncture of the common femoral artery. The method consists of placing a 3F Fogarty catheter into the origin of the PFA, which addresses the guidewire toward the superficial femoral artery. When a repeated passage of the guidewire down the PFA is experienced despite conventional manipulation of the wire or needle, the barrier technique is an easy alternative approach for the catheterization of the superficial femoral artery.


Utility of FDG PET/CT in IgG4-related systemic disease.
IgG4-related systemic disease (IgG4-RSD) is an emerging clinical entity about which much remains to be elucidated, in terms of its aetiology, pathogenesis, diagnosis, treatment and outcome. Autoimmune pancreatitis (AIP) and Mikulicz disease (MD) are the two major, well-studied constituents of IgG4-RSD. AIP and MD have common characteristics of forming tumour-mimicking lesions that consist of lymphoplasmacytic infiltrates and fibrosclerosis with numerous immunoglobulin G4 (IgG4)-positive plasma cells, as well as various multi-organ manifestations of IgG4-RSD. 2-[(18)F]-fluoro-2-deoxy-d-glucose positron-emission tomography/ computed tomography (FDG PET/CT) enables the acquisition of whole-body images and provides functional information about disease activity; as such it has a valuable role in staging extent of disease, guiding biopsy, and monitoring response to treatment. However, FDG PET/CT is likely to be only one component of the management strategy, and clinical, laboratory, imaging and histological findings are crucial in the overall diagnosis of the condition. At present FDG PET/CT does not have a well-established role in the assessment of patients with IgG4-RSD and future prospective studies are required to define the cost-effectiveness and clinical impact in this patient group more accurately.


C4b-binding protein (C4BP) inhibits development of experimental arthritis in mice.
To assess the human complement inhibitor C4b-binding protein (C4BP) for treatment of arthritis. We have used two mouse models of rheumatoid arthritis (RA) to assess the therapeutic effect of C4BP on different phases of arthritis, the collagen antibody-induced arthritis (CAIA), an acute antibody-induced disease and the collagen-induced arthritis (CIA), which carries the full complexity of arthritis. Purified human C4BP injected intraperitoneally alleviated CAIA significantly in a manner similar to cobra venom factor that depletes complement due to massive activation. Furthermore, C4BP was injected before and after the disease development into CIA mice. In the former case, the disease onset was delayed and in the latter, the severity of the disease was reduced in animals treated with C4BP. However, C4BP did not affect the anti-CII antibody synthesis. C4BP present in mouse sera decreased activity of the classical but not the alternative pathway of the complement system when these were assessed in a fluid phase. However, C4BP was efficiently inhibiting the alternative pathway when present on the activating surface. Taken together, the disease ameliorating effect of C4BP appears to be related to inhibition of both pathways of complement. Although human C4BP was cleared relatively fast from the circulation and was only moderately affecting complement activity, its effect on the disease severity was substantial, suggesting that minor alterations in complement activity can have significant therapeutic value in RA.


Differential GC content between exons and introns establishes distinct strategies of splice-site recognition.
During evolution segments of homeothermic genomes underwent a GC content increase. Our analyses reveal that two exon-intron architectures have evolved from an ancestral state of low GC content exons flanked by short introns with a lower GC content. One group underwent a GC content elevation that abolished the differential exon-intron GC content, with introns remaining short. The other group retained the overall low GC content as well as the differential exon-intron GC content, and is associated with longer introns. We show that differential exon-intron GC content regulates exon inclusion level in this group, in which disease-associated mutations often lead to exon skipping. This group's exons also display higher nucleosome occupancy compared to flanking introns and exons of the other group, thus "marking" them for spliceosomal recognition. Collectively, our results reveal that differential exon-intron GC content is a previously unidentified determinant of exon selection and argue that the two GC content architectures reflect the two mechanisms by which splicing signals are recognized: exon definition and intron definition.


Adverse reactions to food additives in children with atopic symptoms.
In a multicenter study conducted at four Danish hospital pediatric departments, the parents of 472 consecutive children were informed of this project to determine the incidence of intolerance of food additives among children referred to an allergy clinic with symptoms of asthma, atopic dermatitis, rhinitis, or urticaria. After a 2-week period on an additive-free diet, the children were challenged with the eliminated additives. The food additives investigated were coloring agents, preservatives, citric acid, and flavoring agents. Carbonated "lemonade" containing the dissolved additives was used for the open challenge. Two doses were used: a low dose and a 10-fold higher dose. Gelatin capsules were used for a double-blind challenge. The children were 4-15 years old, and they were attending an outpatient pediatric clinic for the first time. Of the 379 patients who entered the study, 44 were excluded and 335 were subjected to open challenge. A total of 23 children developed positive reactions after the open challenge. Sixteen of these patients accepted the double-blind challenge, and six showed a positive reaction to preservatives (atopic dermatitis, asthma, rhinitis), coloring agents (atopic dermatitis, asthma, urticaria, gastrointestinal symptoms), and citric acid (atopic dermatitis, gastrointestinal symptoms). The incidence of intolerance of food additives was 2% (6/335), as based on the double-blind challenge, and 7% (23/335), as based on the open challenge with lemonade. Children with atopic skin symptoms had a statistically increased risk of a positive reaction. This may have consequences for the future clinical investigation of children with atopic cutaneous symptoms.


Metabolism of T-2 Toxin in Farm Animals and Human In Vitro and in Chickens In Vivo Using Ultra High-Performance Liquid Chromatography- Quadrupole/Time-of-Flight Hybrid Mass Spectrometry Along with Online Hydrogen/Deuterium Exchange Technique.
After being incubated with animal and human liver microsomes, metabolites of phase I and II were investigated. A comparison was performed by ultrahigh performance liquid chromatography-quadrupole/time-of-flight coupled to mass spectrometry (UHPLC-Q/TOF). Consequently, a total of four phase I metabolites and three glucuronide binding metabolites of T-2 toxin were discovered. Although a significant metabolic difference was observed among six species, HT-2 toxin was the major product in all species. In addition, the in vivo metabolism of T-2 toxin after oral administration was also investigated in chickens, In total, 18 metabolites were detected, of which 13 were novel, to our knowledge, and reported for the first time. To elucidate the structures of these metabolites, besides accurate mass data from their MS and MS2 spectra, online hydrogen/deuterium (H/D) exchange technique was also carried out. These new metabolites were regarded as 3'-hydroxy-T-2 3-sulfate, 3'-hydroxy-HT-2 3-sulfate, 4'-hydroxy-HT-2, 3',4'-dihydroxy-HT-2, 4'-carboxyl-T-2, 4'-carboxyl-HT-2, 4'-carboxyl-4'-hydroxy-T-2, and their isomers, implying that T-2 toxin was metabolized more extensively in animals than previously thought. Furthermore, 3'-hydroxy-HT-2, 4'-carboxyl-T-2, 3'-hydroxy-T-2, HT-2 toxin, and neosolaniol were identified to be the major metabolites of T-2 toxin in chickens. The present study expands existing knowledge about T-2 toxin metabolism, informing assessments of the impact T-2 toxin exposure and metabolism on health.


Pulmonary Hypertension: A Nomogram Based on CT Pulmonary Angiographic Data for Prediction in Patients without Pulmonary Embolism.
To use cardiovascular data from computerized tomographic (CT) pulmonary angiography for facilitating the identification of pulmonary hypertension (PH) in patients without acute pulmonary embolism. The institutional human research committee approved this retrospective study; informed consent was waived. Patients without pulmonary embolism who underwent CT pulmonary angiography and echocardiography within 24 hours of each other between December 2008 and October 2012 were retrospectively identified. The diameters of the pulmonary artery, aorta, and right and left ventricles and the severity of reflux of contrast material were assessed. The volumes of each cardiac compartment were calculated. Doppler echocardiography served as a reference standard for PH. A prediction model for PH was built by using backward logistic regression and was presented on a nomogram. The prediction model was evaluated with 10-fold cross-validation, and a test group of patients was studied between November 2012 and June 2014. The final study group included 182 patients, of whom 98 (54%) were given a diagnosis of PH on the basis echocardiographic results. Age of 67 years or older (odds ratio [OR] = 4.46), reflux grade of 3 or higher (OR = 2.63), right atrial volume of greater than or equal to 106 cm(3) (OR = 3.59), pulmonary artery diameter greater than or equal to 28 mm (OR = 2.52) and pulmonary artery diameter to aorta diameter ratio of greater than or equal to 0.86 (OR = 2.17) were independently associated with PH. The logistic model showed good discrimination ability (area under the curve = 0.844, discrimination slope = 0.359). Tenfold cross-validation showed 85.7% sensitivity, 60.7% specificity, 71.3% positive predictive value, and 76.1% negative predictive value for identification of PH, while the test group showed similar results (84.1%, 60.5%, 71.2%, and 76.7%, respectively). Cardiovascular data derived from CT pulmonary angiography are associated with PH, and a nomogram can be created that may facilitate identification of PH after exclusion of acute pulmonary embolism.


Taurine Reverses Atrial Structural Remodeling in Ach-Cacl2 Induced Atrial Fibrillation Rats.
Taurine has been reported to have anti-arrhythmia effects, but the anti-atrial fibrillation (AF) effects and its mechanism remain incompletely understood. In the present study, the therapy effects and partly mechanisms were investigated. AF animal model was established by intravenous administered with the mixture of acetylcholine (Ach) and CaCl2 (66 μg/mL + 10 mg/mL) (i.v.) for 7 days. The actions of taurine (99 mg/kg∙d, introgastric administration) on the levels of Hs-CRP, IL-6, TNF-α, MMP-9, AngII, the extent of the fibrosis and ultrastructural changes in left atrial were studied. The data showed that the serum levels of TNF-α, IL-6, AngII and the plasma levels of Hs-CRP and MMP-9 were significantly elevated in automatic recovery group relative to the control group (p < 0.01), which were all decreased by taurine administration (p < 0.01) similar to Verapamil treatment. Masson's trichrome staining of the left atrial tissue showed an obvious interstitial fibrosis in rats of automatic recovery group. The alteration could be reversed by additional taurine. Electron microscopy revealed that taurine administration could significantly alleviate the ultrastructural damage of atrial cells, and the effects were similar to the Verapamil treatment. In conclusion, the results suggested that taurine could inhibit the structural remodeling of AF in rats partly by decreasing the levels of inflammatory factors and profibrotic molecules, attenuating the extent of myocardial fibrosis and protecting the integrity of myocardial ultrastructure.


Nonlinear resonances and multi-stability in simple neural circuits.
This article describes a numerical procedure designed to tune the parameters of periodically driven dynamical systems to a state in which they exhibit rich dynamical behavior. This is achieved by maximizing the diversity of subharmonic solutions available to the system within a range of the parameters that define the driving. The procedure is applied to a problem of interest in computational neuroscience: a circuit composed of two interacting populations of neurons under external periodic forcing. Depending on the parameters that define the circuit, such as the weights of the connections between the populations, the response of the circuit to the driving can be strikingly rich and diverse. The procedure is employed to find circuits that, when driven by external input, exhibit multiple stable patterns of periodic activity organized in complex tuning diagrams and signatures of low dimensional chaos.


Positive interventions: An emotion regulation perspective.
The rapid growth of the literature on positive interventions to increase "happiness" has suggested the need for an overarching conceptual framework to integrate the many and apparently disparate findings. In this review, we used the process model of emotion regulation (Gross, 1998) to organize the existing literature on positive interventions and to advance theory by clarifying the mechanisms underlying their effectiveness. We have proposed that positive emotions can be increased both in the short- and longer-term through 5 families of emotion regulation strategies (i.e., situation selection, situation modification, attentional deployment, cognitive change, and response modulation), showing how these emotion regulation strategies can be applied before, during, and after positive emotional events. Regarding short-term increases in positive emotions, our review found that attentional deployment, cognitive change, and response modulation strategies have received the most empirical support, whereas more work is needed to establish the effectiveness of situation selection and situation modification strategies. Regarding longer-term increases in positive emotions, strategies such as situation selection during an event and attentional deployment before, during, and after an event have received strong empirical support and are at the center of many positive interventions. However, more work is needed to establish the specific benefits of the other strategies, especially situation modification. We argue that our emotion regulation framework clarifies existing interventions and points the way for new interventions that might be used to increase positive emotions in both nonclinical and clinical populations.


Patient interest in receiving audiotapes of information presented by their physicians. A survey of patients awaiting treatment in university and private practice settings.
To investigate patient interest in, and willingness to pay for, tape recordings of physicians' explanations and recommendations. Survey. An outpatient university-based practice and an outpatient private group practice of family physicians. A convenience sample of 425 patients. Of the 409 who agreed to complete the survey, 257 (63%) were awaiting treatment in a university practice and 152 (37%) were awaiting treatment in a private practice. Fifty-four percent of respondents believed that a tape would be helpful, 59.1% thought their family would ask to listen to it, and 77.5% said they would play it for family members. If asked to bring a blank tape, 84.5% indicated that they would do so. If recordings were available for purchase, respondents indicated they would be willing to pay a mean of $1.46 for them. If physicians offer recordings of their explanations and recommendations, patients are likely to want them. Investigations of actual compliance and health outcomes associated with the use of these recordings appear warranted.


Synthetic Polypeptide Mimics of Marine Adhesives.
Water soluble copolypeptides containing l-dihydroxyphenylalanine (DOPA) and l-lysine were prepared by ring-opening polymerization of alpha-amino acid N-carboxyanhydride (NCA) monomers. We have prepared a range of different copolymers to probe the effects of functional group composition on adhesive and cross-linking behavior. Aqueous solutions of these copolymers, when mixed with a suitable oxidizing agent (e.g., O2, mushroom tyrosinase, Fe3+, H2O2, or IO4-), formed cross-linked networks that were found to form moisture-resistant adhesive bonds to a variety of substrates (e.g., aluminum, steel, glass, and plastics). It was found that successful adhesive formation was dependent on oxidation conditions, with chemical oxidants giving the best results. Optimized systems were found to form adhesive bonds that rival in strength those formed by natural marine adhesive proteins. Our synthetic systems are readily prepared in large quantities and require no enzymes or other biological components.


Nutritive composition of Tarag, the traditional naturally-fermented goat milk in China.
Nutritive compositions were analyzed in 10 batches of samples of Tarag (the traditional naturally-fermented goat milk), which were collected in the Mongolian community in China. Results showed that Tarag had richer nutrients than yoghurt. Tarag-2 (from Zang goats) had better chemical nutrient density than Tarag-1 (from Chaidamu goats). Tarag was rich in casein, lactoferrin, serum albumin, β-lactoglobulin, α-lactalbumin, and 3 unknown fractions in certain samples. Microbiological enumeration revealed that Tarag contained large lactic acid bacteria and yeast. Tarag was judged nutritious and indicated the latent value for people's health.


Various organizations of the complex repeats in vole sex chromosome heterochromatin.
Different patterns of the DNA sequences organization were revealed in the vole (Rodentia) sex chromosome heterochromatin using dual-label fluorescence in-situ hybridization on extended DNA fibers with different repetitive DNA sequences as probes. In Microtus rossiaemeridionalis, the basic type represents the homogeneous relatively short tracks consisting of tandemly reiterated monomers of the MS3 family alternating with similar tracks of MS4 monomers and with non-fluorescent spacers. These tracks varied in the length of both repeats, with an average size of 12-22 kb or 3-5 copies. Apart from this, some continuous tracks of both families spanning 100-200 kb were interrupted by short spacers or single signals from the sequences with homology to LINEs. These results, together with that obtained by the analysis of phage clones of the genomic library, unequivocally demonstrate a variable large-scale DNA structural organization in heterochromatin of the M. rossiaemeridionalis sex chromosome. The dominant type of large-scale DNA organization in M. transcaspicus heterochromatin represents the unicolor relatively long tracks consisting of monotonous but not alternating monomers of MS3 or MS4 with sizes ranging from 15 to 40 kb and separated by extended spacers with an average length of 20 kb. Thus, the formation of the vole sex chromosome heterochromatic regions occurred relatively recently during speciation.


Histochemical methods for the detection of apoptosis in the nervous system.
Neuroscientists often need to detect neuron death at the light microscope level in tissue sections derived from animal models of neurological disease. In many instances there is a need to detect apoptosis, the most common morphology of programmed cell death. This unit provides two protocols for the detection of apoptosis by immunostaining for either activated forms of caspases or their cleavage products. When used in conjunction with nuclear dyes, these protocols permit visualization not only of caspase activation, but also the nuclear chromatin clumps characteristic of apoptosis. The first protocol utilizes peroxidase-mediated chromogen deposition to visualize antibodies by brightfield microscopy. The second protocol utilizes fluorophores to visualize antibodies by epifluorescence. Double immunofluorescence labeling can be performed to identify the phenotype of cells in which caspases are activated. Not all cell death is apoptotic. Therefore, a third protocol is presented for suppressed silver staining, a useful method to screen for all morphologic forms of cell death.


Age and stress as determinants of the severity of hyperthyroidism caused by Graves' disease in newly diagnosed patients.
The evidence that stress may provoke Graves' hyperthyroidism in genetically susceptible subjects is substantial. Whether exposure to stress is related to the severity of thyrotoxicosis has not been studied. Advancing age is associated with not only less severe Graves' hyperthyroidism but also self-reported stress. We tested the hypothesis whether advancing age is associated with less exposure to stress, resulting in a lower immunological response, and less severe Graves' hyperthyroidism. Cross-sectional multicenter study. Two hundred and sixty-three consecutive untreated patients with a first episode of Graves' hyperthyroidism were included. The severity of Graves' hyperthyroidism was evaluated biochemically (freeT(4)-index and freeT(3)-index, thyrotropin-binding inhibitory immunoglobulin (TBII)) and clinically by the hyperthyroid symptom scale score (HSS score). Stress exposure was quantitated by three questionnaires. Advancing age was associated with less severe Graves' hyperthyroidism, both biochemically by lower serum freeT(3)-index and freeT(4)-index (P<0.01), lower serum TBII (P=0.05), and clinically by lower HSS scores (P=0.04) and smaller goiter size (P<0.01). FreeT(3)-index and freeT(4)-index were directly associated with HSS scores (P<0.01). Stress scores were associated with HSS scores (P<0.01) but not with biochemical severity of Graves' hyperthyroidism. Advancing age was associated with lower scores for stress exposure. Multivariate regression analysis showed that HSS score was independently related to the tendency to report negative feelings (P<0.01) but not to other stress scores and also not to age. Advancing age is associated with less exposure to stress, lower serum TBII and less severe clinical and biochemical Graves' hyperthyroidism. Because no direct relationship exists between stress exposure and TBII or freeT(3)-index and freeT(4)-index, we reject our hypothesis that less stress is causally related to biochemically less severe Graves' hyperthyroidism in old age. HSS score is primarily determined by negative feelings and not by age.


Effects of anti-albumin sera on the synthesis and secretion of soluble proteins by monolayers of hepatocytes.
Hepatocytes were isolated from male Sprague-Dawley rats and monolayer cultures prepared. The effects of supplementation of the incubation medium with homologous and heterologous antisera directed against albumin on the synthesis and secretion of soluble proteins were ascertained. Supplementation of the medium with antisera generally resulted in a time related decrease in the synthesis and secretion of soluble proteins. The observed inhibition did not appear to be due to deficient amino acid uptake and the cell membranes remained intact in the presence of antisera. The results are discussed in relation to findings obtained with malignant cells.


A polyphasic approach to study the dynamics of microbial population of an organic wheat sourdough during its conversion to gluten-free sourdough.
To develop a method for organic gluten-free (GF) sourdough bread production, a long-term and original wheat sourdough was refreshed with GF flours. The dynamics of the sourdough microbiota during five months of back-slopping were analyzed by classical enumeration and molecular methods, including PCR-temporal temperature gel electrophoresis (PCR-TTGE), multiplex PCR, and pulsed field gel electrophoresis (PFGE). The results showed that the yeast counts remained constant, although Saccharomyces cerevisiae, present in the initial wheat sourdough, was no longer detected in the GF sourdough, while lactic acid bacteria (LAB) counts increased consistently. In the first phase, which was aimed at obtaining a GF sourdough from wheat sourdough, Lactobacillus sanfranciscensis, L. plantarum, and L. spicheri were the main LAB species detected. During the second phase, aimed at maintaining the GF sourdough, the L. plantarum and L. spicheri populations decreased whereas L. sanfranciscensis persisted and L. sakei became the predominant species. Multiplex PCRs also revealed the presence of several L. sakei strains in the GF sourdough. In a search for the origin of the LAB species, PCR-TTGE was performed on the flour samples but only L. sanfranciscensis was detected, suggesting a flour origin for this typical sourdough species. Thus, while replacement of the wheat flour by GF flour influenced the sourdough microbiota, some of the original sourdough LAB and yeast species remained in the GF sourdough.


Diuretic and enhanced sodium restriction results in improved antiproteinuric response to RAS blocking agents.
Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and diuretics may exert synergistic antiproteinuric effects. Eighteen patients with a proteinuria >1 g/24 h after 6 mo of treatment with ramipril at 5 mg/d were assigned to receive in random order ramipril at 10 mg/d, valsartan at 160 mg/d, or combined ramipril at 5 mg/d and valsartan at 80 mg/d in addition to their antihypertensive treatment. The treatment periods lasted 4 wk and were separated by a 4-wk washout with ramipril at 5 mg/d. At the end of this crossover sequence, patients received combined ramipril at 5 mg/d, valsartan at 80 mg/d, and an increased furosemide dosage for an additional 4-wk period. The primary end point was the urinary protein/creatinine ratio for two 24-h urine collections at the end of each treatment period. No significant differences were noted between the study end points of the ramipril 10, valsartan 160, and combined ramipril 5 and valsartan 80 treatment groups. However, the urinary protein/creatinine ratio was lower with combined ramipril 5 and valsartan 80-increased furosemide dosage than with valsartan 160 and combined ramipril 5 and valsartan 80, with a similar tendency compared with ramipril 10. Combined ramipril 5 and valsartan 80-increased furosemide dosage decreased systolic home BP and increased serum creatinine but did not significantly increase the number of symptomatic hypotension cases compared with the other three treatments. Thus, in patients with severe proteinuria and hypertension, a cautious increase in diuretic dosage in addition to combined angiotensin-converting enzyme inhibitors and angiotensin receptor blockers decreases proteinuria and BP but may expose the patient to prerenal failure.


Effects of intensive voice treatment (the Lee Silverman Voice Treatment [LSVT]) on ataxic dysarthria: a case study.
This study examined the effects of intensive voice treatment (the Lee Silverman Voice Treatment [LSVT]) on ataxic dysarthria in a woman with cerebellar dysfunction secondary to thiamine deficiency. Perceptual and acoustic measures were made on speech samples recorded just before the LSVT program was administered, immediately after it was administered, and at 9 months follow-up. Results indicate short- and long-term improvement in phonatory and articulatory functions, speech intelligibility, and overall communication and job-related activity following LSVT. This study's findings provide initial support for the application of LSVT to the treatment of speech disorders accompanying ataxic dysarthria. Potential neural mechanisms that may underlie the effects of loud phonation and LSVT are addressed.


Medical resident choices of electronic drug information resources.
To determine medical residents' day-to-day use of drug information resources since their choices of these resources, when faced with common questions, are unknown. An online survey including simulated drug information questions was administered to 146 medical residents in the Department of General Internal Medicine during July 2012. Residents were given a wide range of choices in drug information resources to answer these questions and were instructed to select what they would choose in actual practice. A score was assigned to each resource corresponding to a "best," "intermediate," or "not good" choice. Seventy-three respondents completed the survey and results were analyzed for statistical significance. Fifty-seven percent of respondents reported receiving no formal training regarding drug information. Statistical analyses revealed there were no significant differences in performance based on postgraduate year (P = .43) or extent of prior training (P = .45). Individual question responses revealed a generally infrequent selection of "best" choices. Less than 10% of the respondents chose the "best" answer for drug information questions related to drug interactions, herbal supplements, adverse events, and medication identification. Further training in drug information resource selection is warranted in the medical residency program to increase the frequency of use of higher quality resources.


The natural history of self-harm from adolescence to young adulthood: a population-based cohort study.
Knowledge about the natural history of self-harm is scarce, especially during the transition from adolescence to young adulthood, a period characterised by a sharp rise in self-inflicted deaths. From a repeated measures cohort of a representative sample, we describe the course of self-harm from middle adolescence to young adulthood. A stratified, random sample of 1943 adolescents was recruited from 44 schools across the state of Victoria, Australia, between August, 1992, and January, 2008. We obtained data pertaining to self-harm from questionnaires and telephone interviews at seven waves of follow-up, commencing at mean age 15·9 years (SD 0·49) and ending at mean age 29·0 years (SD 0·59). Summary adolescent measures (waves three to six) were obtained for cannabis use, cigarette smoking, high-risk alcohol use, depression and anxiety, antisocial behaviour and parental separation or divorce. 1802 participants responded in the adolescent phase, with 149 (8%) reporting self-harm, More girls (95/947 [10%]) than boys (54/855 [6%]) reported self-harm (risk ratio 1·6, 95% CI 1·2-2·2). We recorded a substantial reduction in the frequency of self-harm during late adolescence. 122 of 1652 (7%) participants who reported self-harm during adolescence reported no further self-harm in young adulthood, with a stronger continuity in girls (13/888) than boys (1/764). During adolescence, incident self-harm was independently associated with symptoms of depression and anxiety (HR 3·7, 95% CI 2·4-5·9), antisocial behaviour (1·9, 1·1-3·4), high-risk alcohol use (2·1, 1·2-3·7), cannabis use (2·4, 1·4-4·4), and cigarette smoking (1·8, 1·0-3·1). Adolescent symptoms of depression and anxiety were clearly associated with incident self-harm in young adulthood (5·9, 2·2-16). Most self-harming behaviour in adolescents resolves spontaneously. The early detection and treatment of common mental disorders during adolescence might constitute an important and hitherto unrecognised component of suicide prevention in young adults. National Health and Medical Research Council, Australia, and operational infrastructure support programme, Government of Victoria, Australia.


[A systematic review of acupressure for the application on nursing practice].
The purpose of this study was to search articles on acupressure treatment that used clinical control trials (CCT) or randomize control trials (RCT) to review the quality of conducted research quality and the caring effects of acupressure. Literature published in 6 databases, including MEDLINE, was searched. A total of 71 relevant articles were identified and included in the current study. Results showed: (1) Nursing staff conducted the majority of acupressure interventions. Nurses also had the most opportunities to provide acupressure care; (2) 69 articles (97.2%) found acupressure to deliver positive effects; (3) Less than half of the articles (34) remained following our elimination of those that presented substandard researching quality, unspecific caring scope, or a score of only 1 using Jadad Score evaluation. Of these 34, acupressure techniques were most often applied to 8 symptoms / objects; (4) Factors that should be considered in administering acupressure include methods of treatment, application strength, and application period. Study results should help clinical nursing staff and student nurses learn acupressure and develop acupressure standard operating procedures (SOPs). Results further provide direction and design guidance for future research.


Fluorescent aptasensor for chloramphenicol detection using DIL-encapsulated liposome as nanotracer.
A novel fluorescence aptasensor was successfully developed to respond to chloramphenicol (CAP) in food based on magnetic aptamer-liposome vesicle probe. In order to fabricate it, aptamer labeled on functionalized magnetic beads (MB) was firstly employed as capture adsorbent (MB-Apt), then SSB (single-stranded DNA binding protein) and DIL (1,1'-dioctadecyl-3,3,3',3'-tetramethyl-indocarbocyanineperchlorate) coimmobilized liposomes (SSB/DIL-Lip) was employed as vesicle signal tracer. The composite vesicle probe is formed between SSB/DIL-Lip and MB-Apt based on SSB's specific recognition towards aptamer on vesicle signal tracer. Upon the vesicle probe solution reacted with CAP, the aptamer on the magnetic beads preferentially bounded with CAP, and then released SSB/DIL-Lip vesicle signal tracer in the supernatant after magnetic separation. The released tracer can emit fluorescence which was correspondence with the concentration of the analyte. At the optimum conditions, the aptasensor exhibited a good linear response for CAP detection in the range of 0.003-10nM with a detection limit of 1pM. Importantly, the methodology was further validated for analyzing CAP in fish samples with consistent results obtained by ELISA kit, thus providing a promising approach for quantitative monitoring of CAP and significant anti-interference ability in food safety.


[Gender differences in hemispheric interaction during distributed and directed attention].
Gender differences in the functional hemispheric organization during memorization of dichotically presented verbal information in the situation of focused or non-focused attention were studied. Analysis of EEG coherence reactivity in six frequency bands (4-30 Hz) showed that the focused attention to stimuli presented to one ear as compared to divided attention between both ears was accompanied by an increase in the interhemispheric interaction in the thetal frequency band between the frontal cortical areas in men and between the parietoccipital areas in women. In the betal band, the focused attention was associated with a contralateral increase in the intrahemispheric coherence in men, whereas no significant difference in the intrahemispheric coherence was found in women. On the basis of coherence changes in the thetal and betal bands depending on the attention conditions together with the obtained correlation between coherence reactivity and word-recall scores, it may be suggested that verbal memorization in men is associated, predominantly, with the regulation from the anterior system of attention and from the posterior system in women.


The behavioural transition from straight to curve walking: kinetics of leg movement parameters and the initiation of turning.
The control of locomotion requires the ability to adapt movement sequences to the behavioural context of the animal. In hexapod walking, adaptive behavioural transitions require orchestration of at least 18 leg joints and twice as many muscle groups. Although kinematics of locomotion has been studied in several arthropod species and in a range of different behaviours, almost nothing is known about the transition from one behavioural state to another. Implicitly, most studies on context-dependency assume that all parameters that undergo a change during a behavioural transition do so at the same rate. The present study tests this assumption by analysing the sequence of kinematic events during turning of the stick insect Carausius morosus, and by measuring how the time courses of the changing parameters differ between legs. Turning was triggered reliably at a known instant in time by means of the optomotor response to large-field visual motion. Thus, knowing the start point of the transition, the kinematic parameters that initiate turning could be ranked according to their time constants. Kinematics of stick insect walking vary considerably among trials and within trials. As a consequence, the behavioural states of straight walking and curve walking are described by the distributions of 13 kinematic parameters per leg and of orientation angles of head and antennae. The transitions between the behavioural states are then characterised by the fraction of the variance within states by which these distributions differ, and by the rate of change of the corresponding time courses. The antennal optomotor response leads that of the locomotor system. Visually elicited turning is shown to be initiated by stance direction changes of both front legs. The transition from straight to curve walking in stick insects follows different time courses for different legs, with time constants of kinematic parameters ranging from 1.7 s to more than 3 s. Therefore, turning is a behavioural transition that involves a characteristic orchestration of events rather than synchronous parallel actions with a single time constant.


Automatic Assessment of a Rollator-User's Condition During Rehabilitation Using the i-Walker Platform.
Patient condition during rehabilitation has been traditionally assessed using clinical scales. These scales typically require the patient and/or the clinician to rate a number of condition-related items to obtain a final score. This is a time-consuming task, specially if a large number of patients are involved. Furthermore, during rehabilitation, user condition is expected to change steadily in time, so assessment may require to run these scales several times to each user. To save time, much effort has been focused on developing clinical scales that require little time to be completed. This is usually achieved by measuring a reduced set of features, i.e., focusing the scales on specific features of a defined target population (Parkinson's disease, Stroke, and so on). However, these scales still require the therapist's intervention and may be tiresome for patients who have to fill them repeatedly. This paper proposes a novel approach to automatically obtain balance scales from the onboard sensors of a robotic rollator. These sensors are used to extract spatiotemporal gait parameters from patients using the rollator for support. These parameters are derived from the user forces on the rollator handles and its odometry. Resulting parameters are used to predict the Tinetti mobility clinical scale on the fly, without therapist intervention. Our approach has been validated with 19 rollator volunteers with a variety of physical and neurological disabilities at Hospital Civil (Malaga) and Fondazione Santa Lucia (Rome). Clinicians provided traditionally obtained Tinetti scores and the proposed system was used to estimate them on the fly. Results show a small root mean squared prediction error. This method can be used for any rollator user anywhere in everyday walking conditions to obtain the Tinetti scores as often as desired and, hence evaluate their progress.


Glycolysis-related gene induction and ATP reduction during fractionated irradiation. Markers for radiation responsiveness of human tumor xenografts.
Lactate was previously shown to be a prognostic but not a predictive pre-therapeutic marker for radiation response of tumor xenografts. We hypothesize that metabolic changes during fractionated irradiation may restrict the predictiveness of lactate regarding tumor radiosensitivity. Tumor xenografts were generated in nude mice by implanting 4 head and neck squamous cell carcinoma lines with different sensitivities to fractionated irradiation. Tumors were irradiated with up to 15 fractions of 2 Gy over a period of 3 weeks, and ATP and lactate levels were measured in vital tumor areas with induced metabolic bioluminescence imaging. Corresponding changes in mRNA expression of glycolysis-related genes were determined by quantitative RT-PCR. Lactate content decreased significantly in 3 out of 4 cell lines in the course of irradiation showing no correlation with cell line-specific radiosensitivity. Radiation-induced changes in ATP levels and glycolysis-related mRNA expression, however, only occurred in radiosensitive or intermediately radioresistant xenografts, whereas these parameters remained unchanged in radioresistant tumors. Sensitivity-related differences in the transcriptional response of tumors to radiotherapy may be exploited in the clinic for better individualization of tumor treatment.


Prevalence of low anterior resection syndrome at a regional Australian centre.
With decreasing indication for abdominoperineal resection and an increase in sphincter preserving surgery, there is a growing population of patients who suffer from low anterior resection syndrome (LARS). The aim of this study is to use the LARS score to determine the prevalence of LARS at a regional centre in Australia and determine the effect of short- and long-course neoadjuvant therapy, anastomotic technique and interval from surgery will also be assessed. Patients who had undergone an anterior resection (high, low or ultralow) at a regional centre over an 11-year period were identified. Eligible patients were contacted to complete a LARS score questionnaire. Results were analysed to determine the rate of major LARS and possible causative roles of certain patient and treatment-related variables. A total of 64 of 76 patients (84%) returned completed questionnaires. The prevalence of major LARS was 37.5%. Short-course neoadjuvant therapy appeared to be more likely to be associated with major LARS compared to long course (odds ratio (OR) = 2.4, 95% confidence interval (CI) 0.37-15.3, P = 0.35); however, this did not reach statistical significance. Rates of major LARS appear to decrease slowly over time and J-pouch colonic anastomosis appears to be slightly protective against major LARS (OR = 0.7, 95% CI 0.12-3.9, P = 0.70); however, neither results were statistically significant. The rate of major LARS at this regional centre is 37.5%. Larger prospective multicentre studies are required to determine impact of variables such as type of neoadjuvant therapy, anastomotic techniques and progression of LARS over time.


Current challenges in sudden cardiac death prevention.
Ischemic heart disease and non-ischemic dilated cardiomyopathy are the most common causes of arrhythmic sudden cardiac death (SCD). Implantable cardioverter defibrillator (ICD) therapy is the only strategy that proved to be effective in preventing SCD in high-risk individuals while the role of antiarrhythmic drugs is limited to symptoms relief. Current guidelines recommend selecting candidates to ICD implantation based on etiology, symptoms of heart failure (NYHA class), and severely depressed left ventricular ejection fraction, but these parameters are neither sensitive nor specific. The review addresses the mechanisms of SCD in patients with heart failure of either ischemic or non-ischemic etiology, risk stratification, and strategies for prevention of SCD in the clinical practice (including optimization of heart failure therapy, avoidance of triggering factors, antiarrhythmic drugs, ICD therapy, early resuscitation, and public access defibrillators).


The influence of American bioethics in Canada.
The history of bioethics in Canada has yet to be written. When that happens, an important issue to be considered will be the influence of American bioethics. In what follows, I offer some suggestions to the author of the history about what should be included. I will limit my discussion to the formative years of 1970-2000 and leave later developments for another occasion. My article will be structured as follows: individuals, institutions, issues, bioethics education and a conclusion.


Treatment of pediatric molluscum contagiosum with 10% potassium hydroxide solution.
Molluscum contagiosum (MC) is a common cutaneous viral infection of the skin that is frequently seen in children. Although lesions can resolve spontaneously, treatment is mandatory because of the psychological effect of widespread lesions in children. Potassium hydroxide (KOH) is a strong alkali that has been used by dermatologists for a long time in identifying the fungal infections from skin scrapings. We evaluated 40 children with MC for the safety and efficacy of treatment with topical 10% KOH aqueous solution. Parents were instructed to apply a 10% KOH aqueous solution, twice daily, with a cotton stick to all lesions. Treatment was continued till the lesions showed signs of inflammation or superficial ulceration. Assessments of response and side effects were performed at the end of week 2, week 4, week 8 and week 12. We found complete clearance of lesions in 37 (92.5%) patients receiving topical 10%KOH solution after a mean period of four weeks. Three children dropped out of the study; two children reported severe stinging of the lesions and discontinued the treatment; the other patient developed hypopigmentation during the treatment. Local side effects were observed in 12 children (32.4%). Even though 10% KOH solution is associated with some local side effects, it is a safe, effective, inexpensive and noninvasive alternative treatment of MC in children.


[Analysis of heat shock proteins and thermotolerance in a thermoresistant strain of Drosophila melanogaster].
Here we studied the response to heat shock in a desert D. melanogaster strain TT capable of living and propagating at 32 degrees C and the standard Oregon R strain. The TT strain proved to be more resistant to extreme temperatures. On the other hand, the observed high thermotolerance of the strain was not accompanied by a higher level of HSP70 synthesis. Conversely, reliably smaller amounts of HSP70 were synthesized in the TT strain as compared to Oregon R under all shock temperatures except the critical one (39.5 degrees C). Differences in both the structure of HSP70 genes and the pattern of all heat shock proteins have been observed between the studied strains. The role of the heat shock system in the adaptation to hyperthermia is discussed.


Neuropeptide Y-like immunoreactive neurons in the hedgehog (Erinaceus europaeus) and the sheep (Ovis aries) brain.
The peroxidase-antiperoxidase immunohistochemical method has been used in order to investigate the distribution of neurons immunoreactive with antiserum against neuropeptide Y in the hedgehog and the sheep brain. Neuropeptide Y-immunoreactive bipolar and multipolar neurons, with a diameter ranging from 10-30 microns, were found in the following regions: cerebral cortex, striatum, Ammon's horn, gyrus dentatus, amygdala, anterior olfactory nucleus, nucleus accumbens, area along the medial forebrain bundle, arcuate nucleus of the hypothalamus and lateral reticular nucleus of both hedgehog and sheep brain. Furthermore, while neuropeptide Y-immunoreactive neurons were also found in the medial and lateral septal nucleus, interstitial nucleus of the stria terminalis, retrochiasmatic area, central gray substance of the midbrain, colliculus caudalis, and nucleus of the solitary tract of the sheep, respective regions of the hedgehog brain appeared to be devoid of immunoreactive perikarya. This distribution pattern is identical to that observed with antiserum against avian pancreatic polypeptide. The differences in the distribution of neuropeptide Y-immunoreactive neurons in the two species studied as well as between our results and those in other species are briefly discussed.


Eligibility for Lung Volume Reduction Surgery in Patients With COPD Identified in a UK Primary Care Setting.
Although lung volume reduction surgery (LVRS) improves survival in appropriately selected patients with COPD, few procedures are performed. The National Institute for Health and Care Excellence has recommended a more systematic approach to identifying potential candidates. We investigated LVRS referrals from a UK primary care population and aimed to establish an accurate estimate of eligible patients and determine a strategy for identifying potential candidates systematically. Clinical Practice Research Datalink GOLD (a primary care database) and the linked Hospital Episode Statistics inpatient and Diagnostic Imaging Dataset were used. Patients with COPD who had undergone LVRS, patients who met basic eligibility criteria for further screening for LVRS, and patients meeting a more stringent eligibility criteria were identified from April 2012 to September 2015. Thoracic CT scan, pulmonary rehabilitation status, referral to respiratory outpatient clinics, and acute exacerbation of COPD requiring hospitalization were compared between actual LVRS recipients and potentially eligible patients. Among the 73,697 patients with COPD included, 36 (0.05%) received LVRS, 5,984 (8.1%) met basic eligibility criteria, and 159 (0.2%) met more stringent eligibility criteria. LVRS recipients were younger (mean age ± SD, 64 ± 9.2 years) than the stringently eligible patients (mean age ± SD, 69 ± 8.9 years; P = .01). Few patients meeting stringent eligibility criteria (6.9%) had a CT scan of the thorax in the preceding 3 years or had been referred for assessment in secondary care. A substantial unmet need exists among patients with COPD who could potentially benefit from a lung volume reduction procedure but who are not being investigated or referred to consider this possibility.


Direct olive oil analysis by low-temperature plasma (LTP) ambient ionization mass spectrometry.
A fast, reagentless, and direct method is presented for the mass spectrometric analysis of olive oil without any sample pretreatment whatsoever. An ambient ionization technique, the low-temperature plasma (LTP) probe, based on dielectric barrier discharge, is used to detect both minor and trace components (free fatty acids, phenolics and volatiles) in raw untreated olive oil. The method allows the measurement of free fatty acids (the main quality control parameter used to grade olive oil according to quality classes), selected bioactive phenolic compounds, and volatiles. The advantages and limitations of the direct analysis of extremely complex mixtures by the ambient ionization/tandem mass spectrometry combination are discussed and illustrated. The data presage the possible large-scale application of direct mass spectrometric analysis methods in the characterization of olive oil and other foodstuffs.


Resource availability modulates biodiversity-invasion relationships by altering competitive interactions.
Community diversity affects the survival of newly introduced species via resource competition. Competitive interactions can be modulated by resource availability and we hypothesized that this may alter biodiversity-invasion relationships. To study this, we assessed the growth of a bacterial invader, Ralstonia solanacearum, when introduced into communities comprised of one to five closely related resident species under different resource concentrations. The invader growth was then examined as a function of resident community richness, species composition and resource availability. We found that the relative density of the invader was reduced by increasing resident community richness and resource availability. Mechanistically, this could be explained by changes in the competitive interactions between the resident species and the invader along the resource availability gradient. At low resource availability, resident species with a high catabolic similarity with the invader efficiently reduced the invader relative density, while at high resource availability, fast-growing resident species became more important for the invader suppression. These results indicate that the relative importance of different resident community species can change dynamically along to resource availability gradient. Diverse communities could be thus more robust to invasions by providing a set of significant species that can take suppressive roles across different environments.


Gastrointestinal tolerance of a new infant milk formula in healthy infants: multicenter study conducted in Taiwan.
The objective of this study was to test whether the gastrointestinal tolerance of a new infant formula equalled or exceeded the tolerance of other milk-based infant formulas, and to compare the tolerance of the new formula to that of human milk. This prospective, observational, multicenter, open-label study was conducted in Taiwan. Healthy, full-term infants aged 28-98 days were enrolled on their current feeding regimen (no treatment assigned). Feeding regimens included human milk (HM), a new infant formula (NF, Similac Advance), other marketed infant formulas (OF, mainly Enfalac or S-26, HM + NF and HM + OF. Data for stool frequency, stool consistency and gastrointestinal intolerance symptoms were recorded in study diaries by parents for a period of two weeks. Gastrointestinal tolerance was evaluated in 967 infants, of whom 481 (49.7%) received NF, 312 (32.2%) received OF, 101 (10.4%) received HM + NF, 41 (4.2%) received HM + OF and 32 (3.3%) received HM. Infants fed HM only had softer and more frequent stools than those who received NF only or OF only (P < 0.001). Infants fed NF only had softer stools than those fed OF only (P < 0.001), including those fed either Enfalac or S-26 (P < 0.001). There were no significant differences between feeding groups for the incidence of general intolerance, spit-up or flatulence. All feeding regimens were well tolerated. We thereby concluded that NF is well tolerated in healthy infants and results in stool consistencies that more closely resemble those of infants fed human milk than those of infants fed other formulas.


Effect of substance P and thyrotropin-releasing hormone on sympathetic preganglionic neurones in the upper thoracic intermediolateral nucleus of the cat.
When applied by iontophoresis onto single sympathetic preganglionic neurones in he intermediolateral nucleus of spinal segments T1-T3 in the cat, substance P and thyrotropin-releasing hormone (TRH) each had a weak excitatory effect. Two-thirds of the neurones studied were excited by substance P while one-fifth were excited by TRH. The time courses of the responses to substance P and to TRH were similar, and consisted of an increase in the rate of discharge with a latency of approximately 30 s from the onset of application. They were also prolonged (30-320 s) in afterdischarge following termination of application. These results indicate that substance P and TRH exert excitatory effects on single sympathetic pregnanglionic neurones, and support the possibility that they may be chemical mediators of synaptic transmission in the intermediolateral nucleus.


[Functional dyspepsia, constipation and faecal incontinence].
Regarding functional dyspepsia, constipation, fecal incontinence, the main therapeutic acquisitions of the period are the following: for functional dyspepsia, remember that alarm signs are not absolute signs of seriousness; for constipation, encourage and repeat advises such as physical exercise; for fecal incontinence the transcutaneous neuro-modulation and the TENS (Transcutaneous Electrical Nerve Stimulation) are potential alternatives to sacral neuro-modulation.


A modified assay for the detection of human adult active rosette forming lymphocytes.
A modified procedure is described for the detection of a sub-population of peripheral blood T-cells in normal human adults. This sub-population of T-cells has been called the active rosette forming cell by others. The advantages of this modified procedure compared with that previously described are: 1) the elimination of 60 mon incubation period for lymphocytes prior to the assay and 2) the elimination of the need for fetal calf serum in the assay. The mean percentage of RFC in the peripheral blood of 80 healthy adult controls using the modified procedure is 25.2+/-5.5% in buffer lacking FCS. The results were highly reproducible and comparable to the results obtained using the procedure previously described. It was concluded that a 60 min pre-incubation of lymphocytes and the use of FCS are not necessary when the appropriate SRBS: lymphocyte ratio is used in the determination of human adult active RFC. The use of this procedure in evaluating the immune competence of cancer patients is discussed.


[Side-effects of corticosteroid therapy (author's transl)].
In reviewing the unwanted effects and side-effects of corticosteroid therapy, the principle guidelines for their use and contraindications are dealt with. Then the effects of a pharmacodynamic therapy on the metabolism of carbohydrates, proteins and fat and also the mineral balance are discussed and e.g. steroid diabetes, osteoporosis and myopathies are gone into. At the same time, the special properties of the various synthetic derivatives of cortisol, cortisone and corticosterone are referred to. Besides undesirable complications of corticosteroids in the gastrointestinal region, blood clotting and the influence on the course of infections and the psychic behavior, the side-effects on the skin and eyes are discussed. In closing, suggestions on the general measures of supervision and information of the patient are given. The principle of therapeutic decision is finally benefit: assessment of the risk to each patient.


The influence of perceptions of community norms on current contraceptive use among men and women in Ethiopia and Kenya.
The paper uses data from Ethiopia and Kenya to examine how perceptions of community norms differentially shape contraceptive use among men and women. Women whose current number of sons is lower than their perception of the community ideal had lower odds of reporting contraceptive use, while women whose own personal ideal number of sons is lower than the community ideal had greater odds of reporting contraceptive use. Men and women in Kenya were influenced more by their perception of their social network's approval of family planning than by their own approval of family planning. Results highlight the importance of place, conceptualized as the place-specific perceptions of fertility ideals, when conducting reproductive health research. Identification of people who use contraception in the face of pervasive pronatalist community norms presents a point for future intervention.


Assessing the capacity to make everyday decisions: a guide for clinicians and an agenda for future research.
Assessing the capacity of patients to make decisions about their functional problems has substantial ethical, clinical, and financial implications. The growing population of older adults with cognitive impairment either in the community or in long-term care and medical facilities increase the importance of adequately assessing this capacity. This review examines the current approaches to making this assessment, demonstrates how they are incomplete, and considers potential approaches for improving these evaluations. Future research should develop and validate methods to identify patients with impaired capacity to make everyday decisions. These data will supplement functional, cognitive, and medical assessments.


Physiological estrogen replacement may enhance the effectiveness of the gonadotropin-releasing hormone agonist in the treatment of hirsutism.
GnRH agonists (GnRH-A) have been used for the treatment of hirsutism in women with ovarian hyperandrogenism. However, significant side-effects, including vasomotor symptoms and bone loss, have prevented the long term use of this therapy. In this study, we evaluated the effects of low dose (physiological) estrogen replacement on the side-effects and clinical and hormonal parameters of 22 hirsute women with ovarian hyperandrogenism when treated with a long-acting GnRH-A, Decapeptyl. Ten patients with Ferriman-Gallwey (FG) scores averaging 13.4 +/- 1.5 were randomly assigned to be treated with Decapeptyl alone (3.75 mg, im, every 28 days for 6 months), and 12 other patients with FG scores averaging 13.3 +/- 1 received Decapeptyl with estrogen (conjugated equine estrogens, 0.625 mg) for 21 days and medroxyprogesterone acetate (10 mg) for 10 days (days 12-21). After 6 months, LH was suppressed in both groups, whereas FSH was significantly reduced only in the group receiving GnRH-A with estrogen (2.5 +/- 4 vs. 4.8 +/- 0.6 IU/L; P < 0.01). Serum androgen levels were reduced in both groups, although the reduction of testosterone and unbound testosterone was greater in the group receiving hormonal replacement [1.73 +/- 0.3 vs. 2.57 +/- 0.4 nmol/L for testosterone (P < 0.05); 8.3 +/- 1 vs. 14.6 +/- 2.8 pmol/L for unbound testosterone (P < 0.05)]. The reduction in hirsutism scores was greater with hormonal replacement (FG scores, -4.1 +/- 0.3 vs. -2.5 +/- 0.3; P < 0.05), whereas the polycystic appearance of ovaries by ultrasound was decreased in both groups. Amenorrhea and vasomotor symptoms were observed only with GnRH-A alone. Serum osteocalcin rose significantly with GnRH-A alone, reflecting a change in bone turnover (0.49 +/- 0.05 to 0.64 +/- 0.09 nmol/L; P < 0.05), but was unchanged with hormonal replacement. Patients receiving hormonal replacement had treatment extended to 1 yr. A further improvement of hirsutism, with scores dropping into the normal range (4.9 +/- 0.7), as well as a normalization of ovarian morphology were evident at this time. In conclusion, low dose (physiological) estrogen replacement may enhance the effects of GnRH-A treatment, while preventing most of the side-effects encountered with GnRH-A alone. This may allow more prolonged treatment, which is necessary for hirsutism.


Chirality and grain boundary effects on indentation mechanical properties of graphene coated on nickel foil.
We investigate chirality and grain boundary (GB) effects on indentation mechanical properties of graphene coated on nickel foil using molecular dynamics simulations. The models of graphene with different chirality angles, different numbers of layers and tilt GBs were established. It was found that the chirality angle of few-layer graphene had a significant effect on the load bearing capacity of graphene/nickel systems, and this turns out to be more significant when the number of layers is greater than one. The enhancement to the contact stiffness, elastic capacity and the load bearing capacity of graphene with tilt GBs was lower than that of pristine graphene.


Brief communication: Evolution of a specific O allele (O1vG542A) supports unique ancestry of Native Americans.
In this study, we explore the geographic and temporal distribution of a unique variant of the O blood group allele called O1v(G542A) , which has been shown to be shared among Native Americans but is rare in other populations. O1v(G542A) was previously reported in Native American populations in Mesoamerica and South America, and has been proposed as an ancestry informative marker. We investigated whether this allele is also found in the Tlingit and Haida, two contemporary indigenous populations from Alaska, and a pre-Columbian population from California. If O1v(G542A) is present in Na-Dene speakers (i.e., Tlingits), it would indicate that Na-Dene speaking groups share close ancestry with other Native American groups and support a Beringian origin of the allele, consistent with the Beringian Incubation Model. If O1v(G542A) is found in pre-Columbian populations, it would further support a Beringian origin of the allele, rather than a more recent introduction of the allele into the Americas via gene flow from one or more populations which have admixed with Native Americans over the past five centuries. We identified this allele in one Na-Dene population at a frequency of 0.11, and one ancient California population at a frequency of 0.20. Our results support a Beringian origin of O1v(G542A) , which is distributed today among all Native American groups that have been genotyped in appreciable numbers at this locus. This result is consistent with the hypothesis that Na-Dene and other Native American populations primarily derive their ancestry from a single source population.


Denervation and reinnervation of adult skeletal muscle modulate mRNA expression of neuregulin-1 and ErbB receptors.
Skeletal muscle atrophy represents one of the main causes of poor outcome of microsurgical nerve reconstruction. Recent studies have pointed to the importance of the neuregulin/ErbB signaling pathway in the development and regeneration of the neuromuscular system. Here, we show by immunohistochemistry, RT-PCR, and Western blotting analyses, in an in vivo model of adult skeletal muscle denervation/reinnervation, that expression of Neuregulin1 (NRG1) and ErbB receptors is regulated by the innervation condition. We found out that a significant upregulation of the alpha-, but not beta-, isoform of NRG1, as well as of ErbB2, ErbB3, and ErbB4-cyt1 isoform occurs as a consequence of denervation of flexor digitorum muscles of the rat forelimb by median nerve transection. Moreover, after tubulization median nerve repair, and consequent muscle reinnervation, all messengers of the NRG1/ErbB system are promptly downregulated. Therefore, our results suggest the existence of a alpha-NRG1-mediated autocrine and/or paracrine trophic loop in skeletal muscles that is activated after denervation and promptly deactivated after nerve reconstruction. This myotrophic loop is a promising therapeutic target for the prevention of muscle atrophy. Yet, the recent demonstration of a similar alpha-NRG1-mediated gliotrophic loop in denervated Schwann cells provides a possible explanation for the effectiveness of muscle conduits for tubulization nerve repair.


[A novel two-incision minimally invasive method for the treatment of anterior acetabular fractures].
To present a novel two-incision minimally invasive (TIMI) method for the treatment of anterior acetabular fractures. The first TIMI incision is performed using a pararectal approach at the level of the proximal third of the arcuate line of the ilium. After transection of the abdominal wall the iliac vessels are mobilized medially and the neuromuscular bundle laterally. The second approach lies above the medial pubic bone. The soft tissue is held back using a retraction system. After fracture reduction and fixation by isolated screws a conventional reconstruction plate is inserted for fracture neutralization. Since January 2008 we have performed the TIMI method in 88 cases with good results. Recently we have published the data of a first series with 26 patients that were seen at least 12 months after surgery. The mean operative time was 109 ± 30 min and all incisions showed primary healing. Postoperative radiological examination revealed an anatomic reduction in 20 fractures and a satisfactory reduction in 6. There were no local soft tissue complications and no revisions were needed. Follow-up examinations were performed after a minimum of 12 months in 19 patients (73%). The average Harris hip score (HHS) was 86.6 ± 8. Quality of life was comparable to control persons in the same age group. The TIMI approach represents a viable alternative to the ilioinguinal approach. Despite the limited number of incisions a comparable quality of fracture reduction is achieved. The authors believe this technique would be most useful in patients with a higher risk for postoperative soft tissue complications.


Esthetic management of mucogingival defects after total excision in a case of pyogenic granuloma.
Pyogenic granuloma is a relatively rare hyperplastic lesion of the oral tissues. Clinically it is heterogeneous and can be similar to malignant epithelial and mesenchymal neoplasms. The treatment of choice is the surgical excision of the lesion. This approach often results in unpleasant gingival defects, especially when the pyogenic granuloma is located in the esthetic zone. This report describes the clinical and histological findings of pyogenic granuloma diagnosed in the maxilla of a 24-year-old female, as well as the successful treatment of the mucogingival defect that occurred following excision of the lesion, by placement of a subepithelial free connective tissue graft with the envelope-technique concurrently with the biopsy procedure. One-year postoperative complete root coverage of tooth 11 was achieved with a harmonious gingival contour, and no further recurrence was noted. Early diagnosis of pyogenic granuloma, and consequent therapy with adequate excision in a safe distance of at least 1 mm, is essential for prevention of neighboring structures and minimizing the risk of a relapse. Histopathological evaluation is obligatory to confirm the tentative clinical diagnosis and to exclude malignant neoplasms. The immediate esthetic rehabilitation with free connective tissue grafts presents a complementary procedure in the treatment of mucogingival defects after total excision of oralmucosal diseases.


Molecular weight prediction in polystyrene blends. Unprecedented use of a genetic algorithm in pulse field gradient spin echo (PGSE) NMR.
A genetic algorithm that uses boxcar functions (diffGA) has been applied for the first time in PGSE NMR. It reconstructs accurate diffusion coefficients for all the components of the mixture, and therefore predicts correct weight-average molecular weights for all of them. The results reported herein complement those obtained with established methods such as ITAMeD, CONTIN and TRAIn algorithms, and provide a detailed solution picture. Its robustness and limits have been stretched in order to ascertain the minimum separation within diffusion coefficients or relative proportion between components. In addition, the new genetic algorithm has been also applied to a mixture of small molecules, providing excellent results at very low computational times.


[Association of hOGG1 genotype with life style and oxidative DNA damage in five ethnic populations in China].
To assess the natural variation of hOGG1 gene and the gene-environmental interactions. The hOGG1 codon 326 polymorphism and urinary 8-OHdG levels were investigated in a large sample of healthy individuals (n = 953) from five ethnic populations in China by using PCR-RFLP and HPLC-ECD. Life style parameters were obtained through a questionnaire survey. The allelic frequencies of hOGG1 gene in whole subjects were 0.16 (Ser/Ser), 0.49 (Ser/Cys) and 0.35 (Cys/Cys). The frequency of Ser326Cys was significantly different among the five ethnic populations (P = 0.002). No association was found between the hOGG1 gene polymorphism and other life style parameters except for the association between Ser326Cys and smoking (P = 0.027). A significant increase of urinary 8-OHdG level was observed in Cys326Cys allelic healthy subjects (P = 0.033). There are natural variations of hOGG1 gene in different ethnic populations in China. Smoking is related to the frequencies of Cys/Cys polymorphism, and the repairing of oxidative DNA damage is lower in individuals with the hOGG1 Cys326Cys genotype.


A juvenile animal model to study the growth potential of bowel segments in the urinary tract.
A juvenile animal model has been developed to study the growth potential of ileum in the urinary tract. Patch ileocystoplasties of known surface area were constructed in dogs of Group 1. Nonrefluxing ileal nipple valves of known length were created to replace one ureter in dogs of Group 2. After the juvenile animals grew and at minimum doubled their weight, they were reoperated and augmentation surface areas were remeasured at various physiologic intravesical pressures. Nipple valve lengths were remeasured after cystograms ruled out reflux. Results show that the bowel augmentation and an identical control segment increased in surface area proportionate to animal growth and that hydrostatic dilation caused further surface area increase. Nipple valves did not grow and in fact shortened, but remained nonrefluxing. The conclusion is that in the pediatric population, consideration should be given to downscaling the size of bladder augmentations or diversions in anticipation of future bowel growth, but that one should not shorten the ileal nipple valves.


The inguinal canal: anatomy and imaging features of common and uncommon masses.
A variety of benign and malignant masses can be found in the inguinal canal (IC). Benign causes of masses in the IC include spermatic cord lipoma, hematoma, abscess, neurofibroma, varicocele, desmoid tumor, air, bowel contrast material, hydrocele, and prostheses. Primary neoplasms of the IC include liposarcoma, Burkitt lymphoma, testicular carcinoma, and sarcoma. Metastases to the IC can occur from alveolar rhabdomyosarcoma, monophasic sarcoma, prostate cancer, Wilms tumor, carcinoid tumor, melanoma, or pancreatic cancer. In patients with a known malignancy and peritoneal carcinomatosis, the diagnosis of metastases can be suggested when a mass is detected in the IC. When peritoneal disease is not evident, a mass in the IC is indicative of stage IV disease and may significantly alter clinical and surgical treatment of the patient. A combination of the clinical history, symptoms, laboratory values, and radiologic features aids the radiologist in accurately diagnosing mass lesions of the IC. Supplemental material available at radiographics.rsnajnls.org/cgi/content/full/28/3/819/DC1.


Progressing geographic atrophy: choroidal thickness and retinal sensitivity identify two clinical phenotypes.
To analyse changes in choroidal thickness and retinal sensitivity (Se) in patients with geographic atrophy (GA) with or without choroidal neovascularisation (CNV) in the fellow eye. Patients with bilateral GA (B-GA group) and patients with unilateral GA and CNV in the fellow eye (U-GA group) were followed every 6 months, and enhanced depth imaging optical coherence tomography (OCT), blue and near infrared-wavelength fundus autofluorescence (B- and NIR-FAF), and microperimetry were evaluated. GA area, choroidal thickness, and Se were measured in the eye with GA at baseline and every 6 months up to the last follow-up visit. 19 patients (8 in the B-GA group (16 eyes) and 11 in the U-GA group (11 eyes)) were studied. The mean±SD follow-up was 1.66±0.71 years (range 0.74-2.60 years) in the U-GA group, and 1.51±0.86 years (range 0.58-2.95 years) in the B-GA group (p=0.6766). Mean GA area was not significantly different between groups at baseline (p=0.4118 in the B-FA and p=0.6806 in the NIR-FAF) or at follow-up (p=0.5734 in the B-FAF and p=0.8945 in the NIR-FAF). Mean GA area significantly increased in both groups during follow-up (p=0.0050 for B-FAF and p=0.0052 for NIR-FAF in the U-GA group; p=0.0049 for B-FAF and p=0.0072 for NIR-FAF in the B-GA group). Choroidal thickness was significantly greater in the B-GA group compared with the U-GA group both at baseline (mean choroidal thickness 170.5±78.5 μm vs 129.1±36.1 μm; p=0.0371) and at last follow-up (173.2±86.1 μm vs 123±32.1 μm; p=0.0340). During follow-up mean choroidal thickness significantly decreased only in the U-GA group (p=0.0276); conversely mean Se significantly decreased only in B-GA group (p=0.0405). During follow-up, changes in Se and choroidal thickness differed in patients with GA with or without CNV in the fellow eye. These results identify at least two GA phenotypes, in which the development and progression of GA may be primarily due to different pathophysiologic mechanisms.


[Colorectal neoplasms in patients with ulcerative rectocolitis. Their surgical treatment and follow-up].
Patients with ulcerative colitis (UC), especially those with a long-term standing or severe disease, show a higher incidence of colorectal neoplasms. Dysplasia represents the most important risk-factor for malignancy in patients with UC. From 1989 to 1999, 71 patients with UC, were surgically treated at our Institution. Indications for surgery were: non responding disease or refractory bleeding in 61; pathologic evidence of severe dysplasia during endoscopic surveillance in 5 patients, evidence of a neoplasm in the remaining 5 patients. Operative mortality was 1.4%. Infections of the surgical wound has been the most common postoperative complication. In 4 cases pouchitis has been reported. In 7 patients because of progression of the proctitis a second surgical treatment has been made. When surgical treatment is indicated in the course of ulcerative colitis, several operations may be performed. In the large majority of patients, total colectomy, mucosectomy and ileal pouch-anal anastomosis is the procedure of choice.


The impact of the initial ventilatory strategy on survival in hematological patients with acute hypoxemic respiratory failure.
The aim of this study was to assess the impact of the 3 types of initial respiratory support (noninvasive positive pressure ventilation vs invasive positive pressure ventilation vs supplemental oxygen only) in hematological patients with acute hypoxemic respiratory failure (ARF). This study is a retrospective analysis of a cohort of hematological patients admitted to the intensive care unit (ICU) of a tertiary care hospital between January 1, 2002, and June 30, 2006. One hundred thirty-seven hematological patients were admitted at the ICU with ARF (defined as Pao(2)/Fio(2) <200): within the first 24 hours, 24 and 67 patients received noninvasive positive pressure ventilation and invasive positive pressure ventilation, respectively, and 46 received supplemental oxygen only. Intensive care unit mortality in the 3 patient categories was 71%, 63%, and 32%, respectively (P = .001), and in-hospital mortality was 75%, 80%, and 47%, respectively (P = .001). In multivariate regression analysis, increasing cancer-specific severity-of-illness score upon admission and more organ failure after 24 hours of ICU admission, but not the type of initial respiratory support, were significantly associated with ICU or in-hospital mortality. Intensive care unit and in-hospital mortality in our population of hematological patients with hypoxemic ARF was determined by severity of illness and not by the type of initial respiratory support.


Surgical repair of type II paraesophageal hernia: our experience.
Type II paraesophageal hiatal hernia is a rare entity that is rarely discussed in the literature. This report is intended to depict the clinical profile of the disease and to discuss several controversial issues involved in the repair, including indications for surgery, the most appropriate surgical approach, and the need for a concomitant antireflux procedure. This study retrospectively reviews the experience with 12 patients affected by paraesophageal hernia who underwent a surgical repair between 1973 and 2001. Ten were women and two were men, with a mean age of 56.8 years. Clinical features and diagnostic assessment, as well as operative findings, are presented. Nine patients underwent an elective operation, and three patients underwent an emergency procedure for hernia complications. A thoracic approach was used in one patient, whereas the remaining 11 patients underwent an abdominal repair; the hernia sac was resected, and the hiatus was reconstructed in all of the patients. No postoperative deaths occurred; complications occurred in one patient, and only one recurrence was observed. Type II paraesophageal hernia seems to be a rare primary diaphragmatic defect. Its surgical repair is mandatory, because paraesophageal hernia is a potentially life-threatening disease because of the risk of severe complications; an elective repair should be performed wherever possible, even in asymptomatic patients. The main problems of the management are the choice of the surgical approach and the usefulness of an associated antireflux procedure to the hiatoplasty; in our opinion, a fundoplication should be added to all repairs.


[Exposure of children to benzene and other motor vehicle emissions].
The concentrations of benzene, toluene, and lead and the percentage of carboxyhemoglobin (COHb) were measured in the venous blood of 48 children living in a central urban area with high traffic density (Cologne, FRG). The same parameters were also evaluated in a reference group of children (n = 72) living in a small city located in a rural area of West-Germany (Borken, Münsterland). The above named parameters could be quantitated in all blood samples. The children living in the central urban area had, on average, significantly higher concentrations of benzene, toluene, lead, and COHb in blood than the children of the reference group. The blood benzene concentrations were, on average, 71% and the toluene concentrations 56% higher in the urban children when compared to the reference group. The median values of the urban group/reference group were: benzene, 115/70 ng/l; toluene, 545/370 ng/l; lead, 5.2/4.7 micrograms/dl; COHb, 0.9/0.6%. It is concluded that the higher levels of benzene, toluene, lead, and COHb found in the blood of the urban children result from the higher atmospheric concentrations of these pollutants generally found in central urban areas with high traffic density.


Risk Factors for BK Polyoma Virus Treatment and Association of Treatment With Kidney Transplant Failure: Insights From a Paired Kidney Analysis.
Identification of risk factors for BK polyoma virus (BKPyV) without confounding by donor factors and era effects in paired analysis may inform strategies to prevent BKPyV. In this analysis of 21,575 mate kidney pairs in the Scientific Registry of Transplant Recipients between 2004 and 2010, the presence of a treatment code for BKPyV virus in follow-up forms was used to identify pairs in which 1 of 2 mate kidneys was treated (discordant treatment) or both mate kidneys were treated (concordant treatment). Among 1975 discordant pairs, younger than 18 years or 60 years or older, male sex, HLA mismatch or 4 greater, acute rejection, and depleting antibody induction had a higher odds of treatment, whereas diabetes and sirolimus had a lower odds of treatment, and treatment was associated with a higher risk of allograft failure (hazards ratio, 2.01; 95% confidence interval, 1.63-2.48). The rate of concordant treatment (0.81%) was 2.8 times higher than expected. Concordant treatment was associated with nonwhite donor ethnicity, donation after circulatory death, transplantation after 2008, and transplantation of mate kidneys in the same center. This analysis of kidneys from the same donor in which only 1 transplant was treated for BKPyV identifies specific risk factors (age <18 or ≥ 60 years, male sex, depleting antibody, HLA mismatch ≥ 4) for BKPyV and provides an estimate of the BKPyV-associated risk of allograft failure (hazards ratio = 2.01) without confounding by donor factors or era effects. The higher than expected rate of concordant treatment suggests the importance of donor factors in BKPyV pathogenesis and warrants further study.


Solajiangxins A-C, three new cytotoxic sesquiterpenoids from Solanum lyratum.
One new eudesmane-type (1, named solajiangxin A) and two new eudesmane-related sesquiterpenoids (2-3, named solajiangxins B-C) were isolated from the whole plant of Solanum lyratum. Their structures were elucidated on the basis of integrated spectroscopic techniques. In vitro, three new sesquiterpenoids were found to show significant cytotoxicities against three human cancer lines (P-388, HONE-1 and HT-29), and gave ED50 values in the range of 1.9-3.7 μg/ml.


Is nursing a profession? Results of a Missouri study.
This article examines the question of whether or not nursing is or should be a profession. The conclusion is based primarily on an analysis of what constitutes a profession and an empirical study of some nursing practices and attitudes. The analysis of professions recognizes three prominent models in sociology: trait, functional, and power or control. It bypasses these in favor of a "cluster concept," which asserts that the public has a number of expectations of an occupation before it will bestow the status of profession upon it. We then give an analysis of some of the results of the survey of a sample of Missouri registered nurses. The gist of the data is said to reflect the facts that these nurses think nursing is or should be a profession, but that other factors tend to show that nursing lacks the requisite cluster to substantiate the claim to be a profession. We conclude that nursing should perhaps not be a profession since it has been a bastion of the "ethics of compassion" in a world that is increasingly beset by an "ethics of competence."


Factors associated with reported food allergy tolerance among US children.
Limited studies exist on predictors of food allergy tolerance. To describe factors associated with tolerance to 9 common food allergens based on caregiver report in a nationally representative survey. Data from children with current and outgrown food allergies were identified for analysis from a randomized, cross-sectional survey administered in US households with children from June 2009 through February 2010. Allergies were analyzed based on type of allergy, age at which allergies were outgrown, and reaction history. Adjusted models were formulated to examine the association of child and food allergy characteristics with odds of reporting an allergy as being outgrown. Of 40,104 children surveyed, 1,245 cases of outgrown food allergy were identified. The frequency of tolerance in children with food allergy was 26.6% at a mean age of 5.4 years. Children with milk (41.1%), egg (40.2%), or soy (35.7%) allergy had significantly higher frequencies of tolerance, whereas children with shellfish (13.0%), tree nut (14.3%), and peanut (15.6%) allergies had significantly lower frequencies (P < .05). Factors significantly associated with a report of outgrowing an allergy included a mild to moderate reaction history, being allergic to only 1 food, eczema as the sole allergy symptom, and white compared with black race (P < .05). Probability of tolerance also was significantly higher at younger ages of first reaction and decreased for first reactions occurring later in life, irrespective of allergen, severity, or presentation (P < .05). Multiple factors were associated with a report of outgrowing an allergy. Understanding factors associated with outgrowing an allergy can improve disease management and counseling.


Spiking Survanta with synthetic surfactant peptides improves oxygenation in surfactant-deficient rats.
The hypothesis that the in vivo function of Survanta (Beractant) can be improved by supplementation with synthetic surfactant peptides B and C was tested in a surfactant-deficient rat model. Full length surfactant protein-B (SP-B1-78) (B) and palmitoylated surfactant protein-C (SP-C1-35) (C), and synthetic KL4 peptide were added to Survanta after extraction, creating extracted Survanta (ES) with 1% B, 2% B, and 2% B plus 1% C, or mixed with Survanta without extraction, creating modified Survanta (S) with 2% B, 2% B plus 1% C, and 2% KL4. Adult rats were ventilated with 100% oxygen, tidal volumes (VT) of 7.5 ml/kg and a rate of 60/min, and were lavaged until the PaO2 dropped below 80 mm Hg, when 100 mg/kg of surfactant was instilled. After 15 to 60 min of ventilation, pressure-volume (P-V) curves were generated in situ. Instillation of ES or S with 2% B plus 1% C led to the greatest increase in oxygenation, closely followed by ES and S with 2% B, and more distantly by S plus 2% KL4. TLC was comparable among the ES and S groups, but greater than that of air-placebo controls. These data suggest that spiking of Survanta with synthetic SP-B and SP-C increased oxygenation more effectively than B or KL4 alone in this surfactant-deficient rat model.


The sizes and characteristics of the minority ethnic populations of Great Britain--latest estimates.
This article presents estimates of the minority ethnic populations of Great Britain in 2000 and describes the regional distributions of the different groups. It also discusses changes in the sizes of the different minority ethnic populations during the 1990s. The paper provides information on some key demographic features of these populations at the end of the 1990s--age and sex structures, proportions born in the United Kingdom and whether children lived with their natural parents.


No genetic association between dopamine D1 receptor gene and [early onset] schizophrenia.
Decreased dopaminergic activity in the prefrontal cortex (PFC) has been consistently reported in schizophrenia patients. The dopamine D1 receptor (DRD1) plays an important role in mediating dopaminergic transmission in the PFC. Controversy about this topic still exists despite ample evidence suggesting that the DRD1 gene is associated with performance on neuropsychological tests probing the function of the PFC in schizophrenia, as well as positive and negative symptoms and therapeutic response to antipsychotics. To determine whether this gene is involved in the etiology of schizophrenia, we undertook a case-control study to look for an association. We genotyped five single nucleotide polymorphisms (SNPs) rs4532, rs5326, rs2168631, rs6882300 and rs267418 within the DRD1 involving 373 schizophrenia patients with early age of onset and 379 healthy subjects. No significant differences of genotype, allele or haplotype distribution were identified between patients and controls. Our results do not preclude a possible role of DRD1 in the etiology of schizophrenia. As an important dopaminergic gene, DRD1 may contribute to schizophrenia by interacting with other genes. Further relevant studies are warranted.