Prospective, Randomized, Surgeon-Blinded Comparison of Standard Magnification Assumption vs Magnification Marker Usage for Preoperative Templating in Total Hip Arthroplasty.
We undertook this prospective, randomized, surgeon-blinded study to compare the accuracy of using of a magnification marker on preoperative radiographs for templating vs using a standard 21% magnification. One hundred consecutive total hip arthroplasties were randomized to preoperative templating using a 25-mm magnification marker (50 patients) or a standard 21% magnification (50 patients). Intraoperative data were collected regarding the actual and predicted size of the femoral and acetabular components. The 2 groups were found to be comparable with respect to body mass index (28.9 vs 27.9, P = .26) and gender (P = .69). In the magnification marker group, we predicted the femoral size within 1 size in 80% of the cases and the acetabular component in 94%. In the group of a standard 21% magnification, we predicted the femoral size within 1 size in 90% of the cases and the acetabular component in 96%. These proportions did not statistically differ (femur: χ2P = .16, odds ratio = 2.3, 95% confidence interval = 0.7-7.1; acetabulum: χ2P = .65, odds ratio = 1.5, 95% confidence interval = 0.3-9.6). We did not detect a statistically significant difference in accuracy by using one method over the other when comparing the accuracy of component size selection. As the use of the magnification marker adds to the time and expense of preoperative radiographic acquisition, we feel using a standard 21% magnification is an equally accurate technique.


Dexamethasone-induced enhancement of resistance to ionizing radiation and chemotherapeutic agents in human tumor cells.
Dexamethasone-induced changes in radioresistance have previously been observed by several authors. Here, we examined effects of dexamethasone on resistance to ionizing radiation in 10 additional human cell lines and strains, and on resistance to carboplatin and paclitaxel in 13 fresh tumor samples. Eight human carcinoma cell lines, a glioblastoma cell line and a strain of normal human diploid fibroblasts were arbitrarily chosen for these in-vitro studies. Effects on radiosensitivity were assessed using a conventional colony formation assay. Effects on resistance to the drugs were investigated prospectively (ATP cell viability assay) using 13 fresh tumor samples from consecutive patients operated for ovarian cancer within the context of a Swiss nation-wide randomized prospective clinical trial (SAKK 45/94). Dexamethasone promoted proliferation of 1 of the cell lines without affecting radiosensitivity, while it completely inhibited proliferation of another cell line (effects on radiosensitivity could thus not be examined). Furthermore, dexamethasone induced enhanced radioresistance in 1 of the 8 carcinoma cell lines examined. In the glioblastoma cell line, there was no effect on growth or radioresistance, nor in the fibroblasts. Treatment with dexamethasone enhanced resistance of the malignant cells to carboplatin in 4 of the 13 fresh tumor samples examined, while no enhancement in resistance to paclitaxel was observed. In agreement with previous reports, we found that dexamethasone may induce radioresistance in human carcinoma cells. Including the published data from the literature, dexamethasone induced enhancement in radioresistance in 4 of 12 carcinoma cell lines (33%), but not in 3 glioblastoma cell lines, nor in 3 fibroblast strains. Dexamethasone also induced enhanced resistance to carboplatin with a similar probability in fresh samples of ovarian cancer evaluated prospectively (in 4 of 13 samples; 31%). We worry that induction of resistance by corticosteroids given to patients undergoing either radiotherapy or chemotherapy with agents causing DNA damage might be associated with a reduced clinical responsiveness in a significant fraction of patients with a carcinoma.


Enzyme-assisted asymmetric total synthesis of (-)-podophyllotoxin and (-)-picropodophyllin.
Described is the first catalytic, asymmetric synthesis of (-)-podophyllotoxin and its C(2)-epimer, (-)-picropodophyllin. Asymmetry is achieved via the enzymatic desymmetrization of advanced meso diacetate 20, through PPL-mediated ester hydrolysis. A second key feature of the synthesis is the strategically late introduction of the highly oxygenated natural ring E through an arylcopper species. The successful implementation of this approach augers well for the introduction of other functionalized rings E for future SAR work. The synthesis begins from piperonal, which is fashioned into isobenzofuran (IBF) precursor 14 in three steps (bromination, acetalization, and halogen-metal exchange/hydroxymethylation). Interestingly, treatment of 14 with HOAc in commerical dimethyl maleate (contains 5% dimethyl fumarate) leads to a nearly equimolar mixture of fumarate- (15) and maleate-IBF Diels-Alder adducts (16 and 17), indicating that IBF 11 reacts about 15 times faster with dimethyl fumarate than with dimethyl maleate. With scrupulously pure dimethyl maleate a 2.8:1 endo:exo mixture of maleate DA adducts is still obtained. On the other hand, the desired meso diester 16 is obtained pure and in nearly quantitative yield by employing neat dimethyl acetylene dicarboxylate as the dienophile, followed by catalytic hydrogenation. Reduction (LiAlH(4)) of 16 provides meso diol 19, which is then treated with Ac(2)O, BzCl, and PhCH(2)COCl to provide the corresponding meso diesters, 20-22. Screening of these meso benzoxabicyclo[2.2.1]heptyl substrate candidates across a battery of acyl transfer enzymes leads to an optimized match of diacetate 20 with PPL. Even on 10-20 g scales, asymmetry is efficiently introduced here, yielding the key chiral intermediate, monoacetate 25 (66% isolated yield, 83% corrected yield, 95% ee). Protecting group manipulation and oxidation (Swern) provide aldehyde 27b, which undergoes efficient retro-Michael ring opening to produce dihydronaphthalene 30, in which the C(3) and C(4) stereocenters are properly set. Following several unsuccessful approaches to the intramolecular delivery of ring E (via Claisen rearrangement, Heck-type cyclization, or radical cyclization), a highly diastereoselective, intermolecular conjugate addition of the arylcopper reagent derived from (3,4,5-trimethoxy)phenylmagnesium bromide and CuCN to acyl oxazolidinone 50 was developed (85% yield, only the required alpha-stereochemistry at C(1) is observed). The conjugate addition product is converted to (-)-picropodophyllin in two steps (lactonization, SEM deprotection) or to (-)-podophyllotoxin, in three steps, through the introduction of a C(2)-epimerization step, under Kende conditions, prior to the final conjugate addition.


Effects of haloperidol and risperidone on cerebrohemodynamics in drug-naive schizophrenic patients.
Use of antipsychotics may be associated with cerebrovascular adverse events in psychotic patients. In this study, the effects of haloperidol and risperidone on the cerebral hemodynamics and the possible relationships between antipsychotics and cerebrovascular risks tendency were evaluated by Transcranial Doppler ultrasonography (TCD). Twenty drug-nai ve schizophrenic patients and 20 normal control subjects were included. The patients were divided into haloperidol- and risperidone-treated groups and received treatment for 8 weeks double-blindly. The subjects' cerebral blood flow mean velocities (MV) and pulsatility index (PI) were measured weekly by TCD. The Positive and Negative Syndrome Scale for schizophrenia (PANSS) was used to assess the patients' psychopathological symptoms. Increased MV and decreased PI were found significantly in drug-nai ve schizophrenic patients than normal subjects before treatment (p<0.01). The decreased PI could be normalized after 8 weeks of antipsychotic treatment, while the increased MV could not. Treatment with haloperidol could significantly increase the PI than the treatment with risperidone (p<0.01) throughout the treatment course. The PANSS scores of both groups were significantly improved (p<0.05) at the endpoints of treatment. Our findings indicate that haloperidol may affect the cerebral hemodynamics in drug-naive schizophrenics more prominently than that of risperidone via TCD monitoring.


Recognition of morphologically complex words in Finnish: evidence from event-related potentials.
The temporal dynamics of processing morphologically complex words was investigated by recording event-related brain potentials (ERPs) when native Finnish-speakers performed a visual lexical decision task. Behaviorally, there is evidence that recognition of inflected nouns elicits a processing cost (i.e., longer reaction times and higher error rates) in comparison to matched monomorphemic words. We aimed to reveal whether the processing cost stems from decomposition at the early visual word form level or from re-composition at the later semantic-syntactic level. The ERPs showed no early effects for morphology, but revealed an interaction with word frequency at a late N400-type component, as well as a late positive component that was larger for inflected words. These results suggest that the processing cost stems mainly from the semantic-syntactic level. We also studied the features of the morphological decomposition route by investigating the recognition of pseudowords carrying real morphemes. The results showed no differences between inflected vs. uninflected pseudowords with a false stem, but differences in relation to those with a real stem, suggesting that a recognizable stem is needed to initiate the decomposition route.


Short-term desensitization of fast escape behavior associated with suppression of Mauthner cell activity in larval zebrafish.
Escape is among the simplest animal behaviors employed to study the neural mechanisms underlying learning. Teleost fishes exhibit behavioral learning of fast escape initiated with a C-shaped body bend (C-start). C-starts are subdivided into short-latency (SLC) and long-latency (LLC) types in larval zebrafish. Whether these two can be separately modified, and the neural correlates of this modification, however, remains undetermined. We thus performed Ca2+ imaging of Mauthner (M-) cells, a pair of giant hindbrain neurons constituting a core element of SLC circuit, during behavioral learning in larval zebrafish. The Ca2+ response corresponding to a single spiking of the M-cells was coupled with SLCs but not LLCs. Conditioning with a repeated weak sound at subthreshold intensity to elicit C-starts selectively suppressed SLC occurrence for 10min without affecting LLC responsiveness. The short-term desensitization of SLC was associated with the suppression of M-cell activity, suggesting that changes in single neuron responsiveness mediate behavioral learning. The conditioning did not affect the acoustically evoked mechanotransduction of inner ear hair cells, further suggesting plastic change in transmission efficacy within the auditory input circuit between the hair cells and the M-cell.


Children eroticized by incest.
The assumption that children involved in incest are passive, unwilling victims is an oversimplification of a complex situation. Young children may find such relationships gratifying and, when exposed over time to intense genital and extragenital stimulation, they often become highly erotic. This hypermature responsiveness may be viewed as learned behavior; the behavior is self-reinforcing and may be difficult to modify. The author describes three children to illustrate their arousal, inability to differentiate sensual from affectionate touch, early gender discrimination, and stereotyped role modeling. Foster homes are neither trained nor supported in caring for these children, so serial placements are common.


Postoperative daily living activities of geriatric patients administered general or spinal anesthesia for hip fracture surgery: A retrospective cohort study.
Maintaining independence after hip fracture repair is important for geriatric patients and general welfare. We investigated the effects of anesthetic methods on postoperative activities of daily living (ADLs) following hip fracture surgery in elderly patients. The medical records of 12,342 patients aged ≥65 years who underwent typical surgeries for hip fracture using either general anesthesia or spinal anesthesia were reviewed. To adjust for baseline differences and minimize selection bias for the chosen method of anesthesia, patients were matched by propensity scores. Factors affecting the deterioration in ADLs during hospital stay were also investigated in all subjects using a multivariate logistic regression analysis. Eating, grooming, toileting, bathing, and walking were selected as the ADL parameters, as they are considered important for an independent life. Of the 12,342 patients, 6918 (56.1%) received general anesthesia and 5424 (43.9%) received spinal anesthesia. After the propensity score matching, the anesthesia types were not associated with ADL scores except toileting at discharge. Results from the multivariate logistic regression analysis showed that the types of anesthesia were not associated with deterioration in ADL scores. Advanced age, male sex, high Charlson Comorbidity Index scores, psychiatric disease, no administration of nonsteroidal anti-inflammatory drugs, and short length of hospital stay were associated with deterioration in ADL scores. The anesthesia types were not associated with ADL dependency except toileting at discharge. Spinal anesthesia adversely affected toilet use at hospital discharge. However, anesthesia types were not factors that affected deterioration in ADL during hospital stay in elderly patients who underwent hip fracture surgery.


Mucormycosis after open fracture injury.
An 18-year-old woman (a former intravenous drug abuser) sustained open tibial plateau and shaft fractures, followed by cellulitis and a wound infection caused by a Rhizopus species, which is a fungus of the class Mucorales. The patient responded to surgical debridement and a prolonged course of amphotericin B. No lymphocyte abnormality or other host immune defect could be demonstrated in this patient.


HU protein of Escherichia coli has a role in the repair of closely opposed lesions in DNA.
Closely opposed lesions form a unique class of DNA damage that is generated by ionizing radiation. Improper repair of closely opposed lesions could lead to the formation of double strand breaks that can result in increased lethality and mutagenesis. In vitro processing of closely opposed lesions was studied using double-stranded DNA containing a nick in close proximity opposite to a dihydrouracil. In this study we showed that HU protein, an Escherichia coli DNA-binding protein, has a role in the repair of closely opposed lesions. The repair of dihydrouracil is initiated by E. coli endonuclease III and processed via the base excision repair pathway. HU protein was shown to inhibit the rate of removal of dihydrouracil by endonuclease III only when the DNA substrate contained a nick in close proximity opposite to the dihydrouracil. In contrast, HU protein did not inhibit the subsequent steps of the base excision repair pathway, namely the DNA synthesis and ligation reactions catalyzed by E. coli DNA polymerase and E. coli DNA ligase, respectively. The nick-dependent selective inhibition of endonuclease III activity by HU protein suggests that HU could play a role in reducing the formation of double strand breaks in E. coli.


The association between pre-operative PSA and prostate cancer-specific mortality in patients with long-term follow-up after radical prostatectomy.
The clinical and pathologic predictors of prostate cancer-specific mortality (PCSM) many years after radical prostatectomy (RP) remain to be fully elucidated. We explored the association between pre-operative prostate-specific antigen (PSA) and other pathologic predictors and PCSM in men who have undergone (RP). We report on 459 patients with PCSM data after RP who were followed prospectively over a 23-year period between 1987 and 1997. Cox regression and Kaplan-Meier analysis were used to evaluate pre-operative PSA, pathologic Gleason sum, pathologic stage, and surgical margin status as predictors of PCSM. The median PSA was 6.6 ng/ml (± 9.9) and the median follow-up time was 9.4 (± 4.9) years. Fourteen patients (3.1%) died of PC. On multivariate analysis, only PSA (HR: 1.050; P = 0.001) and binary Gleason sum (HR: 3.402; P = 0.043) remained significant predictors of PCSM. The predicted 10-year PCSM was significantly worse in those patients in the highest PSA tertile compared to those in other tertiles [PSA > 9.9: 87% (82-92%) vs. PSA = 4-9.9: 95% (93.0-97.0%) vs. PSA = 0-3.9: 100.0% (100.0-100.0%)]. We have highlighted the importance of pre-operative PSA in predicting PCSM many years after RP. It is a more significant predictor than Gleason sum and pathologic stage. Thus, PSA may help identify patients with life-threatening PC at a time when their disease is curable with definitive therapy.


Dynamical heterogeneities as fingerprints of a backbone structure in Potts models.
We investigate slow nonequilibrium dynamical processes in a two-dimensional q-state Potts model with both ferromagnetic and ±J couplings. Dynamical properties are characterized by means of the mean-flipping time distribution. This quantity is known for clearly unveiling dynamical heterogeneities. Using a two-times protocol we characterize the different time scales observed and relate them to growth processes occurring in the system. In particular we target the possible relation between the different time scales and the spatial heterogeneities originated in the ground-state topology, which are associated to the presence of a backbone structure. We perform numerical simulations using an approach based on graphis processing units (GPUs) which permits us to reach large system sizes. We present evidence supporting both the idea of a growing process in the preasymptotic regime of the glassy phases and the existence of a backbone structure behind this process.


Fetal hemorrhage associated with congenital intestinal atresia.
We encountered two cases of severe intrauterine hemorrhage associated with congenital intestinal atresia. In both cases, the first sign that necessitated immediate clinical management was the abnormal fetal heart rate patterns, represented by prolonged bradycardias and late decelerations. This occurred immediately after the onset of labor. An emergency cesarean section was performed on both patients and, despite being born with severe anemia, the condition of the infants was excellent. We found that continuous fetal heart rate monitoring should be performed if polyhydramniosis suspected, when the fetus is diagnosed with congenital intestinal atresia and when changes in intrauterine pressure are clinically expected, such as at the onset of labor or after amniocentesis.


The effect of lipid intermediates on Ca2+ and Na+ permeability and (Na+ + K+)-ATPase of cardiac sarcolemma. A possible role in myocardial ischemia.
The effect of fatty acid and acylcarnitine on Ca2+ and Na+ transporting enzymes and carriers was studied in sealed cardiac sarcolemma vesicles of mixed polarity. Palmitoylcarnitine markedly reduced the Na+ gradient-induced Ca2+ uptake. Half-maximal reduction was obtained at 15 microM of the carnitine derivative. In a same concentration range palmitoylcarnitine caused a rapid release of accumulated Ca2+ when added to Ca2+-filled vesicles, which suggests that palmitoylcarnitine increases the permeability of the sarcolemma vesicles to Ca2+. A rapid release of Ca2+ was also observed if Ca2+ was taken up by action of the Ca2+ pump. The (Ca2+ + Mg2+)-ATPase, which most likely drives this active Ca2+ uptake, was 90% increased by 50 microM palmitoylcarnitine and evidence was presented that the acylcarnitine effect again was linked to an alteration of Ca2+ permeability of the vesicles. At the same concentration acylcarnitine was not able to unmask the latent protein kinase, so that probably the sarcolemma ATP permeability was not affected. Palmitoylcarnitine at 25 microM did not affect the ouabain-sensitive (Na+ + K+) -ATPase in native sarcolemma vesicles, however, it inhibited markedly if the enzyme was measured in SDS-treated vesicles. The effect of increased free fatty acid concentration on some of the sarcolemma transporting properties was tested by adding oleate-albumin complexes with different molar ratios to the sarcolemma vesicles. In contrast to molar ratios 1 and 5, the ratio of 7 was able to induce a rapid Ca2+ release and to inhibit (Na+ + K+)-ATPase in either native or SDS-treated vesicles markedly. 22Na release from 22Na-preloaded sarcolemma vesicles was shown to be stimulated by either palmitoylcarnitine (50 microM) or oleate-albumin complex (with a molar ratio of 7). The possible significance of the observed effects of lipid intermediates on ion permeability and (Na+ + K+)-ATPase activity in isolated sarcolemma vesicles for the derangement of cardiac cell function in ischemia is discussed.


Hairworm Infection and Seasonal Changes in Paratenic Hosts in a Mountain Stream in Japan.
For parasites with complex life cycles, the ecological traits determining host competence and seasonal changes in infection in natural habitats are often unclear, making it difficult to predict infection dynamics, including disease outbreaks. Hairworms (phylum Nematomorpha) require both aquatic and terrestrial hosts to complete their life cycle. Although hairworm host competencies have been tested in laboratory experiments, knowledge of the paratenic hosts (aquatic insect larvae) in their natural habitats is limited. This study clarified the species of aquatic insect larvae that are primarily infected by hairworms as paratenic hosts over a year in a mountain stream in central Honshu, Japan. The monthly prevalence and mean abundance of hairworm cysts were high in Ephemera japonica larvae (Ephemeridae: Ephemeroptera) throughout the study period (20.0-88.9 and 0.2-36.8%, respectively). These high prevalence and abundance values may be attributable to their filter-feeding behavior as well as their depositional habitat use. The hairworms also infected leptophlebiids (Ephemeroptera; scrapers), the perlid Calineulia sp., the chloroperlid Haploperla japonica (Plecoptera; predators), and chironomids (Diptera; filter-feeders or predators). The abundance of the cysts tended to be high in aquatic insects inhabiting pools rather than riffles, and the seasonality reflects the reproductive season of the hairworms as well as the phenology of their paratenic hosts. Filter-feeding ephemeropterans inhabiting pools were the major paratenic host of the hairworms in our study site, although their universality and effectiveness as the transporter to definitive hosts remain unclear.


Flow-through anterior thigh flaps for one-stage reconstruction of soft-tissue defects and revascularization of ischemic extremities.
"Flow-through" anterior thigh flaps are used to reconstruct defects accompanied by major vessel damage in the extremities. These flaps have long flow-through pedicle vessels (which are the descending branch of the lateral circumflex femoral system) that can be interposed into the vascular gaps in the extremities and are composed anatomically of the rectus femoris muscle. The defects of eight patients were repaired successfully with flow-through anterior thigh flaps, which were from 10 to 30 cm in length and 7 to 15 cm in width. The advantages of these flaps are (1) the damaged main vessels (< 20 cm in length) can be reconstructed simultaneously with large skin defects (up to 30 cm in length and 15 cm in width), (2) double arterial inflow by means of both ends of the pedicle artery ensures safe blood circulation of the flap, (3) the lateral circumflex femoral system, the pedicle of the anterior thigh flaps, can be used for chimeric composite flaps for the reconstruction of composite defects with major vessel loss in the extremities, (4) two concomitant veins can be used as a drainage system in extremities with severe edema, and (5) multistage flap transfers are possible to repair recurring defects in the extremities with a single major vessel using additional transection and pedicle interposition.


Generalized acanthosis nigricans in childhood.
Acanthosis nigricans in children is usually associated with obesity. Generalized acanthosis nigricans in childhood is rare. We report a 13-year-old boy with an 8-year history of generalized hyperpigmentation and velvety thickening of the skin. Despite an extensive physical and laboratory examination no evidence of underlying endocrinological or neoplastic disease was found.


Risk factors for choledocholithiasis in a south Indian population: a case-control study.
To identify risk factors for common bile duct (CBD) stones in a south Indian population. Demographic characteristics and diet details were obtained from patients with isolated CBD stones (Gp I) and those with combined CBD and gallstones (Gp II) and age- and sex-matched controls. The risk factors were compared between the two groups. The demographic characteristics were similar between the two groups and matched controls. The significant risk factors for Gp I were infrequent consumption of green vegetable (odds ratio (OR), 2.3; p < 0.05), intake of tea/coffee (OR 3.3; p < 0.01) and less consumption of sugar (p < 0.01). For Gp II, the risk factors were frequent intake (>3 times per week) of spices (OR, 2.8; p < 0.05), fried foods (OR, 2.7; p < 0.05), tamarind (OR, 2.8; p < 0.01), and quantum of oil (p < 0.01) per month. Green vegetables (OR, 8.5; p < 0.00001) and sugar (9.5 + 4.2 vs. 13.8 + 11.2 g; p < 0.00001) were protective. Between the two groups, the risk factors for Gp II were less frequent green vegetable intake (OR: 6.4; p < 0.00001), more frequent spicy food (0-3 times per week) (OR, 7.0; p < 0.05), and higher monthly oil intake (251 + 105 vs. 292 + 89 mL; p < 0.05). CBD stones in both groups were associated with reduced intake of sugar and green vegetables. Our findings need to be validated in larger studies.


Production of monospecific antibody to immunodominant epitopes of the caprine arthritis encephalitis virus transmembrane glycoprotein and analysis of their activity in vitro.
Caprine arthritis encephalitis virus (CAEV)-infected goats develop high titers of nonneutralizing antibody to several immunodominant epitopes of the viral envelope glycoprotein. Antibodies directed to these structures, and especially the principal immunodominant domain (PID) of the transmembrane portion of the envelope glycoprotein, have been implicated in the immunopathological mechanisms leading to the development of arthritis. We previously mapped the PID and additional epitopes of CAEV gp38 and showed an association between the development of clinical arthritis in infected animals and the antibody response to these epitopes. The development of clinical arthritis is associated with a higher rate of viral expression, especially in the affected tissue, indicating that antibody may favorably modulate virus replication. To test this hypothesis, we immunized goats with synthetic peptides corresponding to the mapped epitopes. The immunized animals developed high titers of nonneutralizing antibody to the immunizing peptides. In radioimmunoprecipitation experiments these antibodies were shown to react to the envelope glycoproteins in extracts obtained under nondenaturing conditions. Finally, these sera were tested in cultures of primary macrophages infected at low multiplicity without showing any (either positive or negative) modulatory activity.


[Law of Pollutant Erosion and Deposition in Urban Sewage Network].
In order to investigate the scouring and deposition law of pollutants in urban sewer systems, the investigation of sewer systems was carried out in Xi'an. The results showed that the thickness of sediment in the branch pipe and the main pipe varied obviously. At the peak of the drainage, the velocity increased gradually, and the thickness of the pipeline sediment decreased. At the bottom of the drainage trough, the changes of the velocity and the thickness of the pipeline sediment were opposite, with variations of 0-24 mm and 0-12 mm, respectively. And the probability of granular contaminants sedimentation and scouring in sewer systems was high, while the thickness of sediment in sewage main pipe was less than the above mentioned pipes, the variation of which was 0-7 mm. In addition, the sedimentation and scouring in the main pipeline kept relatively balanced and the thickness of sediment remained stable. In order to clarify the relationship between the concentration of pollutants and the flow velocity, a pilot sewer system was established. The effects of different flow rates, which were 0.1, 0.3, 0.6, 0.9, 1.2 m·s-1, respectively, on the contents of carbon (organic), nitrogen and phosphorus in the pipeline were studied. The results showed that with the increase of the flow velocity, the scour intensity increased and the concentration of pollutants in the pipeline also increased sharply. As shown by the monitoring results of the static light scattering particle size analyzer, the carbon organic pollutants in the pipeline were easily adsorbed on the larger particles, while nitrogen and phosphorus pollutants were easily adsorbed on the particles with smaller size. Analysis on the change of the urban sewage pipeline showed, when the flow rate was less than 0.6 m·s-1, the sedimentation of granular pollutants in the sewage was greater than the scouring effect. When the flow velocity was higher than 0.6 m·s-1, the water scouring intensity increased and the scouring action was greater than the sedimentation, meanwhile, the sediments were carried by the water and the thickness of the sediments was reduced. The increase of the organic pollutants in the sewage was bigger than the nitrogen and phosphorus pollutants, so that the existing sewage carbon source was improved.


A store-forward ophthalmic telemedicine case report from deployed U. S. Army forces in Kuwait.
This telemedicine test was developed to determine the relative ease with which an off-the-shelf ophthalmic telemedicine package could be successfully applied from within a remote theatre of operations. The project was conducted at the Camp Doha Health Clinic, located just outside Kuwait City, during the period from April 12(th) through April 23(rd), 1998. The deployed signal unit had contracted for a direct T-1 commercial satellite link (via MCI), which allowed for direct internet connectivity using a PCMCIA network card. Digital images were sent via this connection to 140 e-mail sites throughout the world, including an unsolicited image to each of 134 Army optometry officers for their review, analysis, and diagnosis. Return responses to this unsolicited survey were 53 out of 134, for a 39.7% response rate. Half of the respondents were able to view the image with ease and clarity, rendering an accurate clinical diagnosis. The other half of the respondents either did not have the software to display an image on their clinical desktop PC, or did not know how to use their provided software. This project clearly indicates that an off-the-shelf ophthalmic digital system can be successfully used from a remote deployed site. However, the consulting clinicians require up-to-date training, and their computer packages should have as wide a capability base as possible.


Role of CO2 in the formation of gold deposits.
Much of global gold production has come from deposits with uneconomic concentrations of base metals, such as copper, lead and zinc. These 'gold-only' deposits are thought to have formed from hot, aqueous fluids rich in carbon dioxide, but only minor significance has been attached to the role of the CO2 in the process of gold transport. This is because chemical bonding between gold ions and CO2 species is not strong, and so it is unlikely that CO2 has a direct role in gold transport. An alternative indirect role for CO2 as a weak acid that buffers pH has also appeared unlikely, because previously inferred pH values for such gold-bearing fluids are variable. Here we show that such calculated pH values are unlikely to record conditions of gold transport, and propose that CO2 may play a critical role during gold transport by buffering the fluid in a pH range where elevated gold concentration can be maintained by complexation with reduced sulphur. Our conclusions, which are supported by geochemical modelling, may provide a platform for new gold exploration methods.


Structural and functional analyses of the FinP antisense RNA regulatory system of the F conjugative plasmid.
The efficiency of conjugation of F-like plasmids is regulated by the FinOP fertility inhibition system. The transfer (tra) operon is under the direct control of the TraJ transcriptional activator which, in turn, is negatively regulated by FinP, an antisense RNA, and FinO, a 22 kDa protein. Recently, FinO has been shown to extend the chemical stability of FinP in vivo in the absence of traJ mRNA. The in vitro secondary structures of both the FinP and TraJ RNAs were determined by the use of single- and double-strand-specific nucleases; both RNAs were found to have double stem-loop structures that are complementary to each other and, therefore, FinP RNA and TraJ RNA have the potential to form a duplex with each other. This was verified by in vitro binding experiments. The reaction was shown to be biomolecular with an apparent rate constant (kapp) of 5 x 10(5)M-1s-1, a value that is similar to those found for other natural antisense RNA systems. Preliminary evidence for the in vivo formation of the FinP-TraJ RNA duplex was obtained by primer extension of the traJ mRNA; the presence of both FinO and FinP was required to cause a dramatic reduction in the steady-state level of traJ mRNA, perhaps as a result of RNase III degradation of the resulting RNA duplex.


Sequential development of histiocytic sarcoma and diffuse large b-cell lymphoma in a patient with a remote history of follicular lymphoma with genotypic evidence of a clonal relationship: a divergent (bilineal) neoplastic transformation of an indolent B-cell lymphoma in a single individual.
Follicular lymphoma (FL) often transforms to diffuse large B-cell lymphoma (DLBCL) during its protracted clinical course. Rarely, histiocytic sarcoma (HS) occurs secondary to or concurrent with FL, although the biological relationship between these 2 morphologically and immunophenotypically distinct entities in the same individual has not been well characterized. We report a unique case showing the sequential occurrence of first, HS and then DLBCL in a patient with a remote history of FL. In this case, HS developed 17 years after the diagnosis of FL and was shown to partly retain the immunophenotypic features characteristic of FL, while showing the morphologic and immunophenotypic profiles diagnostic of HS. DLBCL occurred 18.5 years after FL. Both HS and DLBCL harbored the IGH/BCL2 fusion gene, a hallmark of FL, per interphase fluorescence in situ hybridization analysis. Immunoglobulin gene rearrangement studies showed a clonal rearrangement of the IGH gene in both HS and DLBCL with identical amplicons, suggesting a shared origin of the neoplastic clones. These data support the hypothesis of transdifferentiation or transevolution in a mature B-cell neoplasm, and, in addition, suggest the possibility of a divergent (bilineal) neoplastic transformation of FL in a single individual.


LDL-C reductions and goal attainment among naive statin users in the Netherlands: real life results.
The effectiveness of statin therapy in a real life setting may differ from that in clinical trials, as physicians make non-randomised treatment decisions for patients with less uniform and possibly different characteristics. We therefore performed a study to compare the effectiveness of different statins and doses in routine clinical practice with respect to total serum cholesterol and LDL-cholesterol (LDL-C) reduction and goal attainment according to European guidelines on the prevention of cardiovascular disease (CVD). Naive statin users starting treatment in 2003 and 2004 with LDL-C measurements at baseline and between 30 and 365 days after start of treatment were extracted from the PHARMO database. During treatment with their initial statin dose LDL-C reduction and attainment of cholesterol goals were compared between different statins and doses. Of 2303 identified naive patients, approximately 30% were allocated to the high CVD-risk group. Average LDL-C reductions were 48%, 42%, 39%, and 32% at mean doses of 11 mg rosuvastatin, 17 mg atorvastatin, 22 mg simvastatin and 35 mg pravastatin, respectively. The proportion of patients attaining cholesterol goals was 75% for rosuvastatin, 68% for atorvastatin, 56% for simvastatin, and 42% for pravastatin. Dose comparisons showed greater LDL-C reduction and increased goal attainment for rosuvastatin 10 mg compared to other statins at most doses (adjusted p < 0.05). In a real life setting, both LDL-C reduction and the proportion of patients attaining cholesterol goals appear to be significantly increased among users of rosuvastatin compared to other statins. These results confirm and extend reported clinical trial results to a real world setting.


Computed tomography of the head as a screening examination for facial fractures.
We hypothesized that head computed tomography (CT) is an accurate screening tool for detecting nonnasal midfacial fractures in trauma patients. We retrospectively reviewed charts and official readings for all patients who underwent both head and facial CT scans for trauma at our trauma center between August 2002 and April 2003. The ability of head CT to diagnose nonnasal bone midfacial fractures was compared with that of facial CT using sensitivity, specificity, accuracy, as well as positive and negative predictive values. Agreement was measured with kappa statistics. Ninety-five percent confidence intervals (CIs) were used to assess precision. Ninety-one patient records with head and facial CT scan reports were reviewed. Of the patients, 50 (55%) had nonnasal bone midfacial fractures. The sensitivity and specificity of head CT were 90% (95% CI = 79%-96%) and 95% (95% CI = 84%-99%), respectively; the positive and negative predictive values were 96% (95% CI = 86%-99%) and 89% (95% CI = 76%-95%), respectively. The rate of accuracy was 92%. The agreement was excellent (kappa = 0.85, 95% CI = 0.74-0.96). Head CT was sensitive and specific for identifying nonnasal bone midfacial fractures. An initial head CT alone may limit the need for a Waters view radiography or screening facial CT in detecting injuries.


Memory capacity in large idiotypic networks.
Many models of immune networks have been proposed since the original work of Jerne [1974, Ann. Immun. (Inst. Pasteur)125C, 373-389]. Recently, a limited class of models (Weisbuch et al., 1990, J. theor. Biol 146, 483-499) have been shown to maintain immunological memory by idiotypic network interactions. We examine generalizations of these models when the networks are both large and highly connected to study their memory capacity, i.e., their ability to account for immunization to a large number of random antigens. Our calculations show that in these minimal models, random connectivities with continuously distributed affinities reduce the memory capacity to essentially nil.


Defect Activity in Lead Halide Perovskites.
The presence of various types of chemical interactions in metal-halide perovskite semiconductors gives them a characteristic "soft" fluctuating structure, prone to a wide set of defects. Understanding of the nature of defects and their photochemistry is summarized, which leverages the cooperative action of density functional theory investigations and accurate experimental design. This knowledge is used to describe how defect activity determines the macroscopic properties of the material and related devices. Finally, a discussion of the open questions provides a path towards achieving an educated prediction of device operation, necessary to engineer reliable devices.


Lack of anticonvulsant tolerance to the neuroactive steroid pregnanolone in mice.
GABA-potentiating neuroactive steroids such as pregnanolone have potent protective effects in the pentylenetetrazol seizure test. We sought to determine if tolerance develops to the anticonvulsant activity of pregnanolone with chronic administration. Mice were treated with two daily injections of a 2 x ED50 dose of pregnanolone (25 mg/kg, i.p.) for 7 days. On the day after the chronic treatment protocol, the dose-response relationship for protection in the pentylenetetrazol seizure test was obtained. The ED50 value after the chronic treatment protocol was not significantly different from that in naive mice (12 mg/kg), indicating that tolerance does not develop to the anticonvulsant activity of pregnanolone. In subsequent experiments, we extended the chronic treatment protocol to 14 days with three daily injections of pregnanolone (25 mg/kg, i.p.). Again, no tolerance was observed (ED50, 13 mg/kg). The anticonvulsant activity of pregnanolone was well correlated with plasma levels in both the naive and chronically (14 day) treated mice. The estimated plasma concentrations of pregnanolone representing threshold (10%) protection (125-150 ng/ml) and 50% protection (575-700 ng/ml) were similar in naive and chronically treated animals. In both chronically treated and naive animals, plasma levels of pregnanolone declined rapidly (t1/2, 16-19 min) and there was a corresponding reduction in the anticonvulsant activity. Our results with pregnanolone suggest that tolerance does not develop to the anticonvulsant activity of neuroactive steroids as it does with other GABA potentiating drugs such as benzodiazepines, supporting the potential clinical utility of neuroactive steroids in chronic seizure therapy.


Evaluating the protective efficacy of antigen combinations against Photobacterium damselae ssp. piscicida infections in cobia, Rachycentron canadum L.
Cobia, Rachycentron canadum L., is a very important aquatic fish that faces the risk of infection with the bacterial pathogen Photobacterium damselae ssp. piscicida, and there are few protective approaches available that use multiple antigens. In the present study, potent bivalent antigens from P. damselae ssp. piscicida showed more efficient protection than did single antigens used in isolation. In preparations of three antigens that included recombinant heat shock protein 60 (rHSP60), recombinant α-enolase (rENOLASE) and recombinant glyceraldehyde-3-phosphate dehydrogenase (rGAPDH), we analysed the doses that elicited the best immune responses and found that this occurred at a total of 30 μg of antigen per fish. Subsequently, vaccination of fish with rHSP60, rENOLASE and rGAPDH achieved 46.9, 52 and 25% relative per cent survival (RPS), respectively. In addition, bivalent subunit vaccines--combination I (rHSP60 + rENOLASE), combination II (rENOLASE + rGAPDH) and combination III (rHSP60 + rGAPDH)--were administered and the RPS in these groups (65.6, 64.0 and 48.4%, respectively), was higher than that achieved with single-antigen administration. Finally, in combination IV, the trivalent vaccine rHSP60 + rENOLASE + rGAPDH, the RPS was 1.6%. Taken together, our results suggest that combinations of two antigens may achieve a better efficiency than monovalent or trivalent antigens, and this may provide new insights into pathogen prevention strategies.


Retrograde ascending aortic dissection after thoracic endovascular aortic repair.
Thoracic endovascular aortic repair is a valuable alternative treatment option for patients with thoracic aortic aneurysms and type B dissections. However, thoracic endovascular aortic repair is associated with the risk of previously unanticipated severe complications including retrograde ascending aortic dissection. We report the case of an 86-year-old man who developed retrograde ascending aortic dissection as a delayed complication of thoracic endovascular aortic repair. Open surgical repair resulted in a successful outcome.


Cloning of peroxiredoxin, a novel antioxidant enzyme, from the helminth parasite Fasciola hepatica.
A cDNA was isolated from a cDNA expression library using serum prepared against a high molecular mass fraction of Fasciola hepatica excretory-secretory products. The full-length cDNA encodes a member of the recently described peroxiredoxin antioxidant family. Peroxiredoxin could be the major hydrogen peroxide removing antioxidant in F. hepatica since this parasite does not express a catalase and expresses little glutathione peroxidase activity. This novel antioxidant may be involved in functions such as protection against reactive oxygen species (ROS) generated by metabolic processes and/or protection of the parasite against ROS released by immune effector cells.


Reactive Molecular Dynamics Simulation of Fullerene Combustion Synthesis: ReaxFF vs DFTB Potentials.
The dynamic fullerene self-assembly process during benzene combustion was studied using classical Reactive Force Field (ReaxFF) nonequilibrium molecular dynamics (MD) simulations. In order to drive the combustion process, the hydrogen to carbon (H/C) ratio was gradually reduced during the course of the MD simulations. Target temperatures of 2500 and 3000 K were maintained by using a Berendsen thermostat. Simulation conditions and hydrogen removal strategies were chosen to match closely a previous quantum chemical MD (QM/MD) study based on the density-functional tight-binding (DFTB) potential ( Saha et al. ACS Nano 2009 , 3 , 2241 ) to allow a comparison between the two different potentials. Twenty trajectories were computed at each target temperature, and hydrocarbon cluster size, CxHy composition, average carbon cluster curvature, carbon hybridization type, and ring count statistics were recorded as a function of time. Similarly as in the QM/MD simulations, only giant fullerene cages in the range from 155 to 212 carbon atoms self-assembled, and no C60 cages were observed. The most notable difference concerned the time required for completing cage self-assembly: Depending on temperature, it takes between 50 and 150 ps in DFTB/MD simulations but never less than 100 ps and frequently several 100s ps in ReaxFF/MD simulations. In the present system, the computational cost of ReaxFF/MD is about 1 order of magnitude lower than that of the corresponding DFTB/MD. Overall, the ReaxFF/MD simulations method paints a qualitatively similar picture of fullerene formation in benzene combustion when compared to direct MD simulations based on the DFTB potential.


Pb isotopic variability in melt inclusions from oceanic island basalts, polynesia
Previous studies have suggested that melting processes are responsible for the trace element variability observed in olivine-hosted basaltic melt inclusions. Melt inclusions from three individual lava samples (two from Mangaia, Cook Islands, and one from Tahaa, Society Islands) have heterogeneous Pb isotopic compositions, even though the erupted lavas are isotopically homogeneous. The range of Pb isotopic compositions from individual melt inclusions spans 50 percent of the worldwide range observed for ocean island basalts. The melt inclusion data can be explained by two-component mixing for each island. Our data imply that magmas with different isotopic compositions existed in the volcanic plumbing system before or during melt aggregation.


Characterization of the Anopheles funestus group, including Anopheles funestus-like, from Northern Malawi.
Limited information is available on malaria vector composition, feeding habits and malaria transmission in northern Malawi. Evidence of mosquito species diversity in this area was established in 2009, when Anopheles funestus-like, a new member of the An. funestus group was described. Additional biological information is needed to identify this species and to understand its role in malaria transmission. Anopheline mosquitoes were collected in northern Malawi and analyzed for Plasmodium species infection, blood meal source and susceptibility to insecticides. A new hydrolysis probe assay was designed to identify An. funestus-like. Anopheles funestus and An. rivulorum predominated in the indoor collections. Most An. funestus-like were collected indoors, mainly fed on animals and were uninfected with P. falciparum. Anopheles funestus showed insecticide resistance to deltamethrin and bendiocarb. A high-precision hydrolysis probe assay was successfully developed to identify An. funestus-like. Four species in the An. funestus group were collected in Karonga. Resistance to deltamethrin and bendiocarb was observed in An. funestus and further investigation is needed on the insecticide resistance mechanisms. Anopheles funestus-like, while collected indoors, is mainly zoophilic and most likely not a malaria vector. An. funestus (GenBank accession no. KC771136), An. funestus-like (GenBank accession no. KC771137), An. parensis GenBank accession no. KC771138) and An. vaneedeni GenBank accession no. KC771139).


Tau transgenic mice as models for cerebrospinal fluid tau biomarkers.
Levels of tau in cerebrospinal fluid (CSF) are elevated in Alzheimer's disease (AD) patients. It is believed this elevation is related to the tau pathology and neurodegeneration observed in AD, but not all tauopathies have increased CSF tau. There has been little pre-clinical work to investigate mechanisms of increased CSF tau due to the difficulty in collecting CSF samples from mice, the most commonly used pre-clinical models. We developed methods to collect CSF from mice without contamination from tau in brain tissue, which is approximately 50,000 fold more abundant in brain than CSF. Using these methods, we measured CSF tau from 3xTg, Tg4510, and Tau Alone transgenic mice. All three lines of mice showed age-dependent increases in CSF tau. They varied in phenotype from undetectable to severe tau pathology and neurodegeneration, suggesting that degenerating neurons are unlikely to be the only source of pathologic CSF tau. Overall, CSF tau levels mirrored expression levels and changes of tau in the brain, but they did not always correlate exactly. CSF tau was often more sensitive to changes in brain transgene expression and pathology. In addition, we also developed ELISA assays specific to different regions of the tau protein. We used these assays to provide evidence that CSF tau exists as fragments, with little intact C-terminus and partial loss of the N-terminus. Taken together, these assays and mouse models may be used to facilitate a deeper understanding of CSF tau in neurodegenerative disease.


DSM-IV, DSM-III-R, and ICD-10 alcohol and drug abuse/harmful use and dependence, United States, 1992: a nosological comparison.
This study assessed agreement between DSM-IV, DSM-III-R, and ICD-10 diagnoses of alcohol and drug use disorders using data from a large representative sample of the United States population. Agreement between the three diagnostic systems for dependence was good to excellent for past year, prior to the past year, and life-time diagnoses, for both genders, each ethnic group, and younger and older respondents. Cross-system comparisons between DSM-IV and DSM-III-R abuse were good to excellent, but concordance was consistently poor when ICD-10 harmful use diagnoses were compared with DSM-IV and DSM-III-R abuse diagnoses. Implications of these results are discussed in terms of the degree to which future research findings could be integrated with one another and the results from earlier studies using older versions of the DSM, to advance scientific knowledge in the drug and alcohol fields.


Modeling future land use scenarios in South Korea: applying the IPCC special report on emissions scenarios and the SLEUTH model on a local scale.
This study developed three scenarios of future land use/land cover on a local level for the Kyung-An River Basin and its vicinity in South Korea at a 30-m resolution based on the two scenario families of the Intergovernmental Panel on Climate Change (IPCC) Special Report Emissions Scenarios (SRES): A2 and B1, as well as a business-as-usual scenario. The IPCC SRES A2 and B1 were used to define future local development patterns and associated land use change. We quantified the population-driven demand for urban land use for each qualitative storyline and allocated the urban demand in geographic space using the SLEUTH model. The model results demonstrate the possible land use/land cover change scenarios for the years from 2000 to 2070 by examining the broad narrative of each SRES within the context of a local setting, such as the Kyoungan River Basin, constructing narratives of local development shifts and modeling a set of 'best guess' approximations of the future land use conditions in the study area. This study found substantial differences in demands and patterns of land use changes among the scenarios, indicating compact development patterns under the SRES B1 compared to the rapid and dispersed development under the SRES A2.


Elimination of blood-derived macrophages inhibits the release of interleukin-1 and the entry of leukocytes into the cerebrospinal fluid in experimental pneumococcal meningitis.
Parameters of inflammation during pneumococcal meningitis were determined in rabbits after monocyte elimination by dichloromethylene diphosphonate (Cl(2)MDP)-containing mannosylated liposomes in comparison with untreated controls. Monocyte depletion reduced the migration of white blood cells into the cerebrospinal fluid (CSF) (medians: 42 versus 2146/mm3 at 18 h, 323 versus 7413/mm3 at 24 h p.i., p < 0.01). CSF IL-1beta concentrations were lower in depleted animals (379 versus 3282 pg/ml, 24 h p.i., p < 0.01), whereas TNF-alpha concentrations were not different. Monocyte-depleted animals lost body temperature during the experiment carried out in anaesthesia (p = 0.01) indicating that macrophages are necessary for thermogenesis during meningitis.


Omalizumab therapy for allergic bronchopulmonary aspergillosis in children with cystic fibrosis: a synthesis of published evidence.
Allergic bronchopulmonary aspergillosis (ABPA) complicating cystic fibrosis (CF) is treated with corticosteroids. Since elevated IgE is a cardinal abnormality, anti-IgE has been used sporadically as adjuvant treatment. In eight case reports, 13 children with CF and ABPA received anti-IgE resulting in improved FEV1 , fewer respiratory symptoms and decreased corticosteroid use.


Sampling methods and residential factors affecting formaldehyde concentration in indoor air.
Formaldehyde (HCHO) is the most serious residential pollutant. In order to evaluate residential HCHO levels, two sampling methods have been recommended; one is a 30 minute sampling in a closed room, and the other is a 24 hour sampling with an ordinary lifestyle routine. The aim of this report was to clarify the difference between the HCHO levels obtained by the two sampling methods. Residential air in 58 rooms was sampled for 30 minutes by an active sampling method more than 5 hours after residents closed windows, and by a passive sampling method for 24 hours with an ordinary lifestyle routine. The HCHO concentration with the 30 minute sampling was 0.118+/-0.065 ppm (range: 0.034-0.295 ppm) and 36 rooms (62%) exceeded the Japanese guideline value of 0.08 ppm, while 5% were higher than 0.25 ppm. The HCHO concentration with the 24 hours sampling was 0.053+/-0.039 ppm (range: 0.02-0.167 ppm) and only 13 rooms (22%) exceeded 0.08 ppm. The relationship between the concentrations obtained by the two methods was linear. However, the level with the 24 hour sampling significantly reduced with prolonged window opening time, meaning that occupants made an effort to reduce the usual exposure to about 40% of the exposure in a closed room by opening windows in order to escape from irritation. Since major adverse effects of HCHO are irritation and sensitization, the occasional peak concentration must be focused. In order to evaluate residential HCHO levels, measurement in a closed room is recommended even if people are living there.


Phonetic inventories of 2- and 3-year-old children.
This report provides quasi-longitudinal independent analysis data on two groups of 10 children at 2:0 (years:months), 2:5, 2:9, and 3:3. The analysis included word-initial and word-final phonetic inventories of consonant singletons and clusters and a summary of the relative frequency of seven word shapes. The results indicated that these children were gradually "filling in the gaps" with sounds previously reported to be lacking in slightly younger children.


Electromechanical actuator with controllable motion, fast response rate, and high-frequency resonance based on graphene and polydiacetylene.
Although widely investigated, novel electromechanical actuators with high overall actuation performance are still in urgent need for various practical and scientific applications, such as robots, prosthetic devices, sensor switches, and sonar projectors. In this work, combining the properties of unique environmental perturbations-actuated deformational isomerization of polydiacetylene (PDA) and the outstanding intrinsic features of graphene together for the first time, we design and fabricate an electromechanical bimorph actuator composed of a layer of PDA crystal and a layer of flexible graphene paper through a simple yet versatile solution approach. Under low applied direct current (dc), the graphene-PDA bimorph actuator with strong mechanical strength can generate large actuation motion (curvature is about 0.37 cm(-1) under a current density of 0.74 A/mm(2)) and produce high actuation stress (more than 160 MPa/g under an applied dc of only 0.29 A/mm(2)). When applying alternating current (ac), this actuator can display reversible swing behavior with long cycle life under high frequencies even up to 200 Hz; significantly, while the frequency and the value of applied ac and the state of the actuators reach an appropriate value, the graphene-PDA actuator can produce a strong resonance and the swing amplitude will jump to a peak value. Moreover, this stable graphene-PDA actuator also demonstrates rapidly and partially reversible electrochromatic phenomenon when applying an ac. Two mechanisms-the dominant one, electric-induced deformation, and a secondary one, thermal-induced expansion of PDA-are proposed to contribute to these interesting actuation performances of the graphene-PDA actuators. On the basis of these results, a mini-robot with controllable direction of motion based on the graphene-PDA actuator is designed to illustrate the great potential of our discoveries for practical use. Combining the unique actuation mechanism and many outstanding properties of graphene and PDA, this novel kind of graphene-PDA actuator exhibits compelling advantages to traditional electromechanical actuation technology and may provide a new avenue for actuation applications.


Predicting responses to mechanical ventilation for preterm infants with acute respiratory illness using artificial neural networks.
Infants born prematurely are particularly susceptible to respiratory illness due to underdeveloped lungs, which can often result in fatality. Preterm infants in acute stages of respiratory illness typically require mechanical ventilation assistance, and the efficacy of the type of mechanical ventilation and its delivery has been the subject of a number clinical studies. With recent advances in machine learning approaches, particularly deep learning, it may be possible to estimate future responses to mechanical ventilation in real time, based on ventilation monitoring up to the point of analysis. In this work, recurrent neural networks are proposed for predicting future ventilation parameters due to the highly nonlinear behavior of the ventilation measures of interest and the ability of recurrent neural networks to model complex nonlinear functions. The resulting application of this particular class of neural networks shows promise in its ability to predict future responses for different ventilation modes. Towards improving care and treatment of preterm newborns, further development of this prediction process for ventilation could potentially aid in important clinical decisions or studies to improve preterm infant health.


Transbronchial cryobiopsy: a new tool for lung biopsies.
Specimens from transbronchial lung biopsies lack sufficient quality due to crush artifact and are generally too small for diagnosis of diffuse lung diseases. Flexible cryoprobes have been shown to be useful in therapeutic bronchoscopy. We introduce a novel technique for obtaining lung biopsies bronchoscopically, using a flexible cryoprobe. The purpose of this study was to show the feasibility of using a cryoprobe to obtain lung biopsies during flexible bronchoscopy. Forty-one patients with radiographic signs of diffuse lung disease were selected for transbronchial biopsy. During flexible bronchoscopy, conventional transbronchial biopsies using forceps were done first. Then a flexible cryoprobe was introduced into the selected bronchus under fluoroscopic guidance. Once brought into position, the probe was cooled and then retracted with the frozen lung tissue being attached on the probe's tip. The tissue was processed for histology. After establishing a diagnosis, the specimen area was measured using a digital morphometry system. We evaluated the biopsy samples of 41 patients. The mean specimen area was 5.82 mm(2) (0.58-20.88 mm(2)) taken by forceps compared to 15.11 mm(2) obtained using the cryoprobe (2.15-54.15 mm(2), p < 0.01). Two patients had a pneumothorax which resolved with tube thoracostomy. Biopsy-associated bleeding did not require any intervention. Transbronchial cryobiopsy contributed in a substantial number of cases to a definitive diagnosis. Transbronchial cryobiopsy is a novel technique which allows to obtain large biopsy samples of lung parenchyma that exceed the size and quality of forceps biopsy samples. Prospective trials are needed to compare this technique with surgical lung biopsy for diagnosis of diffuse lung diseases.


Effects of peer-mediated instruction on the acquisition and generalization of written capitalization skills.
This study investigated the effects of a peer teaching procedure, combined with student letter-writing activities, on the acquisition and generalization of capitalization skills. Three students, aged 9 years, obtained instruction from peer partners that included (a) an introduction and review of capitalization rules, (b) feedback on each participant's previous capitalization work, and (c) guided and independent practice on sentences that required capitalization. All three students demonstrated acquisition of the capitalization rules after participating in the teaching sessions with one or two peer partners. In addition, there were increases in capitalization accuracy in participants' letters to peers who did not serve as teaching partners, thus demonstrating a measure of across-peer (stimulus) generalization. Mixed results were obtained on a response generalization task (sentence writing). Finally, sentencing-writing activities also showed that two of the peer partners substantially improved their use of capitalization skills as a result of teaching the target students.


Expression of VEGF-C/-D and lymphangiogenesis in salivary adenoid cystic carcinoma.
Some human neoplasms stimulate lymphangiogenesis through the over-production of vascular endothelial growth factors C/D (VEGF-C/D). Previously little attention has been paid to the mechanisms of lymphogenous spread of salivary adenoid cystic carcinoma (SACC). The current study investigates the presence of lymphatic network and the role of VEGF-C and VEGF-D in its formation. The retrospective study was performed in 20 (12 females and 8 males) patients diagnosed with SACC. For the evaluation of VEGF-C/D immunoreactivity, semiquantitative histoscore was calculated as a sum of positive tumor cell score (range 0-3) and staining intensity (range 0-3). Lymphatic vessel density (LVD) was determined as the number of D2-40 positive lymphatic capillaries present at "hot spots". Moreover, the values of histoscores were calculated in surrounding normal parotid parenchyma and compared to those counted in tumors. LVD in the tumor center (iLVD), in its periphery (pLVD), and in healthy gland were identified. VEGF-C/D expression, iLVD and pLVD were higher in SACC than in normal gland. The VEGF-C/D score correlated neither with pLVD nor with iLVD. High iLVD values were associated with poor survival. The authors present the first study demonstrating the existence of lymphatic vessels in SACC.


Growth behaviour and thermal inactivation of E. coli O157:H7 and Salmonella spp. in ground lean camel meat.
This study aimed to evaluate growth behaviour of Escherichia coli O157:H7, Salmonella spp., and background microbiota in ground lean camel meat during refrigerated storage for up to 7 d, and determine thermal inactivation parameters (D and z-values) of the pathogens in the meat. Fresh ground camel meat samples were individually inoculated with two isolates of each E. coli O157:H7 strains and Salmonella serovars. Inoculated and uninoculated samples were stored aerobically at 4 °C and abusive temperature (10 °C) for 1, 4 and 7 d. Inoculated samples were also heat-treated in a circulating water bath at 55-65 °C. Upon storage for 7 d at 4 °C, the population of E. coli O157:H7 and Salmonella cells decreased significantly in samples. In contrast, samples stored at 10 °C showed significant increases in microbial populations. With storage, the populations of mesophilic lactic acid bacteria, mesophilic total plate counts, yeasts and molds, Pseudomonas spp., as well as Enterobacteriaceae increased significantly. E. coli O157:H7 strains showed average D-values at 57.5 to 65 °C ranging from 1.8 to 0.067 min while Salmonella spp. at 55 to 62.5 °C showed D-values ranging from 2.2 to 0.057 min. The z-values of E. coli O157:H7 strains were 4.6 and 5.0 °C and were 5.1 and 5.5 °C for Salmonella spp. This study provides information to assist food industry and retail meat processors to enhance safety and storage quality of camel meat and facilitate validation of thermal processing of camel meat products.


Serum levels of 1,5-anhydro-D-glucitol during the normal and diabetic pregnancy and puerperium.
In 25 normally non-pregnant women, 543 normally pregnant women and 75 pregnant women with diabetes mellitus or gestational diabetes mellitus, the relationship between the serum concentration of 1,5-anhydro-D-glucitol (1-deoxy-glucose) and carbohydrate metabolism was studied. The concentration of 1,5-anhydro-D-glucitol was estimated by means of gas-liquid chromatography. In normally non-pregnant women the concentration was found to be 18.6 +/- 5.2 mg/l (mean +/- SD). During the normal pregnancy, from 9 weeks of gestation, a steadily decreasing concentration was observed as the pregnancy progressed and the lowest value (10.2 +/- 4.6 mg/l) was found in the third trimester. After 5 days of puerperium the concentrations were found to be 10.8 +/- 3.7 mg/l. On the 30th day postpartum, the level was within the range for non-pregnant subjects. The values in pregnant women with diabetes mellitus and gestational diabetes mellitus were mostly below 10 mg/l throughout the entire pregnant period. The 1,5-anhydro-D-glucitol concentration was not affected by meals or oral glucose loading. A concentration below 10 mg/l was found in 36% of the normally pregnant women, where oral glucose tolerance tests and measurement of glycohemoglobin were shown to be within the normal range. The present study suggests that a change of 1,5-anhydro-D-glucitol level during pregnancy may reflect a mild alteration of carbohydrate metabolism that goes undetected by all the other diabetic indicators.


Near absence of methicillin-resistance and pronounced genetic diversity among Staphylococcus epidermidis isolated from healthy persons in northern Sweden.
The main aim of this study was to examine if hospital-associated clones of multidrug-resistant Staphylococcus epidermidis (MDRSE), commonly identified in hospitals in our region, also are spread among healthy persons in the community. A total of 124 isolates of S. epidermidis sampled from subjects attending a Travel health clinic, Umeå, Sweden during 2008 were examined with antibiotic susceptibility testing and pulsed-field gel electrophoresis (PFGE) analysis. Resistance to methicillin or any antibiotic was detected in 2 and 26 of the isolates, respectively. PFGE analysis showed an extensive genetic diversity with 86 different PFGE types, 62 of which were singletons. No isolates belonged to the previously described hospital-associated MDRSE genotypes, indicating that MDRSE by large are confined to the hospital setting in our region. In conclusion, community-associated isolates of S. epidermidis showed a low level of methicillin-resistance and were genetically extremely diverse with no predominating genotype.


Combination chemotherapy following adrenal suppression in androgen- independent prostate cancer.
Recent trials with modern chemotherapy have demonstrated activity in androgen-independent prostate cancer, but all focused on patients with progression following androgen suppression or antiandrogen withdrawal. Limited data are available on the activity of chemotherapy in androgen-independent, hormone-refractory (progressing following adrenal suppression) prostate cancer. We evaluated the activity of estramustine combined with vinblastine in this subset of androgen-independent prostate cancer. From January 1995 until April 1999, 19 patients with hormone-refractory prostate cancer received estramustine 140 mg p.o., three times daily along with weekly vinblastine 5 mg/m(2). A decrease in prostate-specific antigen of 50% or more was noted in 12 patients (63.1%, 95% CI 38.3-83.7%). The median decrease in prostate-specific antigen was 71.2% (range 50.5-85.2%). None of the 7 patients with measurable soft-tissue disease showed an objective response. The median survival from onset of chemotherapy was 6 (range 1.4-27.7) months and from initiation of adrenal suppression 16.9 (range 3.8-40. 5) months. The combination of estramustine and vinblastine is capable of inducing activity in androgen-independent prostate cancer progressing after adrenal suppression. In our small sample, the survival rate was low, and we obtained no response in soft-tissue sites. Future prospective trials are needed to determine the benefit of sequential versus simultaneous incorporation of adrenal suppression with chemotherapy in the management of androgen-independent prostate cancer.


Effects of perfluorodecanoic acid on de novo fatty acid and cholesterol synthesis in the rat.
Perfluorodecanoic acid (PFDA) is a peroxisome proliferator that causes a dose-dependent (20-80 mg/kg) increase in hepatic triacylglycerol and cholesteryl ester levels in the rat. We hypothesized that PFDA may cause an increase in the de novo synthesis of fatty acids and cholesterol in this species, which would explain observed effects. The incorporation of 3H2O into tissue lipids was examined 7 days after rats received vehicle or 20 or 80 mg/kg of PFDA. PFDA treatment decreased the rate of synthesis of cholesterol and fatty acids in the live and in epididymal fat pad. At a PFDA dose (20 mg/kg) that decreased de novo synthesis of fatty acids and cholesterol, there was no effect on the concentration of fatty acids and cholesterol in the liver, epididymal fat pads, and plasma. We conclude that PFDA induced fatty liver is due to either a decrease in the oxidation of fatty acids in the liver, or an impairment of triacylglycerol catabolism and/or export from the liver, and is not the result of an increase in de novo synthesis of fatty acids and cholesterol.


Managing nasal valve compromise patients with nasal dilators: objective vs. subjective parameters.
Patients suffering from nasal obstruction due to nasal valve compromise may benefit from a nasal dilator. Several devices for widening of the external/internal nasal valve region can be applied endonasally (Airmax, Nasanita, Nozovent) or externally (Breathe Right). 100 patients suffering from nasal obstruction due to external or internal nasal valve compromise were involved in this study. All patients were evaluated for nasal obstruction with visual analogue scores (VAS) and peak nasal inspiratory flow (PNIF) measurements before and after the application of 4 nasal dilators. They were offered to choose 2 out of 4 for a trial period of 1 month. Subsequently, patients were reassessed and asked about their willingness to continue using the dilators, as well as the reasons for discontinuation. There was a significant decrease of VAS scores and improvement in PNIF with the dilators in situ compared to baseline. After 4 weeks, 67% of patients were willing to continue using at least one of the chosen dilators. The reasons for discontinuation were local irritation, inappropriate fit, preference for a permanent solution like surgery, and no relief of symptoms. Nasal dilators represent a valuable option in the therapeutic approach of nasal valve compromise, with endonasal dilators achieving higher increase in PNIF in comparison with external nasal dilators.


Detection of hormone release from individual cells in mixed populations using a reverse hemolytic plaque assay.
Prolactin (Prl) secreting cells in a mixed pituitary cell culture form microscopically-identifiable plaques (zones of hemolysis around the lactotropes) when incubated in a monolayer with staphylococcal protein-A-coated ovine erythrocytes in the presence of Prl antiserum and complement. Plaques form first at 15-30 min and are maximal in size and number at 2 h. Approximately 70% of the adenohypophyseal cells form plaques under these conditions. TRH increases, and dopamine decreases, the size and number of plaques at early times during incubation. This reverse hemolytic plaque assay probably can be used to detect any cell secretion for which an antibody is available. This technique, or a modified version of it in which sequential plaque assays are performed on identified cells--used together with immunocytochemistry, autoradiography or electron microscopy of those cells--should provide better answers to commonly asked questions about secretory systems: Do all or only a subset of cells containing the same hormone respond to a particular secretagogue? Can cells that contain two hormones release one of them preferentially?


Deposition of aerosols delivered by nasal route with jet and mesh nebulizers.
To quantify the amount of aerosol deposited in different parts of the airways with a commercially available nasal sonic jet nebulizer (NJN) using a sound effect, and to compare its performance with a new nasal mesh nebulizer (NMN). Seven healthy non-smoking male volunteers aged 21-36 years with a mean weight of 77±10 kg were included in this single-center study. Both nebulizer systems were loaded with (99m)Tc-DTPA and scintigraphies were performed with a gamma camera. Particle size distribution of the aerosols produced by the two nebulizer systems was measured. There was no statistical difference between the two nebulizers in terms of fraction of particles smaller than 5 μm (44±4% vs 45±2%) (p>0.9). Aerosol deposition in the nasal region was 73±10% (% of aerosol deposited in airways) with the NJN, and 99±3% with the NMN (p=0.01). Total nasal deposition was 9.6±1.9% of the nebulizer charge with the NJN and 28.4±8.9% with the NMN (p=0.01). 0.5±0.3% of the nebulizer charge was deposited in the maxillary sinuses with the NJN, compared to 2.2±1.6% with the NMN (p=0.01). Although the two nebulizers had the same particle size, NMN significantly improved aerosol deposition in nasal cavity and prevents deposition into the lungs.


Multiple transformation pathways of p-arsanilic acid to inorganic arsenic species in water during UV disinfection.
p-Arsanilic acid (p-ASA) is widely used in China as livestock and poultry feed additive for promoting animal growth. The use of organoarsenics poses a potential threat to the environment because it is mostly excreted by animals in its original form and can be transformed by UV-Vis light excitation. This work examined the initial rate and efficiency of p-ASA phototransformation under UV-C disinfection lamp. Several factors influencing p-ASA phototransformation, namely, pH, initial concentration, temperature, as well as the presence of NaCl, NH4(+), and humic acid, were investigated. Quenching experiments and LC-MS were performed to investigate the mechanism of p-ASA phototransformation. Results show that p-ASA was decomposed to inorganic arsenic (including As(III) and As(V)) and aromatic products by UV-C light through direct photolysis and indirect oxidation. The oxidation efficency of p-ASA by direct photosis was about 32%, and those by HO and (1)O2 were 19% and 49%, respectively. Cleavage of the arsenic-benzene bond through direct photolysis, HO oxidation or (1)O2 oxidation results in simultaneous formation of inorganic As(III), As(IV), and As(V). Inorganic As(III) is oxidized to As(IV) and then to As(V) by (1)O2 or HO. As(IV) can undergo dismutation or simply react with oxygen to produce As(V) as well. Reactions of the organic moieties of p-ASA produce aniline, aminophenol and azobenzene derivatives as main products. The photoconvertible property of p-ASA implies that UV disinfection of wastewaters from poultry and swine farms containing p-ASA poses a potential threat to the ecosystem, especially agricultural environments.


Supplemental naringenin prevents intestinal barrier defects and inflammation in colitic mice.
Intestinal barrier defects are involved in the pathogenesis of inflammatory bowel disease. The present study investigated the ameliorative effects of naringenin, a citrus polyphenol, on intestinal tight junction (TJ) barrier defects and inflammation in a murine model of colitis. In Expt. 1, using a 2 × 2 fractional design, the mice were administered water or 2% dextran sulfate sodium (DSS) in combination with feeding control or naringenin-containing diets for 9 d (severe disease stage). DSS administration caused severe colon damage and inflammation, as indicated by body weight loss, increased clinical sores, colon shortening, and gene expressions of inflammatory cytokines [interferon-γ, interleukin (IL)-6, macrophage inflammatory protein-2, and IL-17A). DSS administration also impaired TJ barrier integrity in the colon, as indicated by increased colon permeability and plasma LPS-binding protein levels, resulting from the impaired colonic expression of TJ proteins, occludin, junctional adhesion molecule-A, and claudin-3. Supplemental feeding with naringenin totally or partially attenuated these symptoms, suggesting that naringenin ameliorates the DSS-induced colitis at least partially through protection of the TJ barrier. In Expt. 2, analyses were performed at different disease stages (d 3, 6, and 9) to more widely examine the ameliorative role of naringenin on the initiation and development of colitis. DSS administration moderately induced colon shortening at d 3 and 6 and increased the disease activity index (DAI) and inflammatory cytokine (IL-6 and IL-17A) expression without any significant increases in colonic permeability. Feeding naringenin attenuated the increased DAI and colon shortening and tended to suppress the increased cytokine expression. These findings suggest that the presence of an additional mechanism underlying the naringenin-mediated, anticolitic effect along with barrier protection.


Metal ions directing the geometry and nuclearity of azido-metal(II) complexes derived from bis(2-(3,5-dimethyl-1H-pyrazol-1-yl)ethyl)amine.
The reaction of a methanolic solution containing M(ClO(4))(2)·nH(2)O (M = Cu, Ni, Zn or Cd) or CoCl(2)·6H(2)O with bis(2-(3,5-dimethyl-1H-pyrazol-1-yl)ethyl)amine (bedmpza) in the presence of NaN(3) afforded the complexes [Cu(bedmpza)(μ(1,1)-N(3))](2)(ClO(4))(2) (1), [Ni(bedmpza)(N(3))(μ(1,1)-N(3))](2)·1.5H(2)O (2), [Co(bedmpza)(N(3))(2)] (3), [Zn(bedmpza)(N(3))]ClO(4) (4) and [Cd(bedmpza)(N(3))(μ(1,1)-N(3))](2)·1.5H(2)O (5). The five complexes were characterized by spectroscopic techniques and their molecular structures were determined by single crystal X-ray crystallography. The two mononuclear complexes 3 and 4 display distorted TBP and tetrahedral geometry, respectively with the azide ions acting as monodentate ligands. Doubly bridged end-on-azido dinuclear complexes were obtained in the remaining compounds. Compounds 2 and 5 are isomorphic with distorted octahedral geometry, whereas distorted square pyramidal geometry was determined in the Cu(II) complex 1. The magnetic properties for complexes 1 and 2 were investigated by measuring the magnetic susceptibilities at variable temperatures (300-2 K). The Ni(II) complex exhibits moderate ferromagnetic coupling, whereas [Cu(bedmpza)(μ(1,1)-N(3))](2)(ClO(4))(2) (1) which contains two crystallographic independent dinuclear subunits in the unit cell, with different Cu-N(N3)-Cu bond angles, reveals different signs in the magnetic coupling. The complex represents the first example in the literature that has simultaneously two moieties with ferro- (J = 15.4 cm(-1)) and antiferromagnetic (J = -18.9 cm(-1)) interactions.


Effects of Single-Dose Preemptive Pregabalin and Intravenous Ibuprofen on Postoperative Opioid Consumption and Acute Pain after Laparoscopic Cholecystectomy.
Non-opioid medications as a part of multimodal analgesia has been increasingly suggested in the management of acute post-surgical pain. The present study was planned to compare the efficacy of the combination of pregabalin plus ıv ibuprofen. 58 patients were included in this prospective, randomized, double-blinded study. The pregabalin group (Group P, n = 29) received 150 mg pregabalin, the pregabalin plus ibuprofen group (Gropu PI, n = 29) received 150 mg pregabalin and 400mg ıv ibuprofen before surgery. Postoperative fentanyl consumption, additional analgesia requirements and PACU stay were recorded. Postoperative analgesia was performed with patient-controlled IV fentanyl. VAS scores in the group PI were statistically lower at PACU, 1and 2 hours at rest, at PACU, 1, 2, 4, 12 and 24 hours on movement compared to the group P (P < 0.05). Opioid consumption was statistically significantly higher in the group P compared to the group PI (130.17 ± 60.27 vs 78.45 ± 60.40 μq, respectively, P < 0.001) and reduced in the 4th 24 hours by 55% in group PI. Rescue analgesia usage was statistically significantly higher in the group P than in the group PI (16/29 vs 7/29, respectively, P < 0.001). Four patient in the group PI did not need any opioid drug. Besides, PACU stay was shorter in the group PI than the group P (10.62 ± 2.38 vs 15.59 ± 2.11 min, respectively, P < 0.001). Preemptive pregabalin plus ıv ibuprofen in laparoscopic cholecystectomy reduced postoperative opioid consumption. This multimodal analgesic aproach generated lower pain scores in the postoperative period.


Synthesis and biological evaluation of novel aromatic and heterocyclic bis-sulfonamide Schiff bases as carbonic anhydrase I, II, VII and IX inhibitors.
A series of sixteen novel aromatic and heterocyclic bis-sulfonamide Schiff bases were prepared by conjugation of well known aromatic and heterocyclic aminosulfonamide carbonic anhydrase (CA, EC 4.2.1.1) inhibitor pharmacophores with aromatic and heterocyclic bis-aldehydes. The obtained bis-sulfonamide Schiff bases were investigated as inhibitors of four selected human (h) CA isoforms, hCA I, hCA II, hCA VII and hCA IX. Most of the newly synthesized compounds showed a good inhibitory profile against isoforms hCA II and hCA IX, also showing moderate selectivity against hCA I and VII. Several efficient lead compounds were identified among this bis-sulfonamide Schiff bases with low nanomolar to sub-nanomolar activity against hCA II (Kis ranging between 0.4 and 861.1nM) and IX (Kis between 0.5 and 933.6nM). Since hCA II and hCA IX are important drug targets (antiglaucoma and anti-tumor agents), these isoform-selective inhibitors may be considered of interest for various biomedical applications.


[The analysis of drug cost and direct medical expense in community health management of hypertensive patients].
To investigate the current situation of drug cost, hospitalization cost and direct medical expense in community health management of hypertensive patients, in order to lay foundation for evaluating whether the community health management in basic public health service has cost-effect in Health Economics. A total of 8326 hypertensive patients from 10 survey pilots in 5 provinces were selected by cluster sampling methods, including 3967 patients who took part in community health management for over 1 year as management group and 4359 cases who have never taken part in community health management as control group. The essential information of research objects were collected by questionnaire; and the medical cost information in the last year (from November 2009 to November 2010) were collected retrospectively. The different annual medical treatment cost, hospitalization cost and direct medical expense in the two groups were compared and analyzed. The average annual drug cost in hypertension was (621.50 ± 1337.78) yuan per patient; while the cost was (616.13 ± 1248.40) yuan in management group and (626.44 ± 1414.30) yuan in control group respectively. The average annual drug cost of hypertensive patients who took medicine therapy was (702.05 ± 1401.79) yuan per person, while the cost in the management group ((688.50 ± 1300.70) yuan) was much lower than it in control group ((714.64 ± 1489.60) yuan). The annual average drug cost in urban was (731.88 ± 1403.31) yuan per person, which was higher than it in rural as (407.44 ± 1171.44) yuan per person. The average hospitalized rate was 12.2% (1014/8326), and the average annual cost among the hospitalized patients was (9264.47 ± 18 088.49) yuan per person; while the cost was (7583.70 ± 13 267.00) yuan in management group, which was lower than it in control group as (11 028.00 ± 21 919.00) yuan. The average annual hospitalized cost in hypertension was (1064.87 ± 6804.83) yuan per person; while the cost was (936.73 ± 5284.90) yuan in management group, which was lower than it in control group as (1181.50 ± 7937.90) yuan. The average annual direct medical expense in hypertension was (2275.08 ± 8225.66) yuan per person; while the expense was (2165.10 ± 6564.60) yuan in management group and (2375.20 ± 9487.60) yuan in control group. The average annual direct medical expense in urban ((2801.06 ± 9428.54) yuan per person) was higher than it in rural ((1254.70 ± 4990.27) yuan per person). The community health or standardized management of hypertensive patients can reduce the average annual drug cost and hospitalization cost (around 26 yuan and 245 yuan separately); and thereby save the annual direct medical expense per capita in hypertension (around 210 yuan). In the reform and development of national medical health system, we should enhance and promote the standardized community health management of hypertensive patients.


Towards an exemplar model of face processing: the effects of race and distinctiveness.
Valentine (1991a, 1991b) described a theoretical framework for face recognition in which faces are encoded as locations in a multidimensional space. It was argued that this approach could provide a unified account of the effects of distinctiveness, inversion, and race on face recognition. In this paper we evaluate the ability of this theoretical framework to account for the effects of distinctiveness and race in four experiments in which white British and Japanese faces served as stimuli and both white British and Japanese students acted as subjects. In a recognition memory experiment the expected "own-race bias" was observed as a Race of Subject x Race of Face interaction. Distinctive faces were recognized more accurately than typical faces, but the effect of distinctiveness did not interact with the race of face or the race of subject. Typical faces were classified faster than distinctive faces in a task in which intact faces had to be distinguished from jumbled faces, as found in earlier work, and the effect of distinctiveness did not interact with the race of face or race of subject. In contrast, a task in which subjects classified faces according to their race did show a greater effect of distinctiveness for own-race faces. The results are discussed in relation to the two specific models within the multidimensional space framework identified by Valentine (1991a): a purely exemplar-based model and a norm-based coding model. It is argued that these results are more easily accommodated in terms of a purely exemplar-based model. Some conceptual problems in applying the norm-based coding model to the effect of race are discussed.


Interferon-alpha/5-fluorouracil: a novel outpatient chemo/immunotherapy for progressive metastatic renal cell carcinoma.
In metastatic renal cell carcinoma, most conventional antineoplastic drugs have yielded no or little efficacy. To evaluate the tolerance and therapeutic efficacy of second line chemo/immunotherapies, we treated patients with advanced metastatic renal cell carcinoma upon progression after previous antineoplastic therapy employing an outpatient combination of subcutaneous (SC) recombinant interferon-alpha (rIFN-alpha) and intravenous (IV) 5-fluorouracil(5-FU). Thirty-three patients with metastatic renal cell carcinoma received SC doses thrice weekly of rIFN-alpha at 10 million U/m2 over 8 consecutive weeks. Additionally, patients received IV 5-FU at 750 mg/m2 in weeks 1-3 and 5-7; treatment cycles were repeated until disease progression. Of 33 patients, one achieved a complete remission (response duration, 24 months) and two patients presented with partial remissions (median response duration, 7 months) of pulmonary metastases upon rIFN-alpha/5-FU after failing SC recombinant interleukin-2 (rIL-2) and rIFN-alpha. The present chemo/immunotherapy regimen was overall well tolerated with low to moderate systemic toxicity and predominantly constitutional symptoms i.e., fever, chills, and malaise. In summary, the second line outpatient chemo/immunotherapy regimen of SC rIFN-alpha/IV 5-FU demonstrated a limited albeit significant efficacy in pretreated patients with progressive metastatic renal cell cancer.


[Lamotrigine in the therapy of resistant epilepsy].
To evaluate the efficacy of lamotrigine as single agent in patients with refractory epilepsy. Forty-seven adult patients with refractory epilepsy, in the initial phase received carbamazepine (1208 +/- 82.9 mg/day) plus lamotrigine (561.7 +/- 76.8 mg/day); during the second phase they received lamotrigine alone (206.4 +/- 44.4 mg/day). Lamotrigine monotherapy significantly improved the number of seizures per week in comparison to lamotrigine combined with carbamazepine (p < 0.0001). Lamotrigine as single agent is more effective than carbamazepine + lamotrigine in patients with refractory epilepsy.


Expression of peroxiredoxins in the human testis, epididymis and spermatozoa and their role in preventing H2O2-induced damage to spermatozoa.
High levels of reactive oxygen species (ROS) have potential toxic effects on testicular function and sperm quality. Peroxiredoxins (PRDXs) are enzymes with a role as ROS scavenger. The aim of the study was to reveal the presence and localization of PRDXs in human testis, epididymis and spermatozoa, and the protective roles of PRDX2 and PRDX6 in sperm motility. The presence and localization of PRDXs in the human testis, epididymis and spermatozoa were detected by immunohistochemistry, western blot and immunofluorescence. The effect of anti-peroxidative damage to spermatozoa was examined by adding H2O2 to the recombinant protein-treated spermatozoa. There were strong signals of PRDX1 in spermatogonia and round spermatids; PRDX2 in the round spermatids; PRDX4 and 5 in spermatogonia; PRDX6 in Sertoli cells. PRDXs were also found in epididymal epithelial cells where the expression of PRDX1, 4, 5, 6 in the cauda was higher than in the caput of epididymis. PRDX1-6 immunoreactivity was found throughout acrosome, post-acrosomal region, equatorial segment, neck and cytoplasmic droplet, midpiece and principal piece. The H2O2-induced reduction in sperm motility was reversed by recombinant PRDX2 or PRDX6 in a dose-dependent manner. PRDX1-6 in the human testis and epididymis presented cell-specificity. PRDX2 and 6 are potential antioxidant protectors for human spermatozoa.


Assessing and screening for T-cell epitopes from Mycobacterium tuberculosis RD2 proteins for the diagnosis of active tuberculosis.
The Region of D eletion 2 (RD2) of Mycobacterium tuberculosis encodes reserved antigens that contribute to bacterial virulence. Among these antigens, Rv1983, Rv1986, Rv1987, and Rv1989c have been shown to be immunodominant in infected cattle; however, their diagnostic utility has not been evaluated in humans. In this study, we screened 87 overlapping synthetic peptides encoded by five RD2 proteins for diagnosing tuberculosis epitopes in 50 active tuberculosis (TB) cases, 31 non-tuberculosis patients and 36 healthy individuals. A pool of promising epitopes was then assessed for their diagnostic value in 233 suspected TB patients using a whole blood IFN-γ release assay. Only 10 peptides were recognized by more than 10% of active tuberculosis patients. The IFN-γ release responses to Rv1986-P9, P15, P16, Rv1988-P4, P11, and Rv1987-P11 were significantly higher in the active TB group than in the control groups (p<0.05). The whole blood IFN-γ release assay based on these epitopes yielded a sensitivity of 51% and a specificity of 85% in diagnosing active tuberculosis, and the corresponding results using the T-SPOT.TB assay were 76% and 75%, respectively. In conclusion, these results suggest that the six epitopes from the RD2 of M. tuberculosis have potential diagnostic value in TB.


Structural studies of mixed glass former 0.35Na2O + 0.65[xB2O3 + (1 - x)P2O5] glasses by Raman and 11B and 31P magic angle spinning nuclear magnetic resonance spectroscopies.
The mixed glass former (MGF) effect (MGFE) is defined as a nonlinear and nonadditive change in the ionic conductivity with changing glass former composition at constant modifier composition. In this study, sodium borophosphate 0.35Na(2)O + 0.65[xB(2)O(3) + (1 - x)P(2)O(5)], 0 ≤ x ≤ 1, glasses which have been shown to exhibit a positive MGFE have been prepared and examined using Raman and (11)B and (31)P magic angle spinning nuclear magnetic resonance (MAS NMR) spectroscopies. Through examination of the short-range order (SRO) structures found in the ternary glasses, it was determined that the minority glass former, B for 0.1 ≤ x ≤ 0.7 and P for 0.7 ≤ x ≤ 0.9, is "overmodified" and contains more Na(+) ions than would be expected from simple linear mixing of the binary sodium borate, x = 1, and sodium phosphate, x = 0, glasses, respectively. Changes in the intermediate range order (IRO) structures were suggested by changes in the NMR spectral chemical shifts and Raman spectra wavenumber shifts over the full composition range x in the Raman and MAS NMR spectra. The changes observed in the chemical shifts of (31)P MAS NMR spectra with x are found to be too large to be caused solely by changing sodium modification of the phosphate SRO structural groups, and this indicates that internetwork bonding between phosphorus and boron through bridging oxygens (BOs), P-O-B, must be a major contributor to the IRO structure of these glasses. While not fully developed, a first-order thermodynamic analysis based upon the Gibbs free energies of formation of the various SRO structural units in this system has been developed and can be used to account for the preferential formation of tetrahedral boron groups, B(4), by the reaction of B(3) with P(2) groups to form B(4) and P(3) groups, respectively, where the superscript denotes the number of BOs on these units, in these glasses. This preference for B(4) units appears to be a predominate cause of the changing modifier to glass former ratio with composition x in these ternary MGF glasses and appears to be associated with the large negative value of the Gibbs free energy of formation of this group.


Thermoelectric properties and thermal tolerance of indium tin oxide nanowires.
Highly crystalline indium tin oxide (ITO) nanowires were grown via a vapor-liquid-solid method, with thermal tolerance up to ∼1300 °C. We report the electric and thermoelectric properties of the ITO nanowires before and after heat treatments and draw conclusions about their applicability as thermoelectric building blocks in nanodevices that can operate in high temperature conditions. The Seebeck coefficient and the thermal and electrical conductivities were measured in each individual nanowire by means of specialized micro-bridge thermometry devices. Measured data was analyzed and explained in terms of changes in charge carrier density, impurities and vacancies due to the thermal treatments.


Household food insecurity and hunger among households in Sidama district, southern Ethiopia.
To examine household food insecurity and hunger in Sidama Zone, one of the most populous zones in southern Ethiopia. Cross-sectional survey administered individually by trained interviewers. Food insecurity was calculated with both the Household Food Insecurity Access Scale (HFIAS) and the Household Hunger Scale (HHS), developed by the Food and Nutrition Technical Assistance Project. Rural households from ten kebeles (the smallest administrative district) selected from two agro-climatic zones in Sidama, southern Ethiopia, from December 2010 to January 2011. Men and women respondents from 1094 rural households were selected using multistage sampling techniques. Using the HFIAS, 17·7 % of households were food secure. The percentage of households that were mildly, moderately and severely food insecure was 6·8 %, 27·7 % and 47·8 %, respectively. Using the HHS, 29·0 % and 5·6 % of households fell into the moderate and severe household hunger categories. Using multivariate statistical techniques, five variables were significant predictors of both food insecurity and hunger. These variables were migration of a household member, agro-climatic zone, and younger age, less education and lower radio access for the woman. Being eligible for safety-net credit programmes also was a predictor of hunger, while limited animal ownership and household wealth as well as alcohol use by the household head added to the prediction of food insecurity. The study documented that food insecurity is a major concern of smallholder farming households in the study area. A substantial majority of the households were facing mild to severe food insecurity and hunger for an extended period of time.