title stringlengths 0 1.13k | abstract stringlengths 1 15.7k | PMID int64 22 36.5M |
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Health care M&A advisory alert: Delaware court decision illustrates importance of specialized due diligence on Medicare/Medicaid issues in health care acquisition. | Lawyers and clients contemplating a health care transaction must have a strong working knowledge not only of the applicable law, but also of the provider's needs and culture. As illustrated by a recent Delaware court decision, Interim Healthcare, Inc. et al. v. Spherion Corporation, parties engaging in health care provider acquisitions are well advised to select a team of experienced business and legal advisors with specialized knowledge in health care practices that can find and address any suspicious activities before it is too late. | 18,975,724 |
Prescription drug spending: contribution to health care spending and cost containment strategies. | Prescription drug costs have been the focus of much research in the health care economy, within managed care organizations, and hospital systems. Pharmacy costs are drivers of general health care spending, premium increases, and to a lesser extent, hospital spending. Factors contributing to increased prescription spending include increased prescription use, replacement of older, cheaper drugs with new and more expensive ones, and the costly prices of retail prescription drugs. In this article, we review the cost of prescription drugs as they relate to general health care costs and the costs associated with operating a hospital organization. We also address what is currently being done to control the cost of prescription drugs in the hospital setting. | 18,975,728 |
[Nutrient contents in Kingdonia uniflora ramet and their relations to heterogeneous environment on Taibai Mountains]. | Taking the guerrilla type clonal plant Kingdonia uniflora at different altitudes in Taibai Mountain National Forest Park of Shaanxi Province, China as test material, the C, N, P, K and Mg contents in different vegetative organs of its ramet were measured. The results showed that ramet age, altitude, and their interaction had no significant effects on the total C content in ramet leaf, rhizome, and root (P > 0.05), but different effects on the total N, total P, K and Mg contents in these vegetative organs, suggesting that ramet could regulate the allocation of nutritive elements in its vegetative organs through physiological metabolism. At high altitude (3000-3100 m), ramet age had significant effects on the K content in all vegetative organs and the N content in rhizome and root (P < 0.05). All the test nutrient contents were significantly correlated with each other at all altitudes, except at middle altitude (2800-2900 m) where the ramet K content had no significant correlations with its N, P, and Mg contents. It was suggested that physiological plasticity contributed more to the performances of clonal plants at high altitude than at low altitude. Powerful physiological plasticity could help K. uniflora to effectively utilize heterogeneous resources, realize population expansion, and open up new habitat at high altitude. It was likely that the physiological plasticity of K. uniflora responding to heterogeneous habitats was formed in its long-term evolvement. | 18,975,741 |
[Effects of compensation capacity and palatability on the dominance of plant species in grazing community]. | With simulated mowing experiment and field survey, the compensation capacity and dominance shift of nine alpine plant species in grazing community were studied. The results showed that for most test species, there existed definite correlations between their compensation capacity and palatability. The species with better palatability, i.e., Astragalus polycladus, Medicago rythenica, Kobresia humilis, and Polygonum viviparvum, had higher compensation capacity, with their compensation index being 1.013, 0.907, 0.849, and 0.802, respectively, followed by Elymus nutans, with its compensation index being 0.668, while the species with poorer palatability, i.e., Taraxacum tibetanum, Swertis bimaculata, and Ajania tenuifolia had lower compensation capacity, with their compensation index being 0.649, 0.587, and 0.553, respectively. Festuca sinensis was more palatable but had the lowest compensation index (0.473). The nine species had three types of dominance shift, i.e., decreasing, increasing, and neutral. F. sinensis was of decreasing type, E. nutans, A. polycladus and P. viviparvum were of neutral, and the other five species were of increasing type. The compensation capacity and palatability of plant species in grazing community could explain their dominance shift to a certain extent. | 18,975,742 |
[Impact of urbanization on vegetation phenology in major cities in Yangtze River Delta region]. | Based on the time series NDVI images from 1998 to 2005 and by the method of moving average, the vegetation phenology in urban areas and buffer zones of Shanghai, Hangzhou, Nanjing, Changzhou, Wuxi and Suzhou in Yangtze River Delta region were calculated. The difference of average phenology in urban areas and buffer zones was analyzed, and the relationship between this difference and the distance away from urban edge was studied. The results showed that in 1998-2005, the urbanization of the cities made the vegetations in their urban area had an earlier start of growing season (SOS), later end of growing season (EOS), longer growing season length (GSL), and smaller NDVIamp (difference of maximal and minimal NDVI in a year). These changes were more obvious in buffer zones if they were closer to urban area. In general, urbanization made the SOS within 4 kilometers away from the urban edge started obviously earlier, and the EOS, GSL and NDVIamp within 10 kilometers away from the urban edge changed obviously. The differences of GSL between urban and buffer zones had a significant logarithmic relationship with the distance away from the urban edge, so did the NDVIamp. | 18,975,761 |
[The morphological alteration in myofiber fibrosis and expression in TGF-beta1 in long-term denervated posterior cricoarytenoid muscles]. | To investigate the morphological alteration and the protein expression of TGF-beta1 in long-term denervated posterior cricoarytenoid muscles (PCAMs) and to find the appropriate time point of reinnervation in long-term denervated PCAMs. Thirty-eight patients with vocal paralysis were recruited into four groups, the 6-12 months denervation group, the 1-2 years denervation group, the 2-3 years denervation group and the over 3 years denervation group. Twelve adults served as a control group. The morphological alteration was evaluated using Trichrome Masson staining and the change in expression of TGF-beta1, a fibrosis related factor, were observed using immunofluorescence stain and Western blot. The scars of myofibers were decreased, but the scars of collagen fibers were increased with the denervated time course extension. The ratio of scars of myofibers to scars of collagen fibers were progressively decrease with increased time course of denervation and more decrease within 2 years. There was still 48% scar of myofibers remained after 3 years of denervation. TGF-beta1 showed no staining in innervated, however, by 6-12 months and 1-2 years of muscle denervation there was a significant accumulation of TGF-beta1 protein in endochylema of myofiber. After 2 year of denervation, expression of TGF-beta1 protein in endochylema of myofiber, was decreased significantly, but after 3 year of denervation, there were no expression of TGF-beta1 protein in endochylema. In Western blot, the change in protein expression of TGF-beta1 was observed an 4.5-fold (P<0.01) increase from 6-12 months denervated muscles to innervated muscles, 11.4-fold (P<0.01) increase from 1-2 years denervated muscles to innervated muscles, 11.4-fold (P<0.01) increase from 2-3 years denervated muscles to innervated muscles (P<0.01). After 3 years, the protein expression of TGF-beta1 decreased, 0.5-fold to innervated muscles. The morphological alteration and change in expression of TGF-beta1, a important factor of myelofibrosis, indicated there was a high amplitude of myelofibrosis within 2 years, but there is a morphological basis of muscles to regain their function within 3 years denervated muscles. | 18,975,778 |
[The expression and significance of NF-kappaB in the rat model of otitis media with effusion experimentally induced by ovalbumin]. | To investigate the T helper cells (Th) predominant differentiation and the modulation of nuclear transcription factors kappa B (NF-kappaB) in middle ear of rat model of otitis media with effusion (OME). Sixteen SD rats were randomly divided into OME (Exp group) and control group (Con group). The expression of NF-kappaB were observed by immunohistochemistry. The level of IFN-gamma and IL-4 in tympanic lavage fluid (TLF) were determined by ELISA. As compared to the Con group , the level of IL-4 and the ratio of Th2/Th1 (IL-4/IFN-gamma) in TLF of Exp group significantly increased (P<0.05), when no significant difference in IFN-gamma levels in TLF was found. The ratio of NF-kappaB p65 positive cells to white cells in temporal bone marrow smears and middle ear mucosa of Exp group was significantly higher than that of Con group (P<0.05). The expression of NF-kappaB p65 in temporal bone marrow smears and middle ear mucosa was signficantly positively correlated with the concentration of IL-4 in TLF of Exp group (P<0.05). The middle ear is capable of mounting an allergic response and subsequent formation of effusion. There is Thl/Th2 immune response imbalance, which polarizes toward Th2 response in the middle ear microenvironment of allergic OME rat model. Moreover , NF-kappaB may participate in regulating Th2 predominant reaction. | 18,975,780 |
[Study of electroreflectance spectrum and Franz-Keldysh effect at metal-GaAs interfaces]. | Electronic properties (electric field, Fermi level pinning and density of interface states) of Au-GaAs, Al-GaAs and Ni-GaAs interfaces were studied by optical methods. These interfaces were fabricated by depositing metals (Ni, Au and Al) on specialized surface-intrinsic-n+ (SIN+) GaAs samples. Electroreflectance (ER) was used to study the electric fields and Fermi level pinnings of metal-GaAs interfaces. Fourier transformation (FT) of ER spectra was used to analyze these interfacial properties. Assuming that only a fraction of the total illuminated area was the effective interface state area, the density of interface states was obtained by measuring the relation between the photovoltage induced by an exciting He-Ne laser beam and the illumination intensity of the laser beam. | 18,975,783 |
[Studies of the g factor and optical spectra for CaZrO3:Mn4+ crystal]. | The complete high-order perturbation formula of g factor for 3d(3) ions in cubic octahedral site was derived. In the formula, both the contribution delta g(CF) to g-shift delta g (= g-g(s), where g(s) = 2.0023) due to crystal-field (CF) mechanism (related to the interactions of CF excited states with the ground state) and that (delta g(CT)) due to charge-transfer (CT) mechanism (related to the interactions of CT excited states with the ground state, which is omitted in crystal-field theory) are included. By using the formula and the parameters obtained from the optical spectra of CaZrO3:Mn4+ crystal, the g factor of CaZrO3:Mn4+ was calculated. The result is consistent with the experimental value. The calculations show that the contribution is opposite in sign and about 62% in magnitude compared with the contribution delta g(CF). It appears that both CF and CT mechanisms should be considered in the calculation of g factor for the high valence 3d(3) (e. g. , Mn4+ and Fe3+) ions in crystals. | 18,975,784 |
[Measurement on gas temperature distribution by tunable diode laser absorption spectroscopy]. | The technique of tunable diode laser absorption spectroscopy (TDLAS) can be used for gas temperature distribution measurement by scanning multiple gas absorption lines with a tunable diode laser. The fundamental of gas temperature distribution measurement by TDLAS is introduced in the present paper, and the discretization strategy of equation for gas absorption is also given here. Using constrained linear least-square fitting method, the gas temperature distribution can be calculated with the help of physical constraints under the condition of uniform gas concentration and pressure. Based on the spectral parameters of four CO absorption lines near 6330 cm(-1) from HITRAN database, the model of two-temperature distribution at 300 and 600 K with each path length of 55 cm was set up. The effects of relative measurement error and different path length constraints of temperature bins on the gas temperature distribution measurement results were simulated by constrained linear least-square fitting. The results show that the temperature distribution calculation error increases as the relative measurement error rises. A measurement error of 5% could lead to a maximum relative error of 11%, and an average relative error of 2.2% for calculation result. And the weak physical constraints of path length for temperature bins could increase the calculation result error during the process of constrained linear least-square fitting. By setting up the model of two-temperature distribution with gas cells at room temperature as the cold section and in tube furnace as the hot section, the experiment of gas temperature distribution measurement in lab was carried out. Using four absorption lines of CO near 6330 cm(-1) scanned by VCSEL diode laser, and fitting the background laser intensity without absorption by the cubic polynomial to get the baseline signal, the integrals of spectral absorbance for gas temperature distribution measurement can be calculated. The relative calculation errors of path length for temperature bins are about 7.3%, 6.5%, 4.7% and 2.7% in the four cases. | 18,975,785 |
[Method for measuring water content in fresh meat using diffusion reflectance near infrared spectroscopy and experiment]. | A method was established to determine water content of fresh meat in deep layer based on NIRS diffusion reflectance spectroscopy by using LEDs. The experimental apparatus was established to investigate internal water content with repeated experiments for pork and mince pork; the water concentration and the water content detected by standard method is linear, and the r2 is larger than 0.90. Calculation of coefficient of variability (CV) and intra class correlation (ICC) procedures were applied to assess test-retest reliability of this measuring method. The CV and ICC values were found to be good (CV < or = 5%; ICC = 0.83). The experimental result indicated that the fast non-invasive measurement method for detecting water content in deep layer of fresh meat based on spatially-resolved spectroscopy was feasible. | 18,975,799 |
[Research on the background correction in the non-invasive sensing of glucose by near-infrared spectroscopy]. | For the non-invasive blood glucose concentration sensing by the near-infrared spectroscopy, the signal to noise ratio of the optical measurement system is very low. Both the content of glucose in body and the absorption coefficient of glucose in the near-infrared region are quite weak. More over, the structure of spectral noise is complicated and the variation of noise intensity is very large. The background correction is one of the most effective pre-processing methods to improve the signal to noise ratio of the near-infrared optical detection system. In this paper, the theory expression formula of traditional background correction method was induced firstly. Then in order to avoid the influence from the variation of optical characteristics in the sample and the drift in the optical system, the similar background correction method was proposed, that is, the background which has the similar optical characteristics with the sample was chosen as the reference. The in vitro experiments of pure absorption media and scattering media were conducted to validate the effect. The results showed that, for the glucose in the blood plasma solution and Intralipid-2% solution, after the correction of the background which has the similar optical characteristics with the sample, the prediction precision of multivariate model for glucose concentration has been improved by 25.9% and 40.1%, respectively. | 18,975,800 |
[Study of discrimination of corn seed based on near-infrared spectra and artificial neural network model]. | A new non-destructive and rapid method was developed to discriminate varieties of corn seeds. The method is based on near-infrared reflectance spectroscopy (NIRS) and artificial neural network (ANN). The corn seeds used for this study involved four varieties: Gaoyou115, Nongda368, Nongda108 and Nongda4967. After collecting the near-infrared reflectance spectrum of each single seed in the range between 1000 and 2632 nm, the principal component analysis (PCA) was used to compress the NIR spectra, which had been preprocessed with Savitky-Golay and multiplicative scatter correction (MSC). The analysis results showed that the cumulate reliabilities of PC1 to PC8 (the first eight principal components) were 99.602%. A three-layer back-propagation neural network (BPNN) was developed for classification, which was trained by the Levenberg-Marquard algorithm to improve the network training speed and efficiency. The LMBP was activated by the sigmoid function, and normalization of targets was used to get the best discrimination result of network. The first eight principal components of the samples were applied as LMBPNN inputs, and the values of the type of corn seeds were applied as the outputs. In this model, 120 kernels were used as the training data set and 40 kernels were used as the test data set. Calculation results showed that the distinguishing rate of the four corn seed varieties was 95%. This model is reliable and practicable. The results demonstrated that this identification method was rapid and non-destructive, and could be used for classification. | 18,975,808 |
[Fast detection of sugar content in fruit vinegar using NIR spectroscopy]. | For the fast and exact detection of sugar content of fruit vinegar, near infrared (NIR) spectroscopy technique combined with least squares support vector machines (LS-SVM) algorithm was used to build the prediction model of sugar content in the present research. NIR spectroscopy is a nondestructive, fast and accurate technique for the measurement of chemical compo nents based on overtone and combination bands of specific functional groups. The pivotal step for spectroscopy technique is how to extract quantitative data from mass spectral data and eliminate spectral interferences. Principal component analysis (PCA) is a method which has been widely used in the spectroscopic analysis, and LS-SVM is a new data mining algorithm developed from the machine learning community. In the present study, they were used for the spectroscopic analysis. First, the near infrared transmittance spectra of three hundred samples were obtained, then PCA was applied for reducing the dimensionality of the original spectra, and six principal components (PCs) were selected according the accumulative reliabilities (AR). The six PCs could be used to replace the complex spectral data. The three hundred samples were randomly separated into calibration set and validation set. Least squares support vector machines (LS-SVM) algorithm was used to build prediction model of sugar content based on the calibration set, then this model was employed for the prediction of the validation set. Correlation coefficient (r) of prediction and root mean square error prediction (RMSEP) were used as the evaluation standards, and the results indicated that the r and RMSEP for the prediction of sugar content were 0.9939 and 0.363, respectively. Hence, PCA and LS-SVM model with high prediction precision could be applied to the determination of sugar content in fruit vinegar. | 18,975,809 |
[The estimation model of rice leaf area index using hyperspectral data based on support vector machine]. | In order to compare the prediction powers between the best statistical model and SVM technique using each VI for rice LAI, the VIs are as independent variables in statistical models and are as net inputs in SVM, and the rice LAI are as dependent variables in statistical models and are as net outputs in SVM. Hyperspectral reflectance (350 to 2500 nm) data were recorded in two experiments involving four replicates of two rice cultivars ("Xiushui 110" and "Xieyou 9308"), three nitrogen levels (0, 120, 240 kg x ha(-1) N), and with a plant density of 45 plants x m(-2). The first experiment was seeded on 30 May 2004 and the second experiment on 15 June 2004. Both sets of seedlings were transplanted to the field one month later. Hyperspectral reflectance was ground-based and measured using Analytical Spectral Devices and 1 meter above the rice canopy. The solar angle compared to nadir was for all measurements less than 45 degrees and no disturbing clouds were observed. Hyperspectral reflectance was transformed to ten different vegetation indices including RVI, NDVI, NDVIgreen, SAVI, OSAVI, MSAVI, MCACI, TCARI/OSAVI, RDVI and RVI2, according to the width of TM bands of Ladsat-5. Different statistical models including linearity model, exponent model, power model and logarithm model, were analyzed using all samples' LAI and vegetation indices. Three good relationships including exponent relationship of NDVIgreen, power relationship of TCARI/OSAVI and power relationship of RV12 were selected based on the R2 of models. These three relationships were used to predict the LAI of rice through SVM models with different kernel functions including an analysis of variance kernel (ANOVA), a polynomial kernel (POLY) and a radial basic function kernel (RBF), and corresponding statistical models. The results show that all SVM models have lower RMSE values and higher estimation precision than corresponding statistical models; SVM with POLY kernel function using TCARI/OSAVI has the highest estimation precision for rice LAI compared to other models, and it's RMSE value is lower than corresponding statistical model by 11 percent points. Therefore, SVM has a high accuracy for learning and a good robustness for estimation of LAI of rice using hyperspectral data. Consequently, SVM provides a useful explorative tool for improvement of the relationships between VIs and rice LAI. | 18,975,815 |
[Single particle measurement of suspended soil dust using laser desorption/ionization time-of-flight mass spectrometry]. | Real-time measurement of size and composition of single soil dust particles using an aerosol time-of-flight laser mas spectrometry (ATOFLMS) was designed in our lab. Each particle's aerodynamic diameter was determined by measuring the delay time between two continuous-wave lasers, a Nd:YAG laser with a 266 nm pulsed output was used to desorb and ionize aerosol particles, and ions formed in the laser desorption/ionization process were accelerated into the time-of-flight drift region where they separated by mass-to-charge ratio, then the composition of single particle was obtained. In the present paper, soil samples were collected from four different areas in China. After the pretreatment and suspension, the particle sample was then transferred to ATOFLMS through a plastic transfer line. During the campaign, a large number of size and mass spectra of single par ticles were obtained. The presence of crustal elements was observed in the mass spectra of individual particles. Iron, potassium aluminum and calcium constitute the two most commonly detected cations. Other common cations observed in the mass spectra o soil particles include magnesium, and sodium. The detection results exhibit that the coarse particles with size of 1-2 microm are dominate in the detected particles. Experimental results show the ATOFLMS have important practical value for researching and monitoring of atmospheric aerosol environment. | 18,975,833 |
[Analysis of trace elements and macro elements in 13 anti-anoxic traditional Tibetan medicine]. | Thirteen kinds of anti-anoxic Tibetan traditional medicine including Hongjingtianjiaonang, Anshensan, Wuweishiliusan, Zhangsongbaweichenxiangsan, Shiliuweidujuansan, Ershiwuweiyuganziwan, Ershiwuweizhuhuangjiaonang, Shiwuweilongdanwan, Mijueqingliangsan, Qishiweizhenzhuwan, Bawei-chenxiangsan, Liuweidingxiangsan and Qiweiputansan were digested with HNO3-HClO4 mixed acid. Fourteen trace elements and macro elements in the 13 kinds of anti-anoxic Tibetan traditional medicine, such as silver, aluminium, cadmium, cobalt, chromium, copper, ferrum, hydrargyrum, magnesium, manganese, nickel, lead, stannum and zinc were determined by flame atomic absorption spectrophotometry (FAAS). The results showed that there were comparatively rich trace elements and macro elements in kinds of anti-anoxic Tibetan traditional Medicine. The 13 Anti-anoxic Tibetan traditional medicine contains higher amount of ferrum, magnesium, copper, chromium, zinc and manganese than other elements. This provided useful data for discussing the relationship between trace elements and macro elements and anti-anoxic activities in Tibetan traditional medicine. | 18,975,838 |
Reaction mechanism of HCN+ + C2H4: a theoretical study. | The complex doublet potential energy surface for the ion-molecule reaction of HCN(+) with C(2)H(4) is investigated at the B3LYP/6-311G(d,p) and CCSD(T)/6-311++G(3df,2pd) (single-point) levels. The initial association between HCN(+) and C(2)H(4) forms three energy-rich addition intermediates, 1 (HCNCH(2)CH(2)(+)), 2 (HC-cNCH(2)CH(2)(+)), and 3 (N-cCHCH(2)CH(2)(+)), which are predicted to undergo subsequent isomerization and decomposition steps. A total of nine kinds of dissociation products, including P(1) (HCN + C(2)H(4)(+)), P(2) (HCNCHCH(2)(+) + H), P(3) (NCCH(2) + CH(3)(+)), P(4) (CN + C(2)H(5)(+)), P(5) (NCCHCH(2)(+) + H(2)), P(6) (HNCCHCH(2)(+) + H), P(7) (c-CHCCH(2)N(+) + H(2)), P(8) (c-NHCCH(2)C(+) + H(2)), and P(9) (HNCCCH(+) + H(2) + H), are obtained. Among the nine products, P(1) is the most abundant product. P(2) is the second feasible product but is much less competitive than P(1). P(3), P(4), P(5), and P(6) may have the lowest yields observed. Other products, P(7), P(8), and P(9), may become feasible at high temperature. Because the intermediates and transition states involved in the most favorable pathway all lie below the reactant, the HCN(+) + C(2)H(4) reaction is expected to be rapid, which is confirmed by experiment. The present calculation results may provide a useful guide for understanding the mechanism of HCN(+) toward other unsaturated hydrocarbons. | 18,975,875 |
How important are temperature effects for cluster polarizabilities? | State-of-the-art first-principle all-electron density functional theory calculations on small sodium clusters are performed to study the temperature dependency of their polarizabilities. For this purpose Born-Oppenheimer molecular dynamics simulations with more than 100,000 time steps (>200 ps) are recorded employing gradient corrected functionals in combination with a double-zeta valence polarization basis set. For each cluster 18 trajectories between 50 and 900 K are collected. The cluster polarizabilities are then calculated along these trajectories employing a triple-zeta valence polarization basis set augmented with field-induced polarization functions. The analysis of these calculations shows that the temperature dependency of the sodium cluster polarizabilities varies strongly with cluster size. For several clusters characteristic changes in the polarizability per atom as a function of temperature are observed. It is shown that the inclusion of finite temperature effects resolves the long-standing mismatch between calculated and measured sodium cluster polarizabilities. | 18,975,878 |
Structure/property relationships for the thermotropic behavior of lysine-based amphiphiles: from hexagonal to smectic phases. | Amino acid-derived gemini surfactants arise as a potentially good alternative to the more conventional lipid and synthetic catanionic systems in view of their enhanced interfacial properties, increased chemical stability, and low toxicity. The presence of an amino acid as the polar headgroup allows toxicity reduction, with the simultaneous increase of biodegradability. For these compounds, the establishment of structure/function relationships from the assessment of their basic aggregation properties is therefore of the utmost interest, e.g., in the design of operative self-assembled systems (e.g., liposomes, nanotubes, etc). In this context, the study of the thermal phase behavior of the dry surfactants is a natural, straightforward first step, the more so as thermotropic liquid crystals are also relevant for practical applications. In this work, several lysine-based amphiphiles with a gemini-like configuration have been synthesized, with the amino acid side chain as the spacer group. The molecules are either esters (neutral, with C6-C12 even chains) or sodium carboxylates (anionic, with C6-C12 even chains). Upon increasing the temperature, different crystalline (cr) and liquid-crystalline (lc) phases have been detected and the corresponding thermodynamic and structural parameters determined by a combination of differential scanning calorimetry, polarizing light microscopy and small-angle X-ray scattering. The phase behavior of the amphiphiles is highly dependent on both the chain length and the presence of charge on the headgroup, with significant differences occurring within and between each group of molecules. The C6 and C8 esters form reverse hexagonal cr and lc phases, while C10 and C12 self-assemble into smectic cr and lc structures, with C10 showing also a reverse hexagonal lc phase prior to isotropization. All the carboxylate derivatives form smectic lc phases at high enough temperature prior to isotropization. The rationalization of the phase behavior and phase transition energetics of the compounds has been put forth on the basis of the intermolecular interactions at stake (van der Waals, H-bonding, electrostatic, and packing) and the molecular shape of the amphiphile. | 18,975,881 |
Promiscuous sulfatase activity and thio-effects in a phosphodiesterase of the alkaline phosphatase superfamily. | The nucleotide phosphodiesterase/pyrophosphatase from Xanthomonas axonopodis (NPP) is a structural and evolutionary relative of alkaline phosphatase that preferentially hydrolyzes phosphate diesters. With the goal of understanding how these two enzymes with nearly identical Zn(2+) bimetallo sites achieve high selectivity for hydrolysis of either phosphate monoesters or diesters, we have measured a promiscuous sulfatase activity in NPP. Sulfate esters are nearly isosteric with phosphate esters but carry less charge, offering a probe of electrostatic contributions to selectivity. NPP exhibits sulfatase activity with k(cat)/K(M) value of 2 x 10(-5) M(-1) s(-1), similar to the R166S mutant of alkaline phosphatase. We further report the effects of thio-substitution on phosphate monoester and diester reactions. Reactivities with these noncognate substrates illustrate a reduced dependence of NPP reactivity on the charge of the nonbridging oxygen situated between the Zn(2+) ions relative to that in alkaline phosphatase. This reduced charge dependence can explain about 10(2) of the 10(7)-fold differential catalytic proficiency for the most similar monoester and diester substrates in the two enzymes. The results further suggest that active site contacts to substrate oxygen atoms that do not contact the Zn(2+) ions may play an important role in defining the selectivity of the enzymes. | 18,975,918 |
Rhodium-catalyzed silylation and intramolecular arylation of nitriles via the silicon-assisted cleavage of carbon-cyano bonds. | A rhodium-catalyzed silylation reaction of carbon-cyano bonds using disilane has been developed. Under these catalytic conditions, carbon-cyano bonds in aryl, alkenyl, allyl, and benzyl cyanides bearing a variety of functional groups can be silylated. The observation of an enamine side product in the silylation of benzyl cyanides and related stoichiometric studies indicate that the carbon-cyano bond cleavage proceeds through the deinsertion of silyl isocyanide from eta(2)-iminoacyl complex B. Knowledge gained from these studies has led to the development of a new intramolecular biaryl coupling reaction in which aryl cyanides and aryl chlorides are cross-coupled. | 18,975,946 |
Cationic terminal gallylene complexes by halide abstraction: coordination chemistry of a valence isoelectronic analogue of CO and N2. | While N(2) and CO have played central roles in developing models of electronic structure, and their interactions with transition metals have been widely investigated, the valence isoelectronic diatomic molecules EX (E = group 13 element, X = group 17 element) have yet to be isolated under ambient conditions, either as the "free" molecule or as a ligand in a simple metal complex. As part of a program designed to address this deficiency, together with wider issues of the chemistry of cationic systems [L(n)M(ER)](+) (E = B, Al, Ga; R = aryl, amido, halide), we have targeted complexes of the type [L(n)M(GaX)](+). Halide abstraction is shown to be a viable method for the generation of mononuclear cationic complexes containing gallium donor ligands. The ability to isolate tractable two-coordinate products, however, is strongly dependent on the steric and electronic properties of the metal/ligand fragment. In the case of complexes containing ancillary pi-acceptor ligands such as CO, cationic complexes can only be isolated as base-trapped adducts, even with bulky aryl substituents at gallium. Base-free gallylene species such as [Cp*Fe(CO)(2)(GaMes)](+) can be identified only in the vapor phase by electrospray mass spectrometry experiments. With bis(phosphine) donor sets at the metal, the more favorable steric/electronic environment allows for the isolation of two-coordinate ligand systems, even with halide substituents at gallium. Thus, [Cp*Fe(dppe)(GaI)](+)[BAr(f)(4)](-) (9) can be synthesized and shown crystallographically to feature a terminally bound GaI ligand; 9 represents the first experimental realization of a complex containing a valence isoelectronic group 13/group 17 analogue of CO and N(2). DFT calculations reveal a relatively weakly bound GaI ligand, which is confirmed experimentally by the reaction of 9 with CO to give [Cp*Fe(dppe)(CO)](+)[BAr(f)(4)](-). In the absence of such reagents, 9 is stable for weeks in fluorobenzene solution, presumably reflecting (i) effective steric shielding of the gallium center by the ancillary phosphine and Cp* ligands; (ii) a net cationic charge which retards the tendency toward dimerization found for putative charge neutral systems; and (iii) (albeit relatively minor) population of the LUMOs of the GaI molecule through pi overlap with the HOMO and HOMO-2 of the [Cp*Fe(dppe)](+) fragment. | 18,975,947 |
Authentication of anglerfish species (Lophius spp) by means of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and forensically informative nucleotide sequencing (FINS) methodologies. | Lophius represents the most important genus of the family Lophiidae from a commercial point of view. The main marketing formats of the species included in this genus are tails and cheeks, making impossible the species identification on the basis of their morphological characters. In the present study, two methods based on the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and phylogenetic analysis of DNA sequences [forensically informative nucleotide sequencing (FINS)] were developed to differentiate the seven species contained in the genus Lophius. In both cases, the molecular marker studied was the cytochrome oxidase subunit I gene (COI). The RFLP analysis of the PCR products digested with the endonuclease Mbo I generated species-specific restriction profiles, and the phylogenetic analysis showing a neighbor-joining tree with independent nodes was strongly supported for all of the studied species. These methods were applied to 40 commercial samples, allowing us to detect the samples incorrectly labeled. The fraudulent labeling ratio was higher in processed products (68.75%) than whole fish (31.25%). The species subjected to mislabeling were L. budegassa (68.75%), L. vomerinus (18.75%), and L. piscatorius (12.5%). Therefore, both methodologies can be independently used to authenticate the species belonging to the genus Lophius, being useful to check the fulfillment of labeling regulations of seafood products and to verify the correct traceability of commercial trade and the control of fisheries. | 18,975,961 |
Fenhexamid adsorption behavior on soil amended with wine lees. | The adsorption of fenhexamid (FEN) [N-(2,3-dichloro-4-hydroxyphenyl)-1-methylcyclohexanecarboxamide] on vineyard soil amended with wine lees (WL) produced by vinery was studied. The adsorption extent depends on WL fraction. The addition of the centrifuged solid lees (SWL) increases the FEN adsorption on soil. Most likely, the organic insoluble fraction formed mainly by dead fermentation yeasts is responsible for the observed increase. The adsorption measured on some deactivated yeasts of wine fermentation shows that Saccharomyces cerevisiae are the most active in FEN retention. On the other hand, the soil amendment with whole WL decreases considerably the fungicide adsorption. This opposite effect may be the result of FEN hydrophobic bonds with the dissolved organic matter of lees that keeps fungicide in solution. This hypothesis is substantiated by the increased FEN solubility in the supernatant of centrifuged wine lees (LWL). The results of soil column mobility confirm that the elution with LWL increases the mobility of FEN in soil. | 18,975,967 |
Differential RNA-dependent ATPase activities of four rRNA processing yeast DEAD-box proteins. | S. cerevisiae ribosome biogenesis is a highly ordered and dynamic process that involves over 100 accessory proteins, including 18 DExD/H-box proteins that act at discrete steps in the pathway. Although often termed RNA helicases, the biochemical functions of individual DExD/H-box proteins appear to vary considerably. Four DExD/H-box proteins, Dbp3p, Dbp4p, Rok1p, and Rrp3p, involved in yeast ribosome assembly were expressed in E. coli, and all were found to be active RNA-dependent ATPases with k(cat) values ranging from 13 to 170 min(-1) and K(M)(ATP) values ranging from 0.24 to 2.3 mM. All four proteins are activated by single-stranded oligonucleotides, but they require different chain lengths for maximal ATPase activity, ranging from 10 to >40 residues. None of the four proteins shows significant specificity for yeast rRNA, compared to nonspecific control RNAs since these large RNAs contain multiple binding sites that appear to be catalytically similar. This systematic comparison of four members of the DExD/H-box family demonstrates a range of biochemical properties and lays the foundation for relating the activities of proteins to their biological functions. | 18,975,973 |
Histopathologic and clinical features of medullary microcarcinoma and C-cell hyperplasia in prophylactic thyroidectomies for medullary carcinoma: a study of 42 cases. | Prophylactic thyroidectomies are increasingly performed on patients at risk for developing medullary thyroid carcinoma (MTC); consequently, pathologists are more commonly encountering these specimens in routine practice. To describe the detailed clinicopathologic features of prophylactic thyroidectomies for medullary carcinoma. We present a retrospective series of 42 prophylactic thyroidectomies for MTC performed for one or more of the following: family history of multiple endocrine neoplasia (MEN) or MTC, elevated serum calcitonin level, or detection of a RET proto-oncogene mutation. Patients included 22 men and 20 women (mean age, 26.2 years). Among those with known RET proto-oncogene mutations, affected sites included exons 10, 11, 14, and 16. In 93% (n = 39) of cases, either C-cell hyperplasia (n = 36), medullary microcarcinoma (MMC; n = 29), or medullary macrocarcinoma (n = 1) was found. C-cell hyperplasia was often multifocal (n = 30) and bilateral (n = 23) and included both nonnodular and nodular patterns. A total of 94% of C-cell hyperplasia cases and all MMC cases were microscopically detectable using hematoxylin-eosin stains. The MMCs were characterized by a complex microarchitectural pattern with a desmoplastic stromal response (n = 29) and focal amyloid deposition (n = 12). Most MMCs exhibited a solid pattern (n = 24) of round, polygonal, spindled, or plasmacytoid-shaped cells. Only 1 case of MMC showed evidence of metastatic disease to a pretracheal lymph node. Based upon our clinicopathologic findings and review of the literature, we conclude that thyroidectomies in at-risk patients are very frequently associated with C-cell hyperplasia and/or MMC; however, the clinical prognosis for these patients is very good. | 18,976,013 |
Stability of tumor necrosis factor alpha, interleukin 6, and interleukin 8 in blood samples of patients with systemic immune activation. | Tumor necrosis factor alpha, interleukin 6, and interleukin 8 serum/plasma levels are frequently used for the monitoring of patients with systemic immune activation/ sepsis. This requires comparability of test results over time. However, cytokines are usually not considered to be very stable after blood collection, which might artificially interfere with test results. To obtain better knowledge about stability of these cytokines in blood samples for interpretation of test results. Blood of patients with systemic immune activation was collected in EDTA, lithium heparin, ammonium heparin, and serum tubes. Aliquots were analyzed after storage at room temperature for 2 to 8 hours. Additionally, storage conditions for separated serum/plasma for 24 hours and the reproducibility of repeated cytokine measurements by an automated DPC Immulite analyzer were tested. Tumor necrosis factor alpha level was stable in EDTA plasma for 8 hours, while slightly increasing in heparin plasma and serum. Interleukin 6 concentrations were stable for 8 hours in all blood types, whereas interleukin 8 concentrations were stable only in EDTA plasma and were strongly increasing in heparin plasma and serum. Cytokine concentrations in separated serum/plasma were stable during 24 hours if stored at 4 degrees C or frozen at -20 or -70 degrees C. Reproducibility of repeated cytokine measurements revealed no significant differences for all blood types. Cytokine levels were most critically influenced by the period between blood collection and plasma separation, but its impact was strongly dependent on cytokine and anticoagulant. However, under appropriate conditions cytokine levels were surprisingly stable for up to 8 hours. | 18,976,019 |
Lipid profiles and prevalence of dyslipidemia in schoolchildren in south Khorasan Province, eastern Iran. | The aim of this study was to evaluate serum lipid profiles and the prevalence of dyslipidemia in schoolchildren in south Khorasan Province. The participants of this cross-sectional study were 685 girls and 641 boys, aged seven to 12 years, selected by multistage random cluster sampling from urban and rural areas of south Khorasan Province (eastern Iran). Fasting blood samples were analyzed for total cholesterol, low-density lipoprotein cholesterol, triglycerides, and high-density lipoprotein cholesterol. The mean values of total cholesterol and low-density lipoprotein cholesterol were significantly higher in girls. There was no significant correlation between the mean values of serum lipids with age of the children. The mean values of triglyceride and high-density lipoprotein cholesterol were significantly higher and lower, respectively, in rural areas. In all the participants, the percentiles of triglycerides were higher and the percentiles of high-density lipoprotein cholesterol were lower than standard values according to Lipid Research Clinics data. The most common form of dyslipidemia was decreased high-density lipoprotein cholesterol (14.1%). The prevalence of hypertriglyceridemia, increased low-density lipoprotein cholesterol, and hypercholesterolemia were 5.4%, 4.1%, and 3%, respectively. There was not any significant relation between different forms of dyslipidemia with age of the children. Decreased high-density lipoprotein cholesterol and increased low-density lipoprotein cholesterol were significantly more common in girls. The prevalence of decreased high-density lipoprotein cholesterol was significantly higher in rural than urban areas. Considering the high prevalence of dyslipidemia and undesirable lipid profiles in the schoolchildren of eastern regions of Iran, it is strongly recommended to search for underlying factors. | 18,976,028 |
Synchronous occurrence of small intestinal stromal tumor and cecal adenocarcinoma. | Synchronous development of gastrointestinal stromal tumors with other tumors in the digestive tract is relatively rare, and often occurs in the stomach. We report a 76-year-old woman, who suffered from the exceedingly rare synchronous development of small intestinal stromal tumor and cecal adenocarcinoma. The patient presented with intestinal obstructive symptoms. The pre-operative abdominal ultrasonography demonstrated a very large heterogenous periumbilical mass. Laparotomy was performed and the evaluation of the surgical specimen revealed a huge 14-cm subserosal mass of high risk ileal stromal tumor along with cecal adenocarcinoma with regional lymph node metastasis. The patient died within 3 months of diagnosis. | 18,976,040 |
IL-23 and autoimmunity: new insights into the pathogenesis of inflammatory bowel disease. | The intestinal immune system has the challenge of maintaining both a state of tolerance toward intestinal antigens and the ability to combat pathogens. This balance is partially achieved by reciprocal regulation of proinflammatory, effector CD4(+) T cells and tolerizing, suppressive regulatory T cells. Inflammatory bowel disease (IBD) comprises Crohn's disease (CD) and ulcerative colitis (UC). Genome-wide association studies have linked CD to a number of IL-23 pathway genes, notably IL23R (interleukin 23 receptor). Similar associations in IL-23 pathway genes have been observed in UC. IL23R is a key differentiation feature of CD4(+) Th17 cells, effector cells that are critical in mediating antimicrobial defenses. However, IL-23 and Th17 cell dysregulation can lead to end-organ inflammation. The differentiation of inflammatory Th17 cells and suppressive CD4(+) Treg subsets is reciprocally regulated by relative concentrations of TGFbeta, with the concomitant presence of proinflammatory cytokines favoring Th17 differentiation. The identification of IL-23 pathway and Th17 expressed genes in IBD pathogenesis highlights the importance of the proper regulation of the IL-23/Th17 pathway in maintaining intestinal immune homeostasis. | 18,976,050 |
Characterization of a side population of astrocytoma cells in response to temozolomide. | Cancer progenitor-like cells isolated by Hoechst 33342 dye efflux (termed the "side population" [SP]) have been studied in a variety of cancers, including malignant brain tumors. In this study, the authors investigate the nature of the SP phenotype in 2 glioma cell lines, U87MG and T98G, and their response to temozolomide. The roles of several adenosine triphosphate-binding cassette (ABC) multidrug transporters expressed by SP cells, in particular ABCG2, are also examined. Using fluorescence-activated cell sorting, the cells were separated into SP and non-SP fractions and analyzed for progenitor cell-like properties with immunofluorescence staining, quantitative real-time polymerase chain reaction, and their ability to reform glioma mass in an immune-compromised mouse. The response of the SP cells to temozolomide was investigated at the cellular and molecular levels. Small interfering RNA knockdown was used to examine the specific role of the ABCG2 transporter, and the cells' tumorigenic potential was measured using the soft agar clonogenic assay. Side population cells are characterized by the presence of progenitor cell-like properties: increased expression of nestin, musashi-1, and ABCG2 were observed. In addition, only SP cells were able to reconstitute cellular heterogeneity; these cells were also more invasive than the non-SP cells, and possessed tumorigenic capacity. Temozolomide treatment increased the number of SP cells, and this corresponded to more progenitor-like cells, concurrent with elevated expression of several ABC transporters. Knockdown of ABCG2 transporters did not abrogate the SP cell response to temozolomide. Upregulation of several other ABC drug transporter genes is proposed to account for this chemoresistance. | 18,976,075 |
Controlled release of heparin-binding growth factors using heparin-containing particulate systems for tissue regeneration. | The strategy of growth factor delivery to specific sites for therapeutic applications has been considered an essential process in biomedical fields despite some obstacles, such as a non-controlled release with initial burst. This article focuses on particulate systems using heparin for the controlled delivery of heparin-binding growth factors (HBGFs), an emerging area in the tissue engineering field. Since heparin has been widely utilized for growth factor delivery due to its electrostatic nature and specific affinity with HBGFs, heparin-containing polymeric particulates can be utilized as functional carriers to deliver growth factors in a controlled manner. In particular, examples of the HBGF delivery systems containing heparin, perspectives and potential applications are described and discussed. | 18,976,129 |
Drug delivery strategies for improved azole antifungal action. | Azole antifungal agents are the most commonly used antifungals in clinical treatment of both superficial and systemic fungal infections. Many azoles are poorly water soluble, which limits their bioavailability and antifungal effects. To improve the efficacy of azole antifungal drugs by advances in drug delivery. Manipulation of drug formulations and administration routes to improve the antifungal pharmacokinetics with targeted delivery, rapidly followed by sustained release and prolonged retention of high drug concentration localized at the infection site. Formulation and drug delivery strategies can improve the aqueous wetting and dissolution properties by increasing their chemical potential, stabilizing the drug delivery system and targeting high concentration of the azoles to the infection sites, therefore enhancing the bioavailability and therapeutic efficacy of azole antifungals. | 18,976,131 |
Photosensitiser delivery for photodynamic therapy. Part 2: systemic carrier platforms. | The treatment of solid tumours and angiogenic ocular diseases by photodynamic therapy (PDT) requires the injection of a photosensitiser (PS) to destroy target cells through a combination of visible light irradiation and molecular oxygen. There is currently great interest in the development of efficient and specific carrier delivery platforms for systemic PDT. This article aims to review recent developments in systemic carrier delivery platforms for PDT, with an emphasis on target specificity. Recent publications, spanning the last five years, concerning delivery carrier platforms for systemic PDT were reviewed, including PS conjugates, dendrimers, micelles, liposomes and nanoparticles. PS conjugates and supramolecular delivery platforms can improve PDT selectivity by exploiting cellular and physiological specificities of the targeted tissue. Overexpression of receptors in cancer and angiogenic endothelial cells allows their targeting by affinity-based moieties for the selective uptake of PS conjugates and encapsulating delivery carriers, while the abnormal tumour neovascularisation induces a specific accumulation of heavy weighted PS carriers by enhanced permeability and retention (EPR) effect. In addition, polymeric prodrug delivery platforms triggered by the acidic nature of the tumour environment or the expression of proteases can be designed. Promising results obtained with recent systemic carrier platforms will, in due course, be translated into the clinic for highly efficient and selective PDT protocols. | 18,976,134 |
Enhancing the nail permeability of topically applied drugs. | The topical therapy of nail diseases, especially of onychomycosis, and to a smaller extent, of nail psoriasis, is desirable to avoid the side effects associated with their systemic therapy, to increase patient compliance and reduce the cost of treatment. Systemic therapy is however the mainstay of treatment due to the poor permeability of the nail plate to topically applied drugs. For effective topical therapy, ungual drug permeation must be enhanced. This can be achieved by disrupting the nail plate using physical techniques or chemical agents. Alternatively, drug permeation into the intact nail plate may be encouraged, for example, by iontophoresis or by formulating the drug within a vehicle which enables high drug partition out of the vehicle and into the nail plate. The physical techniques (manual and electrical nail abrasion, acid etching, ablation by lasers, microporation, application of low-frequency ultrasound and electric currents) and chemicals (thiols, sulphites, hydrogen peroxide, urea, water, enzymes) that have shown ungual enhancer activity are discussed in this review. Optimal drug formulation, while crucial to ungual drug delivery, is only briefly reviewed due to the limited literature. | 18,976,136 |
Atomic-scale templates patterned by ultrahigh vacuum scanning tunneling microscopy on silicon. | The ultrahigh vacuum (UHV) scanning tunneling microscope (STM) enables patterning and characterization of the physical, chemical, and electronic properties of nanostructures on surfaces with atomic precision. On hydrogen-passivated Si(100) surfaces, selective nanopatterning with the STM probe allows the creation of atomic-scale templates of dangling bonds surrounded by a robust hydrogen resist. Feedback-controlled lithography, which can remove a single hydrogen atom from the Si(100):H surface, demonstrates high-resolution nanopatterning. The resulting patterns can be used as templates for a variety of materials to form hybrid silicon nanostructures while maintaining a pristine background resist. The versatility of this UHV-STM nanolithography approach has led to its use on a variety of other substrates, including alternative hydrogen-passivated semiconductor surfaces, molecular resists, and native oxide resists. This review discusses the mechanisms of STM-induced hydrogen desorption, the postpatterning deposition of molecules and materials, and the implications for nanoscale device fabrication. | 18,976,139 |
Cost-sharing: a blunt instrument. | Cost-sharing is a health care cost-containment technique in which health care services are partially paid for by patients out of pocket. Cost-sharing can reduce non-cost-effective care, but it can also undermine the financial protection and access values of health insurance. We review the empirical evidence published since the mid-1980s about cost-sharing's effect on utilization, expenditures, health, and adverse consequences, including how the effects vary by form of care, by health status, and by sociodemographic characteristics. Some cost-sharing, such as emergency department copayments, reduces utilization without any harmful effects, whereas other cost-sharing reduces valuable care such as maintenance drug use among the chronically ill. Cost-sharing should be used judiciously, with attention taken not to reduce highly cost-effective care. | 18,976,141 |
Postoperative intravenous patient-controlled analgesia in thyroid surgery: comparison of fentanyl and ondansetron regimens with and without the nonsteriodal anti-inflammatory drug ketorolac. | Nonsteroidal anti-inflammatory drugs (NSAIDs), through synergistic action with opioids, can reduce postoperative nausea and vomiting via intravenous patient-controlled analgesia (PCA). We compared the efficacy of three PCA regimens. Patients (n = 135) undergoing thyroidectomy were randomly allocated to three PCA regimens. All groups received 12 mg ondansetron (a serotonin 5-HT(3) receptor antagonist). In addition, Group I received the opioid fentanyl, 15 microg/kg. Group II received fentanyl 12.5 microg/kg and the NSAID ketorolac, 1.5 mg/kg, and Group III received fentanyl 10 microg/kg and ketorolac 3 mg/kg. Pain scores, nausea and vomiting, and dizziness were assessed 1, 6, 12, and 24 hours postoperatively. Pain scores were similar among the three groups. However, postoperative nausea and vomiting was significantly lower in groups II and III (p < 0.05) than group I. Postoperative dizziness was significantly lower in group III than groups I and II (p < 0.05). The NSAID ketorolac when combined with lower doses of the opioid fentanyl and the same dose of ondansetron is associated with the same analgesic efficacy but less nausea and vomiting after thyroid surgery. A higher ratio of NSAID to opioid, when used as reported here, is associated with less postoperative dizziness. | 18,976,162 |
Vaccination and screening of medical students: results of a student health initiative. | To evaluate the immune status and vaccination needs of first-year medical students in relation to bloodborne viruses and common vaccine-preventable diseases. Survey of first-year medical students at the University of New South Wales, Sydney, NSW, attending a mandatory screening and vaccination clinic, 2002-2005. Self-reported history of vaccination or natural infection; serological evidence of immunity to measles, mumps, rubella and varicella (presence of specific IgG) and hepatitis B (presence of hepatitis B virus surface antibodies) or infection with hepatitis B and C viruses and HIV; and Mantoux test results. 733 students attended the clinic (85% of those enrolled). Four students were positive for HBsAg and four had hepatitis C antibodies. None were HIV-positive. Twenty-nine per cent (216/733) were not immune to hepatitis B, 33% (238/724) to mumps, 26% (190/724) to measles, 13% (91/724) to rubella and 10% (75/724) to varicella. About 23% (91/237) needed further testing for tuberculosis. Immunity corresponded poorly with self-reported history of vaccination. More students reported vaccination against rubella (96%), measles (81%) and mumps (80%) than were immune, and fewer reported vaccination against hepatitis B (44%). Many students were not immune to vaccine-preventable diseases, and a small number had a previously undiagnosed bloodborne virus infection (hepatitis B or C). The level of immunity to vaccine-preventable infections was unacceptable and justified the provision of an easily accessible program for screening and vaccination. | 18,976,187 |
The pathway to dementia diagnosis. | To describe the steps taken by health professionals to diagnose dementia and the timeframes for these steps, as reported by carers. A cross-sectional, anonymous survey was mailed or distributed by Alzheimer's Australia New South Wales, six Sydney residential aged care facilities and 13 Sydney general practitioners to 415 carers or family members of patients with dementia between May and August 2007. First symptoms noticed and actions taken; time to first health professional consultation and diagnosis; reported actions of first health professional; satisfaction with first consultation; and use of dementia and chronic illness resources. 209 surveys were returned. Family members noticed the first symptoms of dementia at a mean of 1.9 years before the first health professional consultation about dementia, and 3.1 years before a firm diagnosis. Resource use first occurred 2.8 years after the first symptoms. Most carers (72%) were satisfied with the first consultation, which was usually with a GP (84%). Two-thirds of carers (64%) reported that the first health professional had performed a memory test. Delays in presentation, diagnosis and resource use may have clinical and social implications for people with dementia and their families, in addition to the challenges of the process of obtaining a firm diagnosis. | 18,976,188 |
Effect of smoking among Indigenous and non-Indigenous mothers on preterm birth and full-term low birthweight. | To estimate the percentage of preterm (< 37 weeks) and full-term low-birthweight (37-41 weeks, < 2500 g) babies born to mothers who smoke, stratified by Indigenous status and statistically adjusted for the potential confounding effects of social and demographic factors, medical conditions and pregnancy complications. Population-based study of singleton babies born to mothers resident in Queensland who gave birth in Queensland from 1 July 2005 to 31 December 2006. Adjusted percentages of preterm birth and full-term low birthweight for babies born to Indigenous and non-Indigenous mothers. Of the 79 803 babies studied, 4228 (5.3%) were born to Indigenous mothers and 16 395 (20.5%) were born to mothers who smoked during pregnancy. The percentage of Indigenous mothers who smoked (54%) was almost triple that for non-Indigenous mothers (risk ratio, 2.90; 95% CI, 2.81-2.99). The adjusted outcomes for babies born to Indigenous non-smokers were similar to those for non-Indigenous non-smokers (preterm, 7.1% v 6.1%; full-term low birthweight, 1.6% v 1.1%). The adjusted percentages for smokers were high regardless of Indigenous status (preterm, Indigenous v non-Indigenous, 8.3% v 7.8%; full-term low birthweight, Indigenous v non-Indigenous, 5.3% v 3.7%). Antenatal smoking remains an important cause of poor health among both Indigenous and non-Indigenous newborn babies. Most pregnant smokers receive their antenatal care in the public sector. State and federal governments, who directly fund this sector, have a particular responsibility to ensure that interventions are offered to all pregnant smokers to help them quit smoking. | 18,976,189 |
The roles of socioeconomic status and Aboriginality in birth outcomes at an urban hospital. | To explore the role of socioeconomic status and Aboriginality on birthweight at an urban hospital. Extraction of data on the demographic characteristics (socioeconomic status, mothers' single-parent status, age and smoking status) and infants' birthweight from a clinical record system. Infants delivered at an outer urban hospital to mothers residing in the local government area during 2002 were included. Infants were identified and results interpreted in consultation with Indigenous health workers. Infant birthweight. Indigenous infants had a lower mean birthweight than non-Indigenous infants (difference, 127 g), and were more likely to weigh < 2,500 g. Mothers of Indigenous infants were more likely to be single, aged < 20 years and to smoke during pregnancy. Lower birthweight was associated with lower socioeconomic status for Indigenous and non-Indigenous infants. Indigenous infants in the most socioeconomically disadvantaged quintile in this study were at higher risk and had a mean birthweight 204 g less than non-Indigenous infants in the same quintile. In multivariate analysis, differences in birthweight were associated with socioeconomic status and smoking during pregnancy. For both Indigenous and non-Indigenous infants, birthweights were associated with socioeconomic status. Differences between Indigenous and non-Indigenous infants were largely explained by low socioeconomic status and smoking during pregnancy. | 18,976,190 |
"All they said was my kidneys were dead": Indigenous Australian patients' understanding of their chronic kidney disease. | To explore the understanding of both Indigenous and non-Indigenous Australians with end-stage kidney disease (ESKD) about the cause of their disease, and how this understanding could affect patients' engagement with their treatment. Qualitative study conducted in 2005-2006 in nine hospital renal units and 17 associated dialysis centres in four states and the Northern Territory as part of the IMPAKT (Improving Access to Kidney Transplants) study. In-depth interviews were conducted with 146 Indigenous and 95 non-Indigenous Australians with ESKD, covering personal history of illness, social and psychosocial context, attitudes to treatments including transplantation, adequacy of information and communication, and satisfaction with services. Indigenous Australians were less certain about the cause of their illness and reported feeling uninformed but eager for information. They commonly reported lifestyle factors as potentially causal, with profound confusion about the role of alcohol. Indigenous Australians had considerable ambivalence towards biomedical explanations. Indigenous Australians are confused, frustrated and feel poorly informed about their illness. This study confirms the need to develop shared understandings about chronic kidney disease and to put in place the high-quality and appropriate educational resources that patients need. | 18,976,191 |
Social justice as a framework for undergraduate community health clinical experiences in the United States. | Educating future registered nurses for social justice is an urgent, yet complex undertaking in undergraduate education. Although the need for social justice education is often highlighted, few articles describe practical teaching strategies for ensuring that undertaking. The purpose of this article is to illustrate how a curricular focus on social justice framed and supported the development of a clinical evaluation tool for undergraduate community health clinical experiences. First, social justice is defined and its relationship to baccalaureate nursing education explained. Then a description is provided of how social justice was highlighted in the vision, curriculum, and community health clinical evaluation tool of a College of Nursing. The article subsequently showcases the content and evaluation of students' journal entries about social justice. The development of the social justice component presented in this article may be useful to nurse educators striving to match theory and practice in the evaluation of social justice in students' community health experience. | 18,976,232 |
Improving communication among healthcare providers: preparing student nurses for practice. | Communication errors are identified by the Joint Commission as the primary root cause of sentinel events across all categories. In addition, improving the effectiveness of communication among healthcare providers is listed as one of the Joint Commission's 2008 National Patient Safety Goals. Nursing programs are expected to graduate practice-ready nurses who demonstrate quality and safety in patient care, which includes interdisciplinary communication. Through objectively structured clinical assessment simulations, faculty evaluate each nursing student's ability to perform many aspects of care, including the ability to communicate effectively with physicians via telephone in an emergent situation. This quality improvement project reports the results of a three-year review of undergraduate student nurse performance (n = 285) related to effective clinical communication. Changes in teaching-learning strategies, implementation of a standardized communication tool, and clinical enhancements which resulted in improved student competency, will be presented. | 18,976,237 |
Self-perceived oral health and salivary proteins in children with type 1 diabetes. | The aim was to validate self-perceived oral health with salivary IgG as an inflammatory parameter in children with type 1 diabetes. Unstimulated whole saliva samples were collected from 36 children with well controlled and 12 with poorly controlled type 1 diabetes and 40 non-diabetic children (Controls). Salivary flow rate, random blood glucose level, salivary protein concentration and immunoglobulin A and G levels were recorded using standard techniques. Data concerning oral health and diabetes status were collected. Self-perceived gingival bleeding (bleeding gums), bad breath and dry mouth were higher in diabetic children when compared with those in controls (P < 0.05). Gingival bleeding was frequently perceived by children with poorly controlled compared to well-controlled type 1 diabetes (P < 0.05) and controls (P < 0.001). Bad breath was common perceived by children with poorly controlled compared to well-controlled type 1 diabetes (P < 0.05) and controls (P < 0.0001). Salivary flow rate was lower in the diabetic children compared to controls (P < 0.01) with no difference between children with poorly controlled and well-controlled type 1 diabetes. Salivary IgG per mg protein concentration was higher in the diabetics when compared with the control group (P < 0.0001). IgG per mg protein levels were also higher in children with poorly controlled when compared with well-controlled type 1 diabetes (P < 0.05). There was no difference in IgA per mg protein and total protein concentrations between children with poorly controlled and well-controlled type 1 diabetes. Self-perceived gingival bleeding and salivary IgG per mg protein concentration were increased in children with type 1 diabetes compared with controls. These variables were also increased in children with poorly controlled compared with well-controlled type 1 diabetes. | 18,976,260 |
Wear of human enamel and nano-filled composite resin denture teeth under different loading forces. | To evaluate and correlate the two-body wear of human enamel and nano-filled composite resin teeth with the loading forces used in a dual-axis chewing simulator. Three groups of human enamel and three of nano-filled composite resin teeth were tested in a chewing simulator. Zirconia ceramic balls were used as antagonists. The teeth were tested with three different loading forces (20, 49 and 78 N). Wear was analysed by measuring the volume and vertical substance loss using a laser scanner after 300000 chewing cycles. Data were statistically analysed using two-way anova followed by the Scheffé test (P < or = 0.05). Spearman correlation test was used to determine whether there was a relationship between the loading force and the degree to which the human enamel and composite resin had worn. An increase in the loading force significantly increased the wear of composite resin and of human enamel. The effect of the loading force on the wear was statistically significant at the 0.001 level. Human enamel showed a lower volume and vertical substance loss than composite resin under loading forces of 20 and 49 N and lower vertical loss under loading force of 78 N. The correlation between the volume loss and loading force was statistically significant (r = 0.616, P < 0.001). Nano-filled composite resin and human enamel exhibited different amount of wear under different loading forces. In general, human enamel showed less vertical substance loss than nano-filled composite resin. | 18,976,262 |
Evaluation of different occlusal splints and counselling in the management of myofascial pain dysfunction. | The aim of this study was to compare the effectiveness of different occlusal splints associated with counselling and self-care in the management of signs and symptoms of myofascial pain. In a double-blind controlled clinical trial, 42 myofascial pain patients with chief complaint of pain in the masseter muscle area were randomly assigned to 1 of the 3 experimental groups: hard (HS), soft (SS) or non-occluding (NS) occlusal splints. The Modified Symptom Severity Index (Mod-SSI) and tenderness to palpation were used as outcome measures during a 90-day follow-up. All patients improved over time and all splints offered the benefit. The results showed that all the three different appliances (HS, SS, and NS) associated with counselling were able to equally reduce the Mod-SSI (symptoms-Tukey test) and digital palpation (signed Kruskal-Wallis) test between baseline and 90 days. | 18,976,268 |
Effect of turban use on temporomandibular joint problems. | The aim of this study was to evaluate the effects of daily turban wear on temporomandibular joint (TMJ) problems. This cross-sectional study was carried out on 249 female patients. Of these, 119 patients were using turban daily, while 130 patients did not use. Patients were asked questions to ascertain the signs of TMJ problems. Thereafter, the TMJ region was examined clinically. Cross-tabulations and Chi-square statistics were computed in accordance with Bonferroni correction for multiple comparisons. To investigate the association between continuous turban wear and temporomandibular disorder symptoms, logistic regression analysis was performed. Limited mouth opening, deviation, pain on TMJ palpation and mouth opening were not affected with turban usage. However, turban users more frequently demonstrated pain during palpation of the masticatory muscles than non-users (P = 0.001). Duration of the turban usage did not affect clinical examination findings except pain on masticatory muscles during palpation (P = 0.001). Complaint of pain on masticatory muscles are more frequently seen among the turban users. | 18,976,273 |
Gestational diabetes mellitus in 13 dogs. | There are few reports on the clinical appearance, prognosis, and risk factors for gestational diabetes mellitus (GDM) in dogs. To describe the clinical characteristics of GDM in dogs. Thirteen dogs with GDM. Retrospective study. Medical records were reviewed and owners and referring veterinarians were contacted for follow-up information. Nordic Spitz breeds (11/13 dogs) were overrepresented in the case material. Diagnosis was established at a median of 50 days after mating (range, 32-64). Median glucose concentration at diagnosis was 340 mg/dL (18.9 mmol/L) (range, 203-587). One dog was euthanized at diagnosis, 5 bitches were treated with insulin until whelping, and in 7 dogs, pregnancy was terminated within 4 days of diagnosis. One dog died after surgery. Tight glycemic control was not achieved in any of the insulin-treated dogs during pregnancy. Diabetes mellitus (DM) resolved in 7 dogs at a median of 9 days after the end of their pregnancies and DM was permanent in 4 dogs. Puppy mortality was increased compared with offspring of healthy dams. This report suggests that GDM affects mainly middle-aged bitches in the 2nd half of pregnancy with a breed predisposition toward Nordic Spitz breeds. GDM may resolve within days to weeks after pregnancy has ended. Further research is needed to investigate optimal treatment regimens for dogs with GDM and risk factors for unsuccessful outcome. | 18,976,285 |
Nox-2 is a modulator of fibrogenesis in kidney allografts. | We studied the role of classical phagocytic NADPH oxidase (Nox) in the pathogenesis of kidney allograft tubulointerstitial fibrosis. Immunofluorescence studies showed that Nox-2 and p22phox (electron transfer subunits of Nox) colocalized in the tubulointerstitium of human kidney allografts. Tubular Nox-2 also colocalized with alpha-SMA in areas of injury, suggestive of epithelial-to-mesenchymal transition (EMT). Interstitial macrophages (CD68(+)) and myofibroblasts (alpha-SMA(+)) expressed Nox-2 while graft infiltrating T cells (CD3(+)) and mature fibroblasts (S100A4(+)) were Nox-2(-). These results were confirmed in the Fisher-to-Lewis rat kidney transplant model. Areas of tubulitis were associated with Nox-2 and alpha-SMA, suggestive of EMT. Immunoblot analyses showed that Nox-2 upregulation was associated with oxidative stress (nitrotyrosine) and fibrogenesis (alpha-SMA and phospho-Smad2) at 3 weeks and 6 months. Allografts treated with Nox inhibitors (DPI or apocynin) for 1 week showed reduced fibronectin and phospho-Smad2 and increased E-cadherin levels. Cyclosporine A, TGF-beta1 and angiotensin II increased Nox-2 mRNA levels 2- to 7-fold in vitro (NRK52E cells). Treatment with specific Nox inhibitors (DPI or apocynin) prevented the downregulation of E-cadherin and upregulation of fibronectin transcripts. In aggregate, these studies suggest that Nox-2 is involved in the pathogenesis of allograft tubulointerstitial fibrosis via activation transcription factor Smad2, EMT and myofibroblasts. | 18,976,289 |
Portal venous donor-specific transfusion in conjunction with sirolimus prolongs renal allograft survival in nonhuman primates. | Pretransplant exposure to donor antigen is known to modulate recipient alloimmunity, and frequently results in sensitization. However, donor-specific transfusion (DST) can have a protolerant effect that is dependent on route, dose and coadministered immunosuppression. Rodent studies have shown in some strain combinations that portal venous (PV) DST alone can induce tolerance, and uncontrolled clinical use of PVDST has been reported. In order to determine if pretransplant PVDST has a clinically relevant salutary effect, we studied it and the influence of concomitant immunosuppression in rhesus monkeys undergoing renal allotransplantation. Animals received PVDST with unfractionated bone marrow and/or tacrolimus or sirolimus 1 week prior to transplantation. Graft survival was assessed without any posttransplant immunosuppression. PVDST alone or in combination with tacrolimus was ineffective. However, PVDST in combination with sirolimus significantly prolonged renal allograft survival to a mean of 24 days. Preoperative sirolimus alone had no effect, and peripheral DST with sirolimus prolonged graft survival in 2/4 animals, but resulted in accelerated rejection in 2/4 animals. These data demonstrate that PVDST in combination with sirolimus delays rejection in a modest but measurable way in a rigorous model. It may thus be a preferable method for donor antigen administration. | 18,976,300 |
Tongue weakness is associated with respiratory failure in patients with severe Guillain-Barré syndrome. | Swallowing impairment may worsen respiratory weakness and conduct to respiratory complications such as aspiration pneumonia in Guillain-Barré syndrome (GBS). We prospectively evaluate how tongue weakness could be associated to bulbar dysfunction and respiratory weakness in severe GBS patients. Tongue strength, dysphagia and respiratory parameters were measured in 16 GBS patients at intensive care unit (ICU) admission and discharge and in seven controls. Tongue strength was decreased in the GBS patients compared with the controls. At admission, patients with dysphagia and those requiring mechanical ventilation (MV) had greater tongue weakness. All the patients with initial tongue strength <150 g required MV during ICU stay. Tongue strength correlated significantly with respiratory parameters. This study confirms the strong association between bulbar and respiratory dysfunction in GBS admitted to ICU. Tongue weakness may be present in GBS, especially during the phase of increasing paralysis, and resolves during the recovery phase. Tongue strength and indices of global and respiratory strength vary in parallel throughout the course of GBS. Further studies are needed to assess if, when used in combination with other respiratory tests, tongue strength measurement could contribute to identify patients at high risk for respiratory complications. | 18,976,323 |
Paramedic self-efficacy and skill retention in pediatric airway management. | The objectives were to determine the effect of pediatric airway management training on paramedic self-efficacy and skill performance and to determine which of several retraining methods is superior. A total of 2,520 paramedics were trained to proficiency in pediatric bag-mask ventilation (BMV) and endotracheal intubation (ETI) on mannequins. Subjects were a convenience sample of 245 (10% of original cohort) presenting for voluntary retraining. A total of 212 of 245 (87%) completed skills testing. Self-efficacy was measured prior to and following initial training and retraining events. Paramedics were assigned to control (no retraining), videotape presentation, self-directed learning, or instructor-facilitated lecture and demonstration retraining. Following retraining, BMV and ETI skills were tested. Paramedics from low-call-volume areas reported lower baseline self-efficacy and derived larger increases with training, but also experienced the most decline between training events. Pass rates for BMV and ETI were 66% (139/211) and 42% (88/212), respectively. However, overall cohort self-efficacy was maintained over the study period. In ordinal regression modeling, only the lecture and demonstration method was superior to control, with an odds ratio (OR) of achieving higher scores of 2.5 (95% confidence interval [CI] = 1.2 to 5.2) for BMV and 5.2 (95% CI = 2.4 to 11.2) for ETI. Poor performance with ETI but not BMV was associated with time elapsed since training (p = 0.01). Self-efficacy ratings were not predictive of skill performance. Training provides increases in self-efficacy, particularly among paramedics from low-call-volume areas. A gap exists between self-efficacy and skill performance, in that self-efficacy may be maintained even when skill performance declines. Pediatric airway skills decay quickly, ETI skills drop off more significantly than BMV skills, and a lecture and demonstration format seems superior to other retraining methods investigated. | 18,976,342 |
Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2: histologic observations. | Studies using ectopic rodent, orthotopic canine, and non-human primate models show that bone morphogenetic proteins (BMPs) coated onto titanium surfaces induce local bone formation. The objective of this study was to examine the ability of recombinant human BMP-2 (rhBMP-2) coated onto a titanium porous oxide implant surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Bilateral, critical-size, 5 mm, supra-alveolar, peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml, and six animals received implants coated with rhBMP-2 at 3.0 mg/ml or uncoated control. Treatments were randomized between jaw quadrants. The mucoperiosteal flaps were advanced, adapted and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7 and 8 post-surgery when they were euthanized for histologic evaluation. Jaw quadrants receiving implants coated with rhBMP-2 exhibited gradually regressing swelling that became hard to palpate disguising the contours of the implants. The histologic evaluation showed robust bone formation reaching or exceeding the implant platform. The newly formed bone exhibited characteristics of the adjoining resident Type II bone including cortex formation for sites receiving implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml. Sites receiving implants coated with rhBMP-2 at 3.0 mg/ml exhibited more immature trabecular bone formation, seroma formation and peri-implant bone remodelling resulting in undesirable implant displacement. Control implants exhibited minimal, if any, bone formation. Thus, implants coated with rhBMP-2 at 0.75, 1.5 and 3.0 mg/ml exhibited significant bone formation (height and area) compared with the sham-surgery control averaging (+/-SD) 4.4+/-0.4, 4.2+/-0.7 and 4.2+/-1.2 versus 0.8+/-0.3 mm; and 5.0+/-2.2, 5.6+/-2.2 and 7.4+/-3.5 versus 0.7+/-0.3 mm(2), respectively (p<0.01). All the treatment groups exhibited clinically relevant osseointegration. rhBMP-2 coated onto titanium porous oxide implant surfaces induced clinically relevant local bone formation including vertical augmentation of the alveolar ridge and osseointegration. Higher concentrations/doses were associated with untoward effects. | 18,976,397 |
The pathobiology of Kaposi's sarcoma: advances since the onset of the AIDS epidemic. | Since the perplexing early Kaposi's sarcoma (KS) observations at the dawn of the acquired immunodeficiency syndrome epidemic, KS has been extensively studied, revealing a complex disease. The identification and complete elucidation of the genome of its causal agent, the KS-associated herpesvirus/human herpesvirus 8, have shed important insights into the pathobiology of this disease. The purpose of this review is to describe the scientific advances and understanding of KS over the past three decades. | 18,976,418 |
Prospective study of physical activity and risk of postmenopausal breast cancer. | To prospectively examine the relation of total, vigorous and non-vigorous physical activity to postmenopausal breast cancer risk. We studied 32,269 women enrolled in the Breast Cancer Detection Demonstration Project Follow-up Study. Usual physical activity (including household, occupational and leisure activities) throughout the previous year was assessed at baseline using a self-administered questionnaire. Postmenopausal breast cancer cases were identified through self-reports, death certificates and linkage to state cancer registries. A Cox proportional hazards regression was used to estimate the relative risk and 95% confidence intervals of postmenopausal breast cancer associated with physical activity. During 269,792 person-years of follow-up from 1987 to 1998, 1506 new incident cases of postmenopausal breast cancer were ascertained. After adjusting for potential risk factors of breast cancer, a weak inverse association between total physical activity and postmenopausal breast cancer was suggested (relative risk comparing extreme quintiles = 0.87; 95% confidence interval = 0.74 to 1.02; p for trend = 0.21). That relation was almost entirely contributed by vigorous activity (relative risk comparing extreme categories = 0.87; 95% confidence interval = 0.74 to 1.02; p for trend = 0.08). The inverse association with vigorous activity was limited to women who were lean (ie, body mass index <25.0 kg/m2: relative risk = 0.68; 95% confidence interval = 0.54 to 0.85). In contrast, no association with vigorous activity was noted among women who were overweight or obese (ie, body mass index > or = 25.0 kg/m2: relative risk = 1.18; 95% confidence interval = 0.93 to 1.49; p for interaction = 0.008). Non-vigorous activity showed no relation to breast cancer (relative risk comparing extreme quintiles = 1.02; 95% confidence interval = 0.87 to 1.19; p for trend = 0.86). The physical activity and breast cancer relation was not specific to a certain hormone receptor subtype. In this cohort of postmenopausal women, breast cancer risk reduction appeared to be limited to vigorous forms of activity; it was apparent among normal weight women but not overweight women, and the relation did not vary by hormone receptor status. Our findings suggest that physical activity acts through underlying biological mechanisms that are independent of body weight control. | 18,976,449 |
Participation in everyday activities and quality of life in pre-teenage children living with cerebral palsy in South West Ireland. | Cerebral palsy (CP) is the most common cause of physical disability in children but its impact on quality of life is not well understood. This study examined participation in everyday activities among children without CP and children with mild, moderate and severe impairment due to CP. We then examined ten domains of quality of life in children with CP and investigated whether participation in everyday activities was associated with improved quality of life independent of gender, age and level of impairment. This was a cross-sectional study of children aged 8-12 years based on two questionnaires, frequency of participation (FPQ) and KIDSCREEN, completed by parents of 98 children on the South of Ireland Cerebral Palsy Register (response rate = 82%) and parents of 448 children attending two Cork city schools (response rate = 69%) who completed one questionnaire (FPQ). Multiple linear regression was used: firstly to estimate the effect of severity of CP on participation in everyday activities independent of age and gender and secondly we estimated the effect of participation on quality of life independent of age gender and level of impairment. Participation in 11 of the 14 everyday activities examined varied across the children without CP and the children with varying severity of CP. In general, increased impairment decreased participation. Independent of age and gender, there was a highly significant decrease in overall participation with a fall of -6.0 (95% CI = -6.9 to -5.2) with each increasing level of impairment. The children with CP generally had high quality of life. Increased impairment was associated with diminished quality of life in just two domains - Physical well-being and Social support and peers. Overall participation in everyday activities was significantly associated with quality of life in 3 of the 10 domains (Physical well-being, Social support and peers & Moods and emotions) in analysis adjusted for gender age and level of impairment. While increased impairment due to CP restricts participation in the majority of everyday activities, the level of participation has a limited effect on the quality of life of the children with CP in age 8-12 years. | 18,976,459 |
Age differences at sexual debut and subsequent reproductive health: Is there a link? | Experiences at sexual debut may be linked to reproductive health later in life. Additionally, young women with older sexual partners may be at greater risk for HIV and sexually transmitted infections. This study examines sexual debut with an older partner and subsequent reproductive health outcomes among 599 sexually experienced women aged 15-24 who utilized voluntary counseling and testing or reproductive health services in Port-au-Prince, Haiti. Logistic regression models, controlling for socioeconomic and demographic factors, examined whether age differences at first sex were significantly associated with STI diagnosis in the previous 12 months and family planning method use at last intercourse. Sixty-five percent of women reported sexual initiation with a partner younger or less than 5 years older, 28% with a partner 5 to 10 years older, and 7% with a partner 10 or more years older. There was a trend towards decreased likelihood of recent use of family planning methods in women who had first sexual intercourse with a partner 5 to 9 years older compared to women with partners who were younger or less than 5 years older. Age differences were not linked to recent STI diagnosis. Programs focusing on delaying sexual debut should consider age and gender-based power differentials between younger women and older men. Future research should examine whether wide age differences at sexual debut are predictive of continued involvement in cross-generational relationships and risky sexual behaviors and explore the mechanisms by which cross-generational first sex and subsequent reproductive health may be connected. | 18,976,477 |
Promoter hypermethylation-mediated inactivation of LRRC4 in gliomas. | Leucine-rich repeat C4 protein (LRRC4) is a new member of the leucine-rich repeat (LRR) superfamily. It is not only a brain-specific gene but also a novel candidate for tumor suppression. LRRC4 inactivation is commonly found in glioma cell lines and primary glioma biopsies. However, little is known about the mechanism controlling LRRC4 expression. In a previous study, we did not find any genetic alteration in LRRC4 in primary glioma, which led us to explore an alternative mechanism underlying this phenomenon. In the present paper, we cloned the LRRC4 promoter with characteristics of a CpG island by luciferase reporter assay. Then, the CpG methylation status around the LRRC4 promoter region in glioma cell lines and primary gliomas was examined by methylation-specific PCR and bisulfite DNA sequencing. In order to demonstrate a functional association between LRRC4 promoter methylation and its gene inactivation, we performed DNA demethylation analysis with two human glioma cell lines using methylation-specific PCR and RT-PCR. The sequence spanning positions -835 to -293 relative to the translation start site was identified as the LRRC4 promoter; this sequence is a TATA- and CAAT- less, high GC content region. It was found that LRRC4 promoter activity is strongly suppressed after treatment with SssI methylase in vitro. Furthermore, LRRC4 promoter methylation was observed by methylation-specific PCR in two glioma cell lines and all 30 primary glioma specimens, but not in normal brain tissue. Bisulfite DNA sequencing showed that most of the CpG sites were located around the LRRC4 promoter methylated in glioma cells and tissues, but not in normal brain tissue. In addition, the methylase inhibitor 5-Aza-2'-deoxycytidine could induce LRRC4 mRNA expression and LRRC4 promoter partial demethylation in SF126 and SF767 glioma cells. Methylation-mediated inactivation of LRRC4 is a frequent and glioma-specific event, and it may be a potential biomarker for diagnosis or prognosis, or serve as a therapeutic target. | 18,976,507 |
Health insurance of rural/township schoolchildren in Pinggu, Beijing: coverage rate, determinants, disparities, and sustainability. | As China re-establishes its health insurance system through various cooperative schemes, little is known about schoolchildren's health insurance. This paper reports findings from a study that examined schoolchildren's insurance coverage, disparities between farmer and non-farmer households, and effects of low-premium cooperative schemes on healthcare access and utilization. It also discusses barriers to sustainable enrollment and program growth. A survey of elementary school students was conducted in Pinggu, a rural/suburban district of Beijing. Statistical analyses of association and adjusted odds ratio via logistic regression were conducted to examine various aspects of health insurance. Children's health insurance coverage rose to 54% by 2005, the rates are comparable for farmers' and non-farmer's children. However, 76% of insured farmers' children were covered under a low-premium scheme protecting only major medical events, compared to 42% among insured non-farmers' children. The low-premium schemes improved parental perceptions of children's access to and affordability of healthcare, their healthcare-seeking behaviors, and overall satisfaction with healthcare, but had little impact on utilization of outpatient care. Enrolling and retaining schoolchildren in health insurance are threatened by the limited tangible value for routine care and low reimbursement rate for major medical events under the low-premium cooperative schemes. Coverage rates may be improved by offering complimentary and supplementary benefit options with flexible premiums via a multi-tier system consisting of national, regional, and commercial programs. Health insurance education by means of community outreach can reinforce positive parental perceptions, hence promoting and retaining insurance enrollment in short-term. | 18,976,508 |
Activation of the JAK-STAT pathway is necessary for desensitization of 5-HT2A receptor-stimulated phospholipase C signalling by olanzapine, clozapine and MDL 100907. | We have previously demonstrated that olanzapine-induced desensitization of 5-HT2A receptor-stimulated phospholipase C (PLC) activity is associated with increases in RGS7 protein levels both in vivo and in cells in culture, and the increase in RGS7 is dependent on activation of the JAK-STAT pathway in cells in culture. In the present study, we found that desensitization of 5-HT2A receptor-stimulated PLC activity induced by olanzapine is dependent on activation of the JAK-STAT pathway. Similar to olanzapine, clozapine-induced desensitization of 5-HT2A receptor signalling is accompanied by increases in RGS7 and activation of JAK2. Treatment with the selective 5-HT2A receptor antagonist MDL 100907 also increased RGS7 protein levels and JAK2 activation. Using a JAK2 inhibitor AG490, we found that clozapine and MDL 100907-induced increases in RGS7 are dependent on activation of the JAK-STAT pathway. Olanzapine, clozapine, and MDL 100907 treatment increased mRNA levels of RGS7. Using a chromatin immunoprecipitation assay we found STAT3 binding to the putative RGS7 promoter region. Taken together, olanzapine-induced activation of the JAK-STAT pathway, and STAT3 binding to the RGS7 gene could underlie the increase in RGS7 mRNA which could subsequently increase protein expression. Furthermore, the increase in RGS7 protein could play a role in the desensitization of 5-HT2A receptor signalling by terminating the activated Galphaq/11 proteins more rapidly. Overall, our data suggest that the complete desensitization of 5-HT2A receptor-stimulated PLC activity by olanzapine, clozapine and MDL 100907 requires activation of the JAK-STAT pathway, which in turn increases RGS7 expression probably by direct transcriptional activity of STAT3. | 18,976,543 |
Examining the geographical heterogeneity associated with risk of mistimed and unwanted pregnancy in Ghana. | After a decade of fertility decline, Ghana's fertility and the level of unmet need for contraception stalled in mid-transition in the late 1990s. Although the literature acknowledges this, the geographical patterns in unmet need have not been adequately documented. Spatial analysis of unmet need can reveal differences in usage and provision of contraceptive commodities, thereby pointing to geographical areas where contraceptive programmes should be strengthened. This study examines the geographical variation of the risk of mistimed and unwanted pregnancies between rural communities and also between urban communities of the three ecological zones of Ghana. The study also investigates if geographical differences in the risks of mistimed and unwanted pregnancies changed during the period when unmet need stalled at the national level. A multilevel regression model was applied to pooled data from the 1998 and 2003 Ghana Demographic and Health Surveys to examine the determinants of the risk of unintended pregnancies, while controlling for clustering of outcomes within communities. The results show that between the two surveys, there was no significant change in the levels of risk of mistimed and unwanted pregnancy. However, geographical heterogeneity in the risk of mistimed and unwanted pregnancy was observed, after controlling for relevant predictors. This showed concentration of mistimed pregnancies in some rural communities relative to others, and variation in the risk of unwanted pregnancies between urban communities. The results give a clear indication that bridging the inequality gap in contraceptive use requires programmes that are area-specific. | 18,976,547 |
Successful treatment of disseminated Acanthamoeba sp. infection with miltefosine. | We report on an HIV-negative but immunocompromised patient with disseminated acanthamoebiasis, granulomatous, amoebic encephalitis and underlying miliary tuberculosis and tuberculous meningitis. The patient responded favorably to treatment with miltefosine, an alkylphosphocholine. The patient remained well with no signs of infection 2 years after treatment cessation. | 18,976,559 |
Role of human polyomaviruses in respiratory tract disease in young children. | KI virus was detected in respiratory secretions of 8/367 (2.2%) symptomatic and 0/96 asymptomatic children (p = 0.215). WU virus was detected in 26/367 (7.1%) symptomatic and 6/96 (6.3%) asymptomatic children (p = 1.00). These human polyomaviruses may not independently cause respiratory tract disease in young children. | 18,976,566 |
Porcine respiratory and reproductive syndrome virus variants, Vietnam and China, 2007. | We characterized isolates from porcine respiratory and reproductive syndrome virus epidemics in Vietnam and China in 2007. These isolates showed approximately 99% identity at the genomic level. Genetic analysis indicated that they share a discontinuous deletion of 30 aa in nonstructural protein 2, which indicates that identical variants emerged in Vietnam and China. | 18,976,568 |
Tourism and specific risk areas for Cryptococcus gattii, Vancouver Island, Canada. | We compared travel histories of case-patients with Cryptococcus gattii infection during 1999-2006 to travel destinations of the general public on Vancouver Island, British Columbia, Canada. Findings validated and refined estimates of risk on the basis of place of residence and showed no spatial progression of risk areas on this island over time. | 18,976,570 |
[Primary mucinous carcinoma of the skin--a literature review]. | Primary mucinous carcinoma of the skin (PKMK) is a rare malignant tumour of the sweat glands. It is often misdiagnosed as it has an uncharacteristic gross appearance - and may microscopically resemble a cutaneous metastasis from a mucinous carcinoma of the breast, gastrointestinal tract, lungs, ovaries or prostate. The recurrence rate is high, but mortality is low. A MEDLINE literature search was performed for reports on PKMK. A total of 228 cases were identified. These are presented with regard to tumour characteristics and clinical features as well as histopathological and immunohistochemical findings. | 18,976,593 |
[The 3-hour meeting concept: an organisational approach for involvement of junior doctors in education]. | In an 850-bed Danish University hospital, "3-hour meetings" provide junior doctors with three hours within normal working hours for discussing training with an innovative purpose. The meetings are followed-up by dialogue and action throughout the organisation. The junior doctors get many of their training initiatives implemented. The Head of Department obtains information, which is used for prioritisation of educational initiatives. At hospital level, an overview of education as well as sharing of knowledge and educational vision is achieved. | 18,976,613 |
[Feedback in relation to training of practical clinical skills]. | Feedback has been identified as an essential component of motor learning. However, feedback principles derived from motor learning theories cannot uncritically be applied to clinical skills training because this knowledge is based primarily on the study of very simple motor skills. Research into feedback in relation to clinical skills training is currently limited. Theories on motor learning can serve as the basis for designing research in this domain, especially the importance of including retention tests when measuring permanent learning outcomes. | 18,976,616 |
[Perspectives on inspector visits in general practice]. | General practice has always provided teaching and training in some form or another, and recent years have seen a discussion on an appraisal system based on visits to practices. The educational dimension of general practice has been described in several publications. Training in general practice is highly esteemed. Even so, extant literature pinpoints educational elements that may be improved, especially in the areas of pedagogic competence, organisation and physical environment. Interviews with trainees, trainers, tutors and members of the board of the Danish Association for Family Medicine. Educational appraisal in Danish teaching practices is assumed to have a positive impact on training. One 3-hours visit very 4th year is suggested, with the possibility for early revisits as needed. Two inspectors per visit and a primary focus on pedagogic competence are recommended. Despite good evaluations there is room for improvement of general practice training. Educational appraisal may provide a method for this. It is assumed that appraisal in conjunction with the currently existing activities would strengthen the training in general practice. The format should be practicable and acceptable. | 18,976,618 |
[Career counselling and choice of speciality]. | Career counselling is meant to support and ensure an early and relevant choice of specialty. Self-awareness regarding personality, life goals, wishes for family life, and lifestyle is of help in narrowing down the number of specialties to those that fit personal attitudes and preferences. The counsellor must be aware that the trainees' subjective opinions about the specialties may not be in line with the actual conditions. Hence, career counselling should provide factual knowledge about the specialties including information on the working conditions and defining characteristics of the specialties. | 18,976,620 |
Using LysoSensor Yellow/Blue DND-160 to sense acidic pH under high hydrostatic pressures. | LysoSensor Yellow/Blue DND-160, a dual-wavelength fluorophore commonly used for sensing pH in acidic organelles, possesses solvatochromic behavior believed to originate from an intramolecular charge transfer (ICT). Given this, we investigated whether DND-160 can be used for acidic pH sensing under hydrostatic pressures up to 510 atm, a range suitable for studying a wide variety of cellular processes. We found that the emission spectrum of the protonated form does not exhibit sensitivity to pressure, whereas the deprotonated form shows a piezochromic shift consistent with increased ICT character. Although pressure effects on the apparent pKa are buffer solvent dependent, DND-160 retains two-state behavior, making it a useful acidic pH probe under pressure. | 18,976,626 |
Small molecule inhibition of a Group II chaperonin: pinpointing a loop region within the equatorial domain as necessary for protein refolding. | The functionality of regions within the equatorial domain of Group II chaperonins is poorly understood. Previously we showed that a 70 amino acid sequence within this domain on the single-subunit recombinant thermosome from Methanocaldococcus jannaschii (rTHS) contains residues directly responsible for refolding protein substrates [L.M. Bergeron, C. Lee, D.S. Clark, Identification of a critical chaperoning region on an archaeal recombinant thermosome, Biochem. Biophys. Res. Commun. 369 (2008) 707-711]. In the present study, 6-aminopenicillanic acid (6-APA) was found to bind to rTHS and inhibit it from refolding proteins. Fluorescence anisotropy was used to measure a 6-APA/rTHS dissociation constant of 17.1 microM and verify that the binding site is within the first 70 amino-terminal rTHS residues. Docking simulations point to a specific loop region at residues 53-57 on rTHS as the most likely binding region. This loop region is located within the oligomeric association sites of the wild-type thermosome. These results implicate a specific equatorial region of Group II chaperonins in the refolding of proteins, and suggest its importance in conformational changes that accompany chaperone function. | 18,976,628 |
Norepinephrine reversibly regulates the proliferation and phenotypic transformation of vascular smooth muscle cells. | To investigate the effect of norepinephrine (NE) on the proliferation and phenotypic transformation of vascular smooth muscle cells (VSMCs) and the mechanisms underlying this effect. VSMCs were isolated from the rat abdominal aorta. VSMCs cultured in both serum-containing or in a serum-free medium were treated with NE, oxidized low-density lipoprotein (ox-LDL), alpha-adrenergic receptor agonist (alpha1-R(-)), beta1-adrenergic receptor antagonist (beta1-R(-)) and various combinations of these factors. VSMC proliferation was determined by bromodeoxyuridine (BrdU) assays. The mRNA expression level of HRG-1 and SM22 alpha were determined by reverse transcription-polymerase chain reaction (RT-PCR). The expressions of HRG-1 and SM22 alpha mRNA in NE- or OX-LDL-treated VSMCs was down-regulated, and the proliferation of BrdU-labeled cells increased; the expression of the above mentioned genes in the VSMCs treated with a combination of NE, alpha1-R, and beta1-R was significantly up-regulated. However, NE was observed to up-regulate the expression of HRG-1 and SM22 alpha mRNA in serum-starved VSMCs. NE could reversibly regulate the proliferation and phenotypic transformation of VSMCs. This regulation might be mediated via its receptors. | 18,976,651 |
Elevated yolk androgen levels and the expression of multiple sexually selected male characters. | Maternal hormones in bird eggs modulate not only offspring development, but recently it has also been shown that these effects can persist into adult life. A number of long-lasting effects concern traits of which the expression or development is modulated by androgens. This suggests that the nature of yolk hormone-mediated maternal effects may be organizational. Maternal androgens may therefore play an important role in sexual selection, since the expression of sexually selected male characters is often androgen-dependent. We experimentally manipulated the yolk androgen concentrations of European Starling (Sturnus vulgaris) eggs. Subsequently we followed 49 unrelated males from hatching until year of first reproduction. We investigated the expression of multiple sexually selected male characters (song, beak color and throat feather characteristics), taking into account whether a trait is androgen-dependent. Elevated levels of yolk androgens affected the length of the embryonic period, but did not modify the expression of either androgen-dependent or androgen-independent sexually selected male characters including song phenotype at adulthood. Thus the most important function of yolk androgens in starlings and possibly other bird species may relate to the early developmental period. The outcome of our study together with the results of our meta-analysis indicates that the effects of yolk androgens on sexually selected male characters may be comparatively small. Our results suggest that this may relate to the numerous other environmental and/or genetic factors influencing the expression of sexually selected male characters. | 18,976,657 |
Des-gamma-carboxy prothrombin increases the expression of angiogenic factors in human hepatocellular carcinoma cells. | Des-gamma-carboxyl prothrombin (DCP) is a serum protein produced by hepatocellular carcinoma (HCC) cells. The aim of this study was to evaluate the angiogenic activity of DCP in HCC cells. The proliferation of HCC cells was measured by 3-[4, 5-dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide (MTT) assay. The growth of HCC cells was also evaluated in vivo by using the xenografts in nude mice. The enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of angiogenic factors in supernatant of cell culture. The expression of angiogenic factors was examined by Western blot analysis and immunohistochemical staining. DCP displayed the stimulation of HCC cell growth in a dose (5-80 ng/ml) and time (24-96 h) dependent manner. The increase of cell growth was also observed in nude mice bearing well-established, palpable HepG2 and SMMC-7721 xenografts after 2 weeks administration of DCP. HCC cell growth was accompanied by the elevated levels of angiogenic factors. The levels of vascular endothelial growth factor (VEGF), transforming growth factor-alpha (TGF-alpha) and basic fibroblast growth factor (bFGF) in supernatant of SMMC-7721 cells were increased from 47, 126, and 60 pg/10(6) cells/24 h to 400, 208, and 298 pg/10(6) cells/24 h, respectively, after 72 h incubation with 80 ng/ml of DCP. The results of Western blot analysis and immunohistochemical staining of HCC xenografts also showed the significant increase of VEGF, TGF-alpha, and bFGF in HCC cells. These results provide the information that DCP is a type of growth factor in progression of HCC. | 18,976,674 |
Genetic variants in the HLA-G region are associated with Kawasaki disease. | Kawasaki disease is an acute, self-limited vasculitis of infants and children, manifest as fever and signs of mucocutaneous inflammation. Treatment with high-dose immunoglobulin reduces systemic inflammation and prevents coronary artery lesions in Kawasaki disease. In this study, we investigated the possible association of the major histocompatibililty complex (MHC) region for the susceptibility to Kawasaki disease using an MHC panel of 2360 single nucleotide polymorphism (SNP) markers. Analysis of data obtained from screening MHC-specific SNP chips with 48 case and 90 control subjects revealed five candidate loci with significance levels of uncorrected p < 0.01. However, only one candidate locus (HLA-G) was confirmed to have a significant association with Kawasaki disease (rs2523790, odds ratio [OR] = 3.00, 95% confidence interval [95% CI] = 1.14-7.91, uncorrected p = 0.0263) in the replication study using 44 new case subjects and the previous 90 controls. In the fine mapping of the HLA-G locus, in particular, a nonsynonymous SNP (C/A) of the HLA-G gene (rs12722477, Leu134Ile) was significantly associated with Kawasaki disease (OR = 3.23, 95% CI = 1.12-9.32). A subgroup analysis showed that this association was more apparent in patients with coronary artery aneurysms (OR = 4.02, 95% CI = 1.23-13.19). Therefore, our results indicate that HLA-G may play a crucial role for the susceptibility to Kawasaki disease. | 18,976,687 |
Glossogin, a novel phenylpropanoid from Glossogyne tenuifolia, induced apoptosis in A549 lung cancer cells. | Glossogyne tenuifolia has been shown to exhibit good antioxidant and anticancer activity. In this study, a new phenylpropanoid compound, glossogin (1'-acetoxy-4-O-isovalyryleugenol), was isolated from ethyl acetate extract of G. tenuifolia by using column chromatography and HPLC. Its chemical structure was determined by (1)H and (13)C NMR, MS and IR spectroscopic evidence. This compound showed the cytotoxicity against A549 human lung cancer cell line and it induced the progressing apoptosis on A549 cells. This apoptosis was verified as A549 cells were arrested at the sub-G(1) phase. The apoptosis was accompanied by release of cytochrome C and activation of caspase-9 and -3. It was also associated with the decrease in Bcl-2 and Bcl-xL protein levels, and the increase in Bad protein expression. Data analysis suggests glossogin exerted significant apoptotic effect on A549 cells through the mitochondrial pathway. Hence, our findings showed that glossogin exhibited potential anticancer activity against lung cancer through proliferating inhibition and apoptosis induction of cancer cells. | 18,976,690 |
VEGFR-2 antagonist SU5416 attenuates bleomycin-induced pulmonary fibrosis in mice. | Abnormal angiogenesis is a central hallmark for the development and progression of idiopathic pulmonary fibrosis. It has been shown that vascular endothelial growth factor (VEGF) is one of the critical angiogenic factors in angiogenesis. The aim of the present study was to assess whether disruption of VEGF pathway would attenuate bleomycin-induced pulmonary fibrosis. Bleomycin-induced pulmonary fibrosis mice were treated intraperitoneally with VEGF receptor tyrosine kinase inhibitor SU5416 at different phases after bleomycin infusion. We measured angiogenesis and inflammatory response in both bleomycin-treated and control mice, and correlated these levels with pulmonary fibrosis. The increased expressions of VEGF/VEGFR (Flk-1) were correlated to a larger number of microvessels and a higher score of pulmonary fibrosis. Early administration of SU5416 inhibited pulmonary collagen deposition, histopathologic fibroplasias and the activation of TGF-beta1/Smad3 signaling pathway in bleomycin-stimulated lung. These were also paralleled by a reduction of VEGF/VEGFR-2 (Flk-1) expression and microvessel numbers in lung. Furthermore, SU5416 inhibited inflammatory cell numbers and LDH activity in BALF and IL-13 expression in lung tissue at early inflammatory phase of bleomycin-induced pulmonary fibrosis. These results suggest that the VEGFR-2 inhibitor, SU5416, attenuates histopathologic fibroplasias and collagen deposition by regulating angiogenesis and inflammation in the lung. | 18,976,720 |
Identifying genetic traces of historical expansions: Phoenician footprints in the Mediterranean. | The Phoenicians were the dominant traders in the Mediterranean Sea two thousand to three thousand years ago and expanded from their homeland in the Levant to establish colonies and trading posts throughout the Mediterranean, but then they disappeared from history. We wished to identify their male genetic traces in modern populations. Therefore, we chose Phoenician-influenced sites on the basis of well-documented historical records and collected new Y-chromosomal data from 1330 men from six such sites, as well as comparative data from the literature. We then developed an analytical strategy to distinguish between lineages specifically associated with the Phoenicians and those spread by geographically similar but historically distinct events, such as the Neolithic, Greek, and Jewish expansions. This involved comparing historically documented Phoenician sites with neighboring non-Phoenician sites for the identification of weak but systematic signatures shared by the Phoenician sites that could not readily be explained by chance or by other expansions. From these comparisons, we found that haplogroup J2, in general, and six Y-STR haplotypes, in particular, exhibited a Phoenician signature that contributed > 6% to the modern Phoenician-influenced populations examined. Our methodology can be applied to any historically documented expansion in which contact and noncontact sites can be identified. | 18,976,729 |
Three-dimensional power Doppler ultrasound scanning for the prediction of endometrial cancer in women with postmenopausal bleeding and thickened endometrium. | The purpose of this study was to evaluate the role of 3-dimensional power Doppler angiography (3D-PDA) to discriminate between benign and malignant endometrial disease in women with postmenopausal bleeding and thickened endometrium. Ninety-nine postmenopausal women (median age, 63.1 years; range, 48-84 years) with uterine bleeding and a thickened endometrium (>or= 5 mm) at baseline transvaginal sonography were assessed by 3D-PDA before endometrial biopsy. Endometrial volume, vascularity index (VI), flow index, and vascularity-flow index were calculated with the virtual organ computer-aided analysis method. Histologic diagnoses were endometrial cancer (44 cases), hyperplasia (13 cases), polyp (23 cases), cystic atrophy (14 cases), and submucous myoma (5 cases). Endometrial volume, VI, and vascularity-flow index were significantly higher in malignant vs benign conditions. Receiver operating characteristic analysis revealed that VI was the best parameter for the prediction of endometrial cancer. The findings show that 3D-PDA may be useful for the prediction of endometrial cancer in women with postmenopausal bleeding and thickened endometrium at baseline sonography. | 18,976,731 |
Occupational factors and risk of preterm birth in nurses. | We evaluated first-trimester exposures and the risk of preterm birth in the most recent pregnancy of participants of the Nurses' Health Study II. Log binomial regression was used to estimate the relative risk (RR) for preterm birth in relation to occupational risk factors, such as work schedule, physical factors, and exposures to chemicals and x-rays, adjusted for age and parity. Part-time work (<or= 20 hours a week) was associated with a lower risk of preterm birth [RR, 0.7; 95% confidence interval [CI], 0.6-0.9]. Working nights was associated only with early preterm birth (< 32 weeks of gestation) (RR, 3.0; 95% CI, 1.4-6.2). Although based on only 11 exposed preterm cases, self-reported exposure to sterilizing agents was associated with an increased risk (RR, 1.9; 95% CI, 1.1-3.4). These data suggest that night work may be related to early but not late preterm birth, whereas physically demanding work did not strongly predict risk. | 18,976,732 |
Ending cervical cancer screening: attitudes and beliefs from ethnically diverse older women. | Guidelines support ending cervical cancer screening in women aged 65-70 years and older with previous normal testing, but little is known about older women's attitudes and beliefs about ending screening. We conducted face-to-face interviews with 199 women aged 65 and older in English, Spanish, Cantonese, or Mandarin. Most interviewees were nonwhite (44.7% Asian, 18.1% Latina, and 11.6% African American). Most (68%) thought lifelong screening was either important or very important, a belief held more strongly by African American (77%) and Latina (83%) women compared with women in other ethnic groups (P < .01). Most (77%) had no plans to discontinue screening or had ever thought of discontinuing (69%). When asked if they would end screening if recommended by their physician, 68% responded "yes." The majority of these women believe that lifelong cervical cancer screening is important. Many women, however, reported that they would end screening if recommended by their physician. | 18,976,734 |
Effects of probiotic Lactobacillus salivarius W24 on the compositional stability of oral microbial communities. | Probiotics are microorganisms beneficial to gastrointestinal health. Although some strains are also known to possess positive effects on oral health, the effects of most intestinal probiotics on the oral microflora remain unknown. We assessed the ability of the intestinal probiotic Lactobacillus salivarius W24 to incorporate into and to affect the compositional stability and cariogenicity of oral microbial communities. Microtiter plates with hydroxyapatite discs were incubated with W24 ("+W24") or without W24 ("-W24") and saliva from four individuals in plain ("-sucrose") or sucrose-supplemented ("+sucrose") medium. Biofilms were subjected to community profiling by 16S rRNA gene-based Denaturing Gradient Gel Electrophoresis (DGGE) after 72h growth. Diversity (Shannon-Weaver index) and similarities (Pearson correlation) between biofilm communities were calculated. Microcosms "+sucrose" were less diverse and more acidic than "-sucrose" microcosms (p<0.001). The effects of W24 on the community profiles were pH dependent: at pH 4 ("+sucrose"), the respective "+W24" and "-W24" microcosms differed significantly more from each other than if the pH was approximately 7 ("-sucrose"). The pH of "+W24/+sucrose" microcosms was lower (p<0.05) than the pH of the microcosms supplemented with sucrose alone ("-W24/+sucrose"). Although not able to form a monospecies biofilm, L. salivarius W24 established itself into the oral community if inoculated simultaneously with the microcosm. In the presence of sucrose and low pH, W24 further lowered the pH and changed the community profiles of these microcosms. Screening of probiotics for their effects on oral microbial communities allows selecting strains without a potential for oral health hazards. | 18,976,742 |
Comparison of low-dose human menopausal gonadotropin and micronized 17beta-estradiol supplementation in in vitro maturation cycles with thin endometrial lining. | A challenge of in vitro maturation (IVM) treatment in some women is insufficient development of the endometrium prior to embryo transfer. Retrospective study. McGill Reproductive Center, Montreal, Canada. Women with endometrial thickness <6 mm on days 6-10 ultrasound (US) scan of IVM treatment. In the human menopausal gonadotropin (hMG) group, 150 IU/day of hMG was started and in the estradiol group, 6 to 12 mg/day of micronized 17beta-estradiol was initiated. Additional US scans were performed 2 to 3 days apart, until endometrial thickness reached > or =8 mm or a dominant follicle (>10 mm) was identified. Endometrial lining before oocyte retrival. In both groups endometrial lining significantly thickened following treatment. However, hMG treatment resulted in a higher number of follicles > or =7 mm compared to estradiol (7.4 +/- 4.8 vs. 3.4 +/- 2.5, respectively) and a significantly higher percentage of mature oocytes that were identified on the day of oocyte retrieval (in vivo matured oocytes) (15.1% vs. 10.5%). In IVM designated cycles with a thin endometrium both low-dose hMG and micronized 17beta-estradiol supplementation significantly improve endometrial thickness. However, low-dose hMG results in larger follicles and a greater number of in vivo matured oocytes. | 18,976,750 |
Elevated ghrelin levels in the peritoneal fluid of patients with endometriosis: associations with vascular endothelial growth factor (VEGF) and inflammatory cytokines. | To study ghrelin concentrations in the peritoneal fluid of women with endometriosis and of control women without pelvic pathology and its associations with the levels of proinflammatory cytokines and vascular endothelial growth factor (VEGF). Case-control study. University research institution and hospital. Forty-six nonobese women with laparoscopically and histopathologically confirmed endometriosis and 20 control women without pelvic pathology. Peritoneal fluid was aspirated during routine diagnostic laparoscopic examination. Concentrations of ghrelin and inflammatory cytokines (interleukin [IL]-1 beta, IL-6, tumor necrosis factor [TNF], and VEGF) in the peritoneal fluid were evaluated by specific enzyme immunoassay and enzyme-linked immunosorbent assays, respectively. Ghrelin concentrations in the peritoneal fluid of women with endometriosis were significantly increased as compared with control subjects. Peritoneal ghrelin levels in patients with endometriosis were strongly positively associated with VEGF (r(s) = 0.625). There was no correlation between ghrelin and IL-1 beta, IL-6, or TNF. The results of the present study show that endometriosis is associated with increased peritoneal ghrelin levels. The association between ghrelin and endometriotic lesion vascularization remains to be elucidated. | 18,976,754 |
Aquaporin-4 deficiency induces subfertility in female mice. | To investigate the effects of aquaporin-4 (AQP4) on female fertility. Prospective, randomized animal study. Medical university. AQP4(+/+) and AQP4(-/-) female mice. Eight- to 10-week-old virgin female AQP4(+/+) and AQP4(-/-) mice were subjected to a mating study. Superovulation was carried out on 4-week-old AQP4(+/+) and AQP4(-/-) mice. The protocol consisted of a single intraperitoneal (IP) injection with 5 units of pregnant mare serum gonadotropin (PMSG) for 48 hours, followed by 5 units of human chorionic gonadotropin (hCG) for an additional 14 or 48 hours. Pregnancy success, oocyte count, morphological changes in ovaries and uteri, and alterations of estrous cycle. AQP4-null mice displayed subfertility as evidenced by a lower rate of pregnancy and decreased litter size. Further studies revealed that in AQP4-null mice, there were fewer numbers of antral follicles and corpora lutea in the ovaries and that uteri presented as hyporeactive to gonadotropins. In addition, in AQP4-null mice, superovulation induced by hCG and PMSG yielded fewer numbers of antral follicles, atretic follicles, corpora lutea, and oocytes in ovaries, and uteri exhibited a decreased response to exogenous gonadotropins. AQP4 deficiency induces subfertility in female mice. | 18,976,758 |
Advanced oxidation protein products are increased in women with polycystic ovary syndrome: relationship with traditional and nontraditional cardiovascular risk factors in patients with polycystic ovary syndrome. | To determine whether or not plasma advanced oxidation protein products (AOPPs) are associated with known cardiovascular risk factors or carotid intima-media thickness (IMT) in patients with polycystic ovary syndrome (PCOS). A prospective, controlled study. University hospital. Forty-six women with PCOS and 46 age- and body mass index-matched healthy women. Carotid IMT was evaluated for both common carotid arteries. We measured serum levels of AOPP, homocysteine (Hcy), C-reactive protein (CRP), malonyldialdehyde (MDA), vitamin B(12), folate, lipid, and hormone profiles. The presence of insulin resistance was investigated by means of homeostasis model assessment (HOMA). Serum AOPP, fasting insulin, HOMA index, Hcy, MDA, CRP, and carotid IMT. The women with PCOS had significantly higher serum AOPP than control women. High AOPP was defined as equaling or exceeding the mean + 2 SD of the plasma AOPP in control subjects (56.2 pg/mLl). Carotid IMT, fasting insulin, HOMA index, Hcy, MDA, and CRP were significantly higher in PCOS patients with high AOPP than in those with normal AOPP. Fasting insulin, insulin resistance, and Hcy were independent determinants of plasma AOPP. Increased AOPP may contribute to the increased risk of atherosclerotic cardiovascular disease in women with PCOS. | 18,976,759 |
Effect of progestogens and combined oral contraceptives on nerve fibers in peritoneal endometriosis. | To investigate how progestogens and combined oral contraceptives change nerve fiber density in peritoneal endometriotic lesions and to identify the types of nerve fibers still present during hormone treatment. Laboratory study using human tissue. University-based laboratory. Hormonally treated and untreated women with endometriosis undergoing laparoscopy, hysteroscopy, and curettage. Biopsy samples from peritoneal endometriotic lesions in hormonally treated and untreated women with endometriosis. Types and density of nerve fibers were immunohistochemically determined in peritoneal endometriotic lesions from hormonally treated and untreated women with endometriosis. The nerve fiber density (mean +/- standard deviation/mm(2)) in peritoneal endometriotic lesions from hormone-treated women with endometriosis (10.6 +/- 2.2/mm(2)) was statistically significantly lower than in peritoneal endometriotic lesions from untreated women with endometriosis (16.3 +/-10.0/mm(2)). Nerve growth factor and nerve growth factor receptor p75 expression in peritoneal endometriotic lesions were slightly reduced in hormone-treated women with endometriosis compared with untreated women with endometriosis. Progestogens and combined oral contraceptives reduced nerve fiber density and nerve growth factor and nerve growth factor receptor p75 expression in peritoneal endometriotic lesions. | 18,976,764 |
ST changes and temporal relation to the J point during heart rate increase and myocardial ischemia. | There is no concensus concerning where in the ST segment to measure. We studied the relation between different J point intervals to ST results during tachycardia and ischemia. Symptomatic (anesthetized) patients with coronary artery disease were paced at ascending incremental levels until they became ischemic. ST vector magnitude and ST vector change from baseline (STC-VM) as well as the sum of ST changes from all 12 electrocardiogram (ECG) leads (ECG ST sum) were measured at J point 0 millisecond, J + 20, J + 60, and J + 80 milliseconds for 34 patients. ST segments increased in similar fashion during pacing and ischemia. There was no difference in ST results when measurement was performed at different time intervals for both STC-VM and ECG ST sum. We conclude that ST assessment by ST change from baseline is not affected by different J point intervals during increased heart rate and ischemia in this clinical model of pacing-induced ischemia and vectorcardiographic ST analysis. | 18,976,774 |
Three-dimensional relationship between the conus branch and the precordial leads confirmed by 64-multidetector-row computed tomography. | A 65-year-old man with effort angina pectoris underwent percutaneous coronary intervention of the proximal right coronary artery. The lesion was dilated with a bare-metal stent under wire protection of the conus branch (CB). However, the jailed CB was occluded. Electrocardiogram with conventional precordial leads (V(1) through V(6)) accompanied with the supplementary leads (V(1) through V(6)) positioned 1 intercostal space higher showed marked ST elevation in V(1) through V(3) that was more prominent in V(1) through V(3). The 64-multidetector-row computed tomographic coronary angiography showed recanalization of the CB located just in the center of the V(1), V(2), V(1), and V(2) electrodes. | 18,976,781 |
Serial CSTR digester configuration for improving biogas production from manure. | A new configuration of manure digesters for improving biogas production has been investigated in laboratory scale. A single thermophilic continuous-flow stirred tank reactor (CSTR) operated with a hydraulic retention time (HRT) of 15 days was compared to a serial CSTR configuration with volume distribution ratio of 80/20 and 90/10, and total HRT of 15 days. The results showed that the serial CSTR could obtain 11% higher biogas yield compared to the single CSTR. The increased biogas yield in the serial CSTR was mainly from the second reactor, which accounted for 16% and 12% of total biogas yield in the 90/10 and 80/20 configuration, respectively. VFA concentration in the serial CSTR was high in the first reactor but very low in the second reactor. The results from organic pulse load test showed that the second reactor in serial CSTR helped utilizing VFA produced from overloading in the first reactor, which improved the effluent quality and conversion efficiency of the serial CSTR. | 18,976,792 |
Leukemic blast and natural killer cell P-glycoprotein function and inhibition in a clinical trial of zosuquidar infusion in acute myeloid leukemia. | A bioassay was developed to assess P-glycoprotein (P-gp) function of peripheral blood natural killer (NK) cells and AML blasts during zosuquidar infusion. Cells were incubated with the fluorescent dye DiOC(2)(3) in the presence and absence of zosuquidar, and dye accumulation measured by flow cytometry. The assay performance was assessed using NK cells and the P-gp-positive K562/R7 cell line, and then utilized to determine the function of P-gp and its inhibition by zosuquidar in AML blasts and NK cells from patients enrolled in a Phase I trial. The assay of zosuquidar-inhibitable accumulation of DiOC(2) is robust and reproducible. | 18,976,810 |
Dysphonia--a rare early symptom of Ehlers--Danlos syndrome? | Ehlers-Danlos syndrome is a connective tissue disorder characterized by joint hypermobility, skin hyperextensibility and cutaneous fragility. It usually presents in young adults and is rarely diagnosed in children. Voice involvement in young children, to our knowledge, has not been reported in the literature. We present two cases with dysphonia from birth and an eventual diagnosis of Ehlers-Danlos syndrome. The syndrome and its relevance to voice pathology are discussed. We suggest that Ehlers-Danlos syndrome should be considered as an underlying diagnosis in atypical presentations of dysphonia in young children. | 18,976,821 |
Oral administration of heat-killed Lactobacillus brevis SBC8803 ameliorates alcoholic liver disease in ethanol-containing diet-fed C57BL/6N mice. | We examined the effect of heat-killed Lactobacillus brevis (L. brevis) SBC8803 on the development of alcoholic liver disease using ethanol-containing diet-fed mice. Heat-killed L. brevis was orally administered at a dose of 100 or 500 mg/kg once a day for 35 days. Alcoholic liver injury was examined by measuring the activity of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in a serum, and the alcoholic fatty liver was assessed from the content of triglyceride (TG) and total cholesterol in the liver. Quantitative RT-PCR was used to examine mRNA expression of tumor necrosis factor (TNF)-alpha, sterol regulatory element-binding protein (SREBP)-1, SREBP-2, and peroxisome proliferator-activated receptor alpha (PPARalpha) in the liver, as well as E-cadherin, Zonula occludens 1 (ZO-1), and heat shock protein (Hsp) 25 in the small intestine. Oral administration of L. brevis significantly inhibited an increase in the level of serum ALT and AST, as well as the content of TG and total cholesterol in the liver caused by ethanol intake. L. brevis supplementation suppressed the overexpression of TNF-alpha, SREBP-1, and SREBP-2 mRNA in the liver induced by ethanol intake and up-regulated the expression of Hsp25 mRNA in the small intestine. These results suggest that L. brevis ameliorated the ethanol-induced liver injury and the fatty liver by suppressing the up-regulation of TNF-alpha and SREBPs in the liver. We speculate that the inhibition of TNF-alpha and SREBPs up-regulation by L. brevis is due to the inhibition of gut-derived endotoxin migration into the liver through the enhancement of intestinal barrier function by the induction of cytoprotective Hsps. | 18,976,829 |
X-ray absorption and photoelectron spectroscopy investigation of selenite reduction by FeII-bearing minerals. | The long-lived radionuclide 79Se is one of the elements of concern for the safe storage of high-level nuclear waste, since clay minerals in engineered barriers and natural aquifer sediments strongly adsorb cationic species, but to lesser extent anions like selenate (SeVIO4(2-)) and selenite (SeIVO3(2-)). Previous investigations have demonstrated, however, that SeIV and SeVI are reduced by surface-associated FeII, thereby forming insoluble Se0 and Fe selenides. Here we show that the mixed FeII/III (hydr)oxides green rust and magnetite, and the FeII sulfide mackinawite reduce selenite rapidly (< 1 day) to FeSe, while the slightly slower reduction by the FeII carbonate siderite produces elemental Se. In the case of mackinawite, both S(-II) and FeII surface atoms are oxidized at a ratio of one to four by producing a defective mackinawite surface. Comparison of these spectroscopic results with thermodynamic equilibrium modeling provides evidence that the nature of reduction end product in these FeII systems is controlled by the concentration of HSe(-); Se0 forms only at lower HSe(-) concentrations related to slower HSeO3(-) reduction kinetics. Even under thermodynamically unstable conditions, the initially formed Se solid phases may remain stable for longer periods since their low solubility prevents the dissolution required for a phase transformation into more stable solids. The reduction by Fe2+-montmorillonite is generally much slower and restricted to a pH range, where selenite is adsorbed (pH < 7), stressing the importance of a heterogeneous, surface-enhanced electron transfer reaction. Although the solids precipitated by the redox reaction are nanocrystalline, their solubility remains below 6.3 x 10(-8) M. No evidence for aqueous metal selenide colloids nor for Se sorption to colloidal phases was found. Since FeII phases like the ones investigated here should be ubiquitous in the near field of nuclear waste disposals as well as in the surrounding aquifers, mobility of the fission product 79Se may be much lower than previously assumed. | 18,976,832 |
Imitation of transitive and intransitive actions in healthy individuals. | A handful of patients have been described as being impaired in performing transitive gestures, despite being still able to perform intransitive gestures. This impairment need not be explained by assuming different mechanisms; rather, it can be due to transitive actions being more difficult. In this study we tested whether neurologically healthy participants had greater difficulties in imitating transitive actions with respect to intransitive actions. Consistent with the prediction, subjects imitated intransitive better than transitive gestures. The ease of imitation of intransitive actions supports the complexity account of apraxic impairments. | 18,976,850 |
Predicted concentrations of biocides from antifouling paints in Visakhapatnam Harbour. | The concentrations of biocides leached from antifouling coatings are monitored in most of the developed countries. However, in India and many other developing countries, there is very little data available on the concentrations of biocides in ports and harbours. The first step was to obtain the order of magnitude levels of concentrations of biocides in the marine environment of the Visakhapatnam Harbour, and the MAM-PEC (Marine Antifoulant Model to Predict Environmental Concentrations) model was used to predict these values. The Visakhapatnam Port lies on the eastern coast of India, roughly halfway between Chennai and Kolkata, and is the largest port in India. This port is a natural harbour; the long and narrow outlet to the open sea makes it a 'poorly flushed' harbour. Predicted concentrations of tributyltin (TBT), copper, dichlofluanid, seanine, irgarol, diuron, tolylfluanid, and zinc pyrithione were computed. The results of the computations indicate that the levels of these biocides are comparable to those in many western countries. This gives credence to the fact that persistence of TBT and some other biocides is a global problem that cannot be ignored. | 18,976,852 |
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