The more preterm they are, the greater the riskPoor neonatal care increases the risk, even in less premature babiesHigh quality neonatal care. If there is not enough equipment to safely deliver and monitor oxygen, this must be strongly advocated forScreening: All babies at risk must be screened before 30 days after birthTreatment: Laser treatment should be given urgently, with confluent spotsFollow-up: All children born preterm are at risk of visual impairment and must be followed up by an ophthalmologist and/or optometristInvolve parents in the day-to-day care of the baby and encourage kangaroo careKeep parents informed of the need for screening and the results of screening, and the need for urgent treatment, if requiredEnsure parents understand the need for follow-up visits


Outcomes related to person-centered care in nursing homes have been difficult to ascertain. Much of the extant literature has suffered from differing definitions of what it means to be person-centered, variation in the levels of implementation of person-centered care that an organization has achieved, and small sample sizes. The PEAK program provides a unique opportunity to control for these variables across a large sample of nursing homes throughout the state of Kansas. This presentation will discuss the methodological advantages of evaluating the PEAK program and the findings from an evaluation of resident satisfaction in nursing homes at varying levels of implementation of person-centeredness.


The self-assembly of polymers is a powerful tool for producing various functional materials with a high precision from nano- to macroscale. Nowadays, the polymer self-assembly has become extremely attractive for both biological  and non-biological  applications. Besides this, a number of key biological processes in nature are driven by self-assembly of macromolecules.This special issue gives insights into diverse spectrum of peculiar tailor-made self-assembled polymer structures and hybrid materials that have been designed through modern powerful techniques and approaches such as the micellization , hydrogeIn particular, significant attention has been attracted to the layer-by-layer assembly of biopolymers. Thus, Balabushevich et al. have presented the study of mucin-based layer-by-layer assemblies that are mainly composed from the natural component of mammalian mucus and therefore show high potential for mucosal drug delivery . In the Another issue in the field of polymer self-assembled structures that has been reflected in this special issue is the design of stimuli-responsive materials. This includes both, chemical stimuli such as pH and physical stimuli including light. In this special issue, Xu et al. presented an elegant way for fabrication of pH-responsive amphiphilic block copolymer-based assembles ; Yang etBridging the gap between the science of the polymer self-assembly and the industrial application of this technology, Nelson et al. have designed and constructed a new solvent vapour annealing chamber that allowed the potential scaling-up of the production of block copolymer thin films .The next equally interesting aspect that has been deciphered in this issue is organisation of self-assembled polymer-based and hybrid structures in 3D. Herein, microfluidics-assisted assembly of porous calcium carbonate templates and their covering with polymer coatings opened new avenues for the fabrication of tailor-made biocompatible scaffolds for advanced tissue engineering and 3D cell culture as reviewed in  and crysThat is rather interesting to note that while the papers listed above mostly aimed at the invention and investigation of the new types of materials, the paper presented by Jeannot et al. took under the consideration a well-known poly(styrene-sulfonate)/poly polyelectrolyte pair and the authors have shown principally new insights into the classical understanding of the internal structure of multilayer capsules . Their fFinally, it is worth to emphasize the review of Savoca et al. that summarises the up to date knowledge on the biocatalysis by transglutaminases, enzymes that crosslink polymer-bound glutamine and lysine residues and plays a special role in the formation of extracellular polymer matrix . The revWe would like to take the opportunity to thank all the authors for submitting their papers to this special issue. We also want to thank all the reviewers for dedicating their time and helping to improve the quality of the submitted papers.


The cSMSustained TCR/CD3 signaling is required to achieve a proper T cell activation and the endocytosed and degraded TCR during activation should be replenished by TCR molecules recruited to the IS from the endosomal compartment  is poorly understood. Although CAR-T cell stimulation induces an efficient MTOC polarization and lytic granule secretion (even faster than in TCR-IS), actin cytoskeleton is not completely depleted from the center of the IS, microclusters of the CAR and signaling molecules are evenly dispersed through the IS, cSMAC and LFA-1 ring at the pSMAC are not properly organized and activating signals as well as cell-cell interactions are shorter than in conventional TCR-IS  Mukherj. It shouIn spite of the above-mentioned recent contributions, a precise understanding of the spatial and temporal topology of the CCB-IS remains elusive. To what degree is the physiological IS organization maintained in the artificial CCB-IS formed in CAR-T cells or following CD3ε engagement by a TAA-bound bsAb? This question is particularly relevant as an altered topology of the TCR-IS has been associated with immune pathologies (Schubert et al., The influence of some of these factors in the assembly of the CCB-IS has been studied. For example, in the bsAb-mediated IS membrane proximal TAA-epitopes are necessary for the assembly of the IS with CD45 exclusion and central clustering of the TAA, the signaling molecule ZAP70 and the bsAb (Li et al., PR-N and LÁ-V contributed to the conception of the work and wrote the manuscript.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Docking simulations illustrated how the TnC molecule undergoes significant conformational transition on complex formation, a phenomenon that can be modeled only when protein flexibility is properly accounted for. This way our procedure opens up a new possibility for studying mechanisms of protein complex assembly, which may be a supporting tool for rational drug design.Most of the current docking procedures are focused on fine conformational adjustments of assembled complexes and fail to reproduce large-scale protein motion. In this paper, we test a new modeling approach developed to address this problem. CABS-dock is a versatile and efficient tool for modeling the structure, dynamics and interactions of protein complexes. The docking protocol employs a coarse-grained representation of proteins, a simplified model of interactions and advanced protocols for conformational sampling. CABS-dock is one of the very few tools that allow unrestrained docking with large conformational freedom of the receptor. In an example application we modeled the process of complex assembly between two proteins: Troponin C (TnC) and the N-terminal helix of Troponin I (TnI N-helix), which occurs The development of new drugs is one of the most challenging tasks in science today. Combined efforts of the pharmaceutical industry, academic researchers and biotech companies have not only improved the process of drug design, but also contributed to advances in science itself. Computational modeling and simulations have become integral procedures in introducing new drugs to the market and it is safe to assume that the role of theoretical computations in this field will increase in the future .Protein activity in organisms involves interactions with other biomolecules, which makes them perfect targets for rationally designed drugs. After the Human Genome Project  was compMolecular docking is a technique for predicting the structure of a molecular complex, given the structures of its individual components. There is a great number of software packages available for protein-ligand docking, including DOCK , AutoDoc vs. the other. The rigid-body assumption is naturally a shortcoming for proteins that exhibit large-scale conformational changes on binding. In some cases even small backbone deformations could be essential  can be defined as follows:K is kernel function and h is the bandwidth (smoothing parameter). The Kernel estimator of an unknown probability density function In our calculation we used the standard Gaussian function with mean zero and variance 1. For more details see the Bioshell  manual.The paper describes the application of the CABS-dock protocol to a difficult problem of protein-peptide complex assembly. Starting from near-native structures of the receptor and completely random structures of the peptide (located at random positions around the receptor structure), we performed REMC simulations of free docking. The docking simulations and the clustering of the manifold of generated conformations led to a well-defined structure of the complex, in good agreement with the available crystallographic structure . ExperimTo investigate the influence of peptide binding on the structure of the whole complex, we also performed CABS-flex simulations, a tool for the computational study of protein domain dynamics. The simulations showed that the binding of the peptide fixed to a large extent the troponin C structure seen in the bound state, while the structures of the receptor without any ligand were closer to the unbound experimental structure of troponin C ,44 and eFinally, let us note that CABS-dock method enables free search (without predefined binding site location) of the peptide docking pathways with properly predefined ranges of the receptor structure fluctuations , which g


This paper provides a brief review of recent progress in the field of metal coordination polymers assembled from azole-containing carboxylic acids and gives a diagrammatic summary of the diversity of topological structures in the resulting infinite metal-organic coordination networks (MOCNs). Azole-containing carboxylic acids are a favorable kind of multifunctional ligand to construct various metal complexes with isolated complexes and one, two and three dimensional structures, whose isolated complexes are not the focus of this review. An insight into the topology patterns of the infinite coordination polymers is provided. Analyzed topologies are compared with documented topologies and catalogued by the nature of nodes and connectivity pattern. New topologies which are not available from current topology databases are described and demonstrated graphically. The diverse coordination modes of diazole, triazole and tetrazole-containing carboxylic acids and the various topology patterns in the one, two, and three-dimensional metal-organic coordination polymers enrich the fields of research in the coordination and structural chemistry of these compounds, and contribute plentiful novel MOFs materials with better practical value as supporting carriers, in gas sorption and magnetic, optic or electronic applications.


To the Editor: We read with interest the recent article describing involvement of Crithidia-related parasites in visceral leishmaniasis (VL) in Brazil  strains with a patient phenotype is risky because of the selection biases of in vitro isolation and maintenance. Using a recently developed method for direct sequencing of


Dear Editor,Indian Journal of Hematology and Blood Transfusion profoundly interesting. The article is devoted to the measurement of the concentration of protein Z (PZ) in patients during the stable phase of acute coronary syndrome (ACS). PZ is a glycoprotein synthesized in the liver and in the vascular endothelium. Its main function is to inhibit, with the participation of another glycoprotein—ZPI (protein Z-dependent protease inhibitor), the active factor X [We found the paper penned by Ghozlan et al.  which wafactor X . The metfactor X  proved tThe main observation made by Ghozlan et al.  is findiIn the light of other papers, it would also be interesting to broaden the panel of tests to determine the concentration of ZPI and anti-PZ autoantibodies class IgG and IgM. The presence of circulating antibodies is relatively rare , but it


In the Primary outcome-functional status subsection of the Results section, there is an error in the sixth sentence. The correct sentence is: In the study by Hensel et al. [29], osteopathic care was found to significantly improve functional status.In the Primary outcome-functional status subsection of the Results section, there is an error in the last sentence. The correct sentence is: In another US study [30], functional status also significantly improved in the osteopathic care group compared to controls .There is an error in


In the Abstract, there is an error in the eighth sentence. The correct sentence is: The parameters of defect fill were significantly higher at EMD-treated site than at EMD-untreated sites in both diabetic and non-diabetic rats.In the Statistical analysis subsection of the Materials and Methods, there are errors in the second sentence of the first paragraph. The correct sentence is: Fisher’s exact test and binomial test were used to compare the frequency of primary closure in control and diabetic rats.In the Observation of postsurgical healing subsection of the Results, there are errors in the first and second sentences of the first paragraph. The correct sentences are: At 7 days after surgery, wound closure rates were higher in control rats than in DM rats (not significant). Wound closure rates were higher at the EMD-treated sites of both control and diabetic rats than at untreated sites (not significant).In the Discussion section, there is an error in the fourth sentence of the fourth paragraph. The correct sentence is: The reduced bone regeneration observed in diabetic animals, although statistical significance was not observed, is attributed to the fact that primary closure is a crucial factor for tissue regeneration.


There is an error in the penultimate sentence of the Abstract. The correct sentence is: Available evidence from medium-to-high quality observational studies suggests that POD and POCD are indeed correlated with the concentration of peripheral inflammatory markers.


The negative impact of obesity on neurocognitive functioning is an issue of increasing clinical interest. Over the last decade, a number of studies have analyzed the influence of high-fat diets (HFDs) on cognitive performance, particularly in adolescent individuals. Different approaches, including behavioral, neurochemical, electrophysiological and morphological studies, have been developed to address the effect of HFDs on neural processes interfering with learning and memory skills in rodents. Many of the studies have focused on learning and memory related to the hippocampus and the mechanisms underlying these processes. The goal of the current review article is to highlight the relationship between hippocampal learning/memory deficits and nutritional/endocrine inputs derived from HFDs consumption, with a special emphasis on research showing the effect of HFDs intake during the juvenile period. We have also reviewed recent research regarding the effect of HFDs on hippocampal neurotransmission. An overview of research suggesting the involvement of fatty acid (FA) receptor-mediated signaling pathways in memory deficits triggered by HFDs is also provided. Finally, the role of leptin and HFD-evoked hyperleptinemia is discussed. Elevated consumption of so-called western diets (WDs) is one of the main causes of overweight and obesity and a matter of concern for public health institutions. The damaging effect of these diets seems to be not only related to their content in terms of both saturated fat and easily assimilated carbohydrates, but also to the fact that they promote disorganized feeding patterns consisting of frequent energy-dense snacking and/or copious meals before bedtime  and choroid plexus permeability  expression in CA1 pyramidal neurons -induced long-term depression (LTD), but does not affect long-term potentiation  up-take kinetics along with the up-regulation of glial GLU transporters (GLT-1 and GLAST) and a concomitant down-regulation of glutamine synthase. In addition, this treatment led to the down-regulation of the glucose transporter GLUT-1 , characterized by the induction of leptin synthesis and the repression of adiponectin expression, which occur together with a rise in WAT-derived inflammatory cytokines, all of which are able to cross brain barriers  and G protein-coupled receptor 120 (GPR120).PPARs mediate pleiotropic actions in the brain, including neurogenesis and synaptic plasticity  makes it difficult to draw reliable conclusions. Systematic studies carried out with diets of defined composition, which do not merge elevated amounts of saturated fat and sugar and that are preferably enriched in a particular FA, would be necessary to investigate in more depth the influence of fat on brain functions. In this regard, future research based on the use of experimental HFD manufactured with highly saturated or unsaturated oils, enriched in a particular FA, are needed to identify the specific contribution of the various types of dietary fat to memory processes.Otherwise, the translational value of all of these findings remains unclear, as strong epidemiological studies are lacking. Therefore, it is necessary to carry out parallel clinical and basic research devoted to the identification of the molecular mechanism underlying memory deficits evoked by the regular consumption of HFD.NDO and MR-G contributed to the conception and design of the review, as well as the drafting and revision of the manuscript. The authors have approved the final version of the manuscript.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


The potential interconnectedness of medication adherence, glycemic control, and clinical inertia in resource-constrained settings of the developing world needs further evaluation. Dear Editor,Low- and middle-income countries account for 80% of the global diabetes burden . MoreoveThe study by Rathish et al. from a rural province in Sri Lanka makes an important contribution to the sparse literature on the subject in the country and establishes the benefits of government-funded universal free-health services in enhancing medication coverage and adherence in low-income diabetes patients . HoweverThe researchers applied the Morisky-Green-Levine scale to assess medication adherence in diabetes patients. The scale has low sensitivity and doubtful validity in this patient population that is further lowered by the application of a cutoff score of 2 that indicates moderate adherence only which might be inadequate in the attainment of good glycemic control. The direct comparison of the rates of adherence of this study with other studies that applied a different medication adherence scale and/or a different adherence definition is inappropriate as more sensitive scales and a more stringent definition of non-adherence could yield different adherence rates.A major limitation of the present study is also the lack of reporting of glycemic control status in the patients. This is particularly important for the identification of the phenomenon of clinical or therapeutic inertia indicating the failure to adequately intensify the treatment in patients showing poor glycemic control that increases the risk of incident diabetes-related complications. Previous studies from government tertiary care hospitals in India that provide free medication coverage have observed a high prevalence of poor glycemic control despite good anti-diabetes medication adherence rates in the patients , 5. This


Noble metal nanostructures are exceptional light absorbing systems, in which electron–hole pairs can be formed and used as “hot” charge carriers for catalytic applications. The main goal of the emerging field of plasmon-induced catalysis is to design a novel way of finely tuning the activity and selectivity of heterogeneous catalysts. The designed strategies for the preparation of plasmonic nanomaterials for catalytic systems are highly crucial to achieve improvement in the performance of targeted catalytic reactions and processes. While there is a growing number of composite materials for photochemical processes-mediated by hot charge carriers, the reports on plasmon-enhanced electrochemical catalysis and their investigated reactions are still scarce. This review provides a brief overview of the current understanding of the charge flow within plasmon-enhanced electrochemically active nanostructures and their synthetic methods. It is intended to shed light on the recent progress achieved in the synthesis of multi-component nanostructures, in particular for the plasmon-mediated electrocatalysis of major fuel-forming and fuel cell reactions. T. T2, whi2 nanosheets  [2 [2 hybrids drastically improve the HER, with a three-fold increase of the current under excitation of the Au LSPR bands.Transition-metal disulfides such as MoSs (HERs) . To overHERs) [2 . The autThis short review summarizes the recent developments on nanomaterials for plasmon-enhanced electrochemical reactions with the aim of interesting the communities working in plasmonic and electrochemical processes, providing a common base for jointly progressing in this exciting area of plasmon-mediated electrochemistry. To understand better the design of the nanostructures, the physical fundamental of localized surface plasmon resonance and the various mechanisms for plasmon-enhanced electrochemistry have been provided. Despite the significant advances achieved in the last three years, researchers are facing many challenges in this field. While a large variety of synthetic methods have been developed for the synthesis of these heterostructures, the scale-up of such processes will be an important and imperative aspect for the use of these concepts on a wider scale. The formation of highly reproducible nanostructures with comparable catalytic and plasmonic properties is at the core of the development to envision scale-up, which is an issue that has not been yet resolved. While laser light is often used for the stimulation of the plasmonic effect, developing plasmonic materials that are responsive to sunlight with high catalytic activity represents an important goal in the field of plasmon-mediated chemical/electrochemical reactions. Which guidelines for the future design of plasmonic electrochemical materials can be provided? The formations of bimetallic and metal/semiconductor nanostructures have both shown to be of great promise for plasmon-enhanced electrochemical systems, taking advantage of the catalytic activity and the strong optical effects of these nanostructures. While such simple plasmonic nanostructures have been demonstrated as concentrating light efficiently from the UV to the near-infrared range of the light spectrum and transferring it to adjacent species, thus improving electrochemical transformations, a better understanding of the underlying mechanism of plasmon-enhanced electrochemistry is primordial for optimizing electrochemical-based oxidation and reduction processes. How to separate the generated hot electrons from the holes in an efficient and controlled manner is one of the critical criteria to be investigated, as it is fundamental for enhancing electrochemical reactions. Next to this, the importance of plasmonic heating in plasmon-enhanced electrocatalysis has to be systematically studied. How to distinguish the contribution from the electromagnetic field-enhancement from hot charge carriers-induced enhancement are big experimental and theoretical challenges to be addressed. Further studies focusing on the morphology, composition, heterojunctions, and other nanomaterials-based aspects need to be conducted in order to fully optimize the plasmon-enhanced electrochemical effects. The future of plasmon-mediated electrochemistry might be full of surprises.


Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.


Bioproduction is the process of producing added-value chemicals on large-scale using cells as biological factories. Cellular burden represents a significant problem in the scaling of fermentation processes from proof-of-concept to long-term cultures, as the load of heterologous gene expression and depletion of the cell intracellular resources cause unpredictable cellular physiological changes that can lead to decreased growth and lower production yields (Borkowski et al., E. coli engineered to produce mevalonic acid in long-term cultivations (Figure In a recent paper in PNAS, Rugbjerg et al.  developes Figure .product addiction, the authors selected the chromosomal genes glmM and folP for a positive feedback control associated with the product. Both of these genes are known to supply essential intermediates for cell growth. In initial screening, the folP-glmM operon was placed under the control of the PBAD arabinose-inducible promoter and integrated into the genome. To avoid imposing extra-burden to cells, different library variants were designed where promoter and RBS strength were tuned. By analyzing the growth profiles in the presence and absence of the arabinose inducer, the authors identified a good genetic design that matches the requirements for both responsive-growth regulation and low burden. In order to make product addiction specific to mevalonic acid, the inducible promoter guiding the expression of the operon was then replaced by the AraCmev promoter, known to be responsive to the mevalonic acid product.To achieve E. coli cells, in presence of a mevalonic acid-producing construct. During long-term growth in bioreactor conditions, the addicted population grew slower than the non-addicted one, but was able to maintain constant and robust mevalonic acid production over time, thus yielding higher titers overall. The addicted population also did not display any outbreak of non-producing subpopulations, as seen with non-addicted cells. These populations were also examined using deep-sequencing techniques, allowing the authors to investigate the presence of genetic heterogeneity in both addicted and non-addicted cells. Interestingly, the sequencing results for the mevalonic acid-producing pathway identified mobile insertion elements from the native host genome as the main cause for the disruption of the genetic program in non-producing cells. This confirmed work released in parallel by the same group investigating the mutation and failure modes of constructs in E. coli (Rugbjerg et al., The authors then went on to compare growth profiles and product yields of mevalonic acid in both addicted and normal This elegant piece of research by Rugbjerg et al. advances metabolic engineering of bacterial cells, by building on previous achievements in synthetic biology and engineered feedback control. In the last decade, bacterial synthetic biology has witnessed the development of a plethora of synthetic systems and tools for the rational control of gene expression (Bradley et al., The approach of Rugbjerg et al. makes use of insights from the synthetic biology field relating to circuit engineering and burden analysis, and combines them for a metabolic engineering application. Previous approaches exploited well-controlled bio-reactor conditions or adaptive evolution to improve synthesis of growth-associated products, leveraging natural selection for reducing metabolic burden (Wu et al., folP-glmM operon variant for the sustained growth of addicted-cells while conferring tunable response to variant product concentrations.By contrast, Rugbjerg et al. smartly exploit non-conditional dependency of growth on the fermentation product so as to render production independent from external inputs. They take a rational approach in circuit design to identify the optimal The general strategy also proves effective as a way to reward producing cells at the expense of non-producing ones limiting the detrimental effects of burden on the population homogeneity. The emergence of escape mutants as a consequence of cellular burden was previously shown by Sleight et al. (Sleight and Sauro, Product addiction is achieved by exploiting a specific promoter responsive to mevalonic acid. If another product were being made instead, a different sensor promoter would need to be identified and the build-and-test cycle of the system repeated ad hoc. Ideally, in the future, variant but related strategies will be developed that are also universal and portable. Overall, the work by Rugbjerg et al. proves the power of the synthetic biology approach toward the optimization of bacterial metabolic engineering.This paper from Rugbjerg et al. represents a fine example of how advances in burden characterization and genetic system design can be exploited to significantly improve yields in bioproduction processes. The strategy they develop is autonomous from external stimuli and allows maximization of product recovery as a consequence of more robust gene expression over time. A potential drawback of the approach presented is its non-universality: All authors listed have made a substantial, direct, and intellectual contribution to the work, and approved it for publication.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


To the Editor,We thank Diaz and co-authors for their recent review of Global Critical Care . We agreUnfortunately, the review misrepresents a finding from our Vital Signs Directed Therapy (VSDT) study . We did Improved recognition of critical illness and the delivery of basic care for critically ill patients throughout the hospital should be a central aspect of a global critical care roadmap. We have recently proposed the concept of Essential Emergency and Critical Care (EECC) – the care that all critically ill patients should receive in all hospitals in the world . If the When assessing the global burden of critical illness, we agree that there are major limitations of extrapolating data from ICU admissions and incomplete diagnosis-based registries and that novel methodologies are needed. Further examples to those mentioned in the review include our ongoing multi-national Critical Illness Prevalence and Outcome Study (CRISPOS), which uses point-prevalence estimations, whereby all in-patients are assessed for critical illness. Similarly, as electronic health information systems start to proliferate in low- and middle-income countries, routinely collected hospital-wide data could be exploited .for all is the foundation of critical care systems.We agree with the authors about the importance of cost-effectiveness. To maximise this, innovative tools that aim at getting the most out of the basics should be paramount in the roadmap for the future. Funders and researchers could reduce the risk that their investments in critical care end up benefitting just a few individuals by acknowledging that the quality of essential services


Implementation of culture change in nursing homes shifts the care model from a traditional, more medically focused approach to person-directed care. Person-directed care promotes resident autonomy and decision making and the empowerment of direct care staff. In this paper, we examine how different stakeholders in nursing homes  conceptualize and experience a selection of person-centered care concepts . We describe the commonalities and differences in the ways different groups of stakeholders operationalize these core person centered care practices and describe areas of potential conflict of views. Lastly, we consider how the well-being and quality of life for residents is affected by the use of these practices.


The cognitive health needs of LGBT older adults have not been adequately addressed in mainstream clinical trials. Aging with Pride: IDEA (Innovations in Dementia Empowerment and Action), is an intervention designed to improve physical functioning and quality of life of LGBT adults with dementia and caregivers. We evaluate the processes and effectiveness of culturally-responsive recruitment approaches implemented in this study. A strong research-community partnership was necessary for the development and implementation of the intervention. LGBT participants with dementia made the first contact to research team as often as caregivers did and showed a higher rate of living alone and having a friend-based care network. The most common reason for ineligibility was not having a caregiver. Participants learned about the study via multiple venues including community events, newsletters, and social media. This study illustrates important new ways to sustain collaborations with disadvantaged communities and conduct a clinical trial with hard-to-reach participants.


A 30-year-old man presented to the emergency department (ED) complaining of right-hand pain after punching a wall in anger approximately one hour prior to arrival. On examination, there was obvious deformity of the dorsal aspect of the hand with a palpable bony step-off extending across the distal aspect of the wrist. Neurovascular examination of the hand and digits was normal. We obtained standard posterior-anterior  and lateCarpometacarpal (CMC) dislocations not involving the thumb are rare, accounting for <1% of all hand trauma.4On radiographs, the usual 1–2 millimeter CMC joint space seen on the posterior-anterior view is obliterated by bony overlap, and displacement of the proximal ends of the metacarpals is seen on the lateral view. Closed reduction by applying longitudinal traction to the involved digits with direct pressure over the bases of the dislocated metacarpals should be performed in the ED since delayed reduction is less likely to be successful.What do we already know about this clinical entity?Carpometacarpal dislocations not involving the thumb are rare. The diagnosis is frequently missed on initial examination, resulting in significant morbidity.What is the major impact of the image(s)?It identifies the characteristic obscurement of the carpometacarpal joints on the posterior-anterior view and displacement of the proximal ends of the metacarpals on the lateral view radiographs.How might this improve emergency medicine practice?Identification of this rare, though commonly missed, injury in the emergency department will prevent long-term hand morbidity.


This paper deals with the experimental studies conducted on the effects of using sea sand on the properties of polymer concrete modified using epoxy resin. The physical properties including workability, mechanical properties, and durability properties were evaluated as a function of sea-sand substitution. The results obtained behave as strong evidence for the feasibility of using sea sand as fine aggregate to solve the problem associated with the exhaustion of natural aggregates when used in combination with epoxy polymer. A clear understanding of the behavior of polymer concrete with sea sand as aggregate was obtained through some preliminary investigations. The test results showed a significant improvement in the compressive and flexural strength due to the sea-sand substitution in polymer concrete. Resistance to the water intrusion was also improved for the concrete mixes due to the inclusion of epoxy resin. The quality and the integrity of the concrete were also improved, as evident from the SEM analysis and infrared (IR) spectroscopy, and the results function as solid basis for the use of sea-sand polymer-modified concrete for practical applications. Results also show that 15% replacement of fine aggregate by sea sand in air-cured polymer concrete exhibited enhanced strength and durability properties; thus, the produced concrete can be an effective material for unreinforced concrete applications. Polymer concrete is in no way new to civil engineering, and several attractive properties were achieved due to its superior performance . SeveralHence, the present research work aimed at investigating the properties of epoxy-modified sea-sand concrete, as well as the internal microstructure of the produced concrete. Polymer concrete shows significant resistance to chloride penetration, and this study aimed at utilizing the lower chloride penetration capacity of epoxy concrete to mitigate the drawback of sea-sand concrete. Thus, the present work not only focuses on studying the strength variations, but also serves as an initiative to propose the widespread usage of epoxy-modified sea-sand polymer concrete to ensure sustainability in the building construction industry.3 of the concrete is presented in Type Iordinary Portland cement (OPC)  was the cement used in the present study. The concrete mixes were produced using natural river sand and sea sand for fine aggregates, and coarse aggregate. The natural river sand conforms to Zone III as per BIS 383-1970 . The finThe workability of the polymer concrete was assessed by measuring the slump values at constant water-binder ratios (IS 1199-1959) . The comThe workability of the epoxy-modified concrete containing different proportions of sea sand is shown in 3 to 2222 kg/m3 with increasing sea-sand substitution ratio and epoxy substitution in the concrete.The bulk densities of the concrete mixes are shown in The compressive strength of the concrete specimens at various ages after being subjected to different curing conditions is shown in 2, which is a major hydration product of cement. This helps in the formation of C3A , which enhances the durability and strength of concrete. Due to the pore-occupying nature of the polymers, they occupy the capillary pores, contributing to an increase in strength.The compressive strength of sea-sand-substituted polymer concretes showed a strength improvement in normal curing and water curing. Generally, the reaction of hydrated pastes of cement with dissolved chlorides and sulfate present in the sea sand leads to the formation of calcium bicarbonates and gypsum, leading to leaching and weakening of the insoluble aggregates. Cement reacts with dissolved salts, leading to the formation of gypsum and complex compounds like ettringite and brucite, which lead to brittleness of the cement matrix, causing strength loss and disruptive expansion. The addition of polymer retards the formation of these complex compounds by controlling the formation of Ca(OH)Thus, it can be concluded that the addition of epoxy polymer played an important role in the improvement of compressive strength at all ages. The higher strength of air-cured specimens may be due to the minimal quantity of epoxy used. An excess quantity of epoxy resins may disturb the hydration mechanism, thereby reducing the compressive strength of concrete. Sea sands have the ability to increase the compressive strength of concrete at early ages, and epoxy resin increases the strength at later ages. Previous works also saw improved compressive strength of the sea-sand concrete at early ages when compared to the strength of ordinary concrete .As per the flexural strength results shown in The bond strength of the concrete mixes is shown in The water absorption of the polymer concrete mixes is shown in −1 to 4000 cm−1 is due to the presence of –OH bonds in the concrete, which corresponds to the chemically combined water of the hydration product Ca(OH)2. The presence of –OH bonds in all the concrete mixes indicates the formation of well-reacted hydration products. The water crystal lattice of CSH gel may also be indicated by the –OH band. The CSH gel formation is indicated by the band formed around 1000 cm−1. The spectra clearly show a strong CSH band with relatively higher intensity in all the epoxy-modified sea-sand concrete mixes when compared to the normal concrete mix. The epoxy-modified concrete showed out-of-plane bending of the phenyl ring around 300–700 cm−1. The band around 1200cm−1 corresponds to the H–O–H deformation which is different in the epoxy concrete, signifying the presence of stretching vibrations of C=C of epoxy polymer. This further confirms that the epoxy resin reacted well with the H–O–H deformations to form highly stable complexes.FTIR spectra of the polymer concrete mixes are shown in The morphology of the polymer concrete mixes and the plain concrete as obtained from the SEM imaging is shown in Generally, sea sand should be subjected to pre-treatments or de-salting procedures to remove the excess chloride content for use in concrete applications due to itsadverse effect on concrete properties by promoting corrosion of reinforcement. The present study utilized sea sand without appropriate de-salting procedures and, hence, cannot be used for reinforced structural applications, which is the limitation of the present study. The high cost associated with the de-salting procedure and lack of appropriate technologies prompted the direct use of sea sand in concrete. With this background, future studies will try to determine the possibility of using sea sand in epoxy-modified concrete for reinforced concrete applications by conducting corrosion studies, thereby ensuring the safety and durability of the proposed methodology.In the current investigation, the properties of concrete utilizing epoxy resin as a cement substitute and sea sand as a substitute for river sand were investigated to their suitability for unreinforced concrete applications. Both epoxy substitution and sea-sand substitution affect the workability of concrete, but the effect of the latter is minimal. The compressive strength development was accelerated at the early ages due to sea sand, whereas the polymer cement concrete produced stronger concrete when compared to the conventional concrete at the latter ages. About 30% improvement in the compressive strength and 35% improvement in the flexural strength were achieved in the 20% sea-sand-substituted air-cured polymer concrete at 180 days when compared to the conventional concrete. The flexural strength of the epoxy concrete was further enhanced by the incorporation of sea sand that acted as a micro filler. Bond strength was markedly superior with improved pull-out strength of the polymer concrete in the presence of sea sand as fine aggregate. Other parameters such as water absorption and pore spaces were reduced showing the superior performance of epoxy-modified sea-sand concrete. Compared to ordinary concrete, the initial and secondary rate of water absorption was also reduced, showing the greater resistance to water permeability. The microstructure of polymer sea-sand concrete showed significant morphological improvement at the inside of the concrete, indicating the bonding between sea sand and the cement matrix. Thus, a limited supply of fine aggregates may be compensated for by the utilization of sea sand as fine aggregate without disturbing the ecosystem and sustainability of the concrete structures when used in combination with epoxy resins.


The effect of different abiotic stresses (extreme temperatures and osmotic stress) on the synthesis of glutathione and hydroxymethylglutathione, on the ratio of the reduced to oxidised forms of these thiols , and on the glutathione reductase (GR) activity was studied in maize and wheat genotypes having different sensitivity to low temperature stress. Cold treatment induced a greater increase in total glutathione (TG) content and in GR activity in tolerant genotypes of both species than in sensitive ones. The GSH/GSSG and hmGSH/hmGSSG ratios were increased by this treatment only in the frost-tolerant wheat variety. High-temperature stress increased the TG content and the GSH/GSSG ratio only in the chilling-sensitive maize genotype, but GR activity was greater after this treatment in both maize genotypes. Osmotic stress resulted in a great increase in the TG content in wheat and the GR activity in maize. The amount of total hydroxymethylglutathione increased following all stress treatments. These results indicate the involvement of these antioxidants in the stress responses of wheat and maize.


The study, funded by the Pennsylvania Council on the Arts and the Pennsylvania Department of Aging, measured the effect that an artist in residence program  had on self-reported loneliness in older adult. All participants were aged sixty years or older and participated in programming in state-funded adult community centers located in fourteen sites throughout the Commonwealth of Pennsylvania. Artists offered 10 sessions in creating and critiquing art to older citizens in the artists’ respective art forms including performing arts, visual arts and multidisciplinary/interdisciplinary arts. Through pre and post-tests, changes in loneliness were measured using the Revised UCLA Loneliness Scale. The data revealed that there was a significant correlation between a self-reported decrease in feelings of loneliness and participation in a program conducted by professional artists. . It was proposed that findings from the study could influence the quality of programs provided by state-funded adult community centers in Pennsylvania and increase funding levels to adult community centers throughout the Commonwealth of Pennsylvania.


The data in the present article are related to the previous article entitled “Coxsackievirus and adenovirus receptor-positive cells compose the putative stem/progenitor cell niches in the marginal cell layer and parenchyma of the rat anterior pituitary” . The data describe the characteristic localization in the immature cells of the prenatal and adult tissues beyond the germ layer. Germ cells and the reproductive tissues of both sexes showed distinct intracellular polarities of CAR: apical, basolateral, and pericellular in the immature cells of the embryo and adult tissues. In addition, the data describe on localization of CAR in the methimazole-induced damage of olfactory epithelium tissue. The data show that the CAR-_immuno-positive cells at the apical side of the olfactory epithelium disappeared following methimazole treatment and reappeared in the regenerating stem/progenitor cells (positive for KI67 and E-cadherin) of the basal layer with basolateral expression. Breeding of rats and sampling of brains are described in the previous papers Lesions in the olfactory epithelium were induced according to a previously published method 2.2Procedures of an antigen retrieval, fixation, and immunostaining were performed as described previously


The gold standard for ensuring satisfactory delivery of an intervention remains fidelity monitoring. In-person observations for fidelity monitoring has received less attention in the literature compared to evaluating sessions via video and audio-recordings. This presentation focuses on a qualitative analysis of field notes from 15 scheduled fidelity visits of a home-based intervention involving persons with dementia and their caregivers . The findings of advantages , disadvantages , and ethical considerations  with be discussed. Future research recommendation is to explore participant perspectives on having an in-person fidelity monitor in the home.


This presentation is a reflective piece on developing and staging of the inaugural Gerontology Student Workforce Day at the Georgia Capitol held in January 2016 through coordination with the state-level Council on Aging (GCOA: Georgia-Council-on-Aging). The aims of this initiative focused on bridging students’ gerontology education and career aims with current legislative concerns for older adults at the state level through networking and advocacy efforts. We also sought out to highlight to state legislators the necessity to support gerontology education. Results of this networking engagement included educating state legislators on both the role of gerontology education to support the needs of older residents at the community-level and highlighting to both parties the impact of gerontology professionals on the state’s workforce. As a result, we engaged gerontology students and early career aging professionals in high-impact networking opportunities focused on service and policy efforts with state legislators and local AAAs (area-agencies-on-aging).


Assessment of skeletal status and bone mineral density (BMD) in the pediatric population requires knowledge of the child’s overall health, clinical history of chronic illness and/or risk factors for osteoporosis, and atraumatic fractures. Dual-energy X-ray absorptiometry (DXA) is the gold standard for the assessment of bone health, in children and adolescents. The interpreting physician needs to acknowledge that diagnosis of low BMD in growing subjects should include in addition to densitometric measurements, the synchronous assessment of the DXA-generated image for collateral findings that may cause erroneous evaluation of bone mass and improper management. Osteonecrosis refers to the in situ death of bone  and usua2Herein we report the case of a young child with osteonecrosis of both hips who underwent dual energy X-ray absorptiometry (DXA) to evaluate bone mass. Although it allowed evaluation of evolution of osteonecrosis over time, this case clearly indicates that osteonecrosis can be another source of diagnostic error causing artifactual elevation of the BMD measurements. The teaching point of this pediatric case is that visual inspection of DXA images should always precede interpretation of the densitometric data.An 8-year-old boy with a history of 5 years of acute lymphoblastic leukemia was referred for radiographic evaluation of the pelvis because of left hip pain and a limp. The patient had undergone radiation therapy of the total body and bone marrow transplantation at age 6. Since the onset of the disease he had been receiving intravenous and oral corticosteroids. Three months post-transplantation, the patient developed lung disease secondary to graft- versus-host disease and received high doses of intravenous and oral steroids. Subsequently, the patient developed autoimmune hemolytic anemia and was treated again with high doses of intravenous and oral steroids.rd and 9th centile and his weight was 54.3 lb, which lies between the 24th and 50th centile. Radiographic evaluation of the spine and hips revealed compression fractures in thoracic spine  and mild deformity of the femoral epiphyses , or at risk for a secondary bone disease  and an elevated risk of fracture . Skeleta6676778In this complex pediatric clinical case, BMD as measured by DXA was found to spuriously increase on the follow-up scans. Osteonecrosis of the femoral head was the cause of false elevation of the BMD, in our patient. If this pitfall was not recognized, this patient with low BMD would be misdiagnosed as responding to treatment over time. Our case highlights the importance of analysis of DXA images in addition to numeric data for identification of the variable sources of diagnostic error, including osteonecrosis of the femoral head.The authors declare that they have no competing interests.


The CFSIE experiments are designed to reduce weather noise and using a few ten-year long forecasts this study shows that reduction in weather noise leads to lower SST forecast skill. To understand the pathways that cause the reduced SST prediction skill, two twenty-year long forecasts produced with CFS and CFSIE for 1980-2000 are analyzed for the ocean subsurface characteristics that influence SST due to the reduction in weather noise in the North Pacific. The heat budget analysis in the oceanic mixed layer across the North Pacific reveals that weather noise significantly impacts the heat transport in the oceanic mixed layer. In the CFSIE forecasts, the reduced weather noise leads to increased variations in heat content due to shallower mixed layer, diminished heat storage and enhanced horizontal heat advection. The enhancement of the heat advection spans from the active Kuroshio regions of the east coast of Japan to the west coast of continental United States and significantly diffuses the basin-wide SST anomaly (SSTA) contrasts and leads to reduction in the SST prediction skill in decadal forecasts.The sensitivity of the sea-surface temperature (SST) prediction skill to the atmospheric internal variability (weather noise) in the North Pacific (20 The view of the first category is that due to the higher heat capacity of oceans in the earth-climate system, stochastic forcing by weather noise acts to redden the low-frequency Ocean SST variability spectra  on North Pacific SST. The primary goal is to understand the pathways that influence the variability in the North Pacific SST in the absence of weather noise at the ocean-atmosphere interface in a CGCM. To achieve this a CGCM simulation should be compared against the exact same CGCM counterpart that has no weather noise. In this study, the impact of weather noise on the North Pacific SST variability is analyzed by comparing a twenty-year long forecast produced by state-of-the-art Climate Forecasting System version 2  againstInteractive Ensemble method . A brieIn the Interactive Ensemble configuration, the momentum, heat and fresh water fluxes that atmospheric component exchanges with ocean component are controlled in a way that the higher frequencies in these fluxes are reduced at the ocean-atmosphere interface. This is achieved by concurrently coupling the mean of the fluxes simulated by several atmospheric components with a single ocean component that in turn forces each atmospheric component with the same SST. This setup leads to a reduction in the atmospheric internal variability in the coupled system. For a more detailed discussion on how the Interactive Ensemble approach reduces the weather noise in a CGCM, refer to Kirtman et al. .http://cfs.ncep.noaa.gov/cfsr/). The initial conditions needed for the six copies of the atmospheric components in CFSIE integration are obtained from the CFS reanalysis data separated by 6 hours starting from 00Z of 1 November 1980.The twenty-year long CFS and CFSIE forecasts are produced from 1 November 1980 to 31 October 2000. The atmosphere and the ocean initial conditions for the forecasts are derived from CFS reanalysis products (available online at http://pcmdi3.llnl.gov/esgcet/), and are run in the 20th century historical external forcing. The CFSf are initialized with NEMOVAR-COMBINE ocean reanalysis data  are produced in this study to understand the SST prediction skill in the NPR. The CFSf are a set of monthly forecasts that follow the guidelines set forth by Coupled Model Intercomparison Project phase 5 . However, in the CFSIE the contribution from the KAA index on PAA index is larger  in each month is estimated by interpolating the ocean depths, between which, the ocean temperature differs from the SST by 0.5∘C  on standard deviation of HT (SD_HT) shows that in the CFSIE, HT contributes more to the variance of PAA index (not shown). The strong spatial contrast of the regression parameter in the NPR indicates that HT acts to diffuse the variance of PAA index. The higher HT in conjunction with the lower MXLD in the CFSIE forecast prompts to diffuse stronger SST contrasts that are specific to decadal SST forecasts in the North Pacific region that were found in the CFS forecasts. The depth cross-section of averaged SST along the transect that connects the locations 20ons Fig. .Fig. 10∘-60∘N and 120∘E-80∘W, referred as NPR) SSTA forecasts as produced by CMIP5-style decadal forecasts with state-of-the-art global climate forecasting system model (CFS) in an Interactive Ensemble set-up (CFSIE), which reduces atmospheric internal variability. The main goal of this study is to examine and understand the pathways that prompted the reduced prediction skill in the CFSIE forecasts in comparison with the regular CFS forecasts. Two 20-year long forecasts produced with CFS and CFSIE for 1980-2000 are compared for the subsurface characteristics that influence SST in the North Pacific Region. The detailed heat budget analysis in the oceanic mixed layer of the CFS and CFSIE experiments reveals that the heat transport in the oceanic mixed layer is driven significantly by the atmospheric internal variability (weather noise). In the CFSIE, the reduction in the weather noise leads to shallower mixed layer depths and the increase in the heat content variations associated with lower heat flux result in diminished heat content storage and enhanced horizontal heat advection throughout the basin. Due to the deeper mixed layer in CFS, the available heat flux channels to raise the temperature in the the mixed layer and this diminishes the heat available for the basin-wide horizontal transport.The motivation for this study stems from the reduced prediction skill in North Pacific region (20The enhanced HT in the CFSIE is basin-wide in the spatial extent and spans from the active Kuroshio regions of east coast of Japan to the west coast of continental United States. This enhanced horizontal advection of heat in the oceanic mixed layer acts in a way to diffuse the SSTA contrasts and leads to reduced skills in decadal forecasts.


The skin of vertebrates acts as a biological barrier defending the organism against many harmful environmental factors. It is well established that the main stress hormone cortisol, together with antioxidants such as melatonin (Mel) and its biologically active metabolites set up a local stress response system in the mammalian skin. Recently, our research group has shown that in fish there are basic conditions for the functioning of a cutaneous stress response system (CSRS) similar to that in mammals, where Mel with its biologically active metabolite AFMK (N1-acetyl-N2-formyl-5-methoxykynuramine) and cortisol act together to protect organism against unfavorable environment. Since aquaculture is making an increasing contribution to the global economy and new laws are demanding people to respect the welfare requirements of animals there has been increasing interest in indicators of fish well-being in aquaculture. This article addresses the problem of on-farm assessment of fish welfare and proposes the CSRS as a new source of information on the welfare status of farmed fish. There has been growing public concern for the well-being of farmed fish since aquaculture is making an increasing contribution to the global economy and, at the same time, new laws are demanding people to respect the welfare requirements of animals to ensure their right treatment  (Gasterosteus aculeatus) (cutaneous synthesis of Mel would seem to be confirmed by studies in various fish species where higher Mel concentrations were found in their skin than in plasma or muscles (Ciconia ciconia) living near a copper smelter, toxic compounds in the diet can stimulate Mel synthesis on-the-spot in the gut, to serve as a first-line defensive step in the protective mechanism of the organism   and the uleatus) . Moreove muscles . A stimu muscles . For insorganism . Variousorganism , but notCertainly, one might expect to find some dissimilarity between the stress response systems in fish skin and in terrestrial vertebrates’ skin. The aquatic environment and the specific structure/function of fish skin make a difference! The skin in fish is covered by mucus and this outermost layer has been considered a first line of defense against a wide range of detrimental environmental conditions  and pathThe author confirms being the sole contributor of this work and has approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.