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Dopamine (DA) release in striatal circuits, including the nucleus accumbens medial shell (mNAcSh), tracks separable features of reward like motivation and reinforcement. However, the cellular and circuit mechanisms by which DA receptors transform DA release into distinct constructs of reward remain unclear. Here we show that DA D3 receptor (D3R) signaling in the mNAcSh drives motivated behavior in mice by regulating local microcircuits. Furthermore, D3Rs coexpress with DA D1 receptors, which regulate reinforcement, but not motivation. Paralleling dissociable roles in reward function, we report nonoverlapping physiological actions of D3R and DA D1 receptor signaling in mNAcSh neurons. Our results establish a fundamental framework wherein DA signaling within the same nucleus accumbens cell type is physiologically compartmentalized via actions on distinct DA receptors. This structural and functional organization provides neurons in a limbic circuit with the unique ability to orchestrate dissociable aspects of reward-related behaviors relevant to the etiology of neuropsychiatric disorders.

Conventional technology for the modification of surfaces loaded with nanomaterials typically requires a three-step process: (1) the construction of a polymer platform, (2) the synthesis of nanoparticles (NPs), and (3) the immobilization or anchoring of NPs. During the immobilization or anchoring process, there is an unavoidable excess of NPs primarily situated at the top of the surface, resulting in the agglomeration of aggregates. These aggregates can form different shapes and sizes, often creating an uneven distribution of NPs, resulting in an unstable coating that gradually releases NPs over time. In this study, argon plasma technology was used to create an innovative nanocoating consisting of polymer chains that are cross-linked to metal NPs, forming a polymer composite. To do this, argon plasma was employed as both an oxidizing and reducing agent during different steps in the nanocoating fabrication process. More specifically, a “grafting-from” approach, coupled with in situ argon plasma-assisted reduction of Cu2+to Cu0, provided an innovative means for the construction of the nanocoating. With this “grafting-from” approach, the covalent binding of acrylic acid monomers to a surface results in a negatively charged nanocoating when exposed to solutions of a pH greater than 4.5. Due to its negative charge, the nanocoating can bind cations from solution, creating a platform for the in situ argon plasma-assisted reduction of Cu2+to primarily Cu0NPs (CuNPs). By controlling grafting conditions, in situ plasma-assisted reduction of NPs, and cross-linking conditions, we can generate nanocoatings with specific (1) polymer graft density and film thickness, (2) NP concentration cross-linked to polymer chains, and (3) NP composition. Under optimal experimental conditions, a nonleaching cross-linkage occurs between the nanocoating and the NPs, with only minimal NP aggregation. We have used this technology to engineer cross-linked nanocoatings possessing extremely low amounts of CuNPs (4.02 μg/cm2), which are distributed within the nanocoating and are capable of preventing infections.

The medial prefrontal cortex (mPFC) controls behavior via connections with limbic excitatory afferents that engage various inhibitory motifs to shape mPFC circuit function. The dynorphin (Dyn) / kappa-opioid receptor (KOR) system is highly enriched in the mPFC, and its dysregulation is implicated in neuropsychiatric disorders. However, it is unclear how the Dyn / KOR system modulates excitatory and inhibitory circuits that are integral for mPFC information processing and behavioral control. Here, we provide a circuit-based framework wherein mPFC Dyn / KOR signaling regulates excitation-inhibition balance by toggling which afferents drive mPFC neurons. Dyn / KOR regulation of afferent inputs is pathway-specific. Dyn acting on presynaptic KORs inhibits glutamate release from afferent inputs to the mPFC, including the basolateral amygdala (BLA), paraventricular nucleus of the thalamus, and contralateral cortex. The majority of excitatory synapses to mPFC neurons, including those from the ventral hippocampus (VH), do not express presynaptic KOR, rendering them insensitive to Dyn / KOR modulation. Dyn / KOR signaling also suppresses afferent-driven recruitment of specific inhibitory sub-networks, providing a basis for Dyn to disinhibit mPFC circuits. Specifically, Dyn / KOR signaling preferentially suppresses SST interneuron- relative to PV interneuron-mediated inhibition. Selective KOR action on afferents or within mPFC microcircuits gates how distinct limbic inputs drive spiking in mPFC neurons. Presynaptic Dyn / KOR signaling decreases KOR-positive input-driven (e.g. BLA) spiking of mPFC neurons. In contrast, KOR-negative input recruitment of mPFC neurons is enhanced by Dyn / KOR signaling via suppression of mPFC inhibitory microcircuits. Thus, by acting on distinct circuit elements, Dyn / KOR signaling shifts KOR-positive and negative afferent control of mPFC circuits, providing mechanistic insights into the role of neuropeptides in shaping mPFC function. Together, these findings highlight the utility of targeting the mPFC Dyn / KOR system as a means to treat neuropsychiatric disorders characterized by dysregulation in mPFC integration of long-range afferents with local inhibitory microcircuits.

Penicillin is the most common drug allergy. While up to 20% of the population may acquire the penicillin allergy label in their lifetime, more than 90% can safely receive it, leading to unnecessary use of higher order antibiotics The PEN-FAST tool is a validated clinical decision rule used to identify low-risk penicillin allergies. By teaching antibiotic stewardship and use of this tool, we can promote better patient and public health outcomes.

Over the last decades, several studies have analyzed the collocational preferences of particular sets of near synonyms from a synchronic viewpoint, while their diachronic development has generally been disregarded. The aim of this paper is to partially fill this gap by examining the collocational behavior of the adjectives fragrant, perfumed, and scented, which denote the concept sweet smelling, over the time span 1810–2009. To this purpose, instances of the three near-synonyms and their L5–R5 collocates were extracted from the Corpus of Historical American English (COHA) and then submitted to statistical modeling. Results indicate that, at the beginning of the time span analyzed, the collocational preferences of scented and perfumed are very similar but, over time, scented becomes semantically closer to fragrant, while at the same time taking over some of its functions.

Aims: In the Iberian Peninsula, high and flat areas called ‘paramos’ are of great ecological interest, due to their unique but little known plant and animal communities. In this work, we contribute to the knowledge of plant composition and carry out a classification of plant communities in central Iberian natural ‘paramos’. Study area: Two Special Areas of Conservation (Natura 2000 Network) in Southern Soria (Spain): ‘Altos de Barahona’ and ‘Páramo de Layna’. Methods: We sampled the vegetation (plant cover) in 345 plots of 1 m2 in the two ‘paramos’ considered. A hierarchical agglomerative clustering of samples and an indicator value (IndVal) analysis were performed to classify the plant communities and to determine the most characteristic species of each community. Results: A total of 193 species, mainly chamaephytes, were found. Most of these are species of Mediterranean biogeographical affinity, with a high percentage of Iberian endemism. Plots were hierarchically classified into three main clusters, which in turn, successfully aggregated into seven subclusters reflecting characteristic visually-known plant communities of these ‘paramos’: grassland-thyme scrublands of Thymus mastigophorus; savory scrublands of Satureja intricata; two types of mixed communities dominated by continental basophilic shrubs; gorse shrublands of Genista pumila subsp. rigidissima; praire-thyme scrublands of Thymus zygis subsp. zygis; and sage scrublands of Salvia lavandulifolia subsp. lavandulifolia. These plant communities, located in unique landscapes mainly in Iberia and other parts of Europe, should be subject to conservation and restoration measures, in order to maintain their ecological value and avoid the loss of unique species. Taxonomic reference: Castroviejo (1986–2020) for plant species and botanical families. Abbreviations: Special Areas of Conservation (SAC), Special Protection Areas (SPA), Indicator Value (IndVal).

To date, 750 000 patients with COVID-19 worldwide have required mechanical ventilation and thus are at high risk of acute brain dysfunction (coma and delirium). We aimed to investigate the prevalence of delirium and coma, and risk factors for delirium in critically ill patients with COVID-19, to aid the development of strategies to mitigate delirium and associated sequelae.

Medical students often have limited exposure to providing care to physically and cognitively disabled patients. To address this gap, Involvement with Disability Education and Advancement (IDEA) was started in 2015 at Rutgers New Jersey Medical School (NJMS). The organization provides NJMS students the opportunity to visit a school dedicated to disabled students and lead educational sessions on health topics.

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AbstractBackgroundIn the midst of this national opioid crisis, it has become apparent that there is a large shortage in the workforce of treatment providers equipped to deliver evidence-based care for opioid use disorders (OUD). Medications for opioid use disorder (MOUD), such as buprenorphine, are crucial in reducing mortality in those with OUD, and yet prescribers must meet federal waiver requirements under the Drug Addiction Treatment Act of 2000 (DATA 2000). There are now several pathways for medical schools to satisfy these waiver requirements for all graduates, but this has not yet become widespread. We propose that including a DATA 2000 waiver training within the medical school curriculum is a feasible and effective way to meet eligibility requirements to prescribe buprenorphine. Methods:As part of a longitudinal opioid curriculum requirement, we implemented a DATA 2000 waiver training for all rising Year 4 medical students. One hundred sixty-nine students completed a hybrid (online and in-person) waiver training. The majority completed a pre- and post-survey. Results:The pre-training survey showed 93% of rising Year 4 medical students (112/120) reported participation in care of patients with OUD. Students six month post-training reported a rise in confidence (1.94 to 2.45; p < 0.01) and knowledge (2.27 to 2.76; p < 0.01) regarding MOUD. They also reported their plans to apply for the buprenorphine waiver once licensed and reported being more likely to prescribe buprenorphine for OUD as a result of the training (mean = 3.35; SD = 1.36; 0 = extremely unlikely to 5 = extremely likely). Conclusions:We successfully implemented a DATA 2000 waiver training as a mandatory requirement for the medical school curriculum. Further studies are needed to determine optimal timing, best format, and frequency of reinforcement of MOUD educational content across the undergraduate and graduate medical education continuum.

Background In the midst of this national opioid crisis, it has become apparent that there is a large shortage in the workforce of treatment providers equipped to deliver evidence-based care for opioid use disorders (OUD). Medications for opioid use disorder (MOUD), such as buprenorphine, are crucial in reducing mortality in those with OUD, and yet prescribers must meet federal waiver requirements under the Drug Addiction Treatment Act of 2000 (DATA 2000). There are now several pathways for medical schools to satisfy these waiver requirements for all graduates, but this has not yet become widespread. We propose that including a DATA 2000 waiver training within the medical school curriculum is a feasible and effective way to meet eligibility requirements to prescribe buprenorphine.Methods As part of a longitudinal opioid curriculum requirement, we implemented a DATA 2000 waiver training for all rising Year 4 medical students. One hundred sixty-nine students completed a hybrid (online and in-person) waiver training. The majority completed a pre- and post-survey.Results The pre-training survey showed 93% of rising Year 4 medical students (112/120) reported participation in care of patients with OUD. Students six month post-training reported a rise in confidence (1.94 to 2.45; p< 0.01) and knowledge (2.27 to 2.76; p< 0.01) regarding MOUD. They also reported their plans to apply for the buprenorphine waiver once licensed and reported being more likely to prescribe buprenorphine for OUD as a result of the training (mean = 3.35; SD = 1.36; 0 = extremely unlikely to 5 = extremely likely).Conclusions We successfully implemented a DATA 2000 waiver training as a mandatory requirement for the medical school curriculum. Further studies are needed to determine optimal timing, best format, and frequency of reinforcement of MOUD educational content across the undergraduate and graduate medical education continuum.

B cells are activated by two temporally distinct signals, the first provided by the binding of antigen to the B cell antigen receptor (BCR), and the second provided by helper T cells. Here we found that B cells responded to antigen by rapidly increasing their metabolic activity, including both oxidative phosphorylation and glycolysis. In the absence of a second signal, B cells progressively lost mitochondrial function and glycolytic capacity, which led to apoptosis. Mitochondrial dysfunction was a result of the gradual accumulation of intracellular calcium through calcium response–activated calcium channels that, for approximately 9 h after the binding of B cell antigens, was preventable by either helper T cells or signaling via the receptor TLR9. Thus, BCR signaling seems to activate a metabolic program that imposes a limited time frame during which B cells either receive a second signal and survive or are eliminated.

Growth of wild ungulate populations within protected areas can cause an expansion towards surrounding non-protected areas and lead to conflicts with human activities. The spatial and demographic structure of colonizing populations inform about their state and potential trends, since the initial colonization by dispersing individuals precedes the establishment of a population with potential for further growth and expansion. Once colonization has succeeded, the spatial pattern of animal abundance is associated with intra- and interspecific interactions and environmental factors (e.g., habitat and food availability) and the population shows similar demographic features throughout the whole occupation area, which has been called a diffusive dispersal pattern. Here, we analyze the current status of colonization by a guanaco population of ranches surrounding a protected area in Chilean Patagonia with data gathered along three consecutive years. We thus compared animal abundance and social structure between the protected and unprotected areas and evaluated throughout the whole area the effect of environmental factors on guanaco abundance, proportion of family groups, and reproductive success. Guanaco abundance significantly declined with increasing distance from the center of the local distribution and marginally with predation risk. Moreover, social structure showed only minor differences between areas, pointing to a diffusive dispersal pattern. These results suggest that the population is already well established and has the potential to grow and continue its expansion. The case exemplifies a challenging outcome of successful animal conservation, and it presents a useful approach to evaluate the state of wild ungulate populations colonizing new areas.

To evaluate whether nicotinamide adenine dinucleotide-positive (NAD+) boosting modulates adaptive immunity, primary CD4+T cells from healthy control and psoriasis subjects were exposed to vehicle or nicotinamide riboside (NR) supplementation. NR blunts interferon γ (IFNγ) and interleukin (IL)-17 secretion with greater effects on T helper (Th) 17 polarization. RNA sequencing (RNA-seq) analysis implicates NR blunting of sequestosome 1 (sqstm1/p62)-coupled oxidative stress. NR administration increases sqstm1and reduces reactive oxygen species (ROS) levels. Furthermore, NR activates nuclear factor erythroid 2-related factor 2 (Nrf2), and genetic knockdown of nrf2and the Nrf2-dependent gene, sqstm1, diminishes NR amelioratory effects. Metabolomics analysis identifies that NAD+boosting increases arginine and fumarate biosynthesis, and genetic knockdown of argininosuccinate lyase ameliorates NR effects on IL-17 production. Hence NR via amino acid metabolites orchestrates Nrf2 activation, augments CD4+T cell antioxidant defenses, and attenuates Th17 responsiveness. Oral NR supplementation in healthy volunteers similarly increases serum arginine, sqstm1, and antioxidant enzyme gene expression and blunts Th17 immune responsiveness, supporting evaluation of NAD+boosting in CD4+T cell-linked inflammation.

Niche theory predicts that coexisting species will partition resources to limit the effects of interspecific competition. We examined microhabitat partitioning in six sets of steppe birds associated to agroecosystems in central Spain (female and male Great Bustards Otis tarda, female and male Little Bustards Tetrax tetrax, Red-legged Partridges Alectoris rufaand Eurasian Stone-curlews Burhinus oedicnemus) to estimate realized niche breadth, overlap and segregation. Principal Components Analysis on data from used and random microhabitat locations produced two axes we retained for analysis related with two key factors: cover-visibility and food availability. Non-parametric kernel density functions were calculated for each of the PCA axes and species (or sexes), and niche overlap estimated as the area shared between species’ density functions. Null models were run to evaluate overlap significance. In analyses of microhabitat selection by the six sets of birds, 13 out of 15 pairs had significant resource partitioning and niche segregation, except for the pairs partridge and female Great Bustard and the two sexes of Great Bustard. Eurasian Stone-curlew showed wider trophic niche breadth, although segregated from the other species, probably because of its higher invertebrate requirements. Great and Little Bustards segregated in both niche axes, selecting microhabitat according to their body size. Accessibility to food resources and shelter seems to be similar for partridges and female Great Bustards, overlapping in their selection, which may indicate the existence of segregation in other niche factors (e.g., feeding habits). Great Bustard males showed niche overlap with females. Little Bustard males showed feeding microhabitat selection patterns similar to those of females, although they preferred more open microhabitats to meet their sexual display requirements. The entire assemblage had significantly less overlap than expected by chance, suggesting that differential microhabitat selection and realized niche partitioning may explain coexistence in steppe bird communities. Our results suggest that the maintenance of different microhabitat structure should be a priority in the management of agricultural environments.

Niche theory predicts that coexisting species will partition resources to limit the effects of interspecific competition. We examined microhabitat partitioning in six sets of steppe birds associated to agroecosystems in central Spain (female and male Great Bustards Otis tarda, female and male Little Bustards Tetrax tetrax, Red-legged Partridges Alectoris rufaand Eurasian Stone-curlews Burhinus oedicnemus) to estimate realized niche breadth, overlap and segregation. Principal Components Analysis on data from used and random microhabitat locations produced two axes we retained for analysis related with two key factors: cover-visibility and food availability. Non-parametric kernel density functions were calculated for each of the PCA axes and species (or sexes), and niche overlap estimated as the area shared between species’ density functions. Null models were run to evaluate overlap significance. In analyses of microhabitat selection by the six sets of birds, 13 out of 15 pairs had significant resource partitioning and niche segregation, except for the pairs partridge and female Great Bustard and the two sexes of Great Bustard. Eurasian Stone-curlew showed wider trophic niche breadth, although segregated from the other species, probably because of its higher invertebrate requirements. Great and Little Bustards segregated in both niche axes, selecting microhabitat according to their body size. Accessibility to food resources and shelter seems to be similar for partridges and female Great Bustards, overlapping in their selection, which may indicate the existence of segregation in other niche factors (e.g., feeding habits). Great Bustard males showed niche overlap with females. Little Bustard males showed feeding microhabitat selection patterns similar to those of females, although they preferred more open microhabitats to meet their sexual display requirements. The entire assemblage had significantly less overlap than expected by chance, suggesting that differential microhabitat selection and realized niche partitioning may explain coexistence in steppe bird communities. Our results suggest that the maintenance of different microhabitat structure should be a priority in the management of agricultural environments.

Chronic neurotoxicity caused by lithium salts can be reversible or irreversible and may appear after years of treatment, even at serum levels considered within the usual therapeutic range. The authors present the case of a patient with bipolar disorder who developed dementia at the age of 54 after being treated with lithium carbonate at therapeutic levels for 4 years. Nevertheless, lithium treatment was continued. At age 56, the patient presented with an acute encephalopathy caused by toxic lithium levels, which resolved only after lithium carbonate was discontinued. Full recovery from the dementia, which had started 2 years earlier, occurred only after cessation of lithium. The authors conclude that when patients treated with lithium develop subacute cognitive impairment, the possibility of lithium toxicity should be considered, even if the serum levels are considered within the therapeutic range. A long duration of neurotoxicity associated with lithium treatment does not necessarily indicate an irreversible prognosis. (Journal of Psychiatric Practice2015;21:154–159)

The mitochondria play an important role in the activation of the innate immune system. This organelle modulates the metabolic reprogramming of the immune cell into proinflammatory or anti-inflammatory subtypes, which typically utilize very different metabolic pathways to fulfill their functions. It also acts as a signaling platform to activate immune routes in both immune and nonimmune cells, as it can generate agonists for inflammatory pathways, including toll-like receptors, inflammasomes, or the cyclic GMP–AMP synthase–stimulator of interferon genes pathway, which lead to the generation of proinflammatory cytokines and antiviral molecules such as type-I interferons. These novel functions of the mitochondria are important in the fight against pathogens, but also contribute to human disease when dysregulated. This review describes recent findings in this field and highlights the role of mitochondrial nucleic acids in the regulation of innate immune signaling pathways.

Cardiovascular diseases and in particular severe coronary stenosis are the main cause of death in the western hemisphere. The diagnostic method considered as gold-standard in the quantification and location of the coronary lesions is the coronary angiography. This procedure is required in patients with a high probability of coronary heart disease. To treat patients, interventional cardiologists analyse the angiographic images, establish a disease diagnosis and may even provide a prognosis, depending on the location, severity, and extent of the coronary disease. From the late 1970s, a large number of studies have been carried out, aimed at building information systems that assess general practitioners in the diagnostic tasks. These systems are based on the quantification of the anatomical information in an objective way. The relevant information is extracted from the coronary angiographies using automatic or semiautomatic image segmentation techniques. The precision of the segmentation is a key element in the subsequent measurement of the stenosis and flow capacity of the arteries, which also enables the establishment of an index or score related to the prognosis of the disease. Multiscalar methods, matching filters, and morphologic mathematical methods present the best balance between precision and processing speed. The best results are frequently obtained through the common use of multiple techniques. The current paper presents a review of the best techniques used for the extraction of anatomical information from coronary angiographies over the past thirty years.

The incidence of neurological complications in the forearm after radial artery harvesting varies in the literature, ranging from 2% to more than 50%. Also, the areas affected and the type of neurological complications differ a lot. Peripheral nerve injuries may be divided into three types: neuroapraxia (conduction block that recovers within 3 months), axonotmesis (recovers 1 ml/day) and neurotmesis (needs surgery for recovering). We decided to perform a neuroelectrophysiological study, before and after surgery, in peripheral nerves of the forearm to find out the real incidence and the type of lesion after radial artery harvesting.

Sal1p is a mitochondrial protein that belongs to the SCaMC (short calcium-binding mitochondrial carrier) subfamily of mitochondrial carriers. The presence of calcium-binding motifs facing the extramitochondrial space allows the regulation of the transport activity of these carriers by cytosolic calcium and provides a new mechanism to transduce calcium signals in mitochondria without the requirement of calcium entry in the organelle. We have studied its transport activity, finding that it is a carboxyatractyloside-resistant ATP-Mg carrier. Mitochondria from a disruption mutant of SAL1 have a 50% reduction in the uptake of ATP. We have also found a clear stimulation of ATP-transport activity by calcium, with an S0.5 of approx. 30 μM. Our results also suggest that Sal1p is a target of the glucose-induced calcium signal which is non-essential in wild-type cells, but becomes essential for transport of ATP into mitochondria in yeast lacking ADP/ATP translocases.

We analysed female body mass change, corrected by tarsus length (body condition) in tawny pipits Anthus campestrisduring the nesting period in a population subject to high nest predation rates (between 70 and 85%), which leads to the need for replacement clutches. Decrease in female body condition over the nesting stage (6.8 g, around 27% of the initial mass during the whole nesting process) was related to laying date, clutch size and nesting period (incubation and nestling phases). Data from recaptured females indicated a decrease during each of the three nesting phases considered (the last days of incubation and first and last days of the nestling phase), with body mass always being higher in the first of the two measurements taken in each of these phases. The observation of a continuous decrease in body condition during the last days of incubation and first and last days of the nestling phase does not support the programmed anorexia hypothesis, but adjusts well to predictions of the stress hypothesis. These results suggest that the costs accumulated during the entire nesting stage in ground passerines subjected to high nest predation rates are linked to a superimposed effect of the cost of replacement clutches.

OBJECTIVE: The homologous upregulation produced by 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] on vitamin D receptor (VDR) levels, and the effects produced by the heterologous agents hydrocortisone or deflazacort, alone or in conjunction with this vitamin D metabolite, were studied in rat osteoblastic UMR-106 osteosarcoma cells. METHODS: VDR were determined by binding analysis (Bmax and dissociation constant). VDR mRNA expression levels were measured by Northern blot analysis. RESULTS: Incubation with 10 nM 1,25(OH)2D3 produced a significant increase in Bmax with respect to ethanol-treated cells (100.2 ± 13.2 vs 11.4 ± 4.8 fmol 3H-1,25(OH)2D3 bound/mg protein) together with a significant increase in VDR mRNA expression (483 ± 170% vs 100%). The addition of 10 nM hydrocortisone to 1,25(OH)2D3 produced a significant decrease in Bmax (from 100.2 ± 13.2 to 44 ± 5.6), with mRNA levels similar to those of basal conditions (116 ± 25% vs 100%). However, the addition of 10 nM deflazacort did not reduce the activation in Bmax produced by 1,25(OH)2D3 (92.4 ± 16 vs 100.2 ± 13.2), maintaining the increase in mRNA levels (430 ± 10% vs 483 ± 170%). If 10 nM hydrocortisone or 10 nM deflazacort was added to UMR-106 cells without 1,25(OH)2D3, a similar increase was observed in Bmax with respect to basal conditions (20.4 ± 1.3 or 20.9 ± 1.6 vs 11.4 ± 4.8 in control cells), but hydrocortisone did not produce any significant variation in mRNA VDR levels, while deflazacort itself produced an increase in VDR mRNA expression. CONCLUSION: Our findings of different actions produced by hydrocortisone and deflazacort on the increase of VDR levels produced by 1,25(OH)2D3 could explain some of the different actions produced by both antiinflammatory medications on bone metabolism.

Abstract:: Fragments derived from degradation of type I collagen C-telopeptide (CTX) can be nonisomerized (α) or β-isomerized (β) depending on the age of bone; i.e., mainly the α form is derived from new bone and the β form from old bone. We have studied 41 female patients with anorexia nervosa (AN), aged 18.5 ± 2.2 years (range 16–24 years), and with an evolution time between 1.5 and 11 years, and 31 healthy control females (C), with a mean age of 19 ± 2.3 years (range 16–24 years). The AN patients showed a significant decrease in bone mass, with a mean Z-score of bone mineral density (BMD) of −3.2 ± 0.8 (range −0.9 to −5.4). The aim of our study was to determine the levels of urinary α- and β-CTX markers of bone resorption, the α/β ratio (α/β), and the level of bone alkaline phosphatase (bAP), a biochemical marker of bone formation, in order to relate them to the degree of osteopenia and the status of bone remodeling. Statistical analysis was by the Mann–Whitney test. The degree of osteopenia correlated with bAP levels (p= 0.0027) but not with the other parameters. Patients with AN were divided into three groups according to their levels of bAP: high (H), normal (N) or low (L). We found that BMD was significantly lower, and α- and β-CTX were significantly higher, in groups H and N than in group L. Bone AP correlated significantly with α-CTX (p= 0.0042) and α/β (0.0095) in the controls, but not with β-CTX, while in AN patients bAP correlated with β-CTX (p= 0.0000) and with α-CTX (p= 0.022) but not with the α/β ratio. The ratio CTX/bAP (resorption/formation) was similar in AN patients and controls. It is concluded that: (1) patients with AN have a high degree of osteopenia which correlated with bAP levels; (2) urinary CTX fragments found in AN patients seem to come mainly from old bone (β-CTX), while CTX found in healthy adolescent control females come from new bone (α-CTX). For this reason, α-CTX is more suitable than β-CTX for measuring bone resorption in controls and β-CTX is more suitable in patients with AN; (3) the resorption/formation ratio (CTX/bAP) was similar in AN patients and controls. From points (2) and (3) it is possible to suggest that, although bAP reflects bone formation in control females, this marker does not reflect effective bone mineralization in AN patients, a similar feature to that of patients with osteomalacia.

An extract from Mothers and Shadows, in which the Argentinian novelist recreates one of the demonstrations of the 'mothers of the Plaza de Mayo' - the mothers of the disappeared

An extract from Mothers and Shadows, in which the Argentinian novelist recreates one of the demonstrations of the ‘mothers of the Plaza de Mayo’ — the mothers of the disappeared

Abstract: A comparative study was performed on the sensitivity of the determination of the available biochemical markers of bone formation — total and bone alkaline phosphatase (TAP and bAP, respectively), osteocalcin (BGP), procollagen I aminoterminal propeptide (PINP) and procollagen I carboxyterminal propeptide (PICP) — in the study of postmenopausal osteoporosis. The comparison between PINP and PICP, due to the recent development of the amino-terminal assay, is of special interest. The study included 26 untreated osteoporotic postmenopausal women, age 59±6 years (range 46–69 years) and 17 healthy control postmenopausal women, age 56±7 years (range 48–70 years). We found a significant increase in the levels of bAP (p=0.0021), BGP (p=0.041), PINP (p=0.0001) and PICP (p=0.0073), but not in the levels of TAP (p=0.3389), in osteoporotic patients with respect to the control group. Serum PINP and bAP showed the highest diagnostic accuracy among the markers of bone formation studied, as can be deduced from the receiver operating characteristics (ROC) curves. In spite of their similar origin (amino-terminal and carboxy-terminal release from a procollagen molecule), the results obtained by measuring levels of PINP are significantly better than those found with PICP.

We report a case of spinal and bulbar muscular atrophy (SBMA), also known as Kennedy disease, with a 38 CAG-repeat expansion in exon-1 of the androgen receptor gene, presenting with a 2-year history of mild speech difficulty, dysphonia, and occasional choking. Initial clinical features and complementary studies were consistent with SBMA. The disease progression, as assessed by the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised, remained stable over the first 5 years from the onset but showed a rapid decline (from 42 to 24 points) over the next 18 months before his death. In the later stages of the disease, deep tendon reflexes were preserved in limbs and a brisk jaw-jerk reflex and bilateral Hoffmann sign were evident. Survival from disease onset was 78 months. The final cause of death was aspiration pneumonia. The atypical clinical features, evolution, and accelerated disease course are not concordant with the relatively short 38 CAG-repeat expansion in the androgen receptor gene. This may represent either a variant SBMA phenotype, which has not been recorded to date, or the development of amyotrophic lateral sclerosis in a known case of SBMA.

The discovery of new and versatile strategies for the immobilization of molecular water-oxidation catalysts (WOCs) is crucial for developing clean energy conversion devices [e.g., (photo)electrocatalytic cells for water splitting]. The traditional approach for surface attachment to transparent conductive oxides [e.g., fluorine doped tin oxide (FTO)] is via synthetic modification of the ligand architecture to incorporate functional groups such as carboxylic acids (−COOH) or phosphonates (−PO3H2) prior to immobilization. However, challenges arising from desorption and the cumbersome derivatizations steps have limited the scope and applications of surface-bound WOCs. Herein, we report the successful immobilization of underivatized Ru(II)-based WOCs (Ru–Cat1= [Ru(tpy) (bpy) (H2O)]2+(tpy = 2,2′:6′2″–terpyridine and bpy = 2,2′-bipyridine) and Ru–Cat2= [Ru(Mebimpy) (bpy) (H2O)]2+(Mebimpy = 2,6-bis(1-methylbenzimidazol-2-yl) pyridine)) and the Ru(II) polypyridyl chromophore Ru–C3= [Ru(bpy)3]2+onto a FTO plasma-grafted poly(acrylic acid) surface (PAA|FTO). Various characterization techniques such as attenuated total reflectance Fourier transform infrared spectroscopy, scanning electron microscopy, atomic force microscopy, and cyclic voltammetry measurements provide evidence for the plasma-induced grafted PAA|FTO film and immobilization. Surface stability and electrocatalytic properties of these new hybrid composite films upon cycling were investigated at different pH values. Immobilized Ru–Cat1and Ru–Cat2onto PAA|FTO displayed pH-dependent (RuIII/RuII) couples and onset potentials indicative of PCET (proton-coupled electron transfer) reactions. Based on cyclic voltammetry results and spectroscopic monitoring, the immobilized WOCs Ru–Cat1and Ru–Cat2exhibited a higher surface stability in neutral aqueous solutions relative to Ru–C3upon electrochemical oxidation. We attribute the surface PCET and stability to the presence of a water ligand in the coordination sphere of immobilized Ru–Cat1and Ru–Cat2which can H-bond with negatively charged carboxylate groups of the cross-linked PAA brushes. Our findings demonstrate that the plasma-grafted polymeric network onto FTO offers a versatile platform to directly anchor unmodified homogeneous WOCs or chromophores for potential applications in solar-to-fuel energy conversion.

Nephrolithiasis is presented in 18–40% of patients with primary hyperparathyroidism. Our work suggests that citrate, an inhibitor of calcium salts, could be involved in the presence of renal lithiasis because hyperparathyroid stone formers show less citrate elimination than nonstone formers.

Areas of ectopic ossification were found in thin sections from 19 of 1,624 calculi submitted to a petrographic procedure, an incidence of 1.16 per cent. Only 8 calculi of renal, pelvic or ureteral origin with osseous tissue in its structure have been described since the first report by Phemister in 1923.

Different mechanisms could explain the elevated calcium elimination, the main cause of calcium oxalate renal stones. Our results suggest that phosphate levels are decreased in patients with absorptive hypercalciuric nephrolithiasis and elevated serum dihydroxyvitamin D. This could be the reason why in this group of patients oral phosphate treatment prevented hypercalciuria and renal lithiasis.

An excerpt from the book "Historia Abierta del Arte Columbiano," Museum of Modern Art La Tertulia, Cali, Colombia,1974 is presented.

Without Abstract: