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Objective: This study evaluated the cost-effectiveness of a 100% human milk-based diet composed of mother's milk fortified with a donor human milk-based human milk fortifier (HMF) versus mother's milk fortified with bovine milk-based HMF to initiate enteral nutrition among extremely premature infants in the neonatal intensive care unit (NICU)., Methods: A net expected costs calculator was developed to compare the total NICU costs among extremely premature infants who were fed either a bovine milk-based HMF-fortified diet or a 100% human milk-based diet, based on the previously observed risks of overall necrotizing enterocolitis (NEC) and surgical NEC in a randomized controlled study that compared outcomes of these two feeding strategies among 207 very low birth weight infants. The average NICU costs for an extremely premature infant without NEC and the incremental costs due to medical and surgical NEC were derived from a separate analysis of hospital discharges in the state of California in 2007. The sensitivity of cost-effectiveness results to the risks and costs of NEC and to prices of milk supplements was studied., Results: The adjusted incremental costs of medical NEC and surgical NEC over and above the average costs incurred for extremely premature infants without NEC, in 2011 US$, were $74,004 (95% confidence interval, $47,051-$100,957) and $198,040 (95% confidence interval, $159,261-$236,819) per infant, respectively. Extremely premature infants fed with 100% human-milk based products had lower expected NICU length of stay and total expected costs of hospitalization, resulting in net direct savings of 3.9 NICU days and $8,167.17 (95% confidence interval, $4,405-$11,930) per extremely premature infant (p < 0.0001). Costs savings from the donor HMF strategy were sensitive to price and quantity of donor HMF, percentage reduction in risk of overall NEC and surgical NEC achieved, and incremental costs of surgical NEC., Conclusions: Compared with feeding extremely premature infants with mother's milk fortified with bovine milk-based supplements, a 100% human milk-based diet that includes mother's milk fortified with donor human milk-based HMF may result in potential net savings on medical care resources by preventing NEC.

Rohitukine is a chromane alkaloid possessing anti-inflammatory, anti-cancer and immuno-modulatory properties. The compound was first reported from Amoora rohituka (Meliaceae) and later from Dysoxylum binectariferum (Meliaceae) and Schumanniophyton problematicum (Rubiaceae). Flavopiridol, a semi-synthetic derivative of rohitukine is a potent CDK inhibitor and is currently in Phase III clinical trials. In this study, the isolation of an endophytic fungus, Fusarium proliferatum (MTCC 9690) from the inner bark tissue of Dysoxylum binectariferum Hook.f (Meliaceae) is reported. The endophytic fungus produces rohitukine when cultured in shake flasks containing potato dextrose broth. The yield of rohitukine was 186 μg/100 g dry mycelial weight, substantially lower than that produced by the host tissue. The compound from the fungus was authenticated by comparing the LC-HRMS and LC-HRMS/MS spectra with those of the reference standard and that produced by the host plant. Methanolic extract of the fungus was cytotoxic against HCT-116 and MCF-7 human cancer cell lines (IC(50) = 10 μg/ml for both cancer cell lines).

Background: Klebsiella pneumoniae is a gram-negative, non-motile, facultative anaerobe belonging to the Enterobacteriaceae family of the γ-Proteobacteria class in the phylum Proteobacteria. Multidrug resistant K. pneumoniae have caused major therapeutic problems worldwide due to emergence of extended-spectrum β-lactamase producing strains. Two-component systems serve as a basic stimulus-response coupling mechanism to allow organisms to sense and respond to changes in many different environmental conditions including antibiotic stress., Principal Findings: In the present study, we investigated the role of an uncharacterized cpxAR operon in bacterial physiology and antimicrobial resistance by generating isogenic mutant (ΔcpxAR) deficient in the CpxA/CpxR component derived from the hyper mucoidal K1 strain K. pneumoniae NTUH-K2044. The behaviour of ΔcpxAR was determined under hostile conditions, reproducing stresses encountered in the gastrointestinal environment and deletion resulted in higher sensitivity to bile, osmotic and acid stresses. The ΔcpxAR was more susceptible to β-lactams and chloramphenicol than the wild-type strain, and complementation restored the altered phenotypes. The relative change in expression of acrB, acrD, eefB efflux genes were decreased in cpxAR mutant as evidenced by qRT-PCR. Comparison of outer membrane protein profiles indicated a conspicuous difference in the knock out background. Gel shift assays demonstrated direct binding of CpxR(KP) to promoter region of ompC(KP) in a concentration dependent manner., Conclusions and Significance: The Cpx envelope stress response system is known to be activated by alterations in pH, membrane composition and misfolded proteins, and this systematic investigation reveals its direct involvement in conferring antimicrobial resistance against clinically significant antibiotics for the very first time. Overall results displayed in this report reflect the pleiotropic role of the CpxAR signaling system and diversity of the antibiotic resistome in hyper virulent K1 serotype K. pneumoniae NTUH-K2044.

Hsp90 chaperone has been identified as an attractive pharmacological target to combat cancer. However, some metastatic tumors either fail to respond to Hsp90 inhibition or show recovery necessitating irreversible therapeutic strategies. In response to this enforced senescence has been proposed as an alternate strategy. Here, we demonstrate that inhibiting Hsp90 with 17AAG sensitizes human neuroblastoma to DNA damage response mediated cellular senescence. Among individual and combination drug treatments, 17AAG pre-treatment followed by doxorubicin treatment exhibited senescence-like characteristics such as increased nucleus to cytoplasm ratio, cell cycle arrest, SA-β-gal staining and the perpetual increase in SAHF. Doxorubicin induced senescence signaling was mediated by p53-p21(CIP/WAF-1) and was accelerated in the absence of functional Hsp90. Sustained p16(INK4a) and H3K4me3 expressions correlating with unaffected telomerase activation annulled replicative senescence and appraised stress induced senescence. Despite increases in [(ROS)i] and [(Ca(2+))i], a concomitant increase in cellular antioxidant defense system suggested oxidation independent senescence activation. Sustained activation of survival (Akt) and proliferative (ERK1/2) kinases fosters robustness of cells. Invigorating senescent cells with growth factor or snooping with mTOR or PI3 kinase inhibitors compromised cell survival but not senescence. Intriguingly, senescence-associated secretory factors from the senescence cells manifested established senescence in neuroblastoma, which offers clinical advantage to our approach. Our study discusses tumor selective functions of Hsp90 and discusses irrefutable strategies of Hsp90 inhibition in anticancer treatments.

Background: The diffusion of antibiotics through the outer membrane is primarily affected by the porin super family, changes contribute to antibiotic resistance. Recently we demonstrated that the CpxAR two-component signaling system alters the expression of an uncharacterized porin OmpC(KP), to mediate antimicrobial resistance in K. pneumoniae., Principal Findings: In this study, functional characterization of the putative porin OmpC(KP) (denoted kpnO) with respect to antimicrobial susceptibility and virulence was evaluated by generating an isogenic mutant, ΔkpnO in a clinical isolate of K. pneumoniae. Estimation of uronic acid content confirmed that ΔkpnO produced ∼2.0 fold lesser capsular polysaccharide than the wild-type. The ΔkpnO displayed higher sensitivity to hyper osmotic and bile conditions. Disruption of kpnO increased the susceptibility of K. pneumoniae to oxidative and nitrostative stress by ∼1.6 fold and >7 fold respectively. The loss of the Klebsiella porin led to an increase in the minimum inhibitory concentration of tetracycline (3-fold), nalidixic acid (4-fold), tobramycin (4-fold), streptomycin (10-fold), and spectinomycin (10-fold), which could be restored following complementation. The single deletion of kpnO reduced the survival of the pathogen by 50% when exposed to disinfectants. In Caenorhabditis elegans model, the kpnO mutant exhibited significantly (P<0.01) lower virulence. To dissect the role of PhoBR signaling system in regulating the expression of the kpnO, a phoB(KP) isogenic mutant was constructed. The phoB(KP) mutant exhibited impaired gastrointestinal stress response and decreased antimicrobial susceptibility. The mRNA levels of kpnO were found to be 4-fold less in phoB(KP) mutant compared to wild type. A regulatory role of PhoB(KP) for the expression of kpnO was further supported by the specific binding of PhoB(KP) to the putative promoter of kpnO., Conclusions and Significance: Loss of PhoBR regulated porin KpnO resulted in increased antimicrobial resistance, increased susceptibility to gastrointestinal stress, and reduced virulence in K. pneumoniae NTUH-K2044.

We present a new framework for feature-based statistical analysis of large-scale scientific data and demonstrate its effectiveness by analyzing features from Direct Numerical Simulations (DNS) of turbulent combustion. Turbulent flows are ubiquitous and account for transport and mixing processes in combustion, astrophysics, fusion, and climate modeling among other disciplines. They are also characterized by coherent structure or organized motion, i.e. nonlocal entities whose geometrical features can directly impact molecular mixing and reactive processes. While traditional multi-point statistics provide correlative information, they lack nonlocal structural information, and hence, fail to provide mechanistic causality information between organized fluid motion and mixing and reactive processes. Hence, it is of great interest to capture and track flow features and their statistics together with their correlation with relevant scalar quantities, e.g. temperature or species concentrations. In our approach we encode the set of all possible flow features by pre-computing merge trees augmented with attributes, such as statistical moments of various scalar fields, e.g. temperature, as well as length-scales computed via spectral analysis. The computation is performed in an efficient streaming manner in a pre-processing step and results in a collection of meta-data that is orders of magnitude smaller than the original simulation data. This meta-data is sufficient to support a fully flexible and interactive analysis of the features, allowing for arbitrary thresholds, providing per-feature statistics, and creating various global diagnostics such as Cumulative Density Functions (CDFs), histograms, or time-series. We combine the analysis with a rendering of the features in a linked-view browser that enables scientists to interactively explore, visualize, and analyze the equivalent of one terabyte of simulation data. We highlight the utility of this new framework for combustion science; however, it is applicable to many other science domains., (© 2011 IEEE)

Placental insufficiency resulting in fetal loss has been recognized in women with thrombophilic predisposition. Recent studies indicate that there is a high prevalence of protein Z (PZ) deficiency in patients with unexplained fetal loss. The objective of this study was to measure the PZ levels in pregnant Omani women in the first, second and third trimesters and correlate with the pregnancy outcome. The study enrolled 126 consecutive pregnant women after an informed consent prospectively. PZ was estimated in the first, second and third trimester in 15, 97 and 66 pregnant women respectively and they were followed for pregnancy outcomes including live birth, still birth, spontaneous abortion/induced abortion, maternal complications, fetal complications and health risks/complications in the newborn. The median PZ level (Mean ± SD) in the first, second and third trimester were 0.98 (1.07 ± 0.46), 1.3 (1.36 ± 0.61) and 1.44 (1.43 ± 0.69) (P < 0.05, Student's t-test, between first vs. second and first vs. third trimester). PZ deficiency defined as PZ level below 0.54 μg/ml (below 10th centile in the Omani population) was observed in 4 (4.7%) women, but interestingly all had a normal pregnancy outcome. Amongst the 43 subjects in whom paired PZ estimations were available, reducing PZ levels were observed from baseline values in 8 (33%) with normal pregnancy outcome; 5 (55%), with diabetes; 3 (50%) with hypertension and 2 (50%) with low birth weight respectively (P < 0.05, chi square test). PZ values increased progressively during the three trimesters of pregnancy. However, this increase is blunted in patients with abnormal pregnancy outcome like low birth weight babies or pregnancies associated hypertension or diabetes. Isolated PZ deficiency alone did not result in an abnormal outcome in this cohort of subjects.

Consanguinity is common in Arab countries. The Sultanate of Oman has a relatively small population with a high prevalence of consanguineous marriages. This is a retrospective study of women who had three or more consecutive miscarriages between January 2002 and December 2008, investigated in the non-pregnant state. Age, parity, menstrual history, number of miscarriages, personal and family history, history of consanguinity and investigations were collected for 141 patients. The mean number of miscarriages was 3.4; 53% of the women had a consanguineous marriage, 42% were non-consanguineous and in 5% the marital interrelationship was unknown. There was no significant difference in the prevalence of parental karyotype abnormalities, anticardiolipin antibodies, antinuclear antibodies, thyroid disorders, or lupus between the consanguineous and non-consanguineous couples. Consanguinity appeared not to play a significant role in the etiology of recurrent spontaneous miscarriage., (© 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.)

Organic acid disorders are inherited metabolic disorders in which organic acids accumulate in tissues and biological fluids of affected individuals. Classical organic acidurias include methylmalonic aciduria, propionic aciduria, isovaleric aciduria and maple syrup urine disease (MSUD). They are considered the most frequent metabolic disorders among severely ill children. Patients frequently present with acute symptoms early in life. 420 cases clinically suspected to have organic aciduria, with upper age limit of 12 years for a 2-year period (January 2007-December 2008) were enrolled into this study. Metabolic acidosis and neurological symptoms were the most common signs. Screening tests and thin layer chromatography were done for detection of organic acidurias. Identification and quantitation of organic acids in urine and quantification of amino acids in blood were done by high performance liquid chromatography. Out of 420 patients, 45 patients (10.7%) were found to have organic acidurias. 15 cases of methylmalonic aciduria, 16 cases of propionic aciduria, 13 cases of MSUD, and one case of isovaleric aciduria were diagnosed. Results demonstrate the importance of testing for organic acidurias. Since organic aciduria may cause irreversible brain damage if not treated, we recommend selective screening amongst severely ill children despite implied extra costs.

Cornual pregnancy constitutes an emergency while its diagnosis and management remain a challenge. Anatomical abnormalities in the uterus, such as fibroids in the cornual region, make the management even more difficult. A nulliparous patient presented with an ectopic pregnancy at the right cornua under a huge fibroid. Despite multiple doses of methotrexate for a cornual ectopic gestation, the serum beta human chorionic gonadotropin (β-hcG) levels doubled on the fifth day and a viable fetus was demonstrated on imaging. Thus surgical intervention in the form of laparoscopy followed by laparotomy, myomectomy of a large cornual fibroid and cornuostomy was performed. The serum beta human chorionic gonadotropin result was negative three weeks later. Surgical intervention in the form of myomectomy and cornuostomy was necessary to preserve fertility in this unusual presentation of cornual ectopic pregnancy.

On the basis of previous results from this laboratory, this study tested the hypothesis that ground beef high in MUFA and low in SFA would increase the HDL-cholesterol (HDL-C) concentration and LDL particle diameter. In a crossover dietary intervention, 27 free-living normocholesterolemic men completed treatments in which five 114-g ground beef patties/wk were consumed for 5 wk with an intervening 4-wk washout period. Patties contained 24% total fat with a MUFA:SFA ratio of either 0.71 (low MUFA, from pasture-fed cattle) or 1.10 (high MUFA, from grain-fed cattle). High-MUFA ground beef provided 3.21 g more 18:1(n-9), 1.26 g less 18:0, 0.89 g less 16:0, and 0.36 g less 18:1(trans) fatty acids per patty than did the low-MUFA ground beef. Both ground beef interventions decreased plasma insulin and HDL(2) and HDL(3) particle diameters and increased plasma 18:0 and 20:4(n-6) (all P ≤ 0.05) relative to baseline values. Only the high-MUFA ground beef intervention increased the HDL-C concentration from baseline (P = 0.02). The plasma TG concentration was positively correlated with the plasma insulin concentration (r = 0.40; P < 0.001) and negatively correlated with HDL-C (r = -0.47; P < 0.001) and plasma 18:0 (r = -0.24; P < 0.01). Plasma insulin and HDL diameters were not correlated (r = 0.01; P > 0.50), indicating that reductions in these measures were not coordinately regulated. The data indicate that dietary beef interventions have effects on risk factors for cardiovascular disease that are independent (insulin, HDL diameters) and dependent (HDL-C) on beef fatty acid composition.

Recognition of the strength of nonhuman primate models in investigating metabolic disorders has resulted in an expanded need for in vivo research techniques. We studied adipose metabolism in 10 baboons (13.0 ± 4.2 years old, 29.5 ± 5.5 kg). Part 1 evaluated the effect of different sedatives on the rate of appearance of plasma free fatty acids (RaFFA), assessed using ¹³C₄-labeled palmitate infusion (7 µmol/kg/min). Animals, were studied with no sedation, with complete isoflurane sedation, and with minimal midazolam infusion (0.04 mg/kg/h), with the last scheme allowing for the most consistent values and animals that were visually more calm. In Part 2, RaFFA and RaGlycerol (D₅-glycerol, 5 mg/kg lean body mass/h) were measured. From midnight to 0300, flux fell and came to a steady state between 0500 and 0700 h (RaFFA, 39.4 ± 29.8 μmol/kg fat mass/min; and RaGlycerol, 26.9 ± 7.3 μmol/kg/min). The RaFFA-to-RaGlycerol ratio was 1.5 ± 0.8 (49% reesterification). The decline in turnover throughout the night reflects natural circadian processes and was mirrored by reductions in FFA and glycerol to 0.62 and ± 0.14 and 0.16 and ± 0.03 mmol/l, respectively. The concurrent changes in both FFA and glycerol kinetics indicate physiologic validity of the method. These techniques will support needed research to determine mechanisms by which treatments act upon the adipocyte in vivo.

Background: Randomized clinical trials [RCT] are the Gold Standard of medical evidence. However, observational comparative effectiveness research [CER] based on real-world data is receiving national attention. This paper demonstrates how observational CER can fill important gaps in clinical knowledge left behind by RCT approaches. An example of CER in bipolar disorders is presented., Methods: Paid claims data from a large commercial insurer were used to identify episodes of drug therapy. Episodes were defined each time a patient initiated or restarted therapy using an antipsychotic, antidepressant or mood stabilizing medication. Episode definitions were based on calculations of continuous days of drug therapy using a 15 day gap definition. 105,440 episodes of drug therapy were included in the analysis., Results: Most episodes were initiated using a mood stabilizing drug (40%) or an antidepressant (40%). Over 59% of all episodes were for augmentation therapy, followed by switching episodes (25%) and restart episodes (16%). Patient outcomes measured by either duration of uninterrupted therapy or one-year post-treatment cost varied significantly with patient treatment history, especially episode type. The comparative effectiveness of alternative therapies was sensitive to the extent to which treatment history is taken into account., Conclusions: Observational research can evaluate patient outcomes across a wide range of clinical presentations with regard to the patient's treatment history. Treatment history is a major determinant of patient compliance and future treatment costs. Failure to account for treatment history can introduce bias into comparative effectiveness results. Observational CER research can also uncover important questions that require future research., (Copyright © 2010 Elsevier B.V. All rights reserved.)

High-sensitivity C-reactive protein is more a marker of obesity than polycystic ovary syndrome itself, in particular in women >30 years of age., (Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Objectives: The objectives of this study were to compare the demographics, semen parameters and hormone profiles in men with primary and secondary infertility., Methods: The study was designed as a retrospective analysis of data collected from men attending a combined infertility clinic (seen together by urologist and gynaecologist) from January 2005 to December 2008 at Sultan Qaboos University Hospital, a tertiary care hospital in Oman. Ninety-eight consecutive male patients with one or more abnormalities in semen analysis were referred to the combined infertility clinic. A complete physical examination was carried out by a urologist followed by hormone evaluation of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) and prolactin (PRL)., Results: The semen parameters and the sex hormone evaluation were not significantly different between the men with primary and secondary infertility. The men with primary infertility were younger than the men with secondary infertility. A total of 24% of the men in the primary group and 16% in the secondary group were azoospermic with normal gonadotropin values in 9 men and 1 man in the primary and secondary group respectively., Conclusion: Azoospermia was more common in the primary infertile group and, based on gonadotropin levels, obstructive causes seemed more prevalent in the primary group compared to secondary group.

A Gram-negative, rod-shaped, motile bacterium was isolated from the soil of a ginseng field in Daejeon, South Korea, and characterized in order to determine its taxonomic position. Phylogenetic analysis based on 16S rRNA gene sequence analysis revealed that strain DCY34(T) belonged to the family Sphingomonadaceae, and the highest degree of sequence similarity was found with Sphingopyxis witflariensis W-50(T) (97.1 %), Sphingopyxis ginsengisoli Gsoil 250(T) (97.0 %), Sphingopyxis chilensis S37(T) (96.9 %), Sphingopyxis macrogoltabida IFO 15033(T) (96.8 %), Sphingopyxis alaskensis RB2256(T) (96.7 %) and Sphingopyxis taejonensis JSS54(T) (96.7 %). Chemotaxonomic data revealed that strain DCY34(T) possessed ubiquinone Q-10 as the predominant respiratory lipoquinone, which is common to members of the genus Sphingopyxis. The predominant fatty acids were C₁₈:₁ω7c (27.5 %), summed feature 4 (C₁₆:₁ω7c and/or C₁₅ :₀ iso 2-OH; 18.6 %), C₁₆:₀ (15.6 %) and summed feature 8 (C₁₉:₁ω6c and/or unknown 18.864; 15.4 %). The major polar lipids were phosphatidylethanolamine, diphosphatidylglycerol, phosphatidylglycerol, phosphatidylcholine, sphingoglycolipid and an unknown polar lipid. The results of physiological and biochemical tests clearly demonstrated that strain DCY34(T) represented a separate species and supported its affiliation to the genus Sphingopyxis. Based on these data, the new isolate represents a novel species, for which the name Sphingopyxis panaciterrulae sp. nov. is proposed. The type strain is DCY34(T) (=KCTC 22112(T)=JCM 14844(T)).

Objectives: To stratify the magnetic resonance (MR) pelvimetric diameters according to mode of delivery and establish possible reference values for pelvic diameters and outlet index for trial of labor after a previous caesarean section., Methods: This is a retrospective study of 125 patients at Sultan Qaboos University Hospital who underwent MR pelvimetry prior to a trial of vaginal delivery after a previous caesarean section between May 2001 and October 2003. Sagittal inlet, Transverse inlet, interspinous diameter, sagittal outlet and transverse outlet diameters were measured in all patients. The mean diameters were stratified according to delivery modality (vaginal delivery or caesarean section). The outlet index (sum of interspinous, sagittal outlet and intertuberous diameters), biparietal diameter of the foetus and head circumference were compared in women who delivered by caesarean section or vaginally., Results: All the diameters except sagittal inlet, were significantly larger (P < 0.05) in women who delivered normally as compared with those who had a caesarean section for any indication. The mean outlet index in the spontaneous delivery group with vertex presentation 31.89 ± 2.05, was significantly larger than that of the elective and emergency caesarean section, which were 29.69 ± 1.85 & 30.62 ± 1.80 respectively. The mean head circumference was also found to be significantly larger in the caesarean section deliveries., Conclusion: An outlet index of 31.89 ± 2.05 and the pelvic diameters, transverse inlet 12.56 ± 0.80cm, sagittal outlet 10.54 ± 1.00 cm, interspinous diameter10.46 ± 0.89cm, and intertuberous diameter (transverse outlet) 10.89 ± 1.02cm are useful cut-off points for vaginal delivery in our population.

The distal nickel site of acetyl-CoA synthase (Ni(d)-ACS) and reduced nickel superoxide dismutase (Ni-SOD) display similar square-planar Ni(II)N(2)S(2) coordination environments. One difference between these two sites, however, is that the nickel ion in Ni-SOD contains a mixed amine/amidate coordination motif while the Ni(d) site in Ni-ACS contains a bisamidate coordination motif. To provide insight into the consequences of the different coordination environments on the properties of the Ni ions, we systematically examined two square-planar Ni(II)N(2)S(2) complexes, one with bisthiolate-bisamidate ligation (Et(4)N)(2)(Ni(L1)).2H(2)O (2) [H(4)L1 = N-(2-mercaptoacetyl)-N'-(2-mercaptoethyl)glycinamide] and another with bisthiolate-amine/amidate ligation K(Ni(HL2)) (3) [H(4)L2 = N-(2''-mercaptoethyl)-2-((2'-mercaptoethyl)amino)acetamide]. Although these two complexes differ only by a single amine versus amidate ligand, their chemical properties are quite different. The stronger in-plane ligand field in the bisamidate complex (Ni(II)(L1))(2-) (2) results in an increase in the energies of the d --> d transitions and a considerably more negative oxidation potential. Furthermore, while the bisamidate complex (Ni(II)(L1))(2-) (2) readily forms a trinuclear species (Et(4)N)(2)({Ni(L1)}(2)Ni).H(2)O (1) and reacts rapidly with O(2), presumably via sulfoxidation, the mixed amine/amidate complex (Ni(II)(HL2))(-) (3) remains monomeric and is stable for days in air. Interestingly, the Ni(III) species of the bisamidate complex formed by chemical oxidation with I(2) can be detected by electron paramagnetic resonance (EPR) spectroscopy while the mixed amine/amidate complex immediately decomposes upon oxidation. To explain these experimentally observed properties, we performed S K-edge X-ray absorption spectroscopy and low-temperature (77 K) electronic absorption measurements as well as both hybrid density functional theory (hybrid-DFT) and spectroscopy oriented configuration interaction (SORCI) calculations. These studies demonstrate that the highest occupied molecular orbital (HOMO) of the bisamidate complex (Ni(II)(L1))(2-) (2) has more Ni character and is significantly destabilized relative to the mixed amine/amidate complex (Ni(II)(HL2))(-) (3) by approximately 6.2 kcal mol(-1). The consequence of this destabilization is manifested in the nucleophilic activation of the doubly filled HOMO, which makes (Ni(II)(L1))(2-) (2) significantly more reactive toward electrophiles such as O(2).

Objective: To study the prevalence of cesarean delivery in hyperuricemic preeclamptic patients., Methods: This is a retrospective study of 94 women with preeclampsia from July 2006 through to December 2007. Serum uric acid was measured on admission. Mode of delivery and neonatal outcome were also recorded., Results: Hyperuricemic preeclamptic mothers were associated with higher probability of delivery by caesarean section (33% versus 12%; p = 0.007). There was a significant negative correlation between uric acid levels and gestational age (rho = -0.456; p < 0.001) but a positive association between uric acid levels and admission to neonatal unit (p < 0.001). There were no neonatal deaths., Conclusion: Hyperuricemia in preeclamptic patients was associated with higher probability of cesarean delivery.

We evaluated the diagnostic accuracy of saline infusion sonohysterography (SISH) over transvaginal sonography (TVS) for the detection of intrauterine abnormalities using hysteroscopy as the gold standard in a retrospective study of 70 women mostly presenting with abnormal uterine bleeding. TVS was normal in 32 women, while in the others polyps or fibroids projecting into the cavity (n = 19) or a thick endometrium (n = 19) were suspected. On performing SISH the uterine cavity was found to be normal in 29 women, while 35 had suspected polyps/fibroids and 6 had other abnormalities. Hysteroscopy proved to be normal in 28 women, 35 had polyps/fibroids and 7 had other abnormalities. The sensitivity, specificity, positive and negative predictive values for TVS were 72.4%, 100%, 100% and 74%, respectively, while for SISH the corresponding figures were 91.4%, 92.6%, 89.3% and 94.1%. SISH is a simple, minimally invasive and cost-effective investigative tool enhancing the diagnostic accuracy of TVS and can be an effective screening test prior to hysteroscopy.

This paper describes the design of a tri-axial microelectromechanical force sensor (FS) that can be mounted on the tip of the guidewire. Piezoresistive silicon nanowires (SiNW) are embedded into a cross cantilever design with a manoeuvrable stylus to allow the detection of force in all directions. The electrical resistance changes in the four SiNWs are used to decode an arbitrary force applied onto the FS. The sensitivity of the device can be improved by two orders of magnitude compared to bulk Si thanks to the giant piezoresistive effects offered by the SiNW. Robustness of the FS is improved due to the novel design by incorporating a mechanical stopper at the tip of the stylus. Finite element analysis (FEM) analysis was used in designing the FS.

Spiders spin high performance threads that have diverse mechanical properties for specific biological applications. To better understand the molecular mechanism by which spiders anchor their threads to a solid support, we solubilized the attachment discs from black widow spiders and performed in-solution tryptic digests followed by MS/MS analysis to identify novel peptides derived from glue silks. Combining matrix-assisted laser desorption ionization tandem time-of-flight mass spectrometry and cDNA library screening, we isolated a novel member of the silk gene family called pysp1 and demonstrate that its protein product is assembled into the attachment disc silks. Alignment of the PySp1 amino acid sequence to other fibroins revealed conservation in the non-repetitive C-terminal region of the silk family. MS/MS analysis also confirmed the presence of MaSp1 and MaSp2, two important components of dragline silks, anchored within the attachment disc materials. Characterization of the ultrastructure of attachment discs using scanning electron microscopy studies support the localization of PySp1 to small diameter fibers embedded in a glue-like cement, which network with large diameter dragline silk threads, producing a strong, adhesive material. Consistent with elevated PySp1 mRNA levels detected in the pyriform gland, MS analysis of the luminal contents extracted from the pyriform gland after tryptic digestion support the assertion that PySp1 represents one of the major constituents manufactured in the pyriform gland. Taken together, our data demonstrate that PySp1 is spun into attachment disc silks to help affix dragline fibers to substrates, a critical function during spider web construction for prey capture and locomotion.

A novel tripodal ligand with three different arms, viz., pyridine, phenol and an oxime and its copper(II) complex were synthesised. The X-ray crystal structure of the compound reveals that it is a dinuclear complex consisting of two copper(II) ions doubly bridged by two oximato groups in a trans arrangement. The complex contains unusual cis-axially coordinated phenolates as well as a novel interligand, intramolecular phenolate-phenol hydrogen bond. Variable-temperature magnetic susceptibility measurements revealed that the two copper(II) centers are strongly antiferromagnetically coupled, with the exchange coupling constant -2J = 800(42) cm(-1) (H = -2J S(1) x S(2)) for the two interacting S = 1/2 centres. The complex yields an (1)H NMR spectrum in CD(3)CN solution at room temperature, with relatively sharp signals and rather small hyperfine shifts, evidencing that the antiferromagnetically coupled dinuclear core is maintained in solution.

Titanium dioxide (TiO2) nanotubes formed by anodization over titanium wires show a significant improvement in photocatalytic activity compared to the nanotubes formed over foils. This is evident when the fractional conversion of a textile dye, methyl orange, increased from 19% over a foil to 40% over wires in the presence of nanotubes of identical dimensions illuminated over the same geometrical area. Higher degradation rates with Pt-TiO2 nanotubes over foils are matched by the Pt-free TiO2 nanotubes over the wires. The higher photocatalytic activity over the anodized wires can be attributed to the efficient capture of reflected and refracted light by the radially outward oriented TiO2 nanotubes formed over the circumference of the titanium wire. The formation of TiO2 nanotubes over wires can be considered as an effective alternate to improve photodegradation rates by avoiding expensive additives.

We describe a complete implementation of all-atom protein molecular dynamics running entirely on a graphics processing unit (GPU), including all standard force field terms, integration, constraints, and implicit solvent. We discuss the design of our algorithms and important optimizations needed to fully take advantage of a GPU. We evaluate its performance, and show that it can be more than 700 times faster than a conventional implementation running on a single CPU core., ((c) 2009 Wiley Periodicals, Inc.)

Twelve novel zidovudine derivatives were prepared by modifying 5 '-hydroxyl group of sugar moiety (1-8) and 5-methyl group of thymidine nucleus (9-12) and characterized spectrally. The compounds were evaluated for anti-HIV-1, antitubercular and antibacterial activities. Compound (3-azido-tetrahydro-5- (3,4-dihydro-5-methyl-2,4-dioxopyrimidin-1(2H)-yl)furan-2-yl)methyl 7-(4-(2-phenylacetoyloxy)-3,5- dimethylpiperazin-1-yl)-5-(2-phenylacetoyloxyamino)-1-cyclopropyl-6,8-difluoro-1,4-dihydro-4-oxoquinoline-3-carboxylate (5) was found to be the most potent anti-HIV-1 agent with EC(50) of 0.0012 microM against HIV-1(IIIB) and CC(50) of 34.05 microM against MT-4 with selectivity index of 28,375. Compound 5 inhibited Mycobacterium tuberculosis with MIC of 1.72 microM and inhibited four pathogenic bacteria with MIC of less than 1 microM.

Implementation of molecular dynamics (MD) calculations on novel architectures will vastly increase its power to calculate the physical properties of complex systems. Herein, we detail algorithmic advances developed to accelerate MD simulations on the Cell processor, a commodity processor found in PlayStation 3 (PS3). In particular, we discuss issues regarding memory access versus computation and the types of calculations which are best suited for streaming processors such as the Cell, focusing on implicit solvation models. We conclude with a comparison of improved performance on the PS3's Cell processor over more traditional processors., ((c) 2008 Wiley Periodicals, Inc.)

Alloimmunisation against the RhD red cell surface antigen was the most common cause of haemolytic disease of the fetus and newborn until recently. Maternal plasma has now almost replaced fetal cells obtained by amniocentesis or chorionic villous sampling, as the source of fetal DNA, hence eliminating the need for invasive sampling procedures. The fetal rhesus typing was done from maternal plasma in a woman in her fourth pregnancy, though she was isoimmunised in her previous pregnancies and needed invasive tests like cordocentesis in the past. The fetus was diagnosed to be rhesus negative from maternal plasma and that avoided the need for amniocentesis or cordocentesis.

The Levonorgestrel intrauterine device (LNG-IUD) is a hormone-containing device licensed for treatment of menorrhagia and contraception. Though complications such as perforation have been reported similar to other non-hormonal intrauterine devices, the diagnosis of such complications is difficult with this device because the LNG-IUD has a different ultrasound appearance compared to copper devices and these case reports are intended to emphasize this point.

Introduction: Adnexal torsion in advanced pregnancy is an uncommon emergency. Torsion usually occurs in ovaries with functional cysts or tumors. It is uncommon for a normal-sized ovary to undergo torsion in advanced gestation. We report torsion of a normal-sized ovary in the third trimester of pregnancy, most probably the first case report of its kind in the English-language literature., Case Presentation: A 32-year-old Omani woman at 32-weeks gestation (gravida 2 para 1) was admitted with right iliac fossa pain, nausea and vomiting of 2 days duration, as well as a history of a similar episode one month earlier. On examination, a provisional diagnosis of appendicitis was made. Laparotomy revealed, however, that the right ovary was gangrenous and had undergone torsion., Conclusion: Adnexal torsion, though rare, should be kept in mind in the differential diagnosis of lower abdominal pain in advanced gestation. Although in our patient, the affected ovary could not be saved, an early diagnosis using imaging like Doppler of the adnexae will enable early intervention to save the ovaries of the patient, especially in young women.

Background: We previously reported ciprofloxacin resistance (CR) and empirical use of fluoroquinolones as predictors of mortality in patients infected with Pseudomonas aeruginosa in a case-control study. Here, we assessed the clinical impact of reducing empirical fluoroquinolone use for P. aeruginosa infections in hospitalized patients by performing a follow-up study in 2005-06 [period 2 (P2)] and comparing this with prior data from 2001-02 [period 1 (P1)]., Methods: Medical charts of infected patients who received at least 72 h of antibiotic therapy were reviewed. Patients were subgrouped based on the susceptibility of infected strains into the CR or ciprofloxacin-susceptible group. Antibiograms, patient and treatment variables and outcome measures were compared between groups and between study periods., Results: Study patients were elderly (median age, 76 years), had a median of three co-morbidities and a median APACHE II score of 13. Most (75%) had pneumonia or urosepsis. Empirical use of fluoroquinolones was reduced by 30% in P2 versus P1, with a corresponding 39% increase in piperacillin/tazobactam use. The resultant positive impact observed in the CR group during P2 includes shortened delay to receipt of effective therapy (1 versus 3.5 days, P < 0.0001), reduced length of stay (13 versus 16 days, P = 0.03) and 2-fold lower mortality (9% versus 22%, P = 0.05). Susceptibility of P. aeruginosa improved by 10% to all antipseudomonal agents tested., Conclusions: In settings where high rates of fluoroquinolone resistance exist, use of non-fluoroquinolone-based empirical regimens for P. aeruginosa infections improves patient outcomes and organism susceptibility over time.

Two mixed ligand complexes [Ru(bpy)(2)(DMHBT)]Cl(2)(1) and [Ru(phen)(2)(DMHBT)]Cl(2) (2) (where DMHBT is 11,13-dimethyl-13H-4,5,9,11,14-hexaaza-benzo[b]triphenylene-10,12-dione) have been synthesized and characterized by electrospray ionization (ESI) mass, (1)H-(1)H correlation spectroscopy (COSY), electronic spectroscopy, fluorescence spectroscopy and cyclic voltammetry. Spectroscopic titration and viscosity changes of calf thymus (CT)-DNA in the presence of incremental amount of complexes 1 and 2 clearly demonstrate that both these complexes bind intercalatively to DNA, with binding constant 2.87+/-0.20 x 10(4)M(-1) and 1.01+/-0.20 x 10(5)M(-1) for complexes 1 and 2, respectively. All the experimental evidences suggest that the ancillary ligand 2,2'-bipyridine (bpy) and 1,10-phenanthroline (phen) influences the intercalative binding of these complexes to DNA.

Objective: We examined whether 5-aminolevulinic acid (ALA) could enhance the spectroscopic contrast between normal and diseased oral tissues, without prolonged photosensitivity., Background Data: ALA is a promising photosensitizing agent., Methods: Adose of 25 mg/kg of ALA was administered intravenously to five dogs with gingivitis and three dogs with oral cancer, respectively. Fluorescence was recorded from the diseased sites in the oral cavity in addition to normal sites., Results: ALA-induced proto-porphyrin IX fluorescence at all gingivitis sites reached a peak in 2-3 h and returned to baseline in 24 h. Fluorescence from the gingivitis site was observed earlier and was higher than the fluorescence from the normal site. For dogs with cancer, fluorescence from the cancerous sites occurred earlier in time compared to gingivitis sites and was comparatively higher in intensity., Conclusion: The fluorescence from the diseased sites was found to be higher than the normal site. Clinical and fluorescence data suggest that a dose of 25 mg/kg may be satisfactory for diagnostic purposes and would have minimal side effects.

By using bifunctional surface modifiers (SH-R-COOH), CdSe quantum dots (QDs) have been assembled onto mesoscopic TiO(2) films. Upon visible light excitation, CdSe QDs inject electrons into TiO(2) nanocrystallites. Femtosecond transient absorption as well as emission quenching experiments confirm the injection from the excited state of CdSe QDs into TiO(2) nanoparticles. Electron transfer from the thermally relaxed s-state occurs over a wide range of rate constant values between 7.3 x 10(9) and 1.95 x 10(11) s(-1). The injected charge carriers in a CdSe-modified TiO(2) film can be collected at a conducting electrode to generate a photocurrent. The TiO(2)-CdSe composite, when employed as a photoanode in a photoelectrochemical cell, exhibits a photon-to-charge carrier generation efficiency of 12%. Significant loss of electrons occurs due to scattering as well as charge recombination at TiO(2)/CdSe interfaces and internal TiO(2) grain boundaries.

Two new mixed ligand copper(II) complexes with diethylenetriamine, 2,2'-bipyridine and 1,10-phenanthroline have been synthesized. The crystal and molecular structures of [Cu(dien)(phen)](ClO(4))(2) and [Cu(dien)(bipy)](BF(4))(2) (dien=diethylenetriamine, phen=1,10-phenanthroline, bipy=2,2'-bipyridine) were determined by X-ray crystallography from single crystal data. These two complexes have similar structures. The EPR spectral data also suggest that these complexes have distorted square pyramidal geometry about copper(II). Anti-microbial and superoxide dismutase activities of these complexes have also been measured. They show the higher SOD activity than the corresponding simple Cu(II)-dien/Cu(II)-PMDT (PMDT=N,N,N',N',N''-pentamethyldiethylenetriamine) complexes because of a strong axial bond of one of the nitrogen atoms of the alpha-diimine. Both the complexes have been found to cleave plasmid DNA in the presence of co-reductants such as ascorbic acid and glutathione.

[Cr(naphen)(H2O)(2)]+, where naphen is 1,2-bis(naphthylideneamino)ethane having the basic salen moiety, has been characterized structurally. [Cr(naphen)(H2O)(2)]+, which has an extended aromatic system and binds with calf thymus DNA (CT DNA) intercalatively, has been found to promote DNA cleavage in the presence of biological reductant such as ascorbate and oxidant like hydrogen peroxide. Results of electron paramagnetic resonance (EPR) experiments suggest involvement of hydroxyl radicals in the oxidative cleavage of DNA in the presence of the Cr(III) complex and hydrogen peroxide. The cell viability study on nicked DNA by [Cr(naphen)(H2O)(2)]+ has shown that the damage brought about to DNA could be repaired by Escherichia coli DNA repair enzymes.

Neurocysticercosis is a common cause of adult onset epilepsy. Neurocysticercosis in pregnancy can present with convulsions and may be difficult to differentiate from a pregnancy related disorder. We present a case of neurocysticercosis diagnosed by magnetic resonance imaging.

Pregnancy increases the risk of cerebrovascular accidents to approximately 13 times the expected rate. Most of the cerebrovascular accidents are due to cerebral venous thrombosis. Headache, seizures and focal neurological deficits are some of the symptoms of cerebral venous thrombosis. Headache can also be due to postural puncture, pre eclampsia and eclampsia in the postpartum period. Neuroimaging with MRI with contrast helps in the diagnosis of cerebral venous thrombosis and giving a definite diagnosis, which aids in the treatment and prognosis. The cases presented in this report highlight the importance of investigations such as MRI or CT in the diagnosis of cerebral venous thrombosis in pregnancy and puerperium.

Fluorescence spectroscopic detection using 5-amino levulinic acid (ALA) may provide an effective, noninvasive approach for early detection of oral cancer. In the present study, the use of ALA-induced fluorescence ratio (red/orange) to differentiate between normal and gingivitis-affected gingiva is investigated. Five dogs with varying degrees of gingivitis are studied. Based on previous studies, a dose of 25 mg/kg of ALA is administered intravenously to the dogs. Autofluorescence and ALA-induced fluorescence from three sites: normal gingiva, pigmented gingiva, and gingivitis, are detected with a fiber optic probe coupled to an optical multichannel analyzer. Four dogs show higher and earlier ALA-induced fluorescence from the gingivitis site as compared to the unpigmented gingiva. In two dogs, ALA-induced fluorescence peaks are seen 15 min after ALA administration. Statistical analysis using mean separation procedures reveal differences in the fluorescence from the various sites in each dog. Using a fluorescence (ratio) cutoff of 1.5, the sensitivity and specificity are found to be 92 and 80%, respectively, 1 h after administration of ALA. The indications from this study-that the characteristic protoporphyrin IX (PpIX) fluorescence is seen earlier and in higher magnitude in more vascular areas of the oral cavity-has implications for oral cancer diagnosis., ((c) 2004 Society of Photo-Optical Instrumentation Engineers.)