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Background: Ocular dominance can be defined as the preference of an individual for viewing with one eye over the other for particular visual tasks. It is relevant to monovision contact lens wear, cataract surgery and sports vision. Clinically, the measurement of ocular dominance is typically done at an arbitrary distance using a sighting test, such as the hole-in-card method that has a binary outcome. We investigated the effect of test distance on ocular dominance measured using a binocular sighting test that provided a continuous measurement of dominance., Methods: Ten participants with normal binocular vision took part in this study. Their binocular sighting ocular dominance and phorias were measured at one, two, four, eight and 10 metres. During the dominance tests participants made a binocular alignment judgment and then were asked to indicate the relative alignment of each eye using a visual analogue scale as a reference., Results: Eight participants had strong ocular dominance (five right, three left). For these participants, there was a significant increase in the magnitude of dominance with increasing test distance (p < 0.001). This could not be fully explained by changes in convergence demand. Two participants showed very weak ocular dominance across all test distances (p > 0.05), despite changes in convergence demand., Conclusion: When ocular dominance is present, its magnitude varies significantly with test distance. This has significant implications for the accurate measurement of ocular dominance in the clinic and may reflect the neural processes that influence eye preference., (© 2017 Optometry Australia.)

Study Objective: Cannabis and its principal active constituent, Δ9-tetrahydrocannabinol (THC), are increasingly available as edibles resembling commercially available food products. In this case series, we describe a population of predominantly pediatric patients who were inadvertently exposed to a THC-containing product in San Francisco., Methods: Twelve children and 9 adults were identified, with 16 patients having detectable serum THC and THC metabolites. All patients presented to hospitals with a variety of constitutional symptoms and all were discharged home within 12 hours., Results: In general, pediatric patients had more severe symptoms and longer hospital length of stay, and, uniquely, a majority presented with leukocytosis and elevated lactic acid levels., Conclusion: We recommend that efforts be made to increase general public awareness in regard to the potential hazards of THC-containing edibles resembling commercially available food products., (Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.)

Introduction: Compared to arterial aneurysms, venous pseudoaneurysms are rare and even more rare are external jugular vein aneurysms (EJV). To our knowledge, there are less than 10 well-documented cases of EJV aneurysms accessible., Presentation of Case: Our patient is a 75 year old hispanic female who noticed a painless right neck mass two months prior. Ultrasound confirmed a cystic mass of unknown etiology containing doppler flow. Excisional biopsy revealed an EJV aneurysm with pathologic results of: blood, calcified debris, and a vessel wall consistent with EJV pseudoaneurysm., Discussion: EJV aneurysms are clinically rare compared to IJV aneurysms. Recent trauma, cardiovascular disease and age are reported to be the highest significant clinical risk factors in the formation of jugular vein aneurism (JVA). The absence of trauma in our patient is noteworthy because it eliminates a direct contributor to a normally low-pressure vessel., Conclusions: Despite their rarity, spontaneous EJV aneurisms should be included in the differential of the elderly hypertensive patient who is presenting with a painless mass of the lateral neck that has cystic appearance and ultrasound findings of doppler flow., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Expression of recombinant proteins exerts stress on cell culture systems, affecting the expression of endogenous proteins, and contributing to the depletion of nutrients and accumulation of waste metabolites. In this work, 2D-DIGE proteomics was employed to analyze differential expression of proteins following stable transfection of a Chinese Hamster Ovary (CHO) cell line to constitutively express a heavy-chain monoclonal antibody. Thirty-four proteins of significant differential expression were identified and cross-referenced with cellular functions and metabolic pathways to identify points of cell stress. Subsequently, 1D-(1)H NMR metabolomics experiments analyzed cultures to observe nutrient depletion and waste metabolite accumulations to further examine these cell stresses and pathways. From among fifty metabolites tracked in time-course, eight were observed to be completely depleted from the production media, including: glucose, glutamine, proline, serine, cystine, asparagine, choline, and hypoxanthine, while twenty-three excreted metabolites were also observed to accumulate. The differentially expressed proteins, as well as the nutrient depletion and accumulation of these metabolites corresponded with upregulated pathways and cell systems related to anaplerotic TCA-replenishment, NADH/NADPH replenishment, tetrahydrofolate cycle C1 cofactor conversions, limitations to lipid synthesis, and redox modulation. A nutrient cocktail was assembled to improve the growth medium and alleviate these cell stresses to achieve a ∼75% improvement to peak cell densities., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: Tapentadol (TAP) and tramadol (TRA) provide pain relief through similar monoaminergic and opioid agonist properties., Objective: To compare clinical effects and medical outcomes between TAP and TRA exposures reported to the National Poison Data System of the American Association of Poison Control Centers., Methods: A retrospective cohort study was conducted analyzing national data for single medication TAP or TRA cases reported from June 2009 through December 2011. Case outcomes, dichotomized as severe versus mild; clinical effects; and use of naloxone were compared., Results: There were 217 TAP and 8566 TRA cases. Significantly more severe outcomes were associated with TAP exposures for an all-age comparison (relative risk [RR] = 1.24; 95% CI = 1.04-1.48), and for the <6-year-old age group (RR = 5.76; 95% CI = 2.20-15.11). Patients with TAP exposures had significantly greater risk of respiratory depression (RR = 5.56; 95% CI = 3.50-8.81), coma (RR = 4.16; 95% CI = 2.33-7.42), drowsiness/lethargy (RR = 1.38; 95% CI = 1.15-1.66), slurred speech (RR = 3.51; 95% CI = 1.98-6.23), hallucination/delusion (RR = 7.25; 95% CI = 3.61-14.57), confusion (RR = 2.54; 95% CI = 1.56-4.13) and use of naloxone (RR = 3.80; 95% CI = 2.96-4.88). TRA exposures had significantly greater risk of seizures (RR = 7.94; 95% CI = 2.99-20.91) and vomiting (RR = 1.96; 95% CI = 1.07-3.60)., Conclusion: TAP was associated with significantly more toxic clinical effects and severe outcomes consistent with an opioid agonist. TRA was associated with significantly higher rates of seizures and vomiting., (© The Author(s) 2015.)

Objectives: Aim of this study was to demonstrate the feasibility, safety, and short-term outcome of left atrial appendage (LAA) closure with a new generation LAA closure device., Background: The Amulet device (AGA, St Jude Medical, Minneapolis, MN) is a new generation of the amplatzer cardiac plug (ACP), specifically designed for LAA closure. This new version is designed to facilitate the implantation process and minimize procedural or device-related complications., Methods: The device was implanted in 17 patients with nonvalvular atrial fibrillation (AF). Clinical data were obtained at baseline, during the procedure, at discharge, at 30 and 90 days., Results: All devices were implanted successfully. Device sizes ranged from 20 mm to 31 mm. A 12 French (Fr) or 14 Fr delivery sheath was used depending on the selected device size. Full and partial recapture was performed in 1 case and 3 cases, respectively. There was 1 procedure-related pericardial effusion successfully managed with pericardiocentesis. There was no device embolization. The mean length of stay was 2.1 ± 0.3 days. At 90 days, there were no deaths, strokes, systemic thromboembolism, or bleeding complications. There was no device-related thrombus or pericardial effusion at 90-day TEE. In 2 of the 17 patients minimal peridevice flow (smaller than 2 mm) was present., Conclusions: The Amulet device, which has new novel features as compared with the first generation ACP, is a feasible option for LAA closure. From our initial experience, implantation of the Amulet is associated with high success rate and good short-term outcome., (© 2014 Wiley Periodicals, Inc.)

Objectives: The Internet may be the first source of information used by parents during a suspected poisoning of their children. Our primary aim was to assess the reliability of the Internet as a resource for information for parents to initially manage a suspected poisoning involving their child without outside consultation., Methods: We distributed a self-administered survey to English-speaking parents to evaluate their Internet access behaviors so we could emulate their search strategies for a poisoning. A panel of clinical toxicologists performed an evaluation of Websites to determine the proportion that provided accurate and adequate information on common substances involved in poisonings., Results: Of 21 parents surveyed, 15 (71%) used the Internet daily, with Google and Yahoo being the most commonly used search engines. Seven parents (39%) were somewhat to very likely to utilize the Internet during a poisoning scenario with prescription medications involving their child. Overall, only 27 (38%) of the Websites reviewed advised the user to call the poison center with the proper 800 telephone number, whereas no Website provided adequate information to manage the poisoning without outside consultation. Few Websites provided information on the toxic dose (13%), how to determine whether to manage the poisoning at home or in a hospital (22%), or first aid (28%)., Conclusions: The information provided on the Internet for substances involved in poisonings is variable and often incomplete. Reliance on the Internet for poisonings could create needless delays and inappropriate assessments and actions to manage a pediatric poisoning incident.

Introduction: Phenelzine is an irreversible monoamine oxidase inhibitor (MAOI). Hypertensive reactions after ingestion of tyramine-rich foods such as cheese are well known. However, a review of the available medical literature found no previous reports of myocardial infarction resulting from the ingestion of cheese by a patient taking a MAOI., Case Report: A 34-year-old female taking phenelzine for depression developed severe chest pain 1 h after eating cheese. She was hypertensive and the electrocardiography showed ischemic changes in the antero-lateral chest leads. The chest pain and elevated blood pressure were relieved with intravenous morphine and nitroprusside. The initial serum troponin I level was normal, but serial repeat levels showed a rising trend with a peak at 4.89 ug/L (reference range <0.05 ug/L) 6 h after the initial blood draw, suggestive of a non-ST elevation myocardial infarction. The patient subsequently developed hypotension 4 h after another therapeutic dose of phenelzine was served to the patient 4 h after her admission to the ED. This was corrected with at least 2 L of intravenous normal saline boluses. Subsequent EKGs and Sestamibi scan showed no evidence of cardiac ischemia. She was discharged home after a hospital stay of 3 days., Discussion: We believe this to be the first reported case of myocardial infarction resulting from ingestion of cheese in a patient taking a MAOI. It might be expected that hypertensive crisis could lead to a myocardial infarction, but a review of the medical literature found no such cases reported.

A self-administered network-based questionnaire survey was conducted on 91 HIV-positive Chinese men having sex with men (MSM). Affiliation matrices were created to assess their networking pattern. The individuals' preferential use of venues for sex partnership before HIV infection has changed over three time periods of 1997-2000, 2001-2003 and 2004-2006. Over time, there was a parallel increase in network density (density scores from 0.26, through 0.36, to 0.53) and degree centrality (from a median score of 9, through 12, to 16), suggesting that connectivity of MSM was becoming higher through sexual networks. The overall practice of unprotected sex has, however, remained the same. The study demonstrated how the application of social network analysis could enrich the epidemiologic description of HIV infection in the population., (2009 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd.)

Alternative patterns of neural activity drive different rhythmic locomotory patterns in both invertebrates and mammals. The neuro-molecular mechanisms responsible for the expression of rhythmic behavioral patterns are poorly understood. Here we show that Caenorhabditis elegans switches between distinct forms of locomotion, or crawling versus swimming, when transitioning between solid and liquid environments. These forms of locomotion are distinguished by distinct kinematics and different underlying patterns of neuromuscular activity, as determined by in vivo calcium imaging. The expression of swimming versus crawling rhythms is regulated by sensory input. In a screen for mutants that are defective in transitioning between crawl and swim behavior, we identified unc-79 and unc-80, two mutants known to be defective in NCA ion channel stabilization. Genetic and behavioral analyses suggest that the NCA channels enable the transition to rapid rhythmic behaviors in C. elegans. unc-79, unc-80, and the NCA channels represent a conserved set of genes critical for behavioral pattern generation.

The reaction of [Fe(II)(beta-BPMCN)(OTf)2] (1, BPMCN = N,N'-bis(2-pyridylmethyl)-N,N'-dimethyl-trans-1,2-diaminocyclohexane) with tBuOOH at low-temperature yields alkylperoxoiron(III) intermediates 2 in CH2Cl2 and 2-NCMe in CH3CN. At -45 degrees C and above, 2-NCMe converts to a pale green species 3 (lambda(max) = 753 nm, epsilon = 280 M(-1) cm(-1)) in 90% yield, identified as [Fe(IV)(O)(BPMCN)(NCCH3)]2+ by comparison to other nonheme [Fe(IV)(O)(L)]2+ complexes. Below -55 degrees C in CH2Cl2, 2 decays instead to form deep turquoise 4 (lambda(max) = 656, 845 nm; epsilon = 4000, 3600 M(-1) cm(-1)), formulated to be an unprecedented alkylperoxoiron(IV) complex [Fe(IV)(BPMCN)(OH)(OOtBu)]2+ on the basis of Mössbauer, EXAFS, resonance Raman, NMR, and mass spectral evidence. The reactivity of 1 with tBuOOH in the two solvents reveals an unexpectedly rich iron(IV) chemistry that can be supported by the BPMCN ligand.

The reaction of [FeII(tpa)(OTf)2] (tpa=tris(2-pyridylmethyl)amine) and its related 5-Me3-tpa complex with hydrogen peroxide affords spectroscopically distinct iron(III)-peroxo intermediates in CH3CN and acetone. The reaction in acetonitrile at -40 degrees C results in the formation of the previously reported Fe(III)-OOH intermediate, the end-on hydroperoxo coordination mode of which is established in this paper by detailed resonance Raman isotope-labeling experiments. On the other hand, the reaction in acetone below -40 degrees C leads to the observation of a different peroxo intermediate identified by resonance Raman spectroscopy to be an FeIII-OOC (CH3)2OH species; this represents the first example of an intermediate derived from the adduct of H2O2 and acetone. The peroxoacetone intermediate decays more rapidly than the corresponding FeIII-OOH species and converts to an FeIV=O species by O-O bond homolysis. This decay process is analogous to that observed for [FeIII(tpa)(OOtBu)]2+ and in fact exhibits a comparable enthalpy of activation of 54(3) kJ mol(-1). Thus, with respect to their physical properties at low temperature, the peroxoacetone intermediate resembles [FeIII(tpa)(OOtBu)]2+ more than the corresponding FeIII-OOH species. At room temperature, however, the behavior of the Fe(tpa)/H2O2 combination in acetone in catalytic hydrocarbon oxidations differs significantly from that of the Fe(tpa)/tBuOOH combination and more closely matches that of the Fe(tpa)/H2O2 combination in CH3CN. Like the latter, the Fe(tpa)/H2O2 combination in acetone catalyzes the hydroxylation of cis-1,2-dimethylcyclohexane to its tertiary alcohol with high stereoselectivity and carries out the epoxidation and cis-dihydroxylation of olefins. These results demonstrate the subtle complexity of the Fe(tpa)/H2O2 reaction surface.

The reaction of [Fe(II)(tris(2-pyridylmethyl)amine, TPA)(NCCH(3))(2)](2+) with 1 equiv. peracetic acid in CH(3)CN at -40 degrees C results in the nearly quantitative formation of a pale green intermediate with lambda(max) at 724 nm ( epsilon approximately 300 M(-1).cm(-1)) formulated as [Fe(IV)(O)(TPA)](2+) by a combination of spectroscopic techniques. Its electrospray mass spectrum shows a prominent feature at mz 461, corresponding to the [Fe(IV)(O)(TPA)(ClO(4))](+) ion. The Mössbauer spectra recorded in zero field reveal a doublet with DeltaE(Q) = 0.92(2) mms and delta = 0.01(2) mms; analysis of spectra obtained in strong magnetic fields yields parameters characteristic of S = 1 Fe(IV)O complexes. The presence of an Fe(IV)O unit is also indicated in its Fe K-edge x-ray absorption spectrum by an intense 1-s --> 3-d transition and the requirement for an ON scatterer at 1.67 A to fit the extended x-ray absorption fine structure region. The [Fe(IV)(O)(TPA)](2+) intermediate is stable at -40 degrees C for several days but decays quantitatively on warming to [Fe(2)(mu-O)(mu-OAc)(TPA)(2)](3+). Addition of thioanisole or cyclooctene at -40 degrees C results in the formation of thioanisole oxide (100% yield) or cyclooctene oxide (30% yield), respectively; thus [Fe(IV)(O)(TPA)](2+) is an effective oxygen-atom transfer agent. It is proposed that the Fe(IV)O species derives from OO bond heterolysis of an unobserved Fe(II)(TPA)-acyl peroxide complex. The characterization of [Fe(IV)(O)(TPA)](2+) as having a reactive terminal Fe(IV)O unit in a nonheme ligand environment lends credence to the proposed participation of analogous species in the oxygen activation mechanisms of many mononuclear nonheme iron enzymes.

Peroxoiron species have been proposed to be involved in catalytic cycles of iron-dependent oxygenases and in some cases as the active intermediates during oxygen-transfer reactions. The catalytic properties of a mononuclear iron complex, [Fe(II)(pb)(2)(CH(3)CN)(2)] (pb=(-)4,5-pinene-2,2'-bipyridine), have been compared to those of its related dinuclear analogue. Each system generates specific peroxo adducts, which are responsible for the oxidation of sulfides to sulfoxides. The dinuclear catalyst was found to be more reactive and (enantio)selective than its mononuclear counterpart, suggesting that a second metal site affords specific advantages for stereoselective catalysis. These results might help for the design of future enantioselective iron catalysts.

In an effort to gain more insight into the factors controlling the formation of low-spin non-heme Fe(III)-peroxo intermediates in oxidation catalysis, such as activated bleomycin, we have synthesized a series of iron complexes based on the pentadentate ligand N4Py (N4Py = N,N-bis(2-pyridylmethyl)-N-(bis-2-pyridylmethyl)amine). The following complexes have been prepared: [(N4Py)Fe(II)(CH(3)CN)](ClO(4))(2) (1), [(N4Py)Fe(II)Cl](ClO(4)) (2), [(N4Py)Fe(III)OMe](ClO(4))(2) (3), and [(N4Py)(2)Fe(2)O](ClO(4))(4) (4). Complexes 1 and 2 have low- and high-spin Fe(II) centers, respectively, whereas 3 is an Fe(III) complex that undergoes a temperature-dependent spin transition. The iron centers in the oxo-bridged dimer 4 are antiferromagnetically coupled (J = -104 cm(-)(1)). Comparison of the crystal structures of 1, 3, and 4 shows that the ligand is well suited to accommodate both Fe(II) and Fe(III) in either spin state. For the high-spin Fe(III) complexes 3 and 4 the iron atoms are positioned somewhat outside of the cavity formed by the ligand, while in the case of the low-spin Fe(II) complex 1 the iron atom is retained in the middle of the cavity with approximately equal bond lengths to all nitrogen atoms from the ligand. On the basis of UV/vis and EPR observations, it is shown that 1, 3, and 4 all react with H(2)O(2) to generate the purple low-spin [(N4Py)Fe(III)OOH](2+) intermediate (6). In the case of 1, titration experiments with H(2)O(2) monitored by UV/vis and (1)H NMR reveal the formation of [(N4Py)Fe(III)OH](2+) (5) and the oxo-bridged diiron(III) dimer (4) prior to the generation of the Fe(III)-OOH species (6). Raman spectra of 6 show distinctive Raman features, particularly a nu(O-O) at 790 cm(-)(1) that is the lowest observed for any iron-peroxo species. This observation may rationalize the reactivity of low-spin Fe(III)-OOH species such as "activated bleomycin".

The catalytic properties of the diiron complex 1, Fe(2)OL(4)(H(2)O)(2)(ClO(4))(4) with L = (-)-4,5-pinenebipyridine, a chiral bipyridine derivative, have been investigated. Complex 1 efficiently catalyzes the oxidation of aryl sulfides to the corresponding sulfoxides by hydrogen peroxide, with yields ranging from 45 to 90% based on the oxidant. Furthermore the reactions were enantioselective and produced a mixture of sulfoxide enantiomers with significant enantiomeric excesses. The largest ee value (40%) was found in the case of p-bromophenyl methyl sulfide. Optimal ee's were obtained in polar solvents and at low temperature (below 0 degrees C), when the excess of the oxidant was limited. The observation of (i) a saturation kinetics with respect to both sulfide and H(2)O(2) concentrations, (ii) a linear Hammett correlation of the initial V(max) values with sigma(p) values, for a series of p-substituted aryl methyl sulfides, (iii) iron-peroxo complexes, characterized by light absorption and Raman resonance spectroscopies, during reaction of complex 1 with H(2)O(2), and (iv) a saturation kinetics with respect to sulfide during oxidation of sulfide into sulfoxide by the iron-peroxo complexes led us to propose that the iron-peroxo moiety is the actual oxygen atom donor to the substrate, thus explaining the enantioselective control of the catalytic reaction. These data demonstrate that oxidations by non heme diiron complexes can proceed through metal-based pathways and can thus be made stereoselective.