Kappa coefficients for each item ranged from

Kappa coefficients for each item ranged from 0.039 to 0.640 prior to rater discussions and 0.203 to 0.895 post rater discussions. Raters commented on the subjectivity of the WAI-O-S. The modified version was determined to be feasible.
The modified version of the WAI-O-S for telephone health coaching sessions for weight loss is a feasible tool for measuring the therapeutic alliance. More research may be necessary to determine further refinements.
Illawarra Health and Medical Health Institute.

The aim of this study was to determine the types of healthy lifestyle programs (HLPs) (diet and physical activity) used by overweight and obese adults to help them maintain or lose weight.
Men and women residing in the Illawarra region who expressed an interest in taking part in a 12 month healthy lifestyle trial were asked to complete an online screening survey asking about their health and wellbeing. The survey was completed by 620 participants and included questions on healthy lifestyle programs and self-reported height and weight.
Median BMI was 32.8 kg/m (range 25.0-63.8 i.e. obese) with no significant difference between males and females ( = 0.103). About two thirds (66%) of participants reported using ≥ 1 HLPs in the previous two years whilst 12% reported using ≥ 3 HLPs. Of the overweight participants (BMI range 25-29.99), 42% did not use a HLP whereas 15% of participants with a BMI ≥ 40 reported using ≥ 3 HLPs in the previous two years. The most commonly used HLPs reported were private programs such as Weight Watchers (33% and mobile applications (33%). This compares to 7% of participants reported to use Government HLPs such as NSW Get Healthy.
These preliminary findings are useful for understanding the frequency and types of healthy lifestyle programs being used by an overweight and obese population. Further research is necessary to determine whether these programs are effective and how they BAY 87-2243 can be further developed and incorporated in weight loss programs.
Illawarra Health & Medical Research Institute.

Dairy contain components that promote fat loss. We conducted a meta-analysis of randomised controlled trials (RCT) in 18-50 year olds investigating effects of dairy during energy restriction on body weight and composition.
RCT ≥ 4 weeks in 18-50 year olds comparing dairy consumption (dairy food & dairy supplements) with control diets lower in dairy during energy restriction on body weight, fat and lean mass were identified by searching MEDLINE (Web of Science), EMBASE, PubMed, Cochrane Central and WHO ICTRP until June 2014. Multi-component interventions, including those with resistance training, were excluded. Reports were identified and critically appraised in duplicate. Data were pooled using random-effects meta-analysis. >50% indicated heterogeneity. Dose effect was assessed using meta-regression analysis. Quality of the body of evidence was rated using GRADE guidelines.
Sixteen RCTs ( = 637) were included, all conducted in overweight/obese participants. Consumption of 2-4 standard servings/day of dairy food compared to ≤ 1 serving/day, or 20-84 g/day of whey protein compared to placebo over median 16 week duration resulted in greater bodyweight loss [mean (95%CI): -1.21 (-1.74, -0.14) kg, < 0.00001, = 15%) and fat mass loss [-1.41 (-2.04, -0.77) kg, < 0.0001, = 36%). Lean mass was not differentially affected. Dairy food and supplement studies did not differ. No dose-response effect was observed and studies were largely undertaken in women (84%). Quality of evidence was rated as moderate. Increased dairy intake as part of an energy restricted diet moderately enhanced bodyweight and fat mass loss in 18-50 year olds. Further research is needed to confirm these effects in men. Dairy Health and Nutrition Consortium.
Despite the important role of core foods in diet quality and energy intake, little is known about portion sizes of core foods. To examine the typical portion sizes of commonly consumed core foods in Australian adults, and to compare these data with the ADG standard serve.

Although C albicans is still the most common species

Although C. albicans is still the most common species, the prevalence of Candida diltiazem hcl other than C. albicans isolated from HIV-infected patients is increasing.C. dubliniensis, C. glabrata, and C. tropicalis are considered as emerging pathogens. Compared with the current study with a proportion of 73.5%, the percentage of C. albicans decreased from 86.7% in 2002 to 68.5% in 2005 in Taiwan. The widespread use of antiretroviral agents, antibiotics, and antifungal agents were assumed to have an effect on the distribution of oropharyngeal yeast colonization. Since the introduction of highly active antiretroviral therapy, there was a significant decline of fluconazole- and itraconazole-resistant Candida colonizing the oral cavity of HIV-infected patients. In the current study, the susceptibility of Candida to antifungal agents was similar to previous reports in Taiwan. Because Candida species other than C. albicans are known to have higher resistant rates to antifungal agents, these gradually increasing species may constitute an important issue in the treatment of opportunistic infections among HIV-infected patients.
In conclusion, the current study found a higher prevalence of oropharyngeal yeast colonization in HIV-infected patients with a low CD4 cell count. Intravenous drug use and PI-containing antiretroviral therapy were significantly associated with oropharyngeal yeast colonization independent of the CD4 cell count and HIV viral load. Although C. albicans was still the prevalent species colonizing the oropharyngeal cavity of HIV-infected patients, the increasing multidrug-resistant Candida species other than C. albicans present an emerging challenge in fungal infection management.

This study was partially supported by research grants from the National Health Research Institutes, Taiwan (99A1-ID-PP-04-014 and 00A1-ID-PP-04-014).

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are increasingly seen among children, which causes skin and soft tissue infection as well as invasive life-threatening infections. However, CA-MRSA is still an uncommon pathogen in the neonatal population, except in some endemic areas. An orbital abscess is a well-delineated form of orbital cellulitis that is characterized by the formation of a collection of pus within the orbital tissue. In children, the most common source of orbital cellulitis is sinusitis. In neonates, orbital abscesses are extremely rare. Here, we report a case of neonatal orbital cellulitis with abscess formation and ethmoid sinusitis that was complicated by bacteremia caused by CA-MRSA.

Case report
Upon admission, blood examination showed a leukocyte count of 16,700 cells/uL (50% neutrophils, 29% lymphocytes, and 14% monocytes), a platelet count of 543,000 cells/uL, hemoglobin level of 9.7mg/dL, and a serum C-reactive protein level of 70mg/L (normal range: < 5mg/L). Serum alanine transaminase, blood urea nitrogen, and creatinine levels were normal. Vancomycin and ceftriaxone were prescribed. An orbital computed tomography (CT) scan with contrast enhancement was performed on the second day of hospitalization, showing low-density lesions with rim enhancement over the medial and superior aspects diltiazem hcl of the left eye globe, subperiosteal abscess formation, and opacity of the left ethmoid sinus (Fig. 1). Soon afterward, the baby underwent an orbitotomy with drainage of the intraorbital abscess. The blood culture obtained at the local hospital (on the first day of illness) subsequently reported MRSA, but the cerebrospinal fluid culture was negative for bacteria. The pus drained from orbital cellulitis also yielded MRSA. After surgical drainage, the fever abated and the local inflammatory symptoms and signs gradually improved. Intravenous vancomycin therapy—at a dosage of 45mg/kg/day—was continued for a total of 14 days, and the patient was uneventfully discharged. He was clinically well without any complications at the 6-month and 1-year follow-up examinations after discharge.

While the susceptibility of S maltophilia to

While the susceptibility of S. maltophilia to ceftazidime, minocycline, ticarcillin-clavulanic acid and TMP-SMX did not change significantly over the 10-year study period, a trend of decreased susceptibility to levofloxacin (83.7% in 1998 to 65.6% in 2008, p=0.014) was observed (Fig. 2). Among all 377 isolates, there was only one isolate with multidrug resistance to ceftazidime, chloramphenicol, levofloxacin, TMP-SMX and ticarcillin-clavulanic acid.

The present study evaluated the susceptibility of clinical S. maltophilia isolates collected over a 10-year period in Taiwan. We found that the activities of TMP-SMX and minocycline remained similarly high over the years. However, the activity of levofloxacin against S. maltophilia has declined. In addition, TMP/SMX-resistant isolates were significantly less susceptible than TMP/SMX-susceptible isolates to levofloxacin.
In a recent study by Farrell et al, who evaluated susceptibilities of 1586 S. maltophilia clinical isolates collected worldwide between 2003 and 2008, rates of susceptibility to ceftazidime, levofloxacin, ticarcillin-clavulanic acid, and TMP-SMX were 44.8%, 83.4%, 39.1%, and 96.0%, respectively. In comparison, S. maltophilia isolates in our study showed significantly lower susceptibility to ceftazidime (24.4% vs. 44.8%, p<0.01), ticarcillin-clavulanic GSK2656157 (18.6% vs. 39.1%, p<0.01) and TMP-SMX (82.5% vs. 96.0%, p<0.01), while susceptibility to levofloxacin was similar between the two studies (79.6% vs. 83.4%, p=0.082). Of note, the low susceptibility to ticarcillin-clavulanic acid was due in part to the large proportions of isolates in the intermediate category (55.9% vs. 36.7%) in both studies. The differences in susceptibility rates between the two studies may be in part due to differences in specimen source. In the study by Farrell et al, over half of the isolates were from blood (51%), while respiratory isolates comprised smaller proportion (37%), and no comparison was made on susceptibility from the two specimen groups. In contrast, the majority of our isolates were from the respiratory tract (67.9%). Although there were fewer blood isolates (48, 12.7%) in our study, it is worth noting that blood isolates were more susceptible to all the agents than respiratory isolates, especially ceftazidime (45.8% vs. 18%). In addition, isolates from the Asia-Pacific region in the study of Farrell et al had the lowest rates of susceptibility to ceftazidime (32.6%), levofloxacin (78.0%), ticarcillin-clavulanic acid (27.0%), and TMP-SMX (90.8%) compared to isolates from North America, Europe, and Latin America. Thus, S. maltophilia isolates from the Asia-Pacific region appeared to be less susceptible to these agents.
We also found a trend of decreased susceptibility to levofloxacin over the 10-year period. Although rapid emergence of resistance against fluoroquinolones has been observed in vitro and in vivo for S. maltophilia, this is, to our knowledge, the first study to investigate levofloxacin resistance over a long period of time. One possible explanation for this finding is that resistant mutants may have emerged following exposure to fluoroquinolones. Increased fluoroquinolone use has been associated GSK2656157 with decreasing susceptibility to fluoroquinolones in many Gram-negative pathogens.
The present study found tigecycline to have potent in vitro activity against S. maltophilia isolates in Taiwan, with MIC50/MIC90 of 0.25/1μg/mL, which were one dilution lower than those reported by Farrell et al, (0.5/2μg/mL). In another study which evaluated the antimicrobial activities against isolates collected from ICUs worldwide, tigecycline also exhibited potent in vitro activity against S. maltophilia. Further studies are needed to determine their clinical efficacy.
There were some limitations to this study. First, although the isolates we tested were from various clinical specimens, there was a predominance of respiratory specimens. Since isolates from the respiratory tract showed higher resistance rates than those from blood, including to ceftazidime and chloramphenicol, further studies are needed to confirm the higher susceptibilities of bloodstream isolates. Second, due to limited clinical information, we could not determine if all S. maltophilia isolates caused infections in the patients from whom the isolates were recovered.

Most patients in our study

Most patients in our study had health care-acquired or hospital-acquired infections. Community-acquired infection affected only five (10.4%) patients, which was lower than in a previously reported study. In cases of health care-associated and hospital-acquired infections, 19 (44.2%) of 43 patients had ESRD that required hemodialysis or peritoneal dialysis. Because S. lugdunensis is a skin commensal, patients undergoing frequent invasive procedures may have a higher risk of infection. The other three most common comorbidities in our patients were hypertension, diabetes mellitus, and cerebrovascular disease. All three comorbidities may cause patients to require frequent hospitalizations or longterm care.
Four (9.8%) of 41 bacteremic patients were diagnosed as having infective endocarditis (IE). One patient had pacemaker-associated IE, which has been rarely reported in previous studies. All four patients were native valve IE, and three of these patients had left-sided valve involvement. All IE patients received surgery, and the mortality was relatively high (75%) in our study. A previous article described the characteristics of S. lugdunensis-related endocarditis, which were of community-acquired origin, predominantly affects left-sided valves, susceptible to penicillin, patients required surgery, and most patients have native-valve involvement. Our IE patients matched most of these characteristics, but had a higher mortality rate (75% vs. 38.8%). Some studies have mentioned possible IE-related virulence proteins such as fibrinogen-binding protein and von Willebrand factor binding protein; however, these data are fragmentary and scarce. A search for the dextromethorphan hydrobromide of virulence factors in IE-related strains may be needed.
S. lugdunensis infections, other than bacteremia, were primarily catheter-associated. Three patients had continuous ambulatory peritoneal dialysis tube-associated peritonitis, and one patient had chest tube drainage-related empyema. There were also two cases of septic knee arthritis, which has been rarely reported in previous studies.
There was one case of pelvic infection, which was diagnosed as chorioamnionitis. The patient was a 34-year-old female who was admitted because of high fever. Just 2 weeks prior to admission, she received McDonald\’s sutures. The specimen was obtained via amniocentesis. The culture was polymicrobial. Other microorganisms included group B Streptococcus and Peptostreptococcus. The patient underwent an abortion because of unstable hemodynamics. Her condition improved dramatically after the abortion. There are few studies reporting amniotic fluid infection related to S. lugdunensis. The role of this organism in chorioamnionitis and septic abortion remains undefined.
The crude mortality of our patients was 20.8% (n = 10), and all of these patients had bacteremia. In previous studies, the mortality rate of S. lugdunensis bacteremia ranged from 0% to 23%. A Pittsburgh bacteremia score of 2 or greater, ESRD, and IE were independently associated with mortality in all patients with bacteremia. Severe underlying diseases that may be responsible for mortality in most conditions have been described in a previous study.
The resistant rate of S. lugdunensis to oxacillin and penicillin varies widely in published studies. In most studies, oxacillin resistance was low (at most 5%). Our study showed a higher oxacillin resistance rate (20.8%), which was similar to the rate in the Korean study. In most studies, the origin of infection was primarily by community acquisition. However, all oxacillin-resistant strains in our study were health care-associated or hospital-acquired infections, which was similar to the finding of the Korean study. Antibiotic use and invasive procedures in noncommunity-acquired infections may explain this situation. Prior to 2005, different breakpoints were used for the oxacillin minimal inhibitory concentration (MIC) of S. lugdunensis. Since 2005, the CLSI revised the oxacillin breakpoints of S. lugdunensis as those established for S. aureus (MIC of 2 μg/mL or less, categorized as “susceptible”; MIC of 4 μg/mL or greater, categorized as “resistant”). This may also cause the different result in oxacillin susceptibility.

Polymeric materials are one option however the strength and

Polymeric materials are one option; however, the strength and stiffness of these implants are often too low for their use in demanding medical applications [3,4]. Magnesium (Mg) and its alloys offer an attractive alternative: Mg is biodegradable, and additionally plays an important positive biological role in the bone healing process [5]. Compared with polymers, Mg is also stiffer and stronger [6]. These are positive attributes per se; however, in bone repair applications one aims not for high values of these properties, but rather for values that match local properties of the bone structures to be repaired. For this reason, metals used in bone implant applications are often given an open microcellular structure, tailored such that the high porosity of the material reduces the stiffness and strength of the metal to values near those of bone and at the same time limits the amount of foreign material to be degraded by the human body. In order to enhance bone ingrowth and also host–implant interaction with regard to implant degradation, permeability and thus open porosity are essential [7–10]. This approach has been adopted in a few pioneering studies of cellular Mg [11–13], often with focus on its use as an implant material [14–18].
Research on Mg alloys in the context of implant materials has so far mostly focused on the characterization of aluminium and rare-earth-containing alloys. Yet the use of these alloying elements should be minimized in the human body as these may cause long-term complications [19–22]. Rather, it is recommended to use only elements already in the human body, or elements shown to have beneficial effects on tissue regeneration, as alloying elements in ‘biomedical alloys’ [23]. Such Mg alloys exist, but have been characterized almost exclusively in bulk form.
We present in what follows an investigation on the processing and properties of four replicated cellular Mg alloys. We show how leaching the salt placeholder, a challenging step in the replication processing of Mg [24,25], can be conducted without degrading the material. We use a customized method for the characterization of their dissolution rates in simulated body fluid, and characterize the materials for compressive mechanical properties, both before and after a 24 h exposure to simulated body fluid. We find that these new alloys have promising mechanical and physical properties but corrode too fast, leading to conclude that these will require post-processing before becoming viable orthopaedic implant materials [26].

Materials and methods

Results and discussion

Hydrogen h2 receptor antagonist
was used to measure the rate of cellular Mg alloy dissolution in simulated body fluid. After 24 h of immersion the H2, converted to relative cellular metal weight loss, ranged from 3.2 ± 0.9% to 67 ± 6%. These values are too high for use of the present cellular alloys within the human body. MZX211 showed the highest H2 production rate, due to the lamellar microstructure and thus large galvanic corrosion surface of its second phase. The layer of dissolution product had a needle-like shape, too open to yield any protection from the dissolution medium.

KL would like to thank the European Commission for their support for the Erasmus Exchange Programme.
This work has been funded by core funding of the Department of Metallurgy and Materials Engineering at KU Leuven and the Laboratory of Mechanical Metallurgy at EPFL.

Magnesium alloys, the lightest metal structure material for engineering applications, have taken a great research interest in the automotive, aerospace, weapons, electronic and other fields, because of their low density, high specific strength and stiffness, good damping characteristics, as well as excellent castability. Especially in the field of automobile industry, magnesium alloys have replaced the steel, cast iron and even aluminum alloys, because they can reduce the weight of vehicles, so that significantly contribute to fuel economy and reducing CO2 emissions [1–6]. Nowadays, magnesium alloy products have been mainly manufactured by the die casting process, but the traditional casting magnesium alloys are unable to meet the growing industrial demands due to various casting defects and poor mechanical properties of the casted material. The h2 receptor antagonist wrought magnesium alloys synthesized by the plastic processing technologies such as rolling, extrusion, and forging etc., have taken serious attentions, since they have the higher mechanical properties. Thus, the sheet forming processes achieved by using wrought magnesium alloys can be feasible alternative methods and they can assure higher productivity and final strength. Therefore, sheet forming processes of magnesium alloys have become the important development direction [7–10]. However, sheet forming processes of magnesium alloys are seriously restricted by the limited ductility at room temperature. This is because, only the basal slip system can start in the hexagonal close-packed (HCP) crystal structure of magnesium alloys. Although non-basal slip planes can also move, they are not active because their critical resolved shear stresses (CRSS) are much higher than those of the basal one at room temperature, resulting in plastic deformation relying more on the coordinated action of the slip and twin. According to the reasons described above, the plastic deformation ability of magnesium alloys is so poor and these alloys are prone to emerge deformation defects such as cracks [8,10–12].

The role of LPSO phase on

The role of LPSO phase on the corrosion resistance of the Mg–Zn–RE alloys is not clear from the literature. Zhang et al. [39] reported that the presence of lamellar LPSO phase in the matrix improved the corrosion resistance and uniform corrosion in a Mg–Gd–Zn–Zr alloy. In contrast, Zhang et al. [40] observed that increase in the volume of bulk X phase containing LPSO structure at the grain boundary in Mg–Zn–Y alloys increased the corrosion rate due to the galvanic coupling effect. Izumi et al. [41] studied the effect of cooling rates on the corrosion behavior of Mg–Zn–Y alloys containing LPSO phase, and observed that the presence of the LPSO phases involved in the filiform corrosion process whereas single phase microstructure obtained by higher solidification rate delayed the occurrence of the filiform corrosion. Pérez et al. [42] also observed that the LPSO phase was more preferably attacked by the corrosion when compared to the other intermetallic, Mg12RE in a apigenin Mg–Zn–Y-MM alloys. The observed filiform corrosion in the present study was probably assisted by the LPSO phase. Severe dissolution of magnesium matrix and striations observed in the microstructure of alloys 1 and 2 (Figs. 10(f) and 11(f)) suggested that LPSO phase facilitated the corrosion in these alloys. Higher corrosion rate observed with alloy 2 can also be related to the higher LPSO phase volume in the matrix expected with the increase in Zn content.

Mg–10Gd–xZn (x = 2 and 6%) alloys consisted of (Mg,Zn)3Gd phase at the grain boundary and lamellar LPSO phase in matrix. These phases increased as the Zn content increased. The grain boundary phase, (Mg,Zn)3Gd, in Mg–10Gd–6Zn alloy was a continuous network along the highly branched dendrite structure of α-Mg, whereas this phase was relatively discrete in Mg–10Gd–2Zn alloy with microstructure containing mostly columnar α-Mg dendrites. Both hydrogen measurement and electrochemical tests confirmed that increase in the Zn content from 2 to 6% in Mg–10Gd–xZn alloys reduced the corrosion resistance. However, both alloys cannot be classified as corrosion resistant magnesium alloys, at least in as cast condition. Micro-galvanic corrosion due to the presence of second phase at the grain boundary occurred initially in both alloys. However, filiform corrosion dominated at the later stage which was facilitated by the LPSO phase in the matrix. Dissolution of second phase occurred after long immersion times, which was probably due to the change in the stability of the phase altered by NaCl, alkainization of the surface during the long immersion times, and/or by retarded dissolution of the original protective film on the intermetallics. Additionally, it was also possible that the chromic acid might have facilitated the removal of the de-stabilized second phase during the cleaning process.


Magnesium alloys, with a good combination of low density and high specific strength, have been attracted much attention as important structure materials. Some commercial Mg alloys have been widely applied to automobile industries, such as AZ91 alloy and AM60 alloy. However, these alloys exhibit poor mechanical properties at elevated temperatures due to the precipitation of β-Mg17Al12 phase at the grain boundaries and interdendritic regions [1–3]. Recently, Mg–Sn based alloys have been considered as the potential heat resistant Mg alloys, because Sn has a high solubility in Mg at eutectic temperature and the precipitable Mg2Sn phase has a higher melting point [4–9]. However, the thermal stability of the phase is not desirable in the T6 heat treatment condition [10].
Previous investigations have indicated that the addition of rare earth (RE) elements could significantly enhance the elevated temperature strength of Mg–Sn based alloys by grain refinement and precipitation strengthening [11–15]. Yang et al. [12,13] reported that the additions of Y, Gd and Ce could improve the tensile strength and creep-resistant properties of as-cast Mg–Sn–Ca alloys by refining the primary CaMgSn phase and decreasing its volume fraction. The addition of La and Di could also enhance the creep resistant behavior of Mg–Sn alloys due to the formation of fine Mg-La phase and Mg-Di phase with a good thermal stability [14,15]. In addition, the apigenin thermal mechanical process, such as extrusion and rolling, can be used to improve the mechanical properties of Mg–Sn-based alloys by producing fine grain structure and dispersive particles [11,16,17]. Cheng et al. [16] pointed out that the indirect extrusion process could significantly refine the grains and make the Mg2Sn phase finer and dispersive in Mg-6–10% Sn alloys, leading to an improvement of tensile and compressive strengths. Lim et al. [17] demonstrated that Mg-MM(Ce–La–Nd–Pr)–Sn–Al–Zn sheets fabricated by cross-rolling method had a good combination of strength and elongation to failure compared with the conventionally rolled one. As mentioned above, the combination of the addition RE elements and thermal mechanical process is an effective method to improve mechanical properties of Mg–Sn based alloys, especially at high temperature. At present, the microstructure and tensile properties of extruded Mg–Sn–xY (x = 1.5, 3.0, 3.5 at.%) alloys have been investigated by Zhao et al. [18]. However, the investigations on the effect of Yb addition on microstructures and mechanical properties of extruded Mg–Sn–Yb sheets have not reported until now.

Introduction In repairing damages of magnesium

In repairing damages of magnesium alloys casings aircraft structures [1–3], the argon arc non-consumable electrode welding is used [4]. One of the causes of reduction of the service characteristics of the restored casings is the presence of residual welding stresses in repair welds, thus reducing the service life of vehicles. Heat treatment are often used to reduce the welding residual stresses. Heat treatment in large electric furnaces increase the cost of repair operations. Moreover, there is no complete guarantee from the occurrence of fatigue cracks in repair welds, leading to the need in development and application of alternative methods of decreasing the level of residual stresses in welded joints. These methods also include the methods of treatment using pulsed electric and magnetic fields [5–8].
One of the methods of a pulsed current effect on metals is the electrodynamic treatment (EDT), based on the ANA 12 of electromagnetic forces on the material, occurring in the current discharge passing through the material being treated [9]. The application of EDT reduces the level of residual stresses in repair welds [4], which can be, in a number of cases, the alternative to heat treatment, and in the future, replace it. This will decrease the cost of repair technologies in restoring the structural elements of aircrafts.

Experimental procedure

EDT schemes and measurements of displacements on the surface of investigated specimens are presented in Fig. 3.
Fig. 4 shows the distribution of a longitudinal component of stresses σx after welding and EDT on the specimen of the first type (Fig. 1a). At the first stage of the investigation, the displacements were measured on the external surface of the specimen along the A–A line, located at a distance of 8 mm from the welding center (Fig. 3a). It is seen that before the EDT, the tensile stresses σx are distributed along the weld line, and their average values are 120 MPa (Fig. 4a curve 1), after treatment, the nature of distribution of σx was not significantly changed, but their average values decreased to 70 MPa (Fig. 4a curve 2).
The distribution of stresses σx at the external surface of the first type of specimen after welding along the line B–B. normal to weld line (Fig. 3a), is presented in Fig. 4 (line 1). The non-equilibrium of the diagram σx is due to the high bending component of stresses on the specimen surface, caused by its initial curvature, and also by that the value σx was measured only on the external surface of the metal. In this case the maximum value of tensile stresses σx in the measured section reaches the yield strength σ0.2 = 120 MPa at 10 mm distance from the weld center.
The electrodynamic effects after EDT No. 1 on the stressed welded joint confirm the distribution of σx along the B–B line (in Fig. 4, curves 2).
It is seen from Fig. 4b that at the treated region of the weld center, the distribution of σx changed the stresses from tensile to compressive ones, the value of which reached –40 MPa. At the surface regions, corresponding to maximum values of stresses σx = 120 MPa, after EDT No. 1 the decrease in stresses to 30 MPa was observed that amounts to 25% of values before treatment. So, Evolutionary clock is possible to note that the result of the EDT is the decrease in values of stresses with their transition from tensile to compressive ones in the treatment zone.
To investigate the effect of successive EDT of weld center and heat-affected zone on change in values σx, the specimens of the first type were used. For this purpose, the EDT No. 2 was carried out on the specimen surface along the A–A line at the distance of 12 mm from the weld center (Fig. 3a). The distribution of σx along the B–B line (Fig. 3a) after EDT No. 2 is shown in Fig. 4b. In this case, the region of compressive stresses, localized at the region of electrodynamic effects is formed, where the values σx are reduced to –20 MPa (in Fig. 4b, curve 3), while in the weld center they are not changed (–40 MPa). The localized nature of σx in the zone of EDT No. 2 is close to that observed after EDT No. 1 in the weld center. As is seen from the distribution of stresses σx (in Fig. 4c, curve 3, at the distance between the regions of EDT of Nos. 1 and 2, they are decreased to 60 MPa in the equally removed zone (at a distance of 6 mm from the weld center), which amounts only to 50% of their value after welding (before making EDT No. 1 and 2). This confirms the localized nature of the electrodynamic effects.

Phenolics flavonoids tannins and saponins have

Phenolics, flavonoids, tannins and saponins have the ability to bind cations and other biomolecules are able to protect the protein membranes from denaturation and stabilize the erythrocyte membrane (Oyedapo, 2001). Therefore, polyphenolic compounds such as phenolic, tannins and flavonoid contents of methanol Ramelteon manufacturer extracts could be the possible reason for anti-denaturation property and able to stabilize the lysosome membrane.
Soxhlet extraction is a classical technique for the solvent extraction of obtaining polyphenolic compounds from plant sources. Even though, some of the heat sensitive compounds may decompose in the Soxhlet technique (Wan and Weller, 2006). However, thermolabile/thermostable compounds cannot be dehydrolyzed due to the stability of compounds. From the result, thermolabile compounds from the Soxhlet extraction method showed good antioxidant and anti-inflammatory properties compared to other techniques (maceration and fractionation).

The present study revealed that different types of extraction methods had a big influence on the antioxidant and anti-inflammatory properties of obtained extracts. These results showed that O. parvifolia could be a potential natural source of antioxidants and could have greater importance as therapeutic agent in preventing or slowing oxidative stress and inflammation related disorders. Further studies are currently underway to assess the in vivo biological activities and to identify the active component responsible for their antioxidant and anti-inflammatory properties.


The presence of the Glu-Pro-Ile-Tyr-Ala (EPIYA) motif or a sequence closely related to the EPIYA motif (EPIYA-like motif) in effector proteins that play roles in the virulence of pathogenic bacteria was analyzed (Table 1). Bacterial effector proteins enter mammalian Ramelteon manufacturer through type III or type IV secretion systems (T3SS or T4SS), and these effector proteins are phosphorylated at tyrosine residues located at the EPIYA (or -like) motif by host kinases, which triggers an interaction with host cell SH2 domain-containing proteins and manipulates the function of host cells for more effective infection and improved colonization (Selbach et al., 2009; Backert et al., 2010; Hayashi et al., 2013).
Among mammalian proteins, it was demonstrated that Pragmin EPIYA motif undergoes tyrosine phosphorylation at the EPIYA motif by Src family kinases (SFKs) or in response to EGF stimulation. Tyrosine phosphorylation at the EPIYA allows Pragmin to interact with the SH2 domain of Csk, and thereby sequesters Csk in the cytoplasm. Sequestration of Csk by Pragmin has a positive feedback on SFK activity (Safari et al., 2011). In another study, Repetto et al. (2013) showed that N-terminal of p140Cap (also known as SRC kinase signaling inhibitor 1) contains two EPIYA-like motifs (EPLYA and EGLYA) which can be tyrosine phosphorylated at EPLYA and EGLYA by c-Abl or in response to integrin-mediated adhesion and EGF stimulation. Upon tyrosine phosphorylation, p140Cap EPLYA and EGLYA sequences serve as binding sites for the SH2 domain of Csk (Repetto et al., 2013; Sharma et al., 2013). Moreover, C-terminal of p140Cap contains a proline rich sequence which interacts with Src SH3 domain and thereby, facilitates inhibition of SFK activity by Csk (Di Stefano et al., 2007). Taken together, it has recently been proposed that the mammalian EPIYA (or -like) motif might have been exploited by pathogenic bacteria (Safari et al., 2011).

Material and methods
NCBI (National Center for Biotechnology Information, U.S. National Library of Medicine, www.ncbi.nlm.nih.gov) was used to obtain sequences of mammalian EPIYA (or -like) motif containing proteins.
PhosphoSitePlus was used for the detection of tyrosine phosphorylation at EPIYA (or -like) containing proteins (http://www.phosphosite.org) (Hornbeck et al., 2012).
RONN tool was used for prediction of structure disorder of EPIYA (or -like) motif in mammalian proteins, (www.strubi.ox.ac.uk/RONN) (Yang et al., 2009).

A number of bioactive molecules including flavonoids phenoic

A number of bioactive molecules including flavonoids, phenoic compounds, alkaloids, and terpenoids previously reported for their cancer properties were identified from this plant in several studies (Gami et al., 2012). Among those isolated bioactive molecules, Lupeol, betulinic acid, gallic acid, and taraxerol have been shown in several reports to possess anti-cancer activity (Shoeb, 2006; Swain et al., 2012). In addition, many number of bioactive molecules were isolated and identified from the leaf and EAI045 of this plant (Misra and Mitra, 1968). Therefore, the anti-cancer activity observed in crude leaf and bark extracts may be specifically due to any single chemical compound or it may due to phytochemical constituents. According to the results obtained, M. elengi leaf and bark extracts appeared to be potent anti-cancer agent and to the best of our knowledge this is the first report on anti-cancer activity of M. elengi against SiHa cell line.
In conclusion, the present study demonstrates the cytotoxic properties of methanolic extracts of leaf and bark of M. elengi L. Further studies to characterise the active principles and to elucidate the mechanism of action are in progress.

Except for thyroid storm we

Except for thyroid storm, we ruled out most of the differential diagnoses for psychosis through history taking, physical examination, and laboratory survey. In contrast, the diagnosis of thyroid storm was based on clinical symptoms and the alertness of physicians. In our case, in the initial stages of history taking, the possibility of sexual assault, the absence of palpable mass in the neck, and the lack of optic proptosis in the patient made the initial diagnosis of thyroid storm difficult. This situation is complicated by the fact that there are no valid, universally accepted diagnostic tools to accurately help identify thyroid storm. One tool that we used to grade the thyroid storm was the Burch and Wartofsky scoring system (Table 1). A score of 45 or higher is highly suggestive of thyroid storm, whereas a score below 25 makes thyroid storm unlikely. Although this scoring system is likely sensitive, it is not very specific. For example, the body temperature of our patient increased to 38.5°C during observation, which scored only a 15, but she had seizure attacks that scored 30 and a heart rate that scored 25. In contrast, she had no signs of heart failure or gastrointestinal–hepatic dysfunction. However, a total score of 70 revealed a high likelihood of thyroid storm.
Thyrotoxicosis is much less common in children than it is in adults. In a national population-based study of thyrotoxicosis in the United Kingdom and Ireland in 2004, the annual incidence was 0.9 per 100,000 children <15 years of age. Females had a significantly higher incidence than males in the 10–14-year-old age group. In fluvoxamine maleate to children and adolescents, the annual incidence of thyrotoxicosis was 80 per 100,000 in women and eight per 100,000 in men in another study. A variety of presenting symptoms were reported: weight loss (64%), fatigue/tiredness (54%), change in behavior (50%), and heat intolerance (47%). In thyroid storm, the clinical symptoms are more severe than hyperthyroidism. Cardiovascular symptoms include tachycardia, congestive heart failure, acute pulmonary edema, cardiogenic shock, and even death from cardiovascular collapse. In addition, hyperpyrexia, agitation, anxiety, delirium, psychosis, stupor, and coma are also common. Moreover, severe nausea, vomiting, diarrhea, abdominal pain, and hepatic failure with jaundice can also occur. Physical examination may reveal a goiter, ophthalmopathy, lid lag, hand tremor, and warm and moist skin.
Although thyroid storm is life threatening, it can be managed with aggressive treatment. Cardiovascular manifestations can be effectively controlled by β-blockers, such as propranolol, by blocking the adrenergic tone and peripheral conversion of T4 to T3. Thioamides, such as propylthiouracil or methimazole, are used to block new hormone synthesis, and their effective doses are larger than those used for regular hyperthyroidism. An iodine solution blocks the release of thyroid hormone and should be used at least 1 hour after thioamide prescription. In addition, glucocorticoids are used to reduce T4 to T3 conversion, promote vasomotor stability, and possibly treat an associated relative adrenal insufficiency.


Hypereosinophilic syndrome (HES) is a rare disorder characterized by a sustained overproduction of eosinophils, peripheral eosinophilia, and eosinophilic tissue infiltration. HES has various clinical presentations, ranging from fatigue and other nonspecific complaints to fatal cardiac and neurological involvement. Cardiac involvement is the major cause of morbidity and mortality in HES. The most common symptom of cardiac involvement in HES patients is heart failure, followed by chest pain and systemic thromboembolic events. We report a patient who presented with junctional rhythm in the emergency department (ED) and was subsequently diagnosed with HES.

Case report
An 80-year-old man presented to the ED with sudden-onset chest tightness and dyspnea for 5–6 hours. He had a history of hypertension, diabetes mellitus with nephropathy (2 years), chronic kidney disease (stage IV), and duodenal ulcer with irregular medication control. He denied coughing, cold sweats, fever, tarry stools, abdominal pain, and radiating pain. His blood pressure was 116/71 mmHg, his heart rate was 42 beats/min (BPM), and his respiratory rate was 20/min. There were no other remarkable findings during physical examination except for the low heart rate. Electrocardiography (EKG) showed junctional bradycardia, without significant ST-T changes (Fig. 1). The initial laboratory examination revealed a white blood cell count of 33.38 × 103/μL, with 32% eosinophils (absolute eosinophil count 10.681 × 103/μL), creatinine 5.4 mg/dL, creatine kinase-MB 1.2 ng/ml, troponin I 0.037 ng/ml, and glucose 238 mg/dL. Results for the hematocrit, coagulation function, electrolyte levels, thyroid function, adrenal function, and other routine biochemical analyses were within reference levels. Chest radiography revealed an enlarged heart with Kerley B lines. Based on the symptomatic junctional bradycardia, atropine and dopamine were administered in the ED with no obvious response. The patient was then admitted to the coronary care unit for monitoring and diagnostic evaluation. Dopamine was administered at 10 μg/kg/min. His heart rate was approximately 40–45 BPM. The results of transthoracic Doppler echocardiography showed four chambers with no abnormalities and four functioning valves. Cardiac enzyme analysis showed creatine kinase-MB 13.1 ng/ml and troponin I 6.097 ng/ml. A Tl-201 myocardial perfusion scan showed no abnormalities. On the basis of these results, HES was suspected. Prednisolone (0.5 mg/kg per day) was prescribed, and additional diagnostic examinations were performed. Examination of blood and stool showed no evidence of an allergic reaction or parasite infection. The results from serological analysis of autoantibodies to nuclear antigen, complement 3, complement 4, antiextractable nuclear antigen, rheumatoid factor, and immunoglobulins G, A, E, and M were within reference limits. Bone marrow biopsy results revealed no evidence of hematological malignancy. An EKG showed normal sinus rhythm 2 days after admission, and the heart rate was approximately 70 BPM (Fig. 2). Dopamine was discontinued. He was discharged on day 13. One year later, his white blood cell count was 20,000 to 25,000 cells/μL, with 5% to 10% eosinophils, and he had no episodes of bradycardia.