A potent peptidomimetic inhibitor of HSV ribonucleotide reductase with antiviral activity in vivo

Herpes simplex viruses (HSV) types 1 and 2 encode their own ribonucleotide reductases (RNRs) (EC 1.17.4.1) to convert ribonucleoside diphosphates into the corresponding deoxyribonucleotides. Like other iron-dependent RNRs, the viral enzyme is formed by the reversible association of two distinct homodimeric subunits. The carboxy terminus of the RNR small subunit (R2) is critical for subunit association and synthetic peptides containing these amino-acid sequences selectively inhibit the viral enzyme by preventing subunit association. Increasing evidence indicates that the HSV RNR is important for virulence and reactivation from latency. Previously, we reported on the design of HSV RNR inhibitors with enhanced inhibitory potency in vitro. We now report on BILD 1263, which to our knowledge is the first HSV RNR subunit-association inhibitor with antiviral activity in vivo. This compound suppresses the replication of HSV-1, HSV-2 and acyclovir-resistant HSV strains in cell culture, and also strongly potentiates the antiviral activity of acyclovir. Most importantly, its anti-herpetic activity is shown in a murine ocular model of HSV-1-induced keratitis, providing an example of potent nonsubstrate-based antiviral agents that prevent protein-protein interactions. The unique antiviral properties of BILD 1263 may lead to the design of new strategies to treat herpesvirus infections in humans.

Comprehensive geriatric assessment in older people: an umbrella review of health outcomes

BACKGROUND

Comprehensive geriatric assessment (CGA) has been in use for the last three decades. However, some doubts remain regarding its clinical use. Therefore, we aimed to capture the breadth of outcomes reported and assess the strength of evidence of the use of comprehensive geriatric assessment (CGA) for health outcomes in older persons.

METHODS

Umbrella review of systematic reviews of the use of CGA in older adults searching in Pubmed, Embase, Scopus, Cochrane library and CINHAL until 05 November 2021. All possible health outcomes were eligible. Two independent reviewers extracted key data. The grading of evidence was carried out using the GRADE for intervention studies, whilst data regarding systematic reviews were reported as narrative findings.

RESULTS

Among 1,683 papers, 31 systematic reviews (19 with meta-analysis) were considered, including 279,744 subjects. Overall, 13/53 outcomes were statistically significant (P < 0.05). There was high certainty of evidence that CGA reduces nursing home admission (risk ratio [RR] = 0.86; 95% confidence interval [CI]: 0.75-0.89), risk of falls (RR = 0.51; 95%CI: 0.29-0.89), and pressure sores (RR = 0.46; 95%CI: 0.24-0.89) in hospital medical setting; decreases the risk of delirium (OR = 0.71; 95%CI: 0.54-0.92) in hip fracture; decreases the risk of physical frailty in community-dwelling older adults (RR = 0.77; 95%CI: 0.64-0.93). Systematic reviews without meta-analysis indicate that CGA improves clinical outcomes in oncology, haematology, and in emergency department.

CONCLUSIONS

CGA seems to be beneficial in the hospital medical setting for multiple health outcomes, with a high certainty of evidence. The evidence of benefits is less strong for the use of CGA in other settings.

Radiofrequency catheter ablation versus medical therapy for initial treatment of supraventricular tachycardia and its impact on quality of life and healthcare costs

We prospectively compared the impact on quality of life and cost effectiveness between ablation and medication as an initial strategy for patients with paroxysmal supraventricular tachycardia (SVT). Seventy-nine consecutive patients with newly documented paroxysmal SVT were treated with either ablation or medication. Health surveys (SF-36 and disease-specific questions) were obtained at baseline and after 12 months of follow up. Cost of health care utilization for the 6 months before and after treatment were measured. Both medication and ablation improved quality of life. However, ablation improved quality of life in more general health categories than medication. At follow up, ablation was associated with significantly improved quality of life in the bodily pain (63+/-24 vs 81+/-20, p <0.005), general health (69+/-21 vs 79+/-21, p <0.05), vitality (55+/-21 vs 66+/-22, p <0.05), and role emotion (78+/-36 vs 94+/-17, p <0.05) categories when compared with medication. Although both medication and ablation decreased frequency of disease-specific symptoms, ablation resulted in complete amelioration of symptoms in more patients (33% vs 74%). Potential long-term costs were similar for medication and ablation. In conclusion, ablation improves health-related quality of life to a greater extent, and in more aspects of general and disease-specific health than medication.

Hip isometric strength following knee surgery

Hip exercises are frequently prescribed following knee injury and subsequent surgery based on the assumption that hip weakness exists. No data, however, are available that support hip weakness following knee trauma or surgery. Therefore, the purpose of this study was to compare hip strength in patients after knee surgery. Twenty-seven patients who had undergone unilateral knee surgery were tested for hip flexor, extensor, abductor, and adductor isometric strength prior to initiation of rehabilitation. Multivariate analysis of variance revealed significant hip weakness in all four hip muscle groups of the surgical extremities (11.9-25.3%, p < or = 0.05) when compared with nonsurgical extremities. Both peak and endurance force were affected. The greatest percent difference between the surgical and nonsurgical extremity occurred for hip extension peak (25.3%) and endurance (22.6%) force development. We recommend assessment of hip strength following knee surgery and appropriate resistive exercises if weakness exists.

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D, Rohlf J, Salyer K, Sperka D, Spitzbart D, Suarez I, Tsatsos A, Yuan S, Zou D, Benelli G, Burkle B, Coubez X, Cutts D, Duh YT, Hadley M, Heintz U, Hogan JM, Laird E, Landsberg G, Lau KT, Lee J, Luo J, Narain M, Sagir S, Usai E, Wong WY, Yan X, Yu D, Zhang W, Brainerd C, Breedon R, De La Barca Sanchez MC, Chertok M, Conway J, Cox PT, Erbacher R, Jensen F, Kukral O, Lander R, Mulhearn M, Pellett D, Regnery B, Taylor D, Tripathi M, Yao Y, Zhang F, Bachtis M, Cousins R, Dasgupta A, Datta A, Hamilton D, Hauser J, Ignatenko M, Iqbal MA, Lam T, Mccoll N, Nash WA, Regnard S, Saltzberg D, Schnaible C, Stone B, Valuev V, Burt K, Chen Y, Clare R, Gary JW, Hanson G, Karapostoli G, Long OR, Manganelli N, Negrete MO, Si W, Wimpenny S, Zhang Y, Branson JG, Chang P, Cittolin S, Cooperstein S, Deelen N, Duarte J, Gerosa R, Giannini L, Gilbert D, Guiang J, Kansal R, Krutelyov V, Lee R, Letts J, Masciovecchio M, May S, Padhi S, Pieri M, Narayanan BVS, Sharma V, Tadel M, Vartak A, Würthwein F, Xiang Y, Yagil A, Amin N, Campagnari C, Citron M, Dorsett A, Dutta V, Incandela J, Kilpatrick M, Marsh B, Mei H, Ovcharova A, Quinnan M, Richman J, Sarica U, Stuart D, Wang S, Bornheim A, Cerri O, Dutta I, Lawhorn JM, Lu N, Mao J, Newman HB, Ngadiuba J, Nguyen TQ, Spiropulu M, Vlimant JR, Wang C, Xie S, Zhang Z, Zhu RY, Alison J, Andrews MB, Ferguson T, Mudholkar T, Paulini M, Vorobiev I, Cumalat JP, Ford WT, MacDonald E, Patel R, Perloff A, Stenson K, Ulmer KA, Wagner SR, Alexander J, Cheng Y, Chu J, Cranshaw DJ, Mcdermott K, Monroy J, Patterson JR, Quach D, Reichert J, Ryd A, Sun W, Tan SM, Tao Z, Thom J, Wittich P, Zientek M, Albrow M, Alyari M, Apollinari G, Apresyan A, Apyan A, Banerjee S, Bauerdick LAT, Beretvas A, Berry D, Berryhill J, Bhat PC, Burkett K, Butler JN, Canepa A, Cerati GB, Cheung HWK, Chlebana F, Cremonesi M, Petrillo KFD, Elvira VD, Freeman J, Gecse Z, Gray L, Green D, Grünendahl S, Gutsche O, Harris RM, Heller R, Herwig TC, Hirschauer J, Jayatilaka B, Jindariani S, Johnson M, Joshi U, Klabbers P, Klijnsma T, Klima B, Kortelainen MJ, Kwok KHM, Lammel S, Lincoln D, Lipton R, Liu T, Lykken J, Madrid C, Maeshima K, Mantilla C, Mason D, McBride P, Merkel P, Mrenna S, Nahn S, O’Dell V, Papadimitriou V, Pedro K, Pena C, Prokofyev O, Ravera F, Hall AR, Ristori L, Schneider B, Sexton-Kennedy E, Smith N, Soha A, Spiegel L, Stoynev S, Strait J, Taylor L, Tkaczyk S, Tran NV, Uplegger L, Vaandering EW, Weber HA, Woodard A, Acosta D, Avery P, Bourilkov D, Cadamuro L, Cherepanov V, Errico F, Field RD, Guerrero D, Joshi BM, Kim M, Konigsberg J, Korytov A, Lo KH, Matchev K, Menendez N, Mitselmakher G, Rosenzweig D, Shi K, Sturdy J, Wang J, Yigitbasi E, Zuo X, Adams T, Askew A, Diaz D, Habibullah R, Hagopian S, Hagopian V, Johnson KF, Khurana R, Kolberg T, Martinez G, Prosper H, Schiber C, Yohay R, Zhang J, Baarmand MM, Butalla S, Elkafrawy T, Hohlmann M, Verma RK, Noonan D, Rahmani M, Saunders M, Yumiceva F, Adams MR, Apanasevich L, Gonzalez HB, Cavanaugh R, Chen X, Dittmer S, Evdokimov O, Gerber CE, Hangal DA, Hofman DJ, Mills C, Oh G, Roy T, Tonjes MB, Varelas N, Viinikainen J, Wang X, Wu Z, Ye Z, Alhusseini M, Dilsiz K, Durgut S, Gandrajula RP, Haytmyradov M, Khristenko V, Köseyan OK, Merlo JP, Mestvirishvili A, Moeller A, Nachtman J, Ogul H, Onel Y, Ozok F, Penzo A, Snyder C, Tiras E, Wetzel J, Amram O, Blumenfeld B, Corcodilos L, Eminizer M, Gritsan AV, Kyriacou S, Maksimovic P, Roskes J, Swartz M, Vámi T, Barrera CB, Baringer P, Bean A, Bylinkin A, Isidori T, Khalil S, King J, Krintiras G, Kropivnitskaya A, Lindsey C, Minafra N, Murray M, Rogan C, Royon C, Sanders S, Schmitz E, Takaki JDT, Wang Q, Williams J, Wilson G, Duric S, Ivanov A, Kaadze K, Kim D, Maravin Y, Mitchell T, Modak A, Nam K, Rebassoo F, Wright D, Adams E, Baden A, Baron O, Belloni A, Eno SC, Feng Y, Hadley NJ, Jabeen S, Kellogg RG, Koeth T, Mignerey AC, Nabili S, Seidel M, Skuja A, Tonwar SC, Wang L, Wong K, Abercrombie D, Andreassi G, Bi R, Brandt S, Busza W, Cali IA, Chen Y, D’Alfonso M, Ceballos GG, Goncharov M, Harris P, Hu M, Klute M, Kovalskyi D, Krupa J, Lee YJ, Maier B, Marini AC, Mironov C, Paus C, Rankin D, Roland C, Roland G, Shi Z, Stephans GSF, Tatar K, Wang J, Wang Z, Wyslouch B, Chatterjee RM, Evans A, Hansen P, Hiltbrand J, Jain S, Krohn M, Kubota Y, Lesko Z, Mans J, Revering M, Rusack R, Saradhy R, Schroeder N, Strobbe N, Wadud MA, Acosta JG, Oliveros S, Bloom K, Bryson M, Chauhan S, Claes DR, Fangmeier C, Finco L, Golf F, Fernández JRG, Joo C, Kravchenko I, Siado JE, Snow GR, Tabb W, Yan F, Agarwal G, Bandyopadhyay H, Hay L, Iashvili I, Kharchilava A, McLean C, Nguyen D, Pekkanen J, Rappoccio S, Williams A, Alverson G, Barberis E, Freer C, Haddad Y, Hortiangtham A, Li J, Madigan G, Marzocchi B, Morse DM, Nguyen V, Orimoto T, Parker A, Skinnari L, Tishelman-Charny A, Wamorkar T, Wang B, Wisecarver A, Wood D, Bhattacharya S, Bueghly J, Chen Z, Gilbert A, Gunter T, Hahn KA, Odell N, Schmitt MH, Sung K, Velasco M, Band R, Bucci R, Dev N, Goldouzian R, Hildreth M, Anampa KH, Jessop C, Lannon K, Loukas N, Marinelli N, Mcalister I, Meng F, Mohrman K, Musienko Y, Ruchti R, Siddireddy P, Wayne M, Wightman A, Wolf M, Zarucki M, Zygala L, Bylsma B, Cardwell B, Durkin LS, Francis B, Hill C, Lefeld A, Winer BL, Yates BR, Addesa FM, Bonham B, Das P, Dezoort G, Elmer P, Frankenthal A, Greenberg B, Haubrich N, Higginbotham S, Kalogeropoulos A, Kopp G, Kwan S, Lange D, Lucchini MT, Marlow D, Mei K, Ojalvo I, Olsen J, Palmer C, Stickland D, Tully C, Xie Z, Malik S, Norberg S, Bakshi AS, Barnes VE, Chawla R, Das S, Gutay L, Jones M, Jung AW, Karmarkar S, Liu M, Negro G, Neumeister N, Paspalaki G, Peng CC, Piperov S, Purohit A, Schulte JF, Stojanovic M, Thieman J, Wang F, Xiao R, Xie W, Dolen J, Parashar N, Baty A, Dildick S, Ecklund KM, Freed S, Geurts FJM, Kumar A, Li W, Padley BP, Redjimi R, Roberts J, Shi W, Leiton AGS, Bodek A, de Barbaro P, Demina R, Dulemba JL, Fallon C, Ferbel T, Galanti M, Garcia-Bellido A, Hindrichs O, Khukhunaishvili A, Ranken E, Taus R, Chiarito B, Chou JP, Gandrakota A, Gershtein Y, Halkiadakis E, Hart A, Heindl M, Hughes E, Kaplan S, Karacheban O, Laflotte I, Lath A, Montalvo R, Nash K, Osherson M, Salur S, Schnetzer S, Somalwar S, Stone R, Thayil SA, Thomas S, Wang H, Acharya H, Delannoy AG, Spanier S, Bouhali O, Dalchenko M, Delgado A, Eusebi R, Gilmore J, Huang T, Kamon T, Kim H, Luo S, Malhotra S, Mueller R, Overton D, Rathjens D, Safonov A, Akchurin N, Damgov J, Hegde V, Kunori S, Lamichhane K, Lee SW, Mengke T, Muthumuni S, Peltola T, Undleeb S, Volobouev I, Wang Z, Whitbeck A, Appelt E, Greene S, Gurrola A, Johns W, Maguire C, Melo A, Ni H, Padeken K, Romeo F, Sheldon P, Tuo S, Velkovska J, Arenton MW, Cox B, Cummings G, Hakala J, Hirosky R, Joyce M, Ledovskoy A, Li A, Neu C, Tannenwald B, Wolfe E, Karchin PE, Poudyal N, Thapa P, Black K, Bose T, Buchanan J, Caillol C, Dasu S, De Bruyn I, Everaerts P, Fienga F, Galloni C, He H, Herndon M, Hervé A, Hussain U, Lanaro A, Loeliger A, Loveless R, Sreekala JM, Mallampalli A, Mohammadi A, Pinna D, Savin A, Shang V, Sharma V, Smith WH, Teague D, Trembath-Reichert S, Vetens W. Precision luminosity measurement in proton-proton collisions at s = 13 TeV in 2015 and 2016 at CMS

The measurement of the luminosity recorded by the CMS detector installed at LHC interaction point 5, using proton-proton collisions at s = 13 TeV in 2015 and 2016, is reported. The absolute luminosity scale is measured for individual bunch crossings using beam-separation scans (the van der Meer method), with a relative precision of 1.3 and 1.0% in 2015 and 2016, respectively. The dominant sources of uncertainty are related to residual differences between the measured beam positions and the ones provided by the operational settings of the LHC magnets, the factorizability of the proton bunch spatial density functions in the coordinates transverse to the beam direction, and the modeling of the effect of electromagnetic interactions among protons in the colliding bunches. When applying the van der Meer calibration to the entire run periods, the integrated luminosities when CMS was fully operational are 2.27 and 36.3 fb - 1 in 2015 and 2016, with a relative precision of 1.6 and 1.2%, respectively. These are among the most precise luminosity measurements at bunched-beam hadron colliders.

Comparison between thermal and ozone regenerations of spent activated carbon exhausted with phenol

Thermal and ozone regenerations of granular activated carbons (GAC) used in the removal of phenol from aqueous solution have been studied. The phenol isotherms for virgin GAC could be well represented by the Langmuir equation. Direct ozonation of GAC introduced large amounts of acidic surface oxygen groups, which caused a decrease in the phenol uptake. Thermogravimetric methods were used to investigate the mechanism of phenol adsorption onto virgin and ozonated carbons. Thermal regeneration was carried out at 1123K using nitrogen (pyrolysis alone) or nitrogen and carbon dioxide (pyrolysis plus oxidation). Results showed that spent carbons do not recover their adsorption characteristics when heated under inert conditions whereas carbon dioxide regeneration was effective at about 15% wt burn-off. Regeneration of GAC was also carried out with ozone as oxidizing gas at room temperature. Ozone dose and the nature of GAC have much influence on the regeneration performance. For an individual GAC there exits an optimum ozone dose for which phenol is eliminated together with most of its oxidation by-products without incurring in carbon surface chemical alterations. However, if excessive ozone is applied some acidic surface groups are formed on the GAC, thereby decreasing the adsorption capacity for phenol. Results showed that spent carbons can recover most of their adsorption characteristics and specific surface areas when regenerated through a number of adsorption-ozone regeneration cycles.

Efficacy and safety of bortezomib in refractory lupus nephritis: a single-center experience

BACKGROUND AND OBJECTIVES

Resistant lupus nephritis (LN) has been associated with the persistence of long-lived plasma cells. Preliminary studies identified bortezomib as a potential treatment option for patients with refractory LN. The aim of this study was to analyze the efficacy and safety of bortezomib in the treatment of severe refractory LN.

METHODS

This retrospective study included 12 female patients diagnosed for the first time with class IV or IV/V LN with acute or rapidly progressive kidney injury (n = 11) and/or severe nephrotic syndrome (n = 1) who showed resistance to induction therapy with cyclophosphamide, steroids, mycophenolate, and rituximab, and were treated with either intravenous or subcutaneous bortezomib plus intravenous dexamethasone.

RESULTS

All patients with acute or rapidly progressive kidney injury showed a significant reduction in both biochemical and immunological activity after a mean of 6 (minimum 5, maximum 7) weekly cycles of bortezomib regimen, with a significant increase in C3 levels and a significant decrease of anti-ds DNA antibody titers, Systemic Lupus Erythematosus Disease Activity Index score, serum creatinine, and proteinuria. One patient (8.3%) achieved a complete response, and 10 patients (83.4%) achieved a partial response. During follow-up, all these patients maintained partial responses under treatment with mycophenolate and low-dose glucocorticoids. The patient with refractory nephrotic syndrome showed a partial response but relapsed 11 months after the end of bortezomib treatment and was resistant to treatment. A significant decrease in serum IgG levels after initiation of bortezomib treatment was observed in all patients, five of them (41.6%) showed hypogammaglobulinemia (<500 mg/dl), but no patient suffered from opportunistic infections; in only two patients (16.6%) hypogammaglobulinemia persisted at the end of follow-up. Two patients (16.6%) suffered from sensory neuropathy, which led to bortezomib treatment discontinuation.

CONCLUSIONS

Bortezomib may be an effective option for refractory LN, but close monitoring must be performed for possible adverse events such as peripheral neuropathy and hypogammaglobulinemia.

Vascular reactivity, tissue levels, and binding sites for endothelin: a comparison in the spontaneously hypertensive and Wistar-Kyoto rats

The role of endothelin (ET-1) in mediating the development of blood pressure was investigated in the spontaneously hypertensive (SHR) rat using the Wistar-Kyoto (WKY) rat as the normotensive control. The following were characterized in both rat strains: age-dependent changes in mean arterial blood pressure (MAP), tissue (blood, lung, heart, and kidney) levels of immunoreactive ET-1 like related peptides (ET-1RP), aortic ring responses to ET-1, and specific high-affinity tissue (lung, atrium, ventricle, aorta, and kidney) binding sites for 125I-labelled ET-1. Commencing at age 10 weeks through to 12 weeks, SHR rats but not WKY rats developed a significant increase in MAP (from 152 +/- 7 to 189 +/- 3 mmHg) (1 mmHg = 133.32 Pa). However, in both WKY and SHR rats immunoreactive levels of ET-1RP increased (100 and 80%, respectively) throughout the same measurement period. The potency of ET-1 to contract aortic rings from SHR rats was slightly but not significantly greater than that for aortic rings from WKY rats, although aortic rings from SHR rats contracted in the presence of 0.5 nM ET-1, while those from WKY rats did not. The levels of immunoreactive ET-1RP were significantly reduced (32%) in the kidney and unchanged in the heart and lung of SHR rats compared with WKY rats. Specific 125I-labelled ET-1 binding sites displayed an increase and a significant decrease (24%) of density in the atrium and ventricle, respectively, a significant increase (31%) of affinity in the lung, and were unchanged in the kidney and aorta of SHR rats compared with WKY rats following the development of hypertension. The lack of a correlation between circulating levels of immunoreactive ET-1RP and the development of hypertension coupled with a lack of significant differences in vascular reactivity suggest that ET-1 is not the sole mediator of hypertension in this animal model. However, the tissue-specific changes in immunoreactive ET-1RP and 125I-labelled ET-1 binding sites suggest that ET-1 may be a partial mediator of hypertension and is subject to compensatory changes in response to the increased total peripheral resistance in SHR rats.

Coffee berry borer Hypothenemus hampei (Coleoptera: Curculionidae): searching for sustainable control strategies

The coffee berry borer Hypothenemus hampei (Ferrari) is the most serious pest of the world's most valuable tropical export crop. Since the last review on this insect was published six years ago, many new studies have contributed to an improved insight into the biology and ecology of the beetle, and have indicated new avenues for integrated and biological control. The latest developments in research, both laboratory and field, on the pest, its natural enemies and their implications for integrated control of H. hampei are summarized, with a particular focus on the situation in The Americas. Lately, the global coffee industry has changed radically; it has suffered a long cycle of lowest-ever world market prices caused by overproduction and technological change. At the same time, the advent of sustainable certification schemes has had a major impact on the industry. The role of integrated pest management and biological control of H. hampei in an era of changes in the coffee industry is discussed.

Tissue specificity of endothelin binding sites

A measurement was made of the binding of 125I-labeled endothelin (125I-ET) to crude membrane fractions prepared from rat aorta, atrium, ventricle, portal vein, trachea, lung parenchyma, vas deferens, ileum, bladder, and guinea-pig taenia coli and lung parenchyma. Scatchard analysis of 125I-ET binding in all tissues indicated binding to a single class of saturable sites. The affinity and density of 125I-ET binding sites varied between tissues. The Kd of 125I-ET binding was approximately 0.5 nM for rat aorta, trachea, lung parenchyma, ventricle, bladder, and vas deferens, and guinea-pig taenia coli and lung parenchyma, 1.8 nM for rat portal vein and atrium, and 3.3 nM for ileum. The Bmax of 125I-ET binding had the following rank order of density in rat tissues: trachea greater than lung parenchyma = vas deferens much greater than aorta = portal vein = atrium greater than bladder greater than ventricle = ileum. The properties of 125I-ET endothelin binding were characterized in rat ventricular membranes. 125I-ET binding was time dependent, reaching a maximum within 45-60 min at 25 degrees C. The calculated microassociation constant was 9.67 x 10(5) s-1 M-1. Only 15-20% of 125I-ET dissociated from its binding site even when dissociation was studied as long as 3 h. Preincubation of ventricular membranes with ET prevented binding of 125I-ET. 125I-ET binding was destroyed by boiling of ventricular membranes and was temperature, pH, and cation (Ca2+, Mg2+, and Na+) dependent.(ABSTRACT TRUNCATED AT 250 WORDS)

A left free-wall, decrementally conducting, atrioventricular (Mahaim) fiber: diagnosis at electrophysiological study and radiofrequency catheter ablation guided by direct recording of a Mahaim potential

A 64-year-old female with Wolff-Parkinson-White syndrome and an ECG demonstrating a right posterolateral accessory pathway was referred for electrophysiological study. During electrophysiological testing two AV pathways were identified: a right posterolateral pathway that displayed conventional electrophysiological properties: and a left free-wall pathway that conducted only anterogradely and demonstrated decremental properties. Two separate wide complex tachycardias were induced that utilized the left free-wall pathway anterogradely and either the AV node or the right posterolateral accessory pathway retrogradely. A discrete electrical potential on the free wall of the mitral annulus was identified during tachycardia and was utilized to facilitate mapping and ablation.

Safety and efficacy of hydrogen peroxide plasma sterilization for repeated use of electrophysiology catheters

OBJECTIVES

The purpose of this study was to evaluate a new technique for sterilizing nonlumen electrophysiology catheters that uses hydrogen peroxide gas plasma.

BACKGROUND

The reuse of electrophysiology catheters may potentially result in a significant cost savings. While ethylene oxide sterilization appears to be safe and effective from a clinical standpoint, toxic ethylene oxide residuals, which exceed Food and Drug Administration standards, have been reported.

METHODS

Ten nonlumen electrophysiology catheters were extensively evaluated. Each catheter was used five times and resterilized after each use with hydrogen peroxide gas plasma. Tests for sterility, mechanical and electrical integrity, chemical residuals and standard and electron microscopic inspection were performed.

RESULTS

Loss of electrical integrity or mechanical integrity was not observed in any catheter. No evidence of microbial contamination was found. Surface integrity was preserved except for one ablation catheter that exhibited fraying of the insulation at the insulation-electrode interface. Surface inspection using standard magnification and electron microscopy revealed no significant change in surface characteristics associated with the sterilization process. Hydrogen peroxide was the only chemical residual noted, with an average concentration of 0.22% by weight, which is within accepted American Association for the Advancement of Medical Instrumentation limits. The cost for a standard electrophysiology catheter ranges from $200 to $800, and one sterilization cycle costs $10. If electrophysiology catheters are used five times, resterilization could potentially result in a savings of $2,000 per catheter, or $9,000 for five ablation procedures.

CONCLUSIONS

Hydrogen peroxide gas plasma sterilization may provide a cost-effective means of sterilizing nonlumen electrophysiology catheters without the problem of potentially harmful chemical residuals. However, careful visual inspection of catheters, particularly at the insulation-electrode interface, is required if catheter reuse is performed.

Antiviral activity of a selective ribonucleotide reductase inhibitor against acyclovir-resistant herpes simplex virus type 1 in vivo

The present study reports the activity of BILD 1633 SE against acyclovir (ACV)-resistant herpes simplex virus (HSV) infections in athymic nude (nu/nu) mice. BILD 1633 SE is a novel peptidomimetic inhibitor of HSV ribonucleotide reductase (RR). In vitro, it is more potent than ACV against several strains of wild-type as well as ACV-resistant HSV mutants. Its in vivo activity was tested against cutaneous viral infections in athymic nude mice infected with the ACV-resistant isolates HSV type 1 (HSV-1) dlsptk and PAAr5, which contain mutations in the viral thymidine kinase gene and the polymerase gene, respectively. Following cutaneous infection of athymic nude mice, both HSV-1 dlsptk and PAAr5 induced significant, reproducible, and persistent cutaneous lesions that lasted for more than 2 weeks. A 10-day treatment regimen with ACV given topically four times a day as a 5% cream or orally at up to 5 mg/ml in drinking water was partially effective against HSV-1 PAAr5 infection with a reduction of the area under the concentration-time curve (AUC) of 34 to 48%. The effects of ACV against HSV-1 dlsptk infection were not significant when it was administered topically and were only marginal when it was given in drinking water. Treatment under identical conditions with 5% topical BILD 1633 SE significantly reduced the cutaneous lesions caused by both HSV-1 dlsptk and PAAr5 infections. The effect of BILD 1633 SE against HSV-1 PAAr5 infections was more prominent and was inoculum and dose dependent, with AUC reductions of 96 and 67% against infections with 10(6) and 10(7) PFU per inoculation site, respectively. BILD 1633 SE also significantly decreased the lesions caused by HSV-1 dlsptk infection (28 to 51% AUC reduction). Combination therapy with topical BILD 1633 SE (5%) and ACV in drinking water (5 mg/ml) produced an antiviral effect against HSV-1 dlsptk and PAAr5 infections that was more than the sum of the effects of both drugs. This is the first report that a selective HSV RR subunit association inhibitor can be effective against ACV-resistant HSV infections in vivo.

Peptidomimetic inhibitors of herpes simplex virus ribonucleotide reductase with improved in vivo antiviral activity

We have been investigating the potential of a new class of antiviral compounds. These peptidomimetic derivatives prevent association of the two subunits of herpes simplex virus (HSV) ribonucleotide reductase (RR), an enzyme necessary for efficient replication of viral DNA. The compounds disclosed in this paper build on our previously published work. Structure-activity studies reveal beneficial modifications that result in improved antiviral potency in cell culture in a murine ocular model of HSV-induced keratitis. These modifications include a stereochemically defined (2,6-dimethylcyclohexyl)amino N-terminus, two ketomethylene amide bond isosteres, and a (1-ethylneopentyl)amino C-terminus. These three modifications led to the preparation of BILD 1351, our most potent antiherpetic agent containing a ureido N-terminus. Incorporation of the C-terminal modification into our inhibitor series based on a (phenylpropionyl)valine N-terminus provided BILD 1357, a significantly more potent antiviral compound than our previously published best compound, BILD 1263.

Enhanced adsorption of metal ions onto functionalized granular activated carbons prepared from cherry stones

Some granular activated carbons (GACs) were prepared from cherry stones (CS), an agricultural waste, by thermal methods following pyrolysis in nitrogen and subsequent activation (with air, carbon dioxide and steam) or single-step activation in steam. A GAC prepared by activation with carbon dioxide was further treated with several oxidizing agents (air, air-ozone mixture, nitric acid and hydrogen peroxide). The non-oxidized GACs produced have surface areas ranged from 508 to 901m(2)/g and show a predominantly micro- and macropores structure. Oxidation treatments, especially with nitric acid and ozone, led to the fixation of high amounts of acidic surface oxygen complexes (SOCs), thus making the carbon surface more hydrophilic. Contrary to oxidation with the other agents, the ozone treatment, at the conditions applied in this work, does not decrease the GAC surface area. Both, the non-oxidized and the oxidized GACs were used as adsorbent to study the adsorption of Cu(II) from aqueous solution. Adsorption isotherms were obtained at 25 degrees C and data were well fitted to the Langmuir equation. The results show that the Cu(II) uptake of the non-oxidized GACs is not great, but similar to that of the commercial grade Filtrasorb 400. The adsorption capacity for Cu(II) could be greatly enhanced by GAC oxidation, especially with nitric acid and ozone treatments. The larger adsorption capacity of the oxidized GACs has been attributed to oxygen functionalities (mainly carboxylic) fixed on the GAC surface, which can remove Cu(II) species from water by both ion-exchange and surface complexation mechanisms. The ozonated GAC was also evaluated for the adsorption of Co(II) species from single solute and Cu(II)-Co(II) binary mixture solutions. The functionalization of GAC by the ozone treatment improved the adsorption of both Cu(II) and Co(II) regardless of the fact that they were in single solute or binary systems.

Strong spatial segregation between wildcats and domestic cats may explain low hybridization rates on the Iberian Peninsula

The European wildcat (Felis silvestris silvestris) is an endangered felid impacted by genetic introgression with the domestic cat (Felis silvestris catus). The problem of hybridization has had different effects in different areas. In non-Mediterranean regions pure forms of wildcats became almost extinct, while in Mediterranean regions genetic introgression is a rare phenomenon. The study of the potential factors that prevent the gene flow in areas of lower hybridization may be key to wildcat conservation. We studied the population size and spatial segregation of wildcats and domestic cats in a typical Mediterranean area of ancient sympatry, where no evidence of hybridization had been detected by genetic studies. Camera trapping of wild-living cats and walking surveys of stray cats in villages were used for capture-recapture estimations of abundance and spatial segregation. Results showed (i) a low density of wildcats and no apparent presence of putative hybrids; (ii) a very low abundance of feral cats in spite of the widespread and large population sources of domestic cats inhabiting villages; (iii) strong spatial segregation between wildcats and domestic/feral cats; and (iv) no relationship between the size of the potential population sources and the abundance of feral cats. Hence, domestic cats were limited in their ability to become integrated into the local habitat of wildcats. Ecological barriers (habitat preferences, food limitations, intra-specific and intra-guild competition, predation) may explain the severe divergences of hybridization impact observed at a biogeographic level. This has a direct effect on key conservation strategies for wildcats (i.e., control of domestic cats).

Resistance of the diabetic rat nerve to ischemic inactivation

The resistance of the action potential to ischemic inactivation observed in diabetic patients has been reproduced in vivo in rat rendered diabetic with streptozotocin and, acutely, in normal rats given p.o. a load of glucose. The resistance phenomenon was not detected in galactosemic rats. The preservation of the action potential was reversed by the administration of insulin, but not by treatment with an aldose reductase (AR) inhibitor. The ischemic resistance is attributed to the metabolic availability of excess glucose to the nerve. AR does not appear to be involved in the phenomenon.

Fragmentation and low density as major conservation challenges for the southernmost populations of the European wildcat

Knowledge of population dynamics of threatened species in the wild is key to effective conservation actions. However, at present, there are many examples of endangered animals for which their current situation is unknown, and not just in remote areas and less developed countries. We have explored this topic by studying the paradigmatic case of the European wildcat (Felis silvestris silvestris), an endangered small carnivore whose status has been subjectively established on the basis of non-systematic approaches and opportunistic records. Little is known about its demographic situation, prompting the need for information to improve conservation measures. However, the secretive behaviour of felines along with its low density in natural conditions have prevented the gathering of sufficient data. We developed a field sampling strategy for one of the largest populations (Andalusia, South Spain, 87,268 km2), based on a logistically viable systematic non-intrusive survey by camera-trapping. This study offers the first large-scale estimation for any European wildcat population, based on analytical approaches applied on Species Distribution Models. A hierarchical approach based on a Maxent model for distribution estimation was used, along with Generalised Linear Models for density estimation from explicit spatial capture-recapture data. Our results show that the distribution range is smaller and more highly fragmented than previously assumed. The overall estimated density was very low (0.069 ±0.0019 wildcats/km2) and the protected areas network seems to be insufficient to cover a significant part of the population or a viable nucleus in demographic terms. Indeed, the most important areas remain unprotected. Our main recommendations are to improve the protected area network and/or vigilance programs in hunting estates, in addition to studying and improving connectivity between the main population patches.

Comparison of Photorefractive Keratectomy and Laser in situ Keratomileusis for Myopia of -6 D or Less Using the Nidek EC-5000 Laser

PURPOSE

We compared the efficacy, predictability, and safety of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) for the surgical correction of low and moderate myopia.

METHODS

A retrospective study was performed to evaluate uncorrected and spectacle-corrected visual acuity, and manifest refraction 1 year after PRK or LASIK. All procedures were done using an automatic microkeratome (Chiron Ophthalmic) and the Nidek EC-5000 excimer laser.

RESULTS

PRK was performed in 75 eyes of 45 patients and LASIK in 133 eyes of 77 patients. Mean age for PRK patients was 32.8 years (range, 18 to 52 yr) and LASIK patients was 29.6 years (range, 18 to 49 yr). Mean preoperative spherical equivalent refraction for PRK patients was -3.28 D (range, -1.00 to -6.00 D) and LASIK, -3.86 D (range, -1.00 to -6.00 D). One year after surgery, mean spherical equivalent refraction for Group 1 (baseline, -1.00 to -3.00 D) PRK eyes was -0.18 +/- 0.61 D (range, -1.50 to +0.75 D) and for LASIK eyes, -0.08 +/- 0.61 D (range, -1.50 to +1.62 D), with no statistically significant difference. For Group 2 eyes (baseline, -3.25 to -6.00 D), mean spherical equivalent refraction for PRK eyes was -0.44 +/- 0.87 D (range, -2.00 to +2.12 D) and for LASIK eyes, -0.09 +/- 0.83 D (range, -1.50 to +1.75 D), with no statistically significant difference. The antilogarithm of the mean UCVA (antilogUCVA) in Group 1 for PRK was 0.79 +/- 0.21 (20/25) and for LASIK was 0.87 +/- 0.19 (20/23), with no statistically significant difference. The antilogUCVA in Group 2 for PRK eyes was 0.70 +/- 0.24 (20/28) and for LASIK eyes was 0.83 +/- 0.18 (20/24), with a statistically significant difference (0.7 vs. 0.83, P < .005). The percentage of eyes with a postoperative UCVA >20/40 in Group 1 for PRK was 91.5% (38 eyes) and for LASIK was 95% (50 eyes) (no statistically significant difference), and in Group 2 for PRK eyes, it was 82% (27 eyes) and 97.5% (78 eyes) for LASIK (statistically significant difference, P < .05).

CONCLUSION

PRK and LASIK with the Nidek EC-5000 excimer laser are effective and safe for correcting low to moderate myopia, but LASIK eyes showed better results for moderate myopia in terms of uncorrected visual acuity.

Laser in situ Keratomileusis for Hyperopia and Hyperopic Astigmatism With the Nidek EC-5000 Excimer Laser

PURPOSE

We evaluated the efficacy, predictability, stability, and safety of laser in situ keratomileusis (LASIK) for hyperopia and hyperopic astigmatism.

METHODS

A retrospective study was performed for 92 eyes of 62 consecutive patients to evaluate uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA) and manifest refraction before and 3 and 6 months after LASIK (Moria LSK-ONE microkeratome, Nidek EC-5000 excimer laser). Eyes were divided into groups: Group 1 (low hyperopia) for spherical correction of +1.00 to +3.00 D (22 eyes), Group 2 (low hyperopic astigmatism) for toric correction with spherical equivalent refraction of +1.00 to +3.00 D (18 eyes), Group 3 (moderate hyperopia) for spherical correction of +3.25 to +6.00 D (10 eyes), and Group 4 (moderate hyperopic astigmatism) for toric correction with spherical equivalent refraction between +3.25 and +6.00 D (18 eyes).

RESULTS

At 3 and 6 months after LASIK, 68 eyes (73.9%) were available for follow-up examination. Percentage of eyes with a spherical equivalent refraction within +/-0.50 D of emmetropia for Group 1 was 54.5% (12 eyes); Group 2, 50% (9 eyes); Group 3, 40% (4 eyes), and Group 4, 38.8% (7 eyes). UCVA > or =20/20 in Group 1 was 14% and in Groups 2, 3, and 4, 0%. One eye (5.5%) lost two lines of BSCVA.

CONCLUSION

LASIK with the Moria LSK-ONE microkeratome and the Nidek EC-5000 excimer laser reduced low and moderate hyperopia and was within +/-0.50 D of target outcome in approximately 50% of eyes. Undercorrection was evident in all groups. The procedure was safe.

Trends and patterns in electrophysiologic and ablation catheter reuse in the United States

In a survey of 140 electrophysiologic laboratories in the USA, 49% reuse catheters to some extent. Catheter reuse is associated with significant reductions in cost but is not conducted in a standardized fashion.

Soluble HLA class I antigens in patients with type I diabetes and their family members

Our objective was to study a possible contribution of MHC genes to S-HLA-I secretion in patients with Type I diabetes. Quantitatively, we used a highly sensitive enzyme-linked immunoassay to measure S-HLA-I in the serum of a total of 39 patients with Type I diabetes, as well as 36 kinships of 12 diabetic patients and 82 normal individuals with known HLA-phenotypes. S-HLA-I levels were abnormally elevated in patients or their non-diabetic relatives compared to normal controls (p < 0.0009). No complete HLA-haplotype had been identified to be correlated with high or low S-HLA-I secretion. Only the HLA-A23 or A24 (splits of HLA-A9) positive individuals sera were found to contain high S-HLA-I concentrations in all populations studied. The difference in S-HLA-I levels of HLA-A24 patients (n = 4) or their HLA-A24 positive non-diabetic relatives (n = 10) to the group of HLA-A24 normal controls (n = 15) was statistically highly significant (p < 0.0005 and p < 0.0009, respectively). The results suggests that HLA-A24 may confer additional independent risk for the disease expression in male children but not in female siblings. Nevertheless, the data implies that the patients or their non-diabetic relatives carrying the HLA-A24 have increased risk of developing ICA associated with high S-HLA-I levels compared to HLA-A24 negative probands or their kinships with low levels of S-HLA-I. This effect occurred irrespective to other diabetes related HLA-DR alleles. In summary, the results show a pronounced genetic heterogeneity of Type I diabetes with MHC control of the expression of S-HLA-I and possible involvement of hormonal factors that might potentiate a specific synthesis of S-HLA-I. The findings have implications for identifying individuals with a possible risk for developing the disease.

A portrait of the Higgs boson by the CMS experiment ten years after the discovery

In July 2012, the ATLAS and CMS collaborations at the CERN Large Hadron Collider announced the observation of a Higgs boson at a mass of around 125 gigaelectronvolts. Ten years later, and with the data corresponding to the production of a 30-times larger number of Higgs bosons, we have learnt much more about the properties of the Higgs boson. The CMS experiment has observed the Higgs boson in numerous fermionic and bosonic decay channels, established its spin-parity quantum numbers, determined its mass and measured its production cross-sections in various modes. Here the CMS Collaboration reports the most up-to-date combination of results on the properties of the Higgs boson, including the most stringent limit on the cross-section for the production of a pair of Higgs bosons, on the basis of data from proton-proton collisions at a centre-of-mass energy of 13 teraelectronvolts. Within the uncertainties, all these observations are compatible with the predictions of the standard model of elementary particle physics. Much evidence points to the fact that the standard model is a low-energy approximation of a more comprehensive theory. Several of the standard model issues originate in the sector of Higgs boson physics. An order of magnitude larger number of Higgs bosons, expected to be examined over the next 15 years, will help deepen our understanding of this crucial sector.

Tissue selectivity and calcium dependence of contractile responses to endothelin

The tissue selectivity and calcium dependence of endothelin, a potent vasoconstrictor peptide obtained from endothelial cells, were investigated in a number of rat and guinea pig tissues. Endothelin produced a significant dose-dependent contraction of rat tissues with the following rank order of efficacy: aorta greater than portal vein greater than trachea much greater than vas deferens = lung parenchyma much greater than bladder. In the rat atrium and ventricle, endothelin possessed positive inotropic effects at low doses and arrhythmogenic effects at high doses. Endothelin also produced a significant contraction of guinea pig lung parenchyma and induced relaxations of guinea pig taenia coli precontracted with potassium chloride. The aortic ring contractile response to endothelin was characterized by both rapid and slow phases of contraction. The rapid phase of contraction was abolished by removal of extracellular calcium or preincubation of tissues with the dihydropyridine calcium channel antagonist, nifedipine. Removal of the endothelium from aortic rings resulted in an increase of approximately 10-fold in the contractile potency of endothelin. In comparison, the potency of the dihydropyridine calcium channel activator, (-)-S-BAY K 8644, was increased approximately 15-fold by the same treatment. These findings suggest that endothelin, while displaying some selectivity as a vascular smooth muscle spasmogen, is a general smooth and cardiac muscle spasmogen which utilizes both intra- and extracellular sources of calcium to support its contractions.