High-yield purification of plasma membranes from transformed human keratinocytes in culture.
The density pertubation technique with cationic silica microbeads was applied to prepare highly purified plasma membranes from cultured human keratinocytes. Trypsinized cells were coated successively with the beads (diameter approximately 50 nm, gravity greater than 2 g/cm3) and polyacrylic acid before they were lysed by osmotic shock and mechanical shear. The plasma membranes remained in the form of large open sheets which could easily be separated from other cell organelles and the cytosol by low-speed centrifugation. The membrane preparation was characterized by scanning and transmission electron microscopy, marker enzyme activities, one-dimensional sodium dodecyl sulfate polyacrylamide electrophoresis, and the specific beta-adrenergic receptor count. A yield of 79 +/- 9% was calculated by comparing the amount of beta-adrenoceptors in the purified membrane preparation with that of a crude cellular particulate fraction. The specific beta-adrenoceptor count of these two preparations was 1.2 +/- 0.02 and 0.2 +/- 0.05 pmol/mg protein, respectively, indicating a 6-fold improved purification with this microbead technique. The purified membranes were essentially free from contamination of other cell organelles.


Masticatory efficiency of implant-supported removable partial dental prostheses in patients with free fibula flap reconstructed mandibles: A split-mouth, observational study.
The aim of this split-mouth study was to evaluate the masticatory efficiency in patients with segmentally reconstructed mandibles using free fibula flaps, with and without stabilizing osteosynthesis material in-situ during implant placement for rehabilitation with implant-supported removable partial dental prostheses (ISRPDPs). Ten participants (n = 10; ♀ = 2, ♂ = 8; mean age = 38.1 years) consented to participate in this study. The participants' normal side (Side N) of the mandible served as the control side, for comparing the masticatory efficiency of the segmentally reconstructed and rehabilitated side (Side R). Masticatory efficiency was evaluated using the two-colored chewing gum test, measured as subjective assessment (SA) and electronically evaluated variance of hue (VOH). Data were checked for normal distribution and statistically analyzed with the level of significance set to p < 0.05. Thirty-four tissue-level implants were placed in reconstructed mandibles of 10 participants. There was no significant difference observed in the masticatory efficiencies between Side N and Side R, in both subjective and electronic assessments. No implant loss was observed after a post-rehabilitated mean follow-up period of 42.7 months, revealing an implant survival rate of 100%. In patients with surgically reconstructed mandibles, a normal masticatory function can be successfully achieved with a rehabilitation of the reconstructed side with implant-supported removable partial dental prostheses. Implant-supported prostheses should be actively advocated in patients with reconstructive surgeries to restore their masticatory function, extend their food choices, and improve their overall oral health-related quality of life.


A new approach for improving the birefringence analysis of dental enamel mineral content using polarizing microscopy.
The main problem in interpreting birefringence of dental enamel under polarizing microscopy is the lack of physical constants able to allow the Wiener equation to be applied directly to the composition of such tissue. The present study introduces a new approach to circumvent this constraint. Because the nonmineral phase of enamel is heterogeneous, its refractive index can be computed in terms of its components (namely, water, which is partially replaced by the immersion medium, and organic matter), thereby providing a more acceptable refractive index to be used in the Wiener equation. Furthermore, the enamel mineral volume is ordinarily calculated on the basis of the density 3.15 g cm(-3). The density 2.99 g cm(-3) has been, however, reported to be more accurate for enamel hydroxyapatite, so enamel mineral volumes from selected published data were converted using such a density. The birefringence of mature enamel computed by the Wiener equation, taking into account the above refinements, matched, for the first time, published experimental birefringence values. The theoretical water and organic contents were also consistent with published experimental data. Thus, a direct application of the Wiener equation to the enamel composition has now been achieved. It is speculated that quantitative data on the mineral, the water and the organic contents of mature dental enamel can be derived from interpretation of birefringence in two immersion media (obtained before and after extraction of the organic matter) with this new approach.


Crafting Carbazole-Based Vorinostat and Tubastatin-A-like Histone Deacetylase (HDAC) Inhibitors with Potent in Vitro and in Vivo Neuroactive Functions.
Small-molecule inhibitors of HDACs (HDACi) induce hyperacetylation of histone and nonhistone proteins and have emerged as potential therapeutic agents in most animal models tested. The established HDACi vorinostat and tubastatin-A alleviate neurodegenerative and behavioral conditions in animal models of neuropsychiatric disorders restoring the neurotrophic milieu. In spite of the neuroactive pharmacological role of HDACi (vorinostat and tubastatin-A), they are limited by efficacy and toxicity. Considering these limitations and concern, we have designed novel compounds 3-11 as potential HDACi based on the strategic crafting of the key pharmacophoric elements of vorinostat and tubastatin-A into architecting a single molecule. The molecules 3-11 were synthesized through a multistep reaction sequence starting from carbazole and were fully characterized by NMR and mass spectral analysis. The novel molecules 3-11 showed remarkable pan HDAC inhibition and the potential to increase the levels of acetyl H3 and acetyl tubulin. In addition, few novel HDAC inhibitors 4-8, 10, and 11 exhibited significant neurite outgrowth-promoting activity with no observable cytotoxic effects, and interestingly, compound 5 has shown comparably more neurite growth than the parent compounds vorinostat and tubastatin-A. Also, compound 5 was evaluated for possible mood-elevating effects in a chronic unpredictable stress model of Zebrafish. It showed potent anxiolytic and antidepressant-like effects in the novel tank test and social interaction test, respectively. Furthermore, the potent in vitro and in vivo neuroactive compound 5 has shown selectivity for class II over class I HDACs. Our results suggest that the novel carbazole-based HDAC inhibitors, crafted with vorinostat and tubastatin-A pharmacophoric moieties, have potent neurite outgrowth activity and potential to be developed as therapeutics to treat depression and related psychiatric disorders.


Management of Patients with Graves' Disease and Orbital Involvement: Role of Spectral Domain Optical Coherence Tomography.
To investigate the role of choroidal thickness evaluation with spectral domain optical coherence tomography (SDOCT) and enhanced depth imaging (EDI) technique in the management of patients with Graves' disease and orbitopathy (GO). Thirty-six eyes of 18 patients with GO and 36 eyes of 18 age-matched control subjects were included in this retrospective observational study. All the subjects underwent a complete ophthalmological evaluation, including clinical activity score (CAS) and exophthalmometry. The SDOCT images of the choroid were obtained by EDI modality. Choroidal thickness was significantly increased in GO than in control eyes (p < 0.01). A significant correlation was found between choroidal thickness and CAS, proptosis, and the duration of disease (p < 0.05). This study shows that choroidal thickness, evaluated with EDI-OCT, is significantly increased in patients with GO and correlates with the activity of the disease, proptosis, and duration of the disease. The choroidal thickening may reflect the ocular hemodynamic changes, and enhanced depth imaging optical coherence tomography may be a useful tool for the evaluation of orbital congestion and management of patients with Graves' disease and orbital involvement.


Polyacrylamide Grafted Xanthan: Microwave-Assisted Synthesis and Rheological Behavior for Polymer Flooding.
Application of polymer-flooding systems in secondary and tertiary oil recovery represents a real challenge for oil industry. In this work, our main objective is to explore possibilities of making use of xanthan-g-polyacrylamide for polymer flooding in a particular Devonian oilfield of medium salinity. The graft polymer was synthesized by using microwave-assisted graft copolymerization reaction of acrylamide on xanthan. The synthesized copolymer with optimized grafting parameters has been characterized by Infrared Spectroscopy and Thermal Analysis (DSC). Rheological analysis by steady shear and oscillatory flow experiments have been subsequently performed for xanthan and grafted xanthan under reservoir conditions. In steady shear, as expected the grafted polymer solutions flow as shear-thinning materials and apparent viscosity showed good fits with Cross's model. The viscosity losses due to salinity or temperature are more controlled for the grafted xanthan compared to pristine xanthan. When the grafted polymer concentration is increased to 2000 ppm the losses were halved. In oscillatory shear, the copolymer solutions followed a global behavior of semi-dilute entangled systems; furthermore, all dynamic properties were influenced by the brine salinity. Compared to xanthan, the elastic properties of xanthan-g-polyacrylamide solutions have been significantly improved in saline media and the losses in elasticity of grafted polymer solutions are lower.


Comparing National College Health Assessment with other surveys of cannabis use and binge drinking among young adult college students 2008-2018.
Objective: We considered the utility of National College Health Assessment (NCHA) data relative to other national data for studying college students' cannabis use and binge drinking, and drug policy effects. Participants: Survey data on 18-22-year old college students were drawn from the 2008-2018 NCHA, National Survey on Drug Use and Health (NSDUH), Monitoring the Future (MTF), and Healthy Minds Study (HMS). Methods: Prevalence estimates were compared across data sources in terms of level and change from 2008-2018 using linear regressions, separately for men and women. Results: Mean prevalence estimates for 30-day cannabis use and 2-week binge drinking, and linear time trends did not differ significantly among NCHA, NSDUH, and MTF. Conclusions: NCHA prevalence estimates are similar to those from NSDUH and MTF, NCHA has unique strengths, and some weaknesses can be offset. Findings support the value of NCHA for studying college students' substance use and effects of drug policy.


Detection of benzotriazole UV stabilizers in the blubber of marine mammals by gas chromatography-high resolution mass spectrometry (GC-HRMS).
Benzotriazole UV stabilizers (BUVSs), such as UV-328 and UV-327, were identified in the blubbers of finless porpoises (Neophocaena phocaenoides) collected from the Ariake Sea, western Japan, by gas chromatography-high resolution mass spectrometry (GC-HRMS). The mean concentrations and standard deviations of UV-328 and UV-327 in five blubber samples were 38 ± 28 ng g(-1) (lipid wt) and 19 ± 19 ng g(-1), respectively. The bioconcentration factor (BCF) of UV-327 between water and finless porpoises was estimated to be 33 300, which is approximately one order of magnitude higher than that found for small fish inhabiting the same regions. The BCF of UV-327 in finless porpoises was similar to that of persistent organochlorine pesticide, hexachlorocyclohexane (HCH: 37 000) in marine mammals from the western North Pacific Ocean. These results suggest that BUVSs appear to be persistent and bioaccumulative in the aquatic food chain. Further investigations on temporal trends, and regional and global monitoring of BUVSs are needed to understand their environmental profiles and potential risks to wildlife and human.


Dimensional change measurements of conventional and flowable composite resins using a laser displacement sensor.
The polymerization shrinkage values of commercial flowable and conventional composites were measured with a newly developed laser displacement sensor. Compressive strength and filler content were also measured. Compared to conventional composites, the flowable composites required a longer time - not exceeding 4 minutes - to reach a constant polymerization shrinkage rate. In terms of shrinkage ratio, it was less than 1.5% for conventional composites at 90 minutes, which was lower than that of flowable composites, i.e. more than 2.0%. The compressive strength of conventional composites was higher than that of flowable composites. A highly significant correlation between filler content and polymerization shrinkage at 90 minutes was observed, and polymerization shrinkage tended to decrease as filler content increased. In light of the results obtained in this study, the newly developed displacement meter with a laser displacement sensor proved to be effective for in-depth investigation of the polymerization shrinkage of dental composites.


Neural correlates of progressive reduction of bradykinesia in de novo Parkinson's disease.
A progressive reduction in the speed and amplitude of repetitive action is an essential component of bradykinesia, which is called sequence effect (SE). Because SE is specific to Parkinson's disease (PD) and is suggested to be associated with motor arrest, its features are of great interest. The aim of this study was, for the first time, to find the neural correlates of SE and to demonstrate whether dopaminergic deficit is correlated with SE. We enrolled 12 patients with de novo PD at a tertiary referral hospital. Correlations between SE severity and alterations in gray and white matter were studied. The association between severity of the SE and striatal dopaminergic deficits was also analyzed. There was a significant negative correlation between the volumetric changes in the anterior cingulate cortex (ACC) and the inferior semilunar lobule of the cerebellum and the degree of SE. There was a significant correlation between the long association fibers (the superior longitudinal fasciculus, the uncinate fasciculus, and the inferior fronto-occipital fasciculus) connecting the frontal lobes to the temporal, parietal, and occipital lobes and SE. There was a significant negative correlation between SE in the more affected hand and the caudate dopamine transporter binding in the more affected hemisphere. Our results suggest that the ACC and the cerebellum (inferior semilunar lobule) are associated with the severity of SE. Taken together with DTI findings, the present study proposes that ACC may have an important role. Our data show that the caudate dopaminergic activity may be related to SE.


Proline/pipecolinic acid-promoted copper-catalyzed P-arylation.
We have developed a convenient and efficient approach for P-arylation of organophosphorus compounds containing P-H. Using commercially available and inexpensive proline and pipecolinic acid as the ligands greatly improved the efficiency of the coupling reactions, so the method can provide an entry to arylphosphonates, arylphosphinates and arylphosphine oxides.


Effects of Post-Harvest Ozone Treatment on Some Molecular Stability Markers of Amelanchier alnifolia Nutt. Fruit during Cold Storage.
Fruits of Amelanchier alnifolia Nutt. ex M. Roem. (Nutt.) are a good source of bioactive compounds and vitamins. Due to the fact that the berries are a soft fruit, they require special procedures to increase their molecular and mechanical stability during cold storage. The study investigated the effects of ozone treatment applied cyclically (every 24 h) on selected chemical and mechanical parameters of saskatoon berries kept in storage. For this purpose, measurements were performed to assess changes in some molecular markers such as antioxidant potential, content of vitamin C, and total polyphenols, as well as microbial stress and maximum destructive force under uniaxial compression of samples. The effectiveness of the storage process was also assessed in relation to the conditions used by determining the proportion of fruit affected by diseases occurring in storage. The findings show that ozone treatment led to increased content of bioactive compounds at the initial stages of storage and resulted in decreased loss of water and bioactive compounds at the later stages. Ultimately, irrespective of the conditions applied during ozone treatment, it was observed that the growth of micro-organisms on the fruit surface was inhibited, and as a result, storage losses during the relevant period were significantly reduced.


Persistent improvement of gas exchange and lung mechanics by aerosolized perfluorocarbon.
The effect of aerosolized perfluorocarbon (PFC) (FC77) on pulmonary gas exchange and lung mechanics was studied in a surfactant depleted piglet model. Sixty minutes after induction of lung injury by bronchoalveolar lavage, 20 piglets were randomized to receive aerosolized PFC (Aerosol-PFC, 10 ml/kg/h, n = 5), partial liquid ventilation (PLV) at FRC capacity volume (FRC-PLV, 30 ml/kg, n = 5) or low volume (LV-PLV, 10 ml/kg/h, n = 5), or intermittent mandatory ventilation (IMV) (Control, n = 5). After 2 h, perfluorocarbon application was stopped and IMV was continued for 6 h. Sixty minutes after the onset of therapy, PaO2 was significantly higher and PaCO2 was significantly lower in the Aerosol-PFC and the FRC-PLV groups than in the LV-PLV and the Control groups; p < 0.001. Six hours after treatment, maximum PaO2 was found in the Aerosol-PFC group: 406.4 +/- 26.9 mm Hg, FRC-PLV: 217.3 +/- 50.5 mm Hg, LV-PLV: 96.3 +/- 18.9 mm Hg, Control: 67.6 +/- 8.4 mm Hg; p < 0.001. PaCO2 was lowest in the Aerosol-PFC group: 24.2 +/- 1.7 mm Hg, FRC-PLV: 35.9 +/- 2.8 mm Hg, LV-PLV: 56.7 +/- 12.4 mm Hg, Control: 60.6 +/- 5.1 mm Hg; p < 0.01. Dynamic compliance (C20/c) was highest in the Aerosol-PFC group; p < 0.01. Aerosolized perfluorocarbon improved pulmonary gas exchange and lung mechanics as effectively as PLV did in surfactant-depleted piglets, and the improvement was sustained longer.


Major Left Bundle Branch Block and Coronary Heart Disease-Are There Any Differences between the Sexes?
Left bundle branch block is not a benign pathology, and its presence requires the identification of a pathological substrate, such as ischemic heart disease. Left bundle branch block appears to be more commonly associated with normal coronary arteries, especially in women. The objectives of our study were to describe the particularities of left bundle branch block in women compared to men with ischemic heart disease. Result: We included seventy patients with left bundle branch block and ischemic heart disease, with a mean age of 67.01 ± 8.89 years. There were no differences in the profile of risk factors, except for smoking and uric acid. The ventricular depolarization (QRS) duration was longer in men than women (136.86 ± 8.32 vs. 132.57 ± 9.19 msec; p = 0.018) and also men were observed to have larger left ventricular diameters. Left bundle branch block duration was directly associated with ventricular diameters and indirectly associated with left ventricular ejection fraction value, especially in women (R = -0.52, p = 0.0012 vs. R = -0.50, p = 0.002). In angiography, 80% of women had normal epicardial arteries compared with 65.7% of men; all these patients presented with microvascular dysfunction. Conclusion: The differences between the sexes were not so obvious in terms of the presence of risk factors; instead, there were differences in electrocardiographic, echocardiographic, and angiographic aspects. Left bundle branch block appears to be a marker of microvascular angina and systolic dysfunction, especially in women.


Preparation and Characterization of UV-Curable Acrylic Membranes Embedding Natural Antioxidants.
We examine the behaviour of acrylic resin-based membranes containing natural anti-oxidants, such as Galla Chinensis tea powder extract (TP) and Taiwanese green propolis (TGP), in different concentrations ranging between 5 and 20 wt %. Membrane morphology was investigated by means of Environmental Scanning Electron Microscopy (ESEM), while the UV-curing reaction was monitored by Fourier-Transform Infra-red (FTIR) spectroscopy. In most cases Thermogravimetric (TG), Differential Scanning Calorimetric (DSC) and Dynamo-mechanical Thermal (DMT) analyses showed that the desirable characteristics of the UV-cured acrylic resin are not substantially altered by the presence of the organic fillers. The release kinetics of polyphenols and flavonoids, determined in water for TP-containing membranes (ETx) and in ethanol/water mixture (7:3 v/v) for TGP-containing ones (EPx), was satisfactory, reaching a plateau after 24 h. Finally, preliminary antibacterial tests against S. Epidermidis were performed on the membranes with higher additive amount and gave positive results for ET-type; on the contrary, no inhibitory effect was observed for the tested EP-type membranes.


Noninvasive chronic recording of auditory nerve potentials.
A system is described which allows repeated, noninvasive recording of auditory nerve responses in the cat to transient acoustic stimuli using a closed acoustic system. N1 responses to clicks are recorded from a stainless steel ring electrode at the end of a hollow earbar, the tapered end of which is made of insulating plastic. Acoustic stimuli are generated by a dynamic earphone coupled to the earbar. A calibrated probe microphone is also imcorporated into the earbar to measure sound pressure near the tympanic membrane. This allows better stimulus control than is available with free-field systems. To facilitate insertion of the earbar, meatoplasties were performed on all animals. Responses recorded with this system in anesthetized cats are described and compared with those recorded at the round window. Good repeatability of measurements is described for an animal population of 20 domestic cats over a period of several months. For some of these animals, response amplitude varied from one session to another, but response latency, especially for condensation clicks, was consistent. By comparing statistics of multiple measurement of both N1 amplitude and latency for rarefaction and condensation clicks, it is concluded that the N1 latency vs click-level function for condensation clicks provides the most reliable measure of the cat's auditory nerve function.


Correlation between Na* emission and "chemically active" acoustic cavitation bubbles.
The emission from electronically excited sodium atoms (Na*) from aqueous solutions containing NaCl or sodium dodecylsulfate under ultrasonic irradiation is studied. Evidence is presented that strongly suggests Na* emission arises from a population of bubbles that are sonochemically active but not producing sonoluminescence (SL). Results indicate that the Na* emission intensity is mainly dependent on the concentration of Na(+) ions near the bubble/solution interface. The results provide further insight into the origin of alkali metal spectral line emission from sonicated aqueous solutions containing sodium ions.


Effect of dietary acetic acid levels on protein and energy utilization in chicks.
Chicks were given diets containing varying amounts of dietary acetic acid (0, 12.7, 25.4, 38.1, 50.8, and 63.5 g/kg diet) under ad libitum feeding in Experiment 1 and under equalized feeding (average feed intake of Experiment 1) conditions in Experiment 2. In Experiment 1, values for body weight gain (g/10 days), feed intake (g/10 days), fat retention (g/10 days), and energy retention (kJ/10 days) were linearly lower as dietary acetic acid was increased. In Experiment 2, values for body weight gain, protein retention, and fat retention (grams/10 days), and for energy retention (kiloJoules/10 days) were changed curvilinearly. These values tended to increase until diets contained 25.4 g acetic acid/kg diet and then decreased significantly when diets contained 50.8 g acetic acid/kg diet. All chicks given the 63.5-g acetic acid/kg diet died during Experiment 2. Dietary acetic acid had a detrimental rather than a beneficial effect on chick performance, particularly at the high level.


Hyaluronic acid: evaluation as a potential delivery vehicle for vitronectin:growth factor complexes in wound healing applications.
We have previously reported that novel vitronectin:growth factor (VN:GF) complexes significantly increase re-epithelialization in a porcine deep dermal partial-thickness burn model. However, the potential exists to further enhance the healing response through combination with an appropriate delivery vehicle which facilitates sustained local release and reduced doses of VN:GF complexes. Hyaluronic acid (HA), an abundant constituent of the interstitium, is known to function as a reservoir for growth factors and other bioactive species. The physicochemical properties of HA confer it with an ability to sustain elevated pericellular concentrations of these species. This has been proposed to arise via HA prolonging interactions of the bioactive species with cell surface receptors and/or protecting them from degradation. In view of this, the potential of HA to facilitate the topical delivery of VN:GF complexes was evaluated. Two-dimensional (2D) monolayer cell cultures and 3D de-epidermised dermis (DED) human skin equivalent (HSE) models were used to test skin cell responses to HA and VN:GF complexes. Our 2D studies revealed that VN:GF complexes and HA stimulate the proliferation of human fibroblasts but not keratinocytes. Experiments in our 3D DED-HSE models showed that VN:GF complexes, both alone and in conjunction with HA, led to enhanced development of both the proliferative and differentiating layers in the DED-HSE models. However, there was no significant difference between the thicknesses of the epidermis treated with VN:GF complexes alone and VN:GF complexes together with HA. While the addition of HA did not enhance all the cellular responses to VN:GF complexes examined, it was not inhibitory, and may confer other advantages related to enhanced absorption and transport that could be beneficial in delivery of the VN:GF complexes to wounds.


The Dosimetric Comparisons of CRT, IMRT, ARC, CRT+IMRT, and CRT+ARC of Postoperative Radiotherapy in IIIA-N2 Stage Non-Small-Cell Lung Cancer Patients.
Currently, studies about PORT in stage IIIA-N2 NSCLC patients in recent years have mostly adopted the conformal radiation therapy (CRT) technique, while other modern techniques such as intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT, hereinafter referred to as ARC), helical tomotherapy (HT), and so forth are also developing quickly. In this paper, we intended to compare the dosimetric characteristics of CRT, IMRT, ARC, CRT+IMRT, and CRT+ARC of PORT in stage IIIA-N2 NSCLC patients. Ten patients with stage IIIA-N2 completely resected NSCLC, whom were treated by PORT in the radiotherapy department of our hospital from January 1, 2017, to January 1, 2018, were randomly selected in this study. For each patient, the CRT plan, IMRT plan, ARC plan, CRT+IMRT plan, and CRT+ARC plan were designed separately on the same set of CT images. The isodose distribution and dose-volume histogram (DVH) of the five plans were compared to determine the dosimetric parameters of the targets, OAR (organs at risk), and the normal tissue (defined as body subtracted to PTV (planning target volume), B-P). No plan had absolute dosimetry advantages than any other plans. In clinical practice, the plans could be chosen according to their dosimetry characteristics.


Beta-adrenergic blockers for chronic heart failure.
Systolic dysfunction and heart failure are major public health problems associated with a significant risk of morbidity and mortality. During the past 2 decades, considerable progress has been made in defining the underlying pathophysiology and the appropriate therapies in heart failure. In patients with chronic heart failure (CHF), sustained sympathetic overactivation leads to down-regulation of beta receptors and uncoupling of the receptors from adenylate cyclase. The clear understanding of the pivotal role of sympathetic overactivation in CHF has led to the evaluation of beta- blocker therapy in CHF. A number of large randomized clinical trials have been conducted with a variety of beta-blockers, and although most of them have shown benefit, there have been differing findings with different molecules. beta-blockers are now considered part of the standard therapy for all patients with symptomatic CHF. Despite the strong evidence supporting their use, beta-blockers continue to be underutilized in CHF.


Ethmoid Sinus Mucosal and Lacrimal Sac Flap Anastomosing in Patients With Failed Dacryocystorhinostomy.
The aim of this work is to demonstrate the outcomes of endonasal dacryocystorhinostomy (En-DCR) with anterior ethmoid sinus mucosal and posterior lacrimal sac flap anastomosing in patients with previous failed DCR. The clinical data of patients who suffered from recurrent epiphora after failed DCR between September 2014 and March 2018 were reviewed retrospectively. Among them, those who received the second En-DCR procedure were enrolled in this study. During the surgery, anterior ethmoidectomy was performed. Posterior lacrimal sac flap was apposed closely to the mucosal of anterior ethmoid sinus instead of nasal flap at end of the surgery. Patients were followed up more than 12 months were included, the success rate and complications were recorded. Sixty-one eyes of 61 patients were enrolled in the study. The success rate of our modified En-DCR was 83.6% (51/61). Among 10 eyes with postoperative obstruction, 4 eyes caused by granuloma, 2 eyes caused by scar synechia, 2 eyes caused by membranous obstruction, and 2 eyes caused by common canalicular stenosis. No serious complications such as orbital fat prolapse, cerebrospinal fluid leak, sinusitis, or visual impairment were occurred in this study. Endoscopic approach with anterior ethmoid sinus mucosal and posterior lacrimal sac flap anastomosing is a good choice for patients with recurrent epiphora after previous failed DCR.


Toward efficient asymmetric carbon-carbon bond formation: continuous flow with chiral heterogeneous catalysts.
A chiral Ca catalyst based on CaCl(2) with a chiral ligand was developed and applied to the asymmetric 1,4-addition of 1,3-dicarbonyl compounds to nitroalkenes as a model system. To address product inhibition issues, the Ca catalyst was applied to continuous flow with a chiral heterogeneous catalyst. The continuous flow system using a newly synthesized, polymer-supported Pybox was successfully employed, and the TON was improved 25-fold compared with those of the previous Ca(OR)(2) catalysts.


Distribution of malignancies in head and neck regions and their management.
A retrospective, cross sectional, series of cases were currently studied in the department of ENT-Head & Neck Surgery of Tribhuvan University Teaching Hospital (TUTH) Kathmandu, Nepal to find out the distribution of different malignancies in head and neck regions and to identify their treatment modalities during the period of one year from January 2003 to December 2003. Altogether 159 new cases of histopathologically/cytopathologically confirmed malignancies of head and neck regions and their treatment modalities were analyzed. Out of 159 cases, malignancies of larynx (41), pharynx (31) and oral cavity (30) were found to be the commonest head and neck malignancies where as malignancies of ear (1), and salivary glands (4) were found to be the least common. Likewise surgery with or without radiotherapy and/or chemotherapy was found to be the commonest treatment modality. Of the 159 cases seven were occult primary. As the laryngo-pharyngo-oral malignancies are the commonest malignancies and surgery with or without radiotherapy and/or chemotherapy the commonest treatment modalities for these head and neck malignancies. A well equipped head and neck unit is needed at TUTH along with proposed radiotherapy and medical oncology support for better management of these malignancies.


[Comparative histological studies of germinative tissue after chemotherapy or radiation therapy in patients with malignant testicular tumors].
Described in this paper are morphological and morphometric alterations that occurred to the remaining testicles in patients who had undergone chemotherapy or radiotherapy for malignant testicular tumours, with findings, on average, being recorded 4.5 years after treatment. Qualitative histological investigations of testicular tissue exhibited differentiated characteristics, with radiotherapy resulting in significantly stronger phenomena. Epithelial height was clearly reduced in conjunction with increase in wall thickness, especially after radiotherapy. Tubular lumens, in the wake of radiotherapy, were more often filled with hyalin than after chemotherapy. Unambiguous evidence was produced to impairment of fertility in response to both chemotherapy and radiotherapy.


Retired National Football League Players are Not at Greater Risk for Suicide.
Some researchers have claimed that former National Football League (NFL) players are at increased risk for suicide as a clinical feature of chronic traumatic encephalopathy (CTE). This review examines the literature on risk for suicide in former professional football players, and the association between suicide and CTE. A narrative review of the literature published between 1928 and 2018. Between 1928 and 2009, suicide was not considered to be a clinical feature of CTE in the literature. The best available evidence from epidemiological studies suggests that former NFL football players are at lesser risk for suicide, not greater risk, compared to men in the general population. However, surveys have revealed that a substantial minority of former NFL players have depression and other mental health problems, chronic pain and opioid use is relatively common, and those with depression and chronic pain also have greater life stress and financial difficulties. That minority would be at increased risk for suicidal thoughts and behaviors. Researchers and clinicians are encouraged to be cautious and circumspect when considering the clinical presentation of former athletes, and to not assume that depression and suicidality are caused by specific types of neuropathology. This represents a reductionistic and Procrustean view. Some former football players have mental health problems, but it should not be assumed uncritically that the underlying cause is an inexorably progressive neurodegenerative disease. Providing evidence-informed and evidence-supported treatments for depression and suicidality might reduce suffering and improve their functioning.


Rare cause of ovarian mass.
Pelvic actinomycosis is a rare entity that occurs almost exclusively in women, the presentation of which is usually non-specific and variable. Pelvic actinomycosis is almost always associated with the use of an intrauterine contraceptive device (IUD). Pelvic actinomycosis unrelated to IUD use is almost always associated with previous surgical procedures. The symptoms, clinical signs and radiological findings are usually non-specific, mimicking an ovarian malignancy. So an awareness of this rare condition and a proper diagnosis can avoid unnecessary surgeries because these cases can be treated with a prolonged course of antibiotics. We present a case of pelvic actinomycosis which masqueraded as an ovarian malignancy.


The deep axillary artery.
An aberrant axillary artery running deep to the brachial plexus during its course was observed. The brachial plexus in this case was formed by the fourth cervical nerve to the first thoracic nerve and the radial nerve received a small nerve bundle (accessory radial nerve root) from the posterior aspect of the lower trunk. The axillary artery passed between the lateral and the medial cords of the brachial plexus, the same as for an ordinary axillary artery. In addition, it passed between their posterior divisions, forming the posterior cord, and further ran between the radial nerve root and the accessory radial nerve root from deep to superficial. This axillary artery was recognized as the deep axillary artery, the same as the axillary artery we have reported previously. It was thought that the branches to the subscapularis and serratus anterior muscles, nutrient branch to the radial nerve root and the subscapular artery played important roles in its formation.


Linkages between changes in plant and mycorrhizal fungal community composition at high versus low elevation in alpine ecosystems.
Arbuscular mycorrhizal fungi (AMF) play an important role in maintaining plant diversity and productivity in grassland ecosystems. However, very few studies have investigated how AMF and plant communities co-vary between contrasting environments in natural ecosystems. Intensive sampling (50 soil samples) was conducted in natural open grasslands at both 3570 and 4556 m on Mount Segrila on the Southeast Tibetan Plateau. We used 454-pyrosequencing to investigate soil AMF communities and to explore relationships between AMF diversity and plant richness, productivity and community composition. AMF diversity was negatively correlated with plant richness at 3570 m but positively at 4556 m. Differences in AMF community composition between elevations were attributable to plant community composition, soil pH and available phosphorus concentration. The AMF community was more phylogenetically clustered at the higher elevation than the lower elevation. However, greater phylogenetic clustering (under dispersion) of AMF communities at the two elevations was positively correlated with above-ground biomass. Our results indicate that plant community composition and environmental filtering are the primary drivers structuring the AMF community. Phylogenetic relatedness may be important in explaining the function of AMF communities in alpine ecosystems.


Safety, pharmacokinetics, and biomarkers of F-652, a recombinant human interleukin-22 dimer, in healthy subjects.
F-652 is a recombinant fusion protein consisting of two human interleukin-22 (IL-22) molecules linked to an immunoglobulin constant region (IgG2-Fc). IL-22 plays critical roles in promoting tissue repair and suppressing bacterial infection. The safety, pharmacokinetics (PK), tolerability, and biomarkers of F-652 were evaluated following a single dose in healthy male volunteers in a randomized, double-blind, placebo-controlled study. Following single-dose subcutaneous (SC) injection of F-652 at 2.0 µg/kg into healthy subjects, six out of six subjects experienced delayed injection site reactions, which presented as erythematous and/or discoid eczematous lesions 10 to 17 days post-dosing. F-652 was then administered to the healthy subjects via an intravenous (IV) infusion at 2.0, 10, 30, and 45 µg/kg. No severe adverse event (SAE) was observed during the study. Among the IV-dosed cohorts, eye and skin treatment emergent adverse events (TEAEs) were observed in the 30 and 45 µg/kg cohorts. F-652 IV dosing resulted in linear increases in Cmax and AUC(0-t), and the T1/2 ranged from 39.4 to 206 h in the cohorts. An IV injection of F-652 induced dose-dependent increases in serum marker serum amyloid A, C-reactive protein, and FIB, and decreased serum triglycerides. The serum levels of 36 common pro-inflammatory cytokines/chemokines were not altered by the treatment of F-652 at 45 μg/kg. In conclusion, IV administration of F-652 to healthy male volunteers is safe and well-tolerated and demonstrates favorable PK and pharmacodynamic properties. These results warrant further clinical development of F-652 to treat inflammatory diseases.


Therapeutic strategy of central vein perforation accompanied by a mediastinal lesion after catheterization.
Central vein perforation associated with a mediastinal lesion is a rare complication of catheterization. A 50-year-old woman was diagnosed with chronic kidney disease and required hemodialysis treatment. The patient developed central vein injury during attempted placement of a double-channel catheter. A computed tomographic scan and venography showed that the catheter had punctured the mediastinum from the central vein. After comprehensive assessment and multidisciplinary consultation, percutaneous catheter thrombin injection with follow-up balloon dilatation under fluoroscopy guidance successfully fixed the perforation. We summarize the therapeutic strategy of this complication and other treatment options, and discuss the related literature of central vein injury.


Effect of Resistance Mechanisms on the Inoculum Effect of Carbapenem in Klebsiella pneumoniae Isolates with Borderline Carbapenem Resistance.
We aimed to examine the effects of resistance mechanisms on several resistance phenotypes among carbapenem-resistant Klebsiella pneumoniae isolates with borderline carbapenem MICs. We compared carbapenemase-negative K. pneumoniae with carbapenemase-producing K. pneumoniae (CPKP) isolates with similar MICs. CPKP isolates exhibited a marked inoculum effect and were more resistant to the bactericidal effect of meropenem. This suggests that MIC measurements alone may not be sufficient in predicting the therapeutic efficacy of carbapenems against CPKP.


Adolescent screen time and unhealthy food consumption in the context of the digital development in New Caledonia.
For several years, the Pacific Island Countries and Territories (PICTs) have been undergoing digital developments that have had an impact on the time adolescents spend in front of screens. The association between screen time and the overconsumption of unhealthy foods has been observed but little studied in New Caledonia. The twofold aim of this research was to analyze adolescent screen time based on the number of screens at home, gender, place of living, ethnic community and family socio-professional category and determine the link with the consumption of unhealthy food and drinks. Self-report questionnaires on time spent in front of tablets, computers and mobile phones, as well as the consumption of unhealthy food and drinks, were administered between July 2018 and April 2019 to 867 adolescents from 11 to 15 years old during school hours in eight schools across the three provinces of New Caledonia. Adolescents in rural areas had fewer screens than their urban counterparts, and the number of screens determined the amount of screen time, which was significantly higher among the adolescents living in urban areas (3.05 h/day weekdays vs rural 2.33 h/day). Screen time was not related to gender, socio-professional category or ethnic community, but correlations were found between screen time and consumption of unhealthy food and drinks. Those who consumed less than 1 u/day of unhealthy drinks watched screens for 3.30 h/day, whereas those who consumed more than 1 u/day watched screens for 4.13 h/day. Also, those who consumed less than 1 u/day of unhealthy food watched screens for 2.82 h/day and those consuming more than 1 u/day did so for 3.62 h/day. Melanesians and Polynesians consumed greater quantities of unhealthy food and drinks than Europeans. As the consumption of unhealthy products is linked to screen time in the context of digital development, there is an urgent need to address the excessive consumption of unhealthy foods in Oceanian populations, particularly among young people.


Leaching behaviour of bisphenol A from municipal solid waste under landfill environment.
With a preliminary insight into the source and leaching behaviour ofbisphenol A (BPA) from municipal solid wastes (MSW), five kinds of plastic and four kinds of paper materials were leached by distilled water. Polyvinyl chloride (PVC) waste was found to have the highest BPA content of 12.1 microg x g(-1) and leachability of 34.7% in distilled water, while cardboard with relatively low BPA content also showed a high ratio of leaching (53.6%). Fresh leachate and leachates from a landfill of age 1.5 and 10 years were adopted as leachants for the PVC plastic and cardboard to simulate the leaching behaviour of BPA under a landfill environment. The enhancement of BPA leachability in the 10-year leachate compared with distilled water was higher than that in the other two leachates due to its basic pH and high content of humic organic matters. Meanwhile, the enhancement of BPA leachability by the fresh leachate was higher than that by the 1.5-year leachate, possibly due to the presence of small molecules such as volatile fatty acids, amino acids, etc. The paper waste was not only a minor origin of BPA leaching, but also a controlling factor in retarding BPA transformation. The BPA sorption K(f) value of the cardboard in the Freundlich equation was 0.2224 mg(1-n)) x L(n) x g(-1) (n = 0.7680), higher than that obtained in sorption experiments by natural organic adsorbents such as sediment. It suggested that the presence of paper with a high sorption capacity in MSW will restrain BPA transport and bioavailability in landfills.


Mechanism of rabbit platelet agglutination induced by acidic mucopolysaccharide extracted from Stichopus japonicus Selenka.
The effects of acidic mucopolysaccharide extracted from sea cucumber (Stichopus japonicus Selenka) (SJAMP) on rabbit platelets were studied. Using citrated platelet-rich plasma (PRP), washed platelets, and formaldehyde fixed platelets from 10 New Zealand white rabbits, we investigated the effects of platelet inhibitors and various plasma and its fractions on SJAMP-induced agglutination. It was found that the tracing of platelet agglutination induced by SJAMP showed a single phase without a lag period. The lowest concentration of SJAMP required for the agglutination of rabbit platelets was approximately 2 micrograms/ml, and the magnitude of agglutination induced by SJAMP was concentration dependent. In 8 out of 10 rabbits, the platelets in PRP were agglutinated by 10 micrograms/ml of SJAMP. Platelet inhibitors, such as aspirin, indomethacin, apyrase, antimycin, 2-deoxy-D-glucose and EDTA did not inhibit the agglutination induced by SJAMP. Washed rabbit platelets were not agglutinated by SJAMP even though the concentration of SJAMP was raised up to 50 micrograms/ml. When rabbit plasma, serum, or 50-60% ammonium sulfate saturated plasma fraction was added to the reaction mixture, agglutination of washed platelets by SJAMP was recovered completely. But human plasma or fibrinogen did not have any effect on the reactivity of washed rabbit platelets to SJAMP. From these data we conclude that the SJAMP-induced rabbit platelet agglutination is independent of energy metabolism but requires plasma cofactor(s) other than fibrinogen. The plasma cofactor is present in 50-60% ammonium sulfate saturated plasma fraction.


Multiple epitopes on human and murine cells expressing HLA-B7 as defined by specific murine cytotoxic T cell clones.
Eleven cytotoxic T lymphocyte (CTL) clones were derived from C57BL/6 spleen cells immunized with HLA-B7 expressing human lymphoblastoid cell lines. Reactivity against HLA-B7 was initially established because the clones lysed 2 target cells that shared only HLA-B7 with the immunizing cell line and they did not lyse five other cell lines that were HLA-B7 negative but expressed other class I or class II antigens found on the immunizing cell. Six of the clones were subsequently shown to lyse all tested HLA-B7-positive B and T lymphoid cell lines, peripheral blood lymphocytes, and a murine L cell that expressed HLA-B7 as a consequence of DNA-mediated gene transfer. On the basis of the inability of the clones to lyse a panel of HLA-B7-negative cell lines, up to 18 other class I antigens could be eliminated as being cross-reactively recognized. However, two of the clones recognized a single HLA-B7-negative cell line. It is suggested that in these cases the clones were cross-reactively recognizing the HLA-B27 or HLA-B40 antigens that were present on these target cells. The remaining five CTL clones failed to lyse one out of seven tested HLA-B7-positive lymphoid lines (either RPMI-1788 or DR1B) and failed to lyse peripheral blood lymphocytes from one out of three tested HLA-B7-positive individuals. These five clones also did not recognize the HLA-B7-positive murine L cell. However, based on analysis with a large target cell panel, the reactivity pattern of these five clones could only be correlated with recognition of HLA-B7. This conclusion is further supported by antibody-blocking studies to be reported elsewhere. As before, lysis of single HLA-B7-negative target cells by two of the clones could be ascribed to recognition of HLA-B27 or HLA-B40. The results show that murine clones raised against HLA-B7 exhibit a high degree of specificity for determinants that are unique or largely confined to the HLA-B7 alloantigen. In addition, these clones define different antigenic determinants on the molecule. Thus, such clones appear to be excellent candidates for use as human tissue typing reagent. The results further show that there is a strong correlation between recognition of particular HLA-B7-positive human cell lines and recognition of the HLA-B7 expressing murine L cell. Possible reasons for such a correlation and their relationship to the general phenomenon of CTL recognition are discussed.


Long-term exposure to noise impairs cortical sound processing and attention control.
Long-term exposure to noise impairs human health, causing pathological changes in the inner ear as well as other anatomical and physiological deficits. Numerous individuals are daily exposed to excessive noise. However, there is a lack of systematic research on the effects of noise on cortical function. Here we report data showing that long-term exposure to noise has a persistent effect on central auditory processing and leads to concurrent behavioral deficits. We found that speech-sound discrimination was impaired in noise-exposed individuals, as indicated by behavioral responses and the mismatch negativity brain response. Furthermore, irrelevant sounds increased the distractibility of the noise-exposed subjects, which was shown by increased interference in task performance and aberrant brain responses. These results demonstrate that long-term exposure to noise has long-lasting detrimental effects on central auditory processing and attention control.


Alternative disinfection techniques to extend the shelf life of minimally processed iceberg lettuce.
Chlorination continues to be widely used by the fresh-cut industry for washing and disinfecting minimally processed fruits and vegetables. However, as chlorination has been reported to produce unhealthy by-products such as, chloramines and trihalomethanes, many alternative methods have been reported in the literature. This study examined the use of silver and hydrogen peroxide as possible alternative to chlorination. The results revealed an obvious bactericidal effect of hydrogen peroxide, silver and their combination on spoilage organisms. Combination of electrochemically generated silver (5 ppm) and hydrogen peroxide (0.4 ppm) caused significant (P < 0.05) reduction in the total plate count (0.87 log), Pseudomonas (2.66 logs), Enterobactericeae (1.61 logs) and yeast and mould (1.60 logs) immediately after washing in comparison to water washed shredded lettuce. However, washing with chlorinated water (5 ppm) under same conditions revealed insignificant reduction in TPC (0.17 log), Pseudomonas (0.60 log), Enterobactericeae (0.15 log) or yeast and mould (0.81 log) counts. Results revealed also that both sources of silver (electrochemical silver and silver nitrate) have similar disinfecting effects, however, electrochemical silver maintained the quality of washed lettuce.


Lung Parenchymal and Endobronchial Metastases From Ovarian Carcinoma.
Ovarian cancer is the seventh most common cancer in women and the eighth most common cause of cancer death in the world with an overall 5-year survival rate of <50%. (1) The most common age of presentation is at the perimenopausal age group and two-thirds of them present with advanced stage of disease. (2) Thoracic metastases occur in up to 50% of patients. Pleural effusion is the most common presentation of thoracic metastases in these patients, whereas pulmonary parenchymal metastases, lymphangitis, and nodal involvement are less commonly reported. (3) Tracheobronchial involvement is rare with few cases reported in literature. Herewith, we are presenting a case of ovarian cancer in a young female with both lung parenchymal and endobronchial metastases. Bronchoscopy revealed endobronchial tumor in right lower lobe bronchus part of which was covered by yellowish necrotic material. Biopsy showed metastatic ovarian malignancy complicated by aspergillosis. She was started on oral itraconazole along with supportive management following which hemoptysis stopped.


Sensory sensitivity to external stimuli in Tourette syndrome patients.
Patients with Tourette Syndrome often state that their sensitivity to sensations is equally or more disruptive than are motor tics. However, their sensory sensitivity is not addressed by standard clinical assessments nor is it a focus of research. This lapse likely results from our limited awareness and understanding of the symptom. In this study (1) we defined the patients' experience of sensitivity to external stimuli in detail, and (2) we tested 2 hypotheses regarding its origin. First, we interviewed in depth and administered a lengthy questionnaire to adult Tourette patients (n = 19) and age-matched healthy volunteers (n = 19). Eighty percent of patients described heightened sensitivity to external stimuli, with examples among all 5 sensory modalities. Bothersome stimuli were characterized as faint, repetitive or constant, and nonsalient, whereas intense stimuli were well tolerated. We then determined whether the sensitivity could be the result of an increased ability to detect faint stimuli. After measuring the threshold of detection for olfactory and tactile stimuli among the patients and healthy volunteers, we found no significant differences between them for either sensory modality. These results indicate that patients' perceived sensitivity derives from altered central processing rather than enhanced peripheral detection. Last, we assessed one aspect of processing: the perception of intensity. When subjects rated the intensity of near-threshold tactile and olfactory stimuli, there was a surprising difference: Tourette patients more frequently used the lowest range of the scale than did healthy volunteers. Future research is necessary to define the anatomical and physiological basis of the patients' experience of heightened sensitivity. © 2011 Movement Disorder Society.


Barriers to Increasing Prescription Drug Monitoring Program Use: A Multidisciplinary Perspective.
Prescription drug monitoring programs are implemented through individual state policies and are one solution to curb the opioid crisis. The objectives of this study are to: (1) describe the multidisciplinary experiences using this program in practice; (2) identify limitations of the program and the desired features for improvement; and (3) characterize expectations for improved access when prescription drug monitoring programs are embedded in the electronic health record. A qualitative descriptive study design used semistructured interviews of 15 multidisciplinary healthcare providers. Textual data were analyzed using content analysis. Results showed the prescription drug monitoring program was helpful to decision-making processes related to opioid prescribing and referral to treatment; there were barriers limiting healthcare providers' use of the prescription drug monitoring program; preferences were delineated for integrating prescription drug monitoring program into electronic health record; and recommendations were provided to improve the program and increase use. In conclusion, the prescription drug monitoring program was viewed as useful in making strides to reduce the impact of inappropriate opioid prescribing in our country. By engaging a multidisciplinary group of healthcare providers, solutions were offered to improve the interface and function of the prescription drug monitoring program to assist in increasing use.


Population genetics, invasion pathways and public health risks of the raccoon and its roundworm Baylisascaris procyonis in northwestern Europe.
The geographic range of the zoonotic raccoon roundworm (Baylisascaris procyonis) is expanding together with the range of its host, the raccoon (Procyon lotor). This creates a new public health risk in parts of Europe where this parasite was previously absent. In the Netherlands, a raccoon population is becoming established and incidental findings of B. procyonis have been reported. To assess the risk to public health, the prevalence of B. procyonis was determined in the province of Limburg, where currently the largest Dutch raccoon population is present, as well as in the adjoining region of southern Belgium. Furthermore, genetic methods were employed to assess invasion pathways of both the raccoon and B. procyonis to aid in the development of control measures. Macroscopic analysis of intestinal content and testing of faecal samples were performed to detect B. procyonis adults and eggs. The population genetics of both B. procyonis and its raccoon host were analysed using samples from central and northwestern Europe. B. procyonis was found in 14/23 (61%, 95% CI: 41%-78%) raccoons from Limburg, but was not detected in 50 Belgian raccoons. Genetic analyses showed that the majority of the Dutch raccoons and their roundworms were introduced through ex-captive individuals. As long as free-living raccoon populations originate from captivity, population control methods may be pursued. However, natural dispersal from the border regions will complicate prolonged population control. To reduce the public health risk posed by B. procyonis, public education to increase awareness and adapt behaviour towards raccoons is key.


[Young people and smoking].
Within the fight against smoking a questionnaire was made among schoolchildren of the Secondary Medical School in Zrenjanin in the period from March 1-8, 1988. The anonymous questionnaire dealt both with the schoolchildren's attitude toward smoking and the distribution of this habit among them. It comprised a total of 207 schoolchildren from the I and IV grade. The questions were aimed at the basic facts about smoking: whether they smoke, how many cigarettes they smoke daily and from when, how much pocket-money they get, their opinion about smoking as the social phenomenon and how much they know about harmful effects of smoking. Out of 119 schoolchildren from the I grade 8 were smokers (7 girls and 1 boy) which made 6.7% while out of 88 schoolchildren from the IV grade (83 girls and 5 boys) 46 (52%) were smokers. Which factors contributed to the increase in the number of smokers from I to IV grade, especially when we know that girls accounted for 94%? These facts were discussed in this paper in detail.


Fetal neurosurgery: current state of the art.
Congenital CNS abnormalities have been targets for prenatal intervention since the founding of fetal surgery 30 years ago, but with historically variable results. Open fetal neurosurgery for myelomenigocele has demonstrated the most promising results of any CNS malformation. Improvements in the understanding of congenital diseases and in fetal surgical techniques have reopened the door to applying fetal surgery to other congenital CNS abnormalities. Advances in gene therapy, bioengineering and neonatal neuroprotection will aid in the future expansion of fetal neurosurgery to other CNS disorders.


Development of multi-route physiologically-based pharmacokinetic models for ethanol in the adult, pregnant, and neonatal rat.
Biofuel blends of 10% ethanol (EtOH) and gasoline are common in the USA, and higher EtOH concentrations are being considered (15-85%). Currently, no physiologically-based pharmacokinetic (PBPK) models are available to describe the kinetics of EtOH-based biofuels. PBPK models were developed to describe life-stage differences in the kinetics of EtOH alone in adult, pregnant, and neonatal rats for inhalation, oral, and intravenous routes of exposure, using data available in the open literature. Whereas ample data exist from gavage and intravenous routes of exposure, kinetic data from inhalation exposures are limited, particularly at concentrations producing blood and target tissue concentrations associated with developmental neurotoxicity. Compared to available data, the three models reported in this paper accurately predicted the kinetics of EtOH, including the absorption, peak concentration, and clearance across multiple datasets. In general, model predictions for adult and pregnant animals matched inhalation and intravenous datasets better than gavage data. The adult model was initially better able to predict the time-course of blood concentrations than was the neonatal model. However, after accounting for age-related changes in gastric uptake using the calibrated neonate model, simulations consistently reproduced the early kinetic behavior in blood. This work provides comprehensive multi-route life-stage models of EtOH pharmacokinetics and represents a first step in development of models for use with gasoline-EtOH blends, with additional potential applicability in investigation of the pharmacokinetics of EtOH abuse, addiction, and toxicity.


Somatropin promotes dermatophagoides farinae-specific IgE generation independently of IL-4 and IL-10.
Interleukin (IL)-10 accelerates the IgE production of anti-CD40- and IL-4-stimulated PBMC by enhancing the IL-6 production of T lymphocytes or antigen-primed spleen cells, in addition to its role as a regulator of the inflammatory responses. To further investigate the mechanisms enhancing IgE synthesis, we determined the effect of somatropin as well as IL-10 on the secretion of Dermatophagoides farinae (Df)-specific IgE by K7 cells, which originate from an EBV-immortalized cell line. Df-pulsed autologous T cells, as well as the supernatants of these cultures, increased the synthesis of Df-specific IgE. Antigen-specific IgE was also enhanced when K7 cells were treated with anti-CD40 antibody and with both IL-4 and IL-10, or with IL-4 and IL-10 without anti-CD40 antibody. The treatment of K7 cells with anti-CD40 antibody and IL-4, or anti-CD40 antibody and IL-10 did not increase IgE production. The Df-specific IgE activity of the supernatants of K7 cells treated with somatropin alone was increased significantly although somatropin did not show any additive effect on the IgE production of anti-CD40 antibody-treated cells. The results indicate that IL-10, a Th2-type cytokine, directly affects the mature B cells that produce IgE, and that the secretion of IgE is increased by treatment with IL-10 in cells that are stimulated with anti-CD40 and IL-4 at the level of the EBV-immortalized cell line, which has already switched to IgE production. Somatropin similarly stimulates activated mature B cells to enhance their production of antigen-specific IgE without class switching, independently of IL-4 and IL-10.


Comparison of four technetium-99m radiopharmaceuticals for detection and localization of gastrointestinal bleeding in a sheep model.
Four Tc-99 radiopharmaceuticals, Tc-99m sulphur colloid, Tc-99m red blood cells (RBCs), Tc-99m mercaptoacetyltriglycine (MAG3), and Tc-99m DTPA, were studied in an experimental animal model for detection and localization of gastrointestinal (GI) bleeding site in both the upper and lower abdomen. With Tc-99m sulphur colloid and Tc-99m RBCs, it was possible to detect and localize the GI bleeding site in the lower abdomen. With Tc-99m MAG3, it was possible to visualize the bleeding site in both the upper and lower abdomen. However, Tc-99m MAG3 is partially excreted by the liver into the bile, hence it will be difficult to use Tc-99m MAG3 to localize the GI bleeding site in the lower abdomen. With Tc-99m DTPA, it was possible to detect and localize the GI bleeding site simultaneously in both upper and lower abdomen. The overall background radioactivity was reduced considerably by diuresis with frusemide and catheterization of the urinary bladder.


Abnormalities in epidermal lipid metabolism in patients with atopic dermatitis.
Atopic dermatitis is an inflammatory skin disease characterized by dryness and itch of the skin. In this study, we measured the phospholipid content and the fatty acid pattern of lesional and lesion-free epidermal keratome biopsies on 15 patients. For comparison, epidermal biopsies were obtained from healthy individuals undergoing plastic surgery. The phospholipid content of atopic epidermis was nearly twice as high as in healthy epidermis. Monounsaturated fatty acids in the phosphoglycerides were significantly increased (p less than 0.001) and n-6 fatty acids were significantly decreased (p less than 0.001) in lesional atopic epidermis compared to lesion-free epidermis. The content of esterified arachidonic acid in phosphatidylcholine from lesional epidermis was only 49% of that found in healthy epidermis (p less than 0.001). The content of free arachidonic acid was 47% higher (p less than 0.05), whereas the content of free long-chain saturated fatty acids was decreased by 29% (p less than 0.01), in lesional compared to lesion-free atopic epidermis. The disease severity, calculated as an arbitrary index, correlated inversely with the n-6 fatty acid content of lesion-free atopic epidermis (r = -0.89, p less than 0.001). Our findings suggest that atopic epidermis is characterized by an increased activity of phospholipase A2 and an incomplete transformation of phospholipids into other lipid classes.


Facial expression recognition by people with mobius syndrome.
We present an investigation of facial expression recognition by three people (BC, LP, and NC) with Mobius syndrome, a congenital disorder producing facial paralysis. The participants were asked to identify the emotion displayed in 10 examples of facial expressions associated with each of 6 basic emotions from the Ekman and Friesen (1976) series. None of the three people with Mobius syndrome was significantly impaired on this task. On a second test of facial expression recognition using computer-morphed facial expressions, NC showed a statistically significant impairment, BC a borderline deficit, and LP was unimpaired. However, even when impairments were found, people with Mobius syndrome still recognised many of the facial expressions shown to them. The recognition of facial expressions by people who have never been able to produce such signals on their own faces demonstrates that the ability to produce facial expressions is not a necessary prerequisite of their recognition.


Phosphoproteomic analysis of gossypol-induced apoptosis in ovarian cancer cell line, HOC1a.
Ovarian cancer is a major cause for death of gynecological cancer patients. The efficacy of traditional surgery and chemotherapy is rather compromised and platinum-resistant cancer recurs. Finding new therapeutic targets is urgently needed to increase the survival rate and to improve life quality of patients with ovarian cancer. In the present work, phosphoproteomic analysis was carried out on untreated and gossypol-treated ovarian cancer cell line, HOC1a. We identified approximately 9750 phosphopeptides from 3030 phosphoproteins, which are involved in diverse cellular processes including cytoskeletal organization, RNA and nucleotide binding, and cell cycle regulation. Upon gossypol treatment, changes in phosphorylation of twenty-nine proteins including YAP1 and AKAP12 were characterized. Western blotting and qPCR analysis were used to determine expression levels of proteins in YAP1-related Hippo pathway showing that gossypol induced upregulation of LATS1, which phosphorylates YAP1 at Ser 61. Furthermore, our data showed that gossypol targets the actin cytoskeletal organization through mediating phosphorylation states of actin-binding proteins. Taken together, our data provide valuable information to understand effects of gossypol on protein phosphorylation and apoptosis of ovarian cancer cells.


RNA-based regulation of transcription and translation of aureusvirus subgenomic mRNA1.
Cucumber leaf spot virus (CLSV) is an aureusvirus (family Tombusviridae) that has a positive-sense RNA genome encoding five proteins. During infections, CLSV transcribes two subgenomic (sg) mRNAs and the larger of the two, sg mRNA1, encodes coat protein. Here, the viral RNA sequences and structures that regulate transcription and translation of CLSV sg mRNA1 were investigated. A medium-range RNA-RNA interaction in the CLSV genome, spanning 148 nucleotides, was found to be required for the efficient transcription of sg mRNA1. Further analysis indicated that the structure formed by this interaction acted as an attenuation signal required for transcription of sg mRNA1 via a premature termination mechanism. Translation of coat protein from sg mRNA1 was determined to be facilitated by a 5'-terminal stem-loop structure in the message that resembled a tRNA anticodon stem-loop. The results from mutational analysis indicated that the 5'-terminal stem-loop mediated efficient base pairing with a 3'-cap-independent translational enhancer at the 3' end of the message, leading to efficient translation of coat protein from sg mRNA1. Comparison of the regulatory RNA structures for sg mRNA1 of CLSV to those used by the closely related tombusviruses and certain cellular RNAs revealed interesting differences and similarities that provide evolutionary and mechanistic insights into RNA-based regulatory strategies.


Janus Kinase Inhibitors in the Treatment of Type I Interferonopathies: A Case Series From a Single Center in China.
This study aimed to assess the efficacy and safety of 2 Janus kinase (JAK) inhibitors (jakinibs) tofacitinib and ruxolitinib in the treatment of type I interferonopathies patients including STING-associated vasculopathy with onset in infancy (SAVI), Aicardi-Goutières syndrome (AGS), and spondyloenchondrodysplasia with immune dysregulation (SPENCD). A total of 6 patients were considered in this study: 2 patients with SAVI, 1 patient with AGS1, 1 patient with AGS7, and 2 patients with SPENCD. Clinical manifestations, laboratory investigations, radiology examinations, treatment, and outcomes were collected between November 2017 and November 2021 in Peking Union Medical College Hospital. The disease score for patients with SAVI and AGS scale for patients with AGS were documented. The expression of 6 interferon-stimulated genes (ISGs) was assessed by real-time PCR. Three patients (1 patient with SAVI, 2 patients with AGS) were treated with ruxolitinib and 3 patients (1 patient with SAVI, 2 patients with SPENCD) were treated with tofacitinib. The mean duration of the treatment was 2.5 years (1.25-4 years). Upon treatment, cutaneous lesions and febrile attacks subsided in all affected patients. Two patients discontinued the corticoid treatment. Two patients with SAVI showed an improvement in the disease scores (p < 0.05). The erythrocyte sedimentation rate normalized in 2 patients with AGS. The interferon score (IS) was remarkably decreased in 2 patients with SPENCD (p < 0.01). Catch-ups with growth and weight gain were observed in 3 and 2 patients, respectively. Lung lesions improved in 1 patient with SAVI and remained stable in 3 patients. Lymphopenia was found in 3 patients during the treatment without severe infections. The JAK inhibitors baricitinib and tofacitinib are promising therapeutic agents for patients with SAVI, AGS, and SPENCD, especially for the improvement of cutaneous lesions and febrile attacks. However, further cohort studies are needed to assess the efficacy and safety.


Method Validation and Assessment of Hazardous Substances and Quality Control Characteristics in Traditional Fruit Wines.
The presence of potentially hazardous substances in fruit wines poses a threat for human health. However, the management standards and specifications of hazardous substances contained within various types of fruit wines are currently insufficient. The aim of this study was to analyze hazardous substances (cyanide, acetaldehyde, and ethyl carbamate) and quality control characteristics (pH, titratable acidity, sulfur dioxide, and diacetyl) in seven different types of fruit wines. The pH levels and titratable acidity varied between fruit wine types. In all fruit wines, sulfur dioxide (SO2) was within acceptable ranges as per the Korean standard. Acetaldehyde content also varied between fruit wine types as well as based on the analytical method (titration or enzymatic analysis) employed. Cyanide was in the range of 0.02−0.35 mg/L. Diacetyl contents were in the range of 0.66−2.95 mg/L (p > 0.05). The contents of ethyl carbamate varied considerably, within the range of 5.22−259.69 μg/kg (p < 0.05). The analytical methods of diacetyl and ethyl carbamate were validated for specificity, linearity, sensitivity, accuracy, and precision. Therefore, the content of hazardous substances and quality control characteristics should be closely monitored and controlled to improve safety and quality of the traditional fruit wines.


Multivariate pattern analysis reveals subtle brain anomalies relevant to the cognitive phenotype in neurofibromatosis type 1.
Neurofibromatosis Type 1 (NF1) is a common genetic condition associated with cognitive dysfunction. However, the pathophysiology of the NF1 cognitive deficits is not well understood. Abnormal brain structure, including increased total brain volume, white matter (WM) and grey matter (GM) abnormalities have been reported in the NF1 brain. These previous studies employed univariate model-driven methods preventing detection of subtle and spatially distributed differences in brain anatomy. Multivariate pattern analysis allows the combination of information from multiple spatial locations yielding a discriminative power beyond that of single voxels. Here we investigated for the first time subtle anomalies in the NF1 brain, using a multivariate data-driven classification approach. We used support vector machines (SVM) to classify whole-brain GM and WM segments of structural T1 -weighted MRI scans from 39 participants with NF1 and 60 non-affected individuals, divided in children/adolescents and adults groups. We also employed voxel-based morphometry (VBM) as a univariate gold standard to study brain structural differences. SVM classifiers correctly classified 94% of cases (sensitivity 92%; specificity 96%) revealing the existence of brain structural anomalies that discriminate NF1 individuals from controls. Accordingly, VBM analysis revealed structural differences in agreement with the SVM weight maps representing the most relevant brain regions for group discrimination. These included the hippocampus, basal ganglia, thalamus, and visual cortex. This multivariate data-driven analysis thus identified subtle anomalies in brain structure in the absence of visible pathology. Our results provide further insight into the neuroanatomical correlates of known features of the cognitive phenotype of NF1.


Effect of change in individual and household level characteristics on anemia prevalence among adolescent boys and girls in India.
Anemia is a significant public health challenge that affects the population of all nations. Anemia among adolescents emerged as an alarming public health issue as it harms an individual's physical capacity and cognitive and work performance. The study aims to determine the effect of changes in individual and household level factors on the prevalence of anemia among adolescent boys and girls. The study utilized data from two waves of the "Understanding the lives of adolescent and young adults" (UDAYA) survey, conducted in Bihar and Uttar Pradesh during 2015-16 (wave-1) and 2018-19 (wave-2). The sample size for the present study was 4216 and 5974 unmarried adolescent boys and girls aged 10-19 years in both waves. We performed descriptive analysis to observe the characteristics of adolescents during 2015-16. Further, changes in selected independent variables from wave-1 to wave-2 were examined using the proportion test. Moreover, random-effect regression models were employed to examine the association of changes in individual and household level factors with anemia prevalence among adolescents. The prevalence of anemia decreased over time among adolescent boys (33 to 30%), whereas it increased among adolescent girls (59 to 63%). The results from the random-effect model show that adolescent boys who used shared toilets were more anemic than those who used a private restroom [β:0.05, 95% CI:(0.01, 0.08)]. Moreover, underweight [β:0.05, CI:(0.01, 0.09)] and thin [β:0.04, CI:(0.00, 0.07)] adolescent boys were more likely to be anemic compared to their normal counterparts. Additionally, boys who belonged to the poorest [β:0.08, CI:(0.02, 0.14)] households had a higher risk of anemia than the richest household. The anemia prevalence was higher among adolescents aged 10-19 years in Uttar Pradesh and Bihar. This study has filled an information gap by providing state-level representative estimates indicating underweight status and thinness as the common factors behind the anemia prevalence among adolescent boys than in girls. Iron deficiency anemia is the most prevalent in certain age groups in India. Hence, Anemia prevention efforts and iron-folic acid (IFA) supplementation programs are currently being strengthened in India, targeting the high-risk population.


Gonadotropin-releasing hormone agonist use to guide diagnosis and treatment of autoimmune progesterone dermatitis.
Autoimmune progesterone dermatitis is a catamenial disorder traditionally diagnosed by subcutaneous or intramuscular progesterone challenge. Little has been reported regarding the use of a gonadotropin-releasing hormone (GnRH) agonist with a progestin add-back challenge to diagnose and guide management of this condition. A 50-year-old premenopausal woman presented with cyclic facial rash minimally responsive to standard treatment. Symptoms improved with depot leuprolide acetate and worsened with add-back progesterone therapy. Hysterectomy and oophorectomy were performed with resolution of symptoms. This surgery eliminated endogenous progesterone and permitted estrogen replacement to treat vasomotor symptoms experienced with GnRH agonist therapy. This case of autoimmune progesterone dermatitis exemplifies the utility of GnRH agonists with a steroid add-back challenge for diagnosing catamenial disorders and guiding treatment.


Recent Trend in Specialty Choices of Medical Students and House Officers from Public Sector Medical Universities, Karachi.
To determine career choices of medical students of public-sector medical universities and factors affecting their career choices. The cross-sectional study was conducted at Dow University of Health Sciences and Jinnah Sindh Medical University, Karachi, from May 2015 to May 2016, and comprised 4th and 5th year medical students and house officers. A self-administrated structured questionnaire was used to collect data which was entered and analysed using SPSS 20. Of the 445 Subjects, 314(70.6%) were females. There were 206(46.3%) 4th year students, 194(43.6%) were from the 5th year and 45(10%) were house officers. Top 15 medical specialties were ranked according to the respondents' top three choices. Internal medicine 67(15.1%), cardiology 47(10.6%), paediatrics 46(10.3%) and general surgery 40(9.0%) were the four highest ranked specialties. Overall, 377(84.7%) subjects said prestige in working in that field was the reason of their respective choices. Medical students chose a wider range of specialties and stated varying factors affecting their choices.


Socioecological Framework for Drivers of Conflict and Postconflict Violence Against Women and Girls.
This article advances our understanding of the drivers and multidimensional nature of conflict-related violence against women and girls (CRVAWG). It presents an adapted socioecological model, which supports research, analysis, and programming and can be further adapted as the empirical evidence base grows. Although models to help explore violence against women and girls generally have advanced over recent decades, these have not addressed the specific dynamics of conflict-affected settings. This article makes a unique contribution by bringing together research on CRVAWG and presenting a new model for deepening current approaches to understanding and preventing CRVAWG.


Photometric analysis of antifading reagents for immunofluorescence with laser and conventional illumination sources.
Bleaching of stained objects is a major problem in immunofluorescence. The prevention of fluorescence fading would allow longer observation times, photographic documentation, fluorometry, and pattern recognition. Fluorescein kinetics and fluorescence intensities (FI) of fluorescein isothiocyanate (FITC) conjugate-stained Sephadex beads were studied with previously described "antibleaching" reagents using an argon laser as the excitation light source. Eight antibleaching reagents were tested (sodium azide (NaN3), sodium iodide (NaI), polyvinyl pyrrolidone (PVP), polyvinyl alcohol (PVA), 1,4-di-azobicyclo-(2,2,2)-octane (DABCO), p-phenylenediamine (PPD), n-propylgallate, and sodium dithionite (Na2S2O4]. Sodium azide and sodium iodide were found to increase FI. This was likewise found with mercury arc illumination and hence they may prove useful for routine immunofluorescence tests. PPD was found to accumulate on the surface of the beads and to disturb immunofluorescence by autofluorescence. The value of any of the other reagents in immunofluorescence is questionable.


Decreasing frequency but worsening mortality of acute respiratory failure secondary to AIDS-related Pneumocystis carinii pneumonia.
To describe changes in incidence and outcome of acute respiratory failure (ARF) due to AIDS-related Pneumocystis carinii pneumonia (PCP) at a tertiary care center over the 4-year period starting April 1, 1987 with reference to previously reported data from the preceding 6 years. All patients admitted to St. Paul's hospital with a diagnosis of AIDS-related PCP during the study period were reviewed with regard to diagnostic, clinical, therapeutic, and outcome variables. A total of 456 episodes of PCP were diagnosed during the study period. These were compared against 127 cases diagnosed between 1981 and 1987. The frequency of hospitalization for PCP decreased to 78% in 1987 to 1991 from 100% in 1981 to 1987 (p < or = 0.001). A similar decreasing trend was observed with regard to the incidence of PCP-related ARF that declined from 21% in 1981 to 1987 to 9% in 1987 to 1991 (p = 0.009). Despite this, overall PCP-related mortality remained stable at 12% in 1981 to 1987 and 9% in 1987 to 1991 (p = 0.26). The proportion of patients with PCP-related ARF who received mechanical ventilation decreased from 89% in 1981 to 1987 to 64% in 1987 to 1991 (p < 0.001). Despite this, the case fatality rate among mechanically ventilated patients increased from 50% in 1981 to 1987 to 89% in 1987 to 1991 (p = 0.003). These changes were associated with a significant change in the pattern of use of corticosteroids as adjunctive therapy for AIDS-related PCP. In 1985 to 1986, nearly 100% of patients admitted to the ICU received corticosteroids only after admission to the ICU, following the development of ARF. In contrast, in 1989 to 1990, 50% of patients were admitted to the ICU already receiving systemic corticosteroids. The rise in the proportion of patients receiving corticosteroids prior to ICU admission between these two intervals was statistically significant (p = 0.017). Our data show a decreasing frequency but a worsening mortality of ARF secondary to AIDS-related PCP. We conclude that ARF secondary to AIDS-related PCP developing despite maximal therapy, including adjunctive corticosteroids, carries a dismal prognosis.


Two-dimensional spatial frequency analysis of the fraunhofer hologram of a small opaque sphere.
The fact that a Fourier transform relationship exists between the front and back focal planes of a thin spherical lens can be used to obtain the power spectral distribution of two-dimensional holographic data. In particular, this form of optical data processing is considered for obtaining the spectral variation as a function of the recording distance of the holographic intensity distribution caused by illuminating an opaque sphere with plane waves. An approximate, closed form solution for the two-dimensional Fourier transform of this problem is derived.


Insight into the Role of Angiopoietins in Ageing-Associated Diseases.
Angiopoietin (Ang) and its receptor, TIE signaling, contribute to the development and maturation of embryonic vasculature as well as vascular remodeling and permeability in adult tissues. Targeting both this signaling pathway and the major pathway with vascular endothelial growth factor (VEGF) is expected to permit clinical applications, especially in antiangiogenic therapies against tumors. Several drugs targeting the Ang-TIE signaling pathway in cancer patients are under clinical development. Similar to how cancer increases with age, unsuitable angiogenesis or endothelial dysfunction is often seen in other ageing-associated diseases (AADs) such as atherosclerosis, Alzheimer's disease, type 2 diabetes, chronic kidney disease and cardiovascular diseases. Thus, the Ang-TIE pathway is a possible molecular target for AAD therapy. In this review, we focus on the potential role of the Ang-TIE signaling pathway in AADs, especially non-cancer-related AADs. We also suggest translational insights and future clinical applications of this pathway in those AADs.


Comparative haemodynamic studies on the acute cardiac effects of alcohol in the rat and guinea pig.
Left ventricular pressure-volume relations, indices of contractility and the resting tension curve were recorded in wistar rats and guinea pigs prior and during acute intoxication with ethyl alcohol. Indices were recorded at blood alcohol concentrations between 2% (200 mg per 100 ml) and 6% in rats and 1.6% and 2.8% in guinea pigs. Due to the higher heart weight and body weight, end-diastolic volume in guinea pigs was increased for any end-diastolic pressure as compared with rats. On the other hand maximal isovolumetric pressure in the rats was twice as high as in the guinea pigs. At a blood alcohol level of 2.8% left ventricular isovolumetric pressure was reduced by 13%, and maximal rate of pressure rise by 25% in rats and guinea pigs. Though the experimental method was identical in rats and guinea pigs, a blood alcohol concentration of 1.6% in the guinea pigs was associated with a mortality of 55% and a blood alcohol concentration of 2.8% with a mortality of 75% whereas the mortality rate in rats was 0% at these blood alcohol concentrations. The reason for this difference could not be entirely clarified. In conclusion, acute alcohol intoxication results in a comparable dose-dependent cardiac depression in rats and guinea pigs despite marked differences in basic haemodynamics of the two species.


Comparison of Three Nursing Workload Assessment Tools in the Neonatal Intensive Care Unit and Their Association with Outcomes of Very Preterm Infants.
Nursing workload assessment tools are widely used to determine nurse staffing requirements in the neonatal intensive care unit (NICU). We aimed to compare three existing workload assessment tools and assess their association with mortality or morbidity among very preterm infants. Single-center retrospective cohort study of infants born <33 weeks and admitted to a 52-bed tertiary NICU in 2017 to 2018. Required nurse staffing was estimated for each shift using the Winnipeg Assessment of Neonatal Nursing Needs Tool (WANNNT) used as reference tool, the Quebec Provincial NICU Nursing Ratio (QPNNR), and the Canadian NICU Resource Utilization (CNRU). Poisson regression models with robust error variance estimators were used to assess the association between nursing provision ratios (actual number of nurses/required number of nurses) during the first 7 days of admission and neonatal outcomes. Median number of nurses required per shift using the WANNNT was 25.0 (interquartile range [IQR]: 23.1-26.7). Correlation between WANNNT and QPNNR was high (r = 0.92, p < 0.0001), but the QPNNR underestimated the number of nurses per shift by 4.8 (IQR: 4.1-5.4). Correlation between WANNNT and CNRU was moderate (r = 0.45, p < 0.0001). The NICU nursing provision ratios during the first 7 days of admission calculated using the WANNNT (adjusted risk ratio [aRR]: 0.96, 95% confidence interval [CI]: 0.93-0.99) and QPNNR (aRR: 0.97, 95% CI: 0.95-0.99) were associated with mortality or morbidity. Lower nursing provision ratio calculated using the WANNNT and CNRU during the first 7 days of admission is associated with an increased risk of mortality/morbidity in very preterm infants. · NICUs use different nursing workload assessment tools.. · We validated three different nursing workload assessment tools used in the NICU.. · Nursing provision ratio is associated the risk of mortality/morbidity in preterm infants..


Prenatal diagnosis of genetic defects.
A wide discrepancy exists between the number of amniocenteses performed for prenatal diagnosis of genetic abnormalities and the size of the population at risk of having offspring with these abnormalities. A small percentage of the women at risk are being offered amniocentesis. The optimal time for amniocentesis is 14 to 16 weeks of pregnancy. Preliminary ultrasonography is indicated in all instances. Highly specialized biochemical tests may be necessary and should be done at special centralized laboratories. The risk of complications of amniocentesis is 0.5% to 1%.


A rare early complication of tracheostomy.
A polytrauma patient on ventilator was admitted to ICU with open tracheostomy, GCS 8/15 and unequal pupils. After 10 days, he was weaned from the ventilator. The patient had respiratory problems i.e. expiratory stridor, shortness of breath, dysphonia and dyspnea on closing tracheostomy. It was diagnosed as a case of asthma, and the patient responded to salbutamol nebulization and intravenous steroid therapy. However, after some time, he desaturated and a plan for rapid sequence intubation was made. Endotracheal tube could not be negotiated beyond vocal cords, so an unprepared tracheostomy without proper equipment had to be immediately done by an anesthetist to save the patient's life. CT scan revealed tracheal stenosis. This case demonstrates that patients with a short 15-days history of previous tracheostomy may have tracheal stenosis.


[A teaching on how to behave in psychotherapy.].
In this text we have presented a certain pedagogic experiment that we have been carrying out for the last three years at the Malartic Hospital Centre in Abitibi and that we have applied to the Amos Hospital Centre with staff members of the psychiatric and obstetrics and gynaecology departments, and to the Notre Dame Hospital in Montreal. This experiment aims to provide the therapists with a training in psychotherapy, teaching them to use themselves as medium in the therapeutic relationship. To achieve this end, we use techniques which, while bearing similarities to those personalIy experienced by the therapists in therapy or learned in training, differ by the originality of their approach. We have thus attempted to show you a pedagogic experiment involving members of a hospital medical staff who, for the most part, had no specialized training and who were able to find in themselves a great inner intelligence and use it in their relations with their patients. For that it was necessary to teach them the means of identifying certain signals coming from themselves and to consider them as a certain kind of knowledge. We stress the fact that the originality of the method used has permitted the use of this type of pedagogy in an environment in which the therapists know one another and work together. We think that this kind of pedagogy should be included with traditional teaching in order that the therapist may draw upon both.


[Neonatal sepsis at Rigshospitalet in 1984-1988].
Eighty-one episodes of bacteremia and candidemia were recorded in 78 infants in our neonatal intensive care unit during the years 1984 to 1988. The species isolated from monomicrobial episodes were as follows: Enterobacteriaceae 38%, group B streptococci or pneumococci 12%, staphylococci 20%, Candida albicans 9%, and other species 15%. Polymicrobial bacteremia occurred in 6%. Group B streptococci and pneumococci were predominantly isolated from early infections, whereas Enterobacteriaceae, Staphylococcus epidermidis and C. albicans were associated mainly with late septicemia. More than 80% of the episodes occurred in premature infants. During the study period, initial empiric antibiotic therapy consisted of ampicillin plus gentamicin. In spite of the fact that Enterobacteriaceae isolates, often ampicillin resistant, and penicillinase producing staphylococci, were the dominant etiologic agents, choice of this initial therapy did not seem to contribute to mortality. Mortality was most convincingly associated with overwhelming infections caused by group B streptococci and pneumococci.


Usefulness of Aerobic Exercise for Home Blood Pressure Control in Patients with Diabetes: Randomized Crossover Trial.
Hypertension usually coexists with diabetes mellitus and significantly increases the risk of macrovascular complications. Blood pressure measured at home, especially nocturnal blood pressure, is particularly important because it is more strongly associated with target organ damage than clinical blood pressure measurements. Regular moderate aerobic exercise has been shown to have anti-hypertensive effects. This study aimed to investigate the effects of aerobic exercise on home blood pressure in patients with diabetes. This randomized crossover trial was based on outpatient treatment at a university hospital. In this randomized crossover trial, 124 patients with type 2 diabetes were randomly assigned to two groups over 56 days: an exercise preceding group (exercise intervention for 28 days and then no exercise intervention for the following 28 days) and an exercise lagging group (no exercise intervention for 28 days and then exercise intervention for the following 28 days). The associations between the nocturnal blood pressure and exercise intervention were assessed accordingly. A decrease in blood pressure was observed in the morning and evening, at 2 a.m. and 3 a.m. after exercise intervention; however, there was no significant difference between groups. Moderate exercise was not effective in lowering nocturnal blood pressure in this study.


Transformation of 1,1-dichloro-2,2-(4-chlorophenyl)ethane (DDD) by Ralstonia eutropha strain A5.
Evidence is presented demonstrating the ability of Ralstonia eutropha A5 to degrade 1,1-dichloro-2,2-bis(4-chlorophenyl)ethane (DDD) aerobically. Strain A5 was able to effect significant transformation of [(14)C]DDD: the hexane extractable radioactivity decreased to approximately 50% of the controls while more than 25% of the total radioactivity became associated with the acidified culture supernatant. There was also an increase in the amount of radioactivity associated with the cell pellet when compared to the biotic control. A meta-fission pathway for the degradation of DDD is proposed based on the recovery of seven chlorinated metabolites identified by gas chromatography-mass spectrometry analysis.


The effects of three serotypes of Ureaplasma urealyticum on spermatozoal motility and penetration in vitro.
The effects of incubation of spermatozoa with three serotypes of Ureaplasma urealyticum on spermatozoal motility and penetration in vitro were investigated. Using computer-assisted video microscopy, three parameters of motility were determined: individual path lengths, individual vectorial distances, and percentage motility. Polyacrylamide gels were used as a medium for assessment of spermatozoal penetration. Ureaplasma-infected spermatozoa did have significantly greater path lengths and individual distances than did uninfected controls, but ureaplasma infection had no significant effect on percentage motility. Overall, there were no significant differences in penetration distances between ureaplasma-infected spermatozoa and their corresponding uninfected controls. Our conclusion is that the ureaplasmas did not adversely affect motility or penetration when spermatozoa were incubated with ureaplasmas for 45 minutes at ureaplasma:sperm ratios as high as 100:1.