Virtual Reality Aids Game Navigation: Evidence from the Hypertext Lostness Measure.
Instead of traditional free movement, node-based movement can be used in virtual reality (VR) games. In node-based movement systems, players navigate by jumping to set locations. Node-based movement is similar to hypertext navigation. We show that the hypertext lostness measure can be used as a game analytic to evaluate navigational efficiency. In a randomized controlled trial with 25 adolescent participants, an immersive desktop game environment and a VR game environment were compared on the transmission of in-game educational content and navigational efficiency. Results show that the hypertext lostness measure is also valuable outside its original hypertext domain: in VR. VR did not improve players' retention of factual knowledge, but did significantly improve players' spatial knowledge and navigational efficiency. We conclude (a) the hypertext lostness measure is also valuable for node-based VR games and (b) VR games add to spatial learning, even when compared with already immersive desktop games.


Functional analysis of GAT-specific T cell clones: H-2-restricted monoclonal T helper cells do not regulate expression of antibody isotypes.
We obtained T cell clones specific for poly (Glu60, Ala30, Tyr10) (GAT) from GAT-primed lymph node cells of BALB/c mice. The clones consisted of helper cells that were carrier-specific and H-2-restricted and required a hapten-carrier bridge to activate B cells. They may be considered TH1 cells. They could all induce antibody responses of various isotypes in adoptive transfer in vitro. Isotypic patterns of the responses obtained with the clones were identical to those obtained with polyclonal T cells and were not dependent on the number of T helper cells added to the culture. Therefore, our observations demonstrate that classic TH1 cells do not regulate isotype expression on secondary responses. The expression of idiotype-like determinants on the GAT-specific clones was assayed. A syngeneic anti-idiotypic serum (B658), prepared in BALB/c mice against BALB/c anti-GAT antibodies previously characterized, was shown to block specifically the helper activity of GAT-specific T cell lines from BALB/c mice. Under the same experimental conditions the activity of none of the BALB/c clones was affected by serum B658.


Calculation of flow velocities from the geometrical shape of contrast agent-induced time-density curves using DSA.
A method for the calculation of flow velocities in vessels is introduced. The method is validated by measurements with an artificial model. Measurements with the carrier fluids sodium chloride solution and human blood using various scattering objects, show good correlation (r greater than +0.9) of the calculated and volumetrically measured velocities. With a menu-oriented computer program, measurement of flow velocities on DSA series can be made following the routine clinical examination.


Diagnosis, Pathological Findings, and Clinical Management of Gangliocytic Paraganglioma: A Systematic Review.
Background: Although gangliocytic paraganglioma (GP) is considered a rare benign neuroendocrine tumor, cases of mortality have been reported. Occasionally, GP is misdiagnosed as neuroendocrine tumor G1, which is associated with a poorer prognosis than GP. To avoid such misdiagnoses, it is important to understand the clinicopathological characteristics of GP. Thus, herein, we discuss the current literature on the clinicopathological characteristics of GP. Methods: We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. PubMed and Japana Centra Revuo Medicina searches were used to identify papers describing GP. Inclusion criteria included confirmation of epithelioid, spindle-shaped, and ganglion-like cells in the main article and/or figures and whether the paper was cited in other studies of GP. Data were collected on age, sex, site of the primary lesion, tumor size, treatment, prognosis, lymph node metastasis (LNM), depth of tumor invasion, rate of preoperative diagnosis, and clinical symptoms. Results: In total, 162 papers containing 263 cases of GP met the criteria. The mean age at diagnosis was 53.5 years. The male-to-female ratio was 157:104. The mean tumor size was 25.7 mm. The predominant site of the primary tumor was the duodenum (89.7%). The most common clinical sign of GP was gastrointestinal bleeding (47.9%). Other signs and symptoms of GP included abdominal pain (44.7%), anemia (20.3%), incidental findings (12.9%), nausea (6.9%), weight loss (5.5%), general fatigue (5.1%), jaundice (4.6%), and incidental autopsy findings (5.1%). LNM was observed in 11.4% of patients. Liver metastasis was observed in 1.1% of patients. Depth of tumor invasion (penetrating beyond the submucosal layer or sphincter of Oddi) was by far the most significant risk factor for LNM in patients with GP. This suggests, along with histological heterogeneity, that GP may have hamartomatous characteristics. Furthermore, immunohistochemical expression of progesterone receptor and pancreatic polypeptide were useful in distinguishing between GP and neuroendocrine tumor G1, even in small biopsy specimens. Conclusions: We reveal the clinicopathological characteristics of GP, including risk factors for LNM, differential diagnostic approaches, and improvements in the clinical management of this tumor.In addition, GP may have hamartomatous characteristics.


The effect of parental feeding behaviours and participation of children in organized sports/activities on child body mass index.
In this cross-sectional descriptive study, we explored the relationship of parental feeding practices and child physical activity levels with measured body mass index (BMI) in a sample of 97 Ontario preschoolers. Child weight and height were measured; physical activity and sedentary behaviours were assessed by questionnaire. Preschoolers' parents used the Child Feeding Questionnaire to report their attitudes, concerns, and practices in relation to child feeding. Hierarchical multiple linear regression was used to determine relationships among variables. Up to 25% of the preschoolers were overweight and/or obese. The regression model accounted for 53% of the variance in child BMI. Child BMI was predicted to be higher when parents had concerns about and perceived their children to be overweight, and when they felt responsible for what their children ate. Children's BMIs were predicted to be lower for those whose parents pressured them to eat and also for those who engaged in organized sports or activities. This study suggests an association between BMI and parental perceptions, concerns, and practices related to child feeding and organized sports or activities. Public health initiatives related to healthy eating and/or obesity prevention should include a focus on parents of preschool-aged children with the home environment as a potential setting.


Management of afferent loop obstruction: Reoperation or endoscopic and percutaneous interventions?
Afferent loop obstruction is a purely mechanical complication that infrequently occurs following construction of a gastrojejunostomy. The operations most commonly associated with this complication are gastrectomy with Billroth II or Roux-en-Y reconstruction, and pancreaticoduodenectomy with conventional loop or Roux-en-Y reconstruction. Etiology of afferent loop obstruction includes: (1) entrapment, compression and kinking by postoperative adhesions; (2) internal herniation, volvulus and intussusception; (3) stenosis due to ulceration at the gastrojejunostomy site and radiation enteritis of the afferent loop; (4) cancer recurrence; and (5) enteroliths, bezoars and foreign bodies. Acute afferent loop obstruction is associated with complete obstruction of the afferent loop and represents a surgical emergency, whereas chronic afferent loop obstruction is associated with partial obstruction. Abdominal multiple detector computed tomography is the diagnostic study of choice. CT appearance of the obstructed afferent loop consists of a C-shaped, fluid-filled tubular mass located in the midline between the abdominal aorta and the superior mesenteric artery with valvulae conniventes projecting into the lumen. The cornerstone of treatment is surgery. Surgery includes: (1) adhesiolysis and reconstruction for benign causes; and (2) by-pass or excision and reconstruction for malignant causes. However, endoscopic enteral stenting, transhepatic percutaneous enteral stenting and direct percutaneous tube enterostomy have the principal role in management of malignant and radiation-induced obstruction. Nevertheless, considerable limitations exist as a former Roux-en-Y reconstruction limits endoscopic access to the afferent loop and percutaneous approaches for enteral stenting and tube enterostomy have only been reported in the literature as isolated cases.


[Don't always rely on PACS: undetected loss of a central venous catheter guide wire].
A 74-year-old woman had a CVC inserted. Unfortunately, the guide wire was lost under the procedure, and despite a chest X-ray control it was not detected. The reason the guide wire was not identified was insufficient fine-tuning of the >>local<< PC monitor. We recommend regular fine-tuning of monitors used for X-ray control.


[A cohort study of association between sleep duration and cognitive impairment in the elderly aged 65 years and older in China].
Objective: To explore the effect of sleep duration on the risk of cognitive impairment in the elderly in China. Methods: Baseline data of 9 679 elderly individuals with intact cognition were collected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2005, and followed up was conducted until 2018. Cox proportional hazards model was used to analyze the association between different sleep durations and the risk for cognitive impairment in the elderly. Results: Compared with elderly with sleep duration of 6 hours per day, those with sleep duration less than 5 hours had increased risk for cognitive impairment by 30% (HR=1.30, 95%CI: 1.05-1.62), and those with sleep durations of 7 hours, 8 hours and more than 9 hours had increased risk for cognitive impairment by 34% (HR=1.34,95%CI: 1.09-1.64), 40% (HR=1.40,95%CI: 1.17-1.69) and 43% (HR=1.43,95%CI: 1.19-1.70), respectively. Trend test showed that the risk of cognitive impairment increased with the extension of sleep duration (>6 h), and there was a dose-response relationship (P<0.001). However, self-rated sleep quality was not associated with the risk for cognitive impairment in the elderly. Conclusions: The shorter and longer sleep duration were associated an increased risk of cognitive impairment in the elderly aged ≥65 years in China, suggesting that optimizing sleep duration might delay the occurrence of cognitive impairment.


Nomograms of the fetal lateral ventricles using transvaginal sonography.
Nomograms of the fetal lateral ventricles were obtained by the transvaginal approach. Three hundred low-risk women with no sonographically apparent fetal anomalies were scanned prospectively in a cross-sectional study. Three measurements in the parasagittal plane, three in the midline coronal plane, and two in the posterior coronal plane were used to generate seven nomograms. Two additional nomograms reflecting two calculated ratios also were created. A mean regression line and the 5th and 95th confidence intervals were determined. We concluded that transvaginal sonography of the fetal brain generates images of both hemispheres of good enough resolution to allow several precise and reproducible measurements.


Translocation of dead or alive bacteria from mucosa to joints and epiphyseal bone-marrow: facts and hypotheses.
The recent demonstration that DNA from several mucosal bacteria, including Prevotella spp, could be found in numerous tissues (mesenteric lymph nodes, spleen, serum, liver, lung, eye and ankle joints), either in HLA-B27 rats with or without arthritis, or control rats without HLA-B27, could be a revolution in our understanding of spondyloarthritis and close disorders, including rheumatoid arthritis. Indeed, similar translocations of dead or alive bacteria or fungi from mucosa to joints, could contribute to the onset and flares of inflammatory rheumatisms. This state of the art article addresses six questions revived by this finding: 1-How does this bacterial DNA or living bacteria traffic from mucosa to joints? 2-Can some mucosal bacteria remain alive in those tissues, including joints? 3-Could bacteria from the gut microbiota ('self-bacteria') protect the host cells from invasion by more pathogenic bacteria (like dog-shepherds protect from wolves)? 4-Does the composition of the joint or bone marrow microbiota depends on local metabolism, which might differ from gut metabolism? 5-Could bacterial antigens from mucosal microbiota be sufficient to trigger trained immunity of presenting cells in joints, or does such phenomenon (with lasting epigenetic changes of presenting cells) require intra-cellular infection of presenting cells or their ancestors? 6-In which subsets of cells could living bacteria preferentially persist for a long period in the joint area? Transient or dormant infections within bone-marrow mesenchymal stem cells leading to trained immunity of some of their daughter cells in joints or enthesis, lasting after clearance or the invader, is an attractive hypothesis to test.


Regulation of divergent cortisol responsiveness in European sea bass, Dicentrarchus labrax L.
Mechanisms regulating differences in cortisol responsiveness between low (LR) and high response (HR) individuals have been poorly studied. In this context, we aimed to study key regulatory processes in cortisol dynamics at the head kidneys of LR and HR European sea bass. To do so, resting plasma cortisol and ACTH concentrations were quantified in these fish. Additionally, the head kidneys of these individuals were superfused through an in vitro superfusion system and stimulated with the same amount of ACTH to assess their cortisol biosynthetic capacity. Moreover, the expression of important genes in cortisol regulation was assessed. Results showed that LR fish had lower resting cortisol concentrations than HR, although no differences existed in the circulating levels of ACTH. Additionally, the biosynthetic capacity of HR was higher than that of LR fish when in vitro stimulated with ACTH. At the molecular level, a statistically significant 3.4-fold higher expression of the ACTH receptor, mc2r, and a 2.3-fold, though not significant, higher expression of 11β-hydroxylase (cyp11b1), an enzyme involved in cortisol biosynthesis, was observed in the HR fish. Finally, a statistically significant 1.3-fold lower expression of 11β-hydroxysteroid dehydrogenase 2 (hsd11b2), an enzyme involved in cortisol inactivation, was observed in HR when compared to LR fish. Therefore, it was for the first time indicated that cortisol dynamics can also be regulated at the post-production level in the head kidney. Collectively, our results highlight the crucial role of the interrenal tissue in the regulation of differences in cortisol response between LR and HR sea bass individuals.


A comparison of heart rate, eye activity, EEG and subjective measures of pilot mental workload during flight.
Mental workload is a major consideration in the design and operation of modern aircraft systems. Objective measures of mental workload that are sensitive and diagnostic are required to meet the needs of both pilots and designers. Due to the multifaceted nature of these complex mental demands multiple measures are required. Psychophysiological and subjective measures provide unique information about mental workload during flight. Cardiac, eye, brain and subjective data were collected during an actual flight scenario designed to provide tasks which required different piloting skills at several levels of mental workload. Heart rate was sensitive to the demands of flight but not diagnostic with regard to determining the cause of the workload. Heart rates increased during take offs and landings and to an intermediate level during instrument flight rules (IFR) segments. By showing sensitivity to only the visual demands of the various segments of flight eye activity was more diagnostic. The theta band of the EEG demonstrated increased power during those flight segments which required inflight mental calculations. The subjective measures showed trends suggesting different levels of mental demand but demonstrated few statistically significant differences. Multiple measures, especially psychophysiological measures, provide a comprehensive picture of the mental demands of flight. The measures used in this study were shown to provide unique, non-overlapping information. Because of the continuous nature of the psychophysiological data it may be possible to develop systems which provide on-line monitoring of mental workload that can provide feedback to the pilot and aircraft systems.


Purification and characterization of a low molecular weight multifunctional cytotoxic phospholipase A2 from Russell's viper venom.
A basic toxin from Russell's viper venom of 7.2 kDa (RVV-7) has been purified to homogeneity after partial unfolding by 4 M urea followed by filtration through Centricon-30 membrane. Its N-terminal sequence showed strong homology with snake venom cytotoxins. Cytotoxic activity of RVV-7 has been demonstrated with B16F10 melanoma cells. PLA2 activity was observed in cytotoxin (CX3) from Naja kauthia bearing sequence homology with RVV-7. Phospholipase A2 and trypsin inhibitory activities were also observed with RVV-7. Chemical modification and inhibition studies suggested independent functional sites for these activities. A qualitative assessment of tumor growth inhibition by RVV-7 has been made.


Optimal dosing of penicillin G in the third trimester of pregnancy for prophylaxis against group B Streptococcus.
We wanted to determine the optimal dose of intravenous penicillin (PCN) in the third trimester of pregnancy for the prophylaxis of group B Streptococcus. Healthy women in the third trimester with a singleton pregnancy were recruited. Eligibility included no previous penicillin or cephalosporin allergy and no history of renal disease. We obtained a baseline 24-hour urine collection for total protein concentration and creatinine clearance. Two intravenous catheters were placed, and 1 million units of penicillin G (PCN G) sodium was infused through one catheter. Serial blood samples were obtained through the second catheter at 1, 5, 15, 30, 60, 90, 120, 150, 180, 210, and 240 minutes. Serum was stored at -80 degrees C until assays were performed. Reverse-phase high-performance liquid chromatography was used to determine serum concentrations. Fifteen patients met the requirements for eligibility. The average 24-hour urine sample for total protein concentration was 187 mg/dL (range, 11-252), and creatinine clearance was 191 mL/min (range, 137-245). Average maximum serum concentration (C(max)) was 67 microg/mL (range, 34-132) and was reached within 5 minutes. Average serum PCN concentration was 12 microg/mL (range, 9-25) after 4 hours of urine collection. The C(max) was 67 microg/mL (670 x minimum inhibitory concentration). One million units of intravenous PCN G exceeds MIC in the treatment of GBS. The dosing interval should be 4 hours to ensure anti-GBS activity in all patients. More frequent dosing does not increase activity. Current recommendations for GBS prophylaxis which use PCN G should be modified pending future studies of neonatal PCN concentrations.


Promoting reflective practice through structured clinical supervision.
This paper outlines some early issues from a research project that is part of a North West Regional Health Authority pilot study on clinical supervision. The aims of the study and the research methodology utilized are discussed. The experiences of both a sister from a busy accident and emergency department and a practice nurse in the community are examined consecutively as supervisor and supervisee.


Infections of the central nervous system as a risk factor for mental disorders and cognitive impairment: A nationwide register-based study.
CNS infections have been suggested as risk factors for cognitive decline and mental disorders; however, large-scale studies have been lacking regarding types and agents of CNS infections. We utilized the unique personal registration number to create a cohort of 1,709,867 individuals born 1977-2010. CNS infection was exposure and data were analysed with 1) cox regression analyses estimating hazard ratios (HR) for developing mental disorders and 2) binomial regression estimating relative risk (RR) for completion of 9th grade including average grade score in a sub-cohort born 1988-1998. CNS infection increased the risk for developing mental disorders with a HR of 1.34 (95% CI 1.27-1.42). The highest risk observed was within the first 6 months after the CNS infection with a HR of 26.98 (95% CI 21.19-34.35). Viral CNS infections (HR 1.47, 95% CI 1.35-1.61) conferred a higher risk (p < 0.001) than bacterial (HR 1.24, 95% CI 1.15-1.35). Encephalitis (HR 1.64, 95% CI 1.41-1.90) conferred a higher risk (p < 0.001) than meningitis (HR 1.26, 95% CI 1.18-1.35). The risk was highest for organic mental disorders (HR 6.50, 95% CI 5.11-8.28) and disorders of intellectual development (HR 3.56, 95% CI 2.94-4.31), with a HR of 19.19 (95% CI 7.46-49.35) for profound disorder of intellectual development (IQ < 20). Furthermore, CNS infection decreased the RR of completing 9th grade of mandatory schooling (RR 0.89, 95% CI 0.88-0.91) and lowered average grade score for completers (p < 0.001). CNS infections increased the risk for mental disorders and decreased the likelihood of completing 9th grade, indicating long-term consequences of CNS infections.


Clinical and echocardiographic survey of the Ehlers-Danlos syndrome.
Cardiac abnormalities such as mitral valve prolapse (MVP) are reported to be common features of the Ehlers Danlos syndrome (EDS), and it has been suggested that the majority of patients with type IV EDS will have cardiac involvement and vascular aneurysms. However, the evidence for valve lesions is inconsistent and often based on early clinical studies using mainly M-mode echo. We studied 33 patients (six male, 27 female; median age 35 yr) with EDS (30 type I, II or III, three type IV) and 30 age- and sex-matched controls. The study assessed skin stretch and joint hypermobility using Beighton and Contompasis scores. Echocardiographic examination included standard two-dimensional views from the parasternal and apical windows, and measurement of the aorta at four sites (annulus, sinotubular junction, arch and abdominal aorta). Echocardiographic abnormalities were found in four patients (12.1%) (one atrial septal aneurysm, one tricuspid prolapse, two MVP) and two controls (6.7%). MVP was found in 6.1% of EDS patients and 7% of controls. Seven patients had previously been diagnosed as having MVP; only two were shown to have true MVP using current criteria. None of those with type IV EDS had any echocardiographic abnormality. No patients with EDS had mean aortic dimensions outside the normal range at any of the points tested. Cardiac symptoms were more frequent amongst the patients than controls (atypical chest pain 48%, P = 0.0001; palpitation 39%, P = 0.001; exertional dyspnoea 30%). A wide range of rheumatological complaints were reported (current arthralgia 75%; recent back pain 72%, P = 0.005; recurrent dislocation 72%). Contrary to earlier published observations, we have not found an increased incidence of cardiac abnormalities in EDS. This syndrome may be relatively more benign, from the cardiac point of view, than was previously thought.


Predation on Bivalve Veligers by Polychaete Larvae.
Polychaete larvae from several families are thought to be natural predators upon planktonic bivalve larvae. However, little direct evidence of interactions between these predators and prey is available. We conducted predator-prey experiments on laboratory roller tables for five putative predatory polychaete larvae, representing four families (metatroch-less larvae of the Polynoidae and metatrochophore larvae of the Spionidae, the Magelonidae, and the Phyllodocidae). D-hinge veliger larvae of the oyster Crassostrea gigas were offered as prey. Predation was monitored over a range of prey densities and in the presence and absence of background plankton. "Background plankton" are any naturally occurring plankton assemblages found in whole, unfiltered seawater at ambient concentrations. For all polychaete larvae examined, when natural C. gigas densities and background plankton were used, no predation was observed. Magelonids and phyllodocids did not consume any C. gigas larvae, regardless of conditions. Polynoid and spionid trochophores consumed C. gigas veligers at both the "natural" and unnaturally high prey densities in filtered seawater. The addition of background plankton eliminated the predation at all natural prey densities and significantly reduced the predation observed at high prey densities.


The effects of N-acetylcysteine supplement on metabolic parameters in women with polycystic ovary syndrome: a systematic review and meta-analysis.
Polycystic ovary syndrome (PCOS) is a common endocrine disease, often accompanied by metabolic disorders. Metformin, as an insulin sensitizer, is widely used to improve the metabolic function of PCOS, but may have gastrointestinal side effects. Emerging evidence suggests that N-acetylcysteine (NAC) improves metabolic parameters in PCOS and may be a potential alternative to metformin. We searched four online databases, PubMed, Embase, Web of Science, and Cochrane Library, from inception to April 1, 2023. The I2 statistic and Cochrane's Q test were employed to determine heterogeneity between studies, with an I2 value >50% or p < 0.1 considered significant. The data were expressed as standardized mean differences and corresponding 95% confidence intervals. A total of 11 randomized controlled trials were included in the final analysis, including 869 women with PCOS. The results showed that NAC caused more changes in body mass index (SMD: -0.16, 95% CI: -0.40 to 0.08), body weight (SMD: -0.25, 95% CI: -0.50 to 0.00), fasting insulin (SMD: -0.24, 95% CI: -0.53 to 0.06), ratio of fasting blood glucose to fasting insulin (SMD: 0.38, 95% CI: -0.33 to 1.08), total cholesterol (SMD: -0.11, 95% CI: -0.39 to 0.17), triglycerides (SMD: -0.18, 95% CI: -0.63 to 0.28), and low-density lipoprotein (SMD: -0.09, 95% CI: -0.51 to 0.33) compared with metformin. Compared with metformin or placebo, NAC significantly reduced fasting blood-glucose levels (SMD: -0.23, 95% CI: -0.43 to -0.04; SMD: -0.54, 95% CI: -1.03 to -0.05, respectively). In addition, NAC significantly reduced total cholesterol (SMD: -0.74, 95% CI: -1.37 to -0.12), and this effect was observed when NAC was compared with placebo. However, NAC reduced HDL levels in women with PCOS compared with metformin (SMD: -0.14, 95% CI: -0.42 to 0.14). This study suggests that NAC is effective in improving metabolic parameters in PCOS and may be a promising nutritional supplement for the treatment of PCOS.Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=415172, identifier CRD42022339171.


Morphological and genetic diversity of traditional varieties of agave in Hidalgo State, Mexico.
The agaves are plants of cultural importance which have been used by humans for about 10,000 years and about 40 specific uses. The most culturally and economically important of those uses are for the production of fermented (pulque) and distilled beverages (mescal). Pulque continues to be produced in nearly all of Mexico, and the agaves used for this purpose have shown domestication syndrome. We carry out an ethnobotanical, morphological, and genetic analysis of the traditional varieties of pulque agave used in the production of aguamiel (agave sap) and pulque in the state of Hidalgo. We did semi-structured interviews, free listings, and tours with 11 agave managers. We analyzed morphology and studied genetic diversity and structure using nuclear microsatellites. We found wild-collected, tolerated, transplanted, and cultivated varieties of agave. This comprised 19 traditional varieties of pulque agave, 12 of them in production during the study, which corresponded to the species Agave americana, A. salmiana y A. mapisaga and five intraspecific entities. The varieties were grouped morphologically according to a management gradient; the wild-collected varieties were the smallest, with more lateral teeth and a larger terminal spine. The cultivated varieties clearly exhibited domestication syndrome, with larger plants and smaller dentition. The expected heterozygosity (He) of the varieties ranged from 0.204 to 0.721. Bayesian clustering suggested the existence of three genetic groups, both at the level of traditional varieties of pulque agaves and for management categories, a result that matches multivariate clustering. Pulque producers in the studied localities maintain high agrobiodiversity. The cultivated varieties exhibit domestication syndrome, as has been reported for other species of the genus with the same selection purposes. Our results support the hypothesis of a decrease in genetic diversity in crops compared to wild-growing agaves, which seems to be due to vegetative propagation, among other factors.


Epithelial cell, blood group related, carbohydrate antigens.
A monoclonal antibody (87.5) with high specificity for the terminal Gal alpha 1--4Gal residue, a receptor for P-fimbriated E. coli, was obtained by immunization with a neoglycoconjugate. A modification of a method for the immunostaining of glycolipids separated on thin layer chromatography plates was developed, in which detection of glycolipids reacting with the antibody was achieved with the immunoperoxidase technique. An affinity chromatographic technique for the analysis of oligosaccharides on immobilized monoclonal antibodies was developed for characterization of tumour associated antigens. Using this method a monoclonal antibody with specificity for human squamous lung carcinoma cells was shown to have high affinity for difuco-p-lacto-N-hexose (Lea-X). The relative amounts of Lea and Leb active glycolipids, obtained from urine sediments in individuals with blood group Lea-b+, was evaluated. A significant number of the samples obtained from patients with urinary bladder carcinoma displayed a ratio Lea/Leb greater than 1, whereas controls showed Lea/Leb less than 1. The results demonstrate the potential use of detailed biochemical investigations on exfoliated material in urine. 3. Urine sediments from patients with the ureteroenterocutaneous type of urinary diversion were shown to contain typical intestinal glycolipids. These were mainly of ABH and Lewis type based on the lacto carbohydrate core sequence. A regional expression of these antigens could be demonstrated. The relative amount of the antigens varied, depending on the intestinal origin of the conduits/reservoirs. The same urinary sediments were also shown to contain considerable amounts of an intestinal type of mucin. High-performance ion exchange chromatography revealed mucin glycopeptides to constitute a very heterogeneous population. The mucin glycopeptides expressed blood group activity mainly correlating with the glycolipids obtained from corresponding samples. Only a minority of the glycopeptides, however, seemed to contain these antigens.


The effect of Clostridium difficile infection on cardiac surgery outcomes.
Clostridium difficile (CD) is a common cause of healthcare-associated infectious colitis that complicates about 1% of all hospital stays in the U.S. The impact of CD on outcomes after coronary artery bypass grafting (CABG) and valvular surgery (VS) is not well known. The Nationwide Inpatient Sample (2002-2009) was queried to identify CABG and VS patients utilizing International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes. Rates of CD, post-operative endocarditis and mediastinitis, hospital mortality rate, and resource utilization were evaluated. We identified 421,294 and 90,923 patients of age 40 yrs and older who underwent CABG and VS, respectively. The CD infection was more likely to develop in patients undergoing VS than in those having CABG (odds ratio [OR] 1.8; 95% confidence interval [CI] 1.64-1.92) and was more likely after urgent or emergency admission than after elective admission (OR 1.8; 95% CI 1.68-1.94). There was a greater likelihood of mediastinitis in patients with CD after CABG than in non-complicated cases without CD, both by univariable (OR 6.0; 95% CI 3.07-11.62) and multivariable analysis with adjustment for patient age, gender, race, type of admission, and co-morbidities (OR 3.1; 95% CI 1.49-6.51). The infection thus was most likely a result of the antibiotics used to treat mediastinitis, as the patients treated for mediastinitis were most likely to develop CD. There was a significant association in patients with CD and endocarditis who underwent VS but not in patients who did not have CD. The CD infection in these patients thus was most likely a result of the antibiotics used to treat endocarditis. Endocarditis and CD developed 3.2 times (95% CI 2.65-3.97) as often as in patients without CD, a finding that was confirmed by multivariable analysis (OR 2.2; 95% CI 1.70-2.84). At the same time, in patients having VS, there was no significant association of CD and mediastinitis. Clostridium difficile infection affected the hospital mortality rate significantly after both CABG (OR 2.0; 95% CI 1.65-2.35) and VS (OR 1.9; 95% CI 1.51-2.39). Development of CD increased median hospital length of stay and cost dramatically after both CABG (from 7 d to 19 d and from $33,105 to $65,535, respectively; p<0.0001 for both) and VS (from 8 d to 24 d and from $41,876 to $95,699, respectively; p<0.0001 for both). The development of CD worsened significantly the outcomes of adult patients undergoing cardiac surgery. There was a greater risk of CD in patients with either mediastinitis or endocarditis. The infection was associated with a higher hospital mortality rate, longer hospital stays, and greater cost after both CABG and VS.


An efficient one-pot two catalyst system in the construction of 2-substituted benzimidazoles: synthesis of benzimidazo[1,2-c]quinazolines.
The benzimidazole core is a common moiety in a large number of natural products and pharmacologically active small molecules. The synthesis of novel benzimidazole derivatives remains a main focus in medicinal research. In continuation of the efforts towards Ce(III) catalysts for organic transformations, we observed for the first time the activity of the iodide ion and copper cation in activating CeCl3·7H2O in the selective formation of prototypical 2-substituted benzimidazoles. The one-pot CeCl3·7H2O-CuI catalytic system procedure includes the cyclo-dehydrogenation of aniline Schiff's bases, generated in situ from the condensation of 1,2-phenylenediamine and aldehydes, followed by the oxidation with iodine, which works as a hydrogen sponge. Mild reaction conditions, good to excellent yields, and clean reactions make the procedure a useful contribution to the synthesis of biologically active fused heterocycles containing benzimidazoquinazolines.


Utility of Borrelia-specific IgM and IgG antibody titer determinations during a 12-year period - results from a clinical laboratory in Northern Sweden.
Interpretation of serological findings in suspected Lyme borreliosis (LB) is challenging and IgM reactivities may have low predictive value. Therefore, if used indiscriminately, there is a risk for incorrect diagnosis of LB. To evaluate the usefulness of IgM titer determination, we performed a study of the prevalence of Borrelia-specific antibodies in serological samples from patients with suspected LB analyzed during the period 2010 - 2021 at the University Hospital of Umeå in Sweden. In total, 19,335 samples had been analyzed for the presence of IgG and IgM antibodies. Overall, there were higher percentages of IgM positive or borderline titers, 1,847 (9.6%) and 905 (4.7%), respectively, than IgG positive or borderline titers, 959 (5.0%) and 406 (2.1%), respectively. Peak number of samples were recorded 2012 - 2013, exceeding 1,800, whereas there were around 1,200 during 2020 - 2021. The peak number of positive IgG and/or positive IgM samples were observed during the period 2015 - 2017 with close to, or above 400, and concomitantly, the proportion of IgG positive samples increased markedly. For IgG positive samples, the increase followed a positive linear time trend (P< 0.001). Peak monthly numbers were observed during August, September, and October. This seasonal increase was significant for the IgG positive group (P< 0.05), but not for the IgM positive/IgG negative group. Repeated samples were obtained from 3,188 individuals and of the initial samples 2,817 were (88%) IgG negative and 2,315 (72%) were IgM negative and of these, 130 (4%) showed IgG seroconversion and 300 (9%) IgM seroconversion. Collectively, the data demonstrate that IgG and/or IgM positive samples represented a minority of all samples, even when repeated sampling had occurred, and IgM positive samples were much more common than IgG positive samples. Thus, the accuracy of the clinical suspicion was low and this will lead to a low predictive value of the analysis, in particular of IgM. These findings question the use of IgM titer determination as a routine analysis.


Limitations of transvaginal sonography and color Doppler imaging in the differentiation of endometrial carcinoma from benign lesions.
We conducted this study to test the hypothesis that transvaginal ultrasonography and color Doppler imaging of the uterine arteries are complementary methods in the assessment of patients with postmenopausal bleeding. Sixty-seven patients were studied. Seventeen suffered from endometrial carcinoma, 12 from benign endometrial lesions (six polyp, six hyperplasia) and 38 had no organic pathology. Transvaginal ultrasonography was found to be superior to CDI in the detection of pathologic conditions of the endometrium, but neither method can distinguish benign lesions from their malignant counterparts. CDI does not give additional information over that obtained by transvaginal ultrasonography in the assessment of patients with postmenopausal bleeding, and the limitations of both methods in the differentiation of endometrial carcinoma from benign lesions need to be recognized.


The CRY2-COP1-HY5-BBX7/8 module regulates blue light-dependent cold acclimation in Arabidopsis.
Light and temperature are two key environmental factors that coordinately regulate plant growth and development. Although the mechanisms that integrate signaling mediated by cold and red light have been unraveled, the roles of the blue light photoreceptors cryptochromes in plant responses to cold remain unclear. In this study, we demonstrate that the CRYPTOCHROME2 (CRY2)-COP1-HY5-BBX7/8 module regulates blue light-dependent cold acclimation in Arabidopsis thaliana. We show that phosphorylated forms of CRY2 induced by blue light are stabilized by cold stress and that cold-stabilized CRY2 competes with the transcription factor HY5 to attenuate the HY5-COP1 interaction, thereby allowing HY5 to accumulate at cold temperatures. Furthermore, our data demonstrate that B-BOX DOMAIN PROTEIN7 (BBX7) and BBX8 function as direct HY5 targets that positively regulate freezing tolerance by modulating the expression of a set of cold-responsive genes, which mainly occurs independently of the C-repeat-binding factor pathway. Our study uncovers a mechanistic framework by which CRY2-mediated blue-light signaling enhances freezing tolerance, shedding light on the molecular mechanisms underlying the crosstalk between cold and light signaling pathways in plants.


Compliance of healthcare workers with hand hygiene practices in neonatal and pediatric intensive care units: overt observation.
Background. The objective of this study was to assess the compliance of hand hygiene (HH) of healthcare workers (HCWs) in the neonatal and pediatric intensive care unit in a tertiary university hospital in Istanbul. Methods. An observational study was conducted on the compliance of HH for the five World Health Organization (WHO) indications. HCWs were observed during routine patient care in day shift. The authors also measured the technique of HH through hand washing or hand hygiene with alcohol-based disinfectant. Results. A total of 704 HH opportunities were identified during the observation period. Overall compliance was 37.0% (261/704). Compliance differed by role: nurses (41.4%) and doctors (31.9%) [P = 0.02, OR: 1.504, CI 95%: 1.058-2.137]. HCWs were more likely to use soap and water (63.6%) compared to waterless-alcohol-based hand hygiene (36.3%) [P < 0.05]. Conclusion. Adherence to hand hygiene practice and use of alcohol-based disinfectant was found to be very low. Effective education programs that improve adherence to hand hygiene and use of disinfectants may be helpful to increase compliance.


An efficient chemoselective reduction of furan series unsaturated dinitriles.
An efficient reduction of double bonds conjugated with nitrile groups and acid or base sensitive furan rings with 2-phenylbenzimidazoline generated in situ has been successfully accomplished with high yields and excellent selectivity. The employed reducing agent was prepared in one step from ordinary chemicals. The other advantages of the presented method include mild and convenient reaction conditions, a benign and cost effective reagent, simple work-up and separation of the products. As this process does neither affect cyano and nitro groups nor furan rings, it is a valuable alternative when metal-catalyzed hydrogenations or borohydride reductions have failed.


Geographical equations of Swertia mussotii bioactivities: evidence from the western Sichuan region of China.
Swertia mussotii is the most authentic raw material used in Tibetan medicine in China for its various bioactivities. This natural medicine resource is at risk of being exhausted due to the double interference of climate change and anthropogenic over-collection. Little is known about habitat characteristics and the crucial environmental factors that influence the levels of active ingredients. The goal of this study is to understand the variability in the bioactive compound content of a wide range of wild S. mussotii as it adapts to changing environmental conditions. The target compound content of the whole plant material was analyzed with the environmental explanatory variables of the field sample sites using a constrained ordination method for their correlation analysis. The results show that 16.3 percent of the sampled wild S. mussotii populations with the highest bioactive content can be grouped into the elite type. The most prominent environmental variables affecting the content of major bioactive products include altitude, aspect, soil TK content, Fe content, and C/N and N/P ratios. Altitude and aspect put indirect effects that are mediated by plant height and density, N/P ratio puts a direct effect, while soil TK content, Fe content and C/N ratio have both direct and indirect effects on the bioactivity of S. mussotii. In addition to the total negative effects of altitude and C/N ratio, the remaining factors play a driving role. These findings demonstrate variation by geographical conditions across S. mussotii accessions for physiologic responses and secondary compounds in wild populations. The knowledge gained from this study can be used for environmental and plant physiology research, efficient collection of naturally active compounds, and conservation strategies for rare natural plant resources.


Variation in Hospice Services by Location of Care: Nursing Home Versus Assisted Living Facility Versus Home.
To describe differences in hospice services for patients living at home, in nursing homes or in assisted living facilities, including the overall number and duration of visits by different hospice care providers across varying lengths of stay. Retrospective cohort study using hospice patient electronic medical record data. Large, national hospice provider. Data from 32,605 hospice patients who received routine hospice care from 2009 to 2014 were analyzed. Descriptive statistics were calculated for utilization measures for each type of provider and by location of care. Frequency and duration of service contacts were standardized to a 1 week period and pairwise comparisons were used to detect differences in care provided between the three settings. Minimal differences were found in overall intensity of service contacts across settings, however, the mix of services were different for patients living at home versus nursing home versus assisted living facility. Overall, more nurse care was provided at the beginning and end of the hospice episode; intensity of aide care services was higher in the middle portion of the hospice episode. Nearly 43% of the sample had hospice stays less than 2 weeks and up to 20% had stays greater than 6 months. There are significant differences between characteristics of hospice patients in different settings, as well as the mix of services they receive. Medicare hospice payment methodology was revised starting in 2016. While the new payment structure is in greater alignment with the U shape distribution of services, it will be important to evaluate the impact of the new payment methodology on length of stay and mix of services by different providers across settings of care.


Out of school female adolescent employment status and sexually transmitted infections (STIs) risk in Uganda: is it a plausible relationship?
High prevalence of Sexually Transmitted Infections (STIs) among adolescents is a serious public health concern. Although many factors are attributed to adolescents' risk of STI infections, the association between out of school adolescents' employment status and STIs has not been thoroughly explored in Uganda, yet many adolescents are known to be employed. Consequently, the extent to which adolescents' employment status may be a risk factor for unprotected sex and STIs among female adolescents is unclear. This study examines the association between female out of school adolescents' employment status and STI status using the Uganda Demographic and Health Survey (UDHS) data for 2016. Both descriptive and multilevel binary logistic regressions were used to analyse the data. The descriptive statistics provided an overview of the association between the two main variables while the multilevel binary logistic estimated the relationship between employment status and STI status, while controlling for other fixed factors and community random factors. Compared to female adolescents who were not employed or not working, the odds of reporting positive STIs were significantly higher for female adolescents who were working but received no pay (1.801(95% CI = 1.105-2.936), were self-employed in agriculture (1.502 (95% CI = 1.003-2.250) and who did manual jobs (2.258(95% CI = 1.429-3.568) whether skilled or not. Likewise, female adolescents who had two or more lifetime sexual partners (11.679 (95% CI = 1.254-2.248) had significantly higher odds of reporting STIs than those who had only one lifetime sexual partner. Out of school female adolescents who are employed in various types of low wage employments are at greater risk of exposure to STIs than their counterparts who do not work in Uganda. Instead of being a protective factor against the risk of STIs, their employment may expose them to risky sexual behaviour and STIs, given the vulnerabilities female adolescents who have dropped out of school tend to report. Therefore, the provision of decent employment opportunities for these females may provide an avenue for instructional scaffolding to build the life skills and empower these females so that they are better able to reduce their exposure to STIs.


Azospirillum brasilense does not affect population structure of specific rhizobacterial communities of inoculated maize (Zea mays).
Positive response of plant species to plant growth-promoting rhizobacteria have led to an increased interest in their use as bacterial inoculants. However, the introduction of exogenous bacteria into natural ecosystems may perturb bacterial populations within the microbial community and lead to the disruption of indigenous populations performing key functional roles. In this study the effect of Azospirillum brasilense inoculation on maize (Zea mays) rhizosphere Actinobacteria, Bacteroidetes, alpha-Proteobacteria, Pseudomonas and Bdellovibrio spp. was assessed using a polymerase chain reaction (PCR)-denaturing gradient gel electrophoresis (DGGE) approach in conjunction with group-specific primers. The DGGE fingerprints analysis revealed that the introduction of A. brasilense did not alter or disrupt the microbial system at the group-specific level. However, some communities such as the alpha-Proteobacteria and Bdellovibrio were influenced by plant age while the other bacterial groups remained unaffected. Based on these as well as previous data, it can be inferred that inoculation with A. brasilense does not perturb the natural bacterial populations investigated.


Cardiovascular changes in elicited by vagal gastric afferents in the rat.
Cardiovascular changes elicited by gastric distension in the urethane anaesthetized rat are described. Heart rate changes were mediated via a vago-vagal pathway with 'in-series' tension receptors in the stomach wall providing the afferent input and cholinergic cardio-inhibitory fibres forming the efferent pathway. Blood pressure changes occurred independently of the heart rate changes; the main afferent pathway was again vagal but the efferent outflow was non-cholinergic and probably sympathetic.


Uncertainty and unwillingness to receive a COVID-19 vaccine in adults residing in Puerto Rico: Assessment of perceptions, attitudes, and behaviors.
Background: Widespread vaccination against COVID-19 is essential to control the pandemic. Estimates of unwillingness and uncertainty toward COVID-19 vaccination and factors associated with it remain unclear among adults in Puerto Rico (PR).Objective: To examine factors associated with uncertainty and unwillingness of COVID-19 vaccination among adults in PR.Methods: The Health Belief Model was used to develop an online survey. Analyses included adjusted logistic regressions (aOR). A total of 1,911 adults completed the survey from December 2020 to February 2021.Results: Overall, 76.2% were females, 33.7% were aged 50 or older, and 82.7% reported an intent to get vaccinated. Individuals who did not perceive that their chances of getting COVID-19 were high (aOR = 2.94; 95%CI = 2.24-3.86), that getting COVID-19 was not a possibility for them (aOR = 2.86; 95%CI = 2.19-3.74), or unafraid of getting COVID-19 (aOR = 3.80; 95%CI = 2.76-5.23) had higher odds of uncertainty and unwillingness to get vaccinated against COVID-19. Participants who perceived that COVID-19 complications were not serious also had higher odds of uncertainty and unwillingness (aOR = 7.50; 95%CI = 3.94-14.3), whereas those who did not perceive that they would get very sick with COVID-19 had 89% increased odds. Those who agreed that they would only take the vaccine if many individuals took it had higher odds of uncertainty and unwillingness (aOR = 3.32; 95%CI = 2.49-4.43). The most reported reasons for uncertainty and unwillingness toward COVID-19 vaccination were vaccine safety (63.8%), efficacy (49.4%), and novelty (45.5%).Discussion: Although COVID-19 vaccination intent was high, the study highlights concern over vaccine safety and efficacy that should be addressed by public health campaigns and interventions to enhance vaccine uptake.


The nitroxyl anion (HNO) is a potent dilator of rat coronary vasculature.
The nitroxyl anion (HNO) is the one-electron reduction product of NO(). This redox variant has been shown to be endogenously produced and to have effects that are pharmacologically distinct from NO(). This study investigates the vasodilator and chronotropic effects of HNO in the rat isolated coronary vasculature. Sprague-Dawley rat hearts were retrogradely perfused with Krebs' solution (8 ml/min) using the Langendorff technique. Perfusion pressure was raised using a combination of infusion of phenylephrine and bolus additions of the thromboxane mimetic U46619 to attain a baseline perfusion pressure of 100-120 mm Hg. The vasodilator effects of a nitroxyl anion donor, Angeli's salt, were examined in the absence and presence of HNO and NO* scavengers, K+ channel inhibition, and soluble guanylate cyclase (sGC) inhibition. In addition, the inotropic and chronotropic effects of Angeli's salt were examined in hearts at resting perfusion pressure (50-60 mm Hg) and compared to responses evoked by acetylcholine and isoprenaline. Angeli's salt causes a potent and reproducible vasodilatation in isolated perfused rat hearts. This response is unaffected by the NO* scavenger hydroxocobalamin (0.1 mM) but is significantly inhibited by the HNO scavenger N-acetyl-L-cysteine (4 mM), suggesting that HNO is the mediator of the observed responses. Vasodilatation responses to Angeli's salt were virtually abolished in the presence of the sGC inhibitor ODQ (10 microM). The magnitude of the vasodilatation response to Angeli's salt was significantly reduced in the presence of 30 mM K+, 10 microM glibenclamide and in the presence of the calcitonin gene-related peptide (CGRP) antagonist CGRP((8-37)) (0.1 microM). Angeli's salt had little effect on heart rate or force of contraction, whilst isoprenaline and acetylcholine elicited significant positive and negative cardiotropic effects, respectively. The HNO donor Angeli's salt elicits a potent and reproducible vasodilatation response. The results suggest that the response is elicited by HNO through sGC-mediated CGRP release and K(ATP) channel activation.


Reversal of multidrug resistance by Marsdenia tenacissima and its main active ingredients polyoxypregnanes.
Multidrug resistance (MDR) of cancer is often associated with the overexpression of ATP-binding cassette (ABC) transporters, such as P-glycoprotein (P-gp), multidrug resistance-associated protein-1 (MRP-1) and breast cancer resistance protein (BCRP or ABCG2), in cancer cells, which facilitates the active efflux of a wide variety of chemotherapeutic drugs out of the cells. Marsdenia tenacissima is a traditional Chinese medicinal herb that has long been clinically used for treatment of cancers, particularly in combinational use with anticancer drugs. Polyoxypregnanes (POPs) are identified as main constituents of this herb, and three of them have been reported to exhibit P-gp modulatory effect and thus reverse MDR. Therefore, it is of great necessity to investigate more POPs that have potential to reverse transporters-mediated MDR. We aimed to identify POPs as the chemical basis responsible for circumventing ABC transporters-mediated MDR by M. tenacissima. The MDR reversal effects of M. tenacissima crude extract together with a series of isolated POPs were evaluated on several MDR cancer cell lines that overexpress P-gp, MRP1 or ABCG2. The activities of P-gp, MRP1 and ABCG2 were determined by the flow cytometry-based substrate efflux assay. Molecular docking of POPs to a three-dimensional human P-gp homology structure was also performed. The crude extract of M. tenacissima was firstly found to circumvent P-gp-mediated MDR. Then, 11 polyoxypregnane compounds (POPs) isolated from this herb were found to overcome P-gp-, MRP1- and/or ABCG2-mediated MDR. Further mechanistic study delineated that the reversal of MDR by these POPs was due to significant increase in the intracellular concentrations of the substrate anticancer drugs via their inhibition of different ABC transporter-mediated efflux activities. Furthermore, molecular docking revealed that POPs with P-gp modulatory effect bound to P-gp and fitted well into the cavity between the alpha and beta subunit of P-gp via forming hydrogen bonds. In addition, several key structural determinants for inhibition of P-gp, MRP1 or ABCG2 by POPs were illustrated. Our findings advocated the rational use of M. tenacissima to enhance efficacies of conventional anticancer drugs in tumors with ABC drug transporters-mediated MDR. Furthermore, 11 POPs were found to contribute to MDR reversal effect of M. tenacissima via inhibition of different ABC efflux transporters.


Synthesis of magnetic, macro/mesoporous bioactive glasses based on coral skeleton for bone tissue engineering.
The magnetic and macro/mesoporous bioactive glasses scaffolds are synthesised successfully by the combination of coral and P123 as co-templates through an evaporation-induced self-assembly process. The prepared material can induce the precipitation of hydroxyapatite layers on their surface in SBF only within 12 h. At the same time, the material exhibited excellent super-paramagnetic and mechanical property. Furthermore, the biocompatible assessment confirmed that the obtained material presented the good biocompatibility and the enhanced adherence of HeLa cells. Herein, the novel materials are expected to have potential application for bone tissue engineering.


Meal Fatty Acids Have Differential Effects on Postprandial Blood Pressure and Biomarkers of Endothelial Function but Not Vascular Reactivity in Postmenopausal Women in the Randomized Controlled Dietary Intervention and VAScular function (DIVAS)-2 Study.
Elevated postprandial triacylglycerol concentrations, impaired vascular function, and hypertension are important independent cardiovascular disease (CVD) risk factors in women. However, the effects of meal fat composition on postprandial lipemia and vascular function in postmenopausal women are unknown. This study investigated the impact of sequential meals rich in saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), or n-6 (ω-6) polyunsaturated fatty acids (PUFAs) on postprandial flow-mediated dilatation (FMD; primary outcome measure), vascular function, and associated CVD risk biomarkers (secondary outcomes) in postmenopausal women. A double-blind, randomized, crossover, postprandial study was conducted in 32 postmenopausal women [mean ± SEM ages: 58 ± 1 y; mean ± SEM body mass index (in kg/m2): 25.9 ± 0.7]. After fasting overnight, participants consumed high-fat meals at breakfast (0 min; 50 g fat, containing 33-36 g SFAs, MUFAs, or n-6 PUFAs) and lunch (330 min; 30 g fat, containing 19-20 g SFAs, MUFAs, or n-6 PUFAs), on separate occasions. Blood samples were collected before breakfast and regularly after the meals for 480 min, with specific time points selected for measuring vascular function and blood pressure. Postprandial FMD, laser Doppler imaging, and digital volume pulse responses were not different after consuming the test fats. The incremental area under the curve (iAUC) for diastolic blood pressure was lower after the MUFA-rich meals than after the SFA-rich meals (mean ± SEM: -2.3 ± 0.3 compared with -1.5 ± 0.3 mm Hg × 450 min × 103; P = 0.009), with a similar trend for systolic blood pressure (P = 0.012). This corresponded to a lower iAUC for the plasma nitrite response after the SFA-rich meals than after the MUFA-rich meals (-1.23 ± 0.7 compared with -0.17 ± 0.4 μmol/L × 420 min P = 0.010). The soluble intercellular adhesion molecule 1 (sICAM-1) time-course profile, AUC, and iAUC were lower after the n-6 PUFA-rich meals than after the SFA- and MUFA-rich meals (P ≤ 0.001). Lipids, glucose, and markers of insulin sensitivity did not differ between the test fats. Our study showed a differential impact of meal fat composition on blood pressure, plasma nitrite, and sICAM-1, but no effect on postprandial FMD or lipemia in postmenopausal women. This trial was registered at www.clinicaltrials.gov as NCT02144454.


Clinical Significance of Wall Changes After Recanalization Therapy in Acute Stroke: High-Resolution Vessel Wall Imaging.
Owing to the excellent recanalization rate of endovascular treatment, new outcome predictors are required for patients with acute stroke, who have sufficient recanalization. In this study, the effects of recanalization therapy on occluded arteries in patients with acute stroke were investigated using high-resolution vessel wall imaging. Twenty-nine patients with stroke were included in the study. High-resolution vessel wall imaging was performed on patients with acute stroke and adequate postrecanalization results. We characterized the postrecanalization arterial wall changes as concentric enhancements and plaques and examined the associations of the postrecanalization changes with procedural factors and neurological outcomes. The most frequent high-resolution vessel wall imaging finding was concentric enhancement, which was associated with thrombectomy procedural factors such as the number of procedures and the type of device. Concentric enhancements were associated with hemorrhagic transformation, whereas plaque was not associated with procedural details. The use of high-resolution vessel wall imaging after successful recanalization can provide information about postrecanalization arterial wall changes and clinical outcomes.


Different metrics for connecting mobility and glassiness in thin films.
Data continue to accrue indicating that experimental techniques may differ in their sensitivity to mobility and glassiness. In this work the Limited Mobility (LM) kinetic model is used to show that two metrics for tracking sample mobility yield quantitatively different results for the glass transition and mobile layer thickness in systems where free surfaces are present. Both LM metrics track the fraction of material that embodies mobile free volume; in one it is relative to that portion of the sample containing any kind (mobile and dormant) of free volume, and in the other it is relative to the overall sample. Without any kind of optimization, use of the latter metric leads to semi-quantitative agreement with experimental film results, both for the mobile layer thickness and the dependence of sample glass transition temperature on film thickness. Connecting the LM predictions with experiment also produces a semi-quantitative mapping between LM model length and temperature scales, and those of real systems.


[Meta-analysis on comparison of long-term complications and quality of life between two digestive tract reconstruction techniques following total gastrectomy].
To compare the incidence of postoperative long-term complications and quality of life between two digestive tract reconstruction techniques after total gastrectomy in order to provide evidence for clinical practice. A systematic literature search was carried out to obtain studies of randomized controlled trials (RCTs) of reconstruction techniques including jejunal interposition and Roux-en-Y. Data extracted from RCTs for meta-analysis were independently assessed by two reviewers. A meta-analysis was performed by RevMan5.0 software. A total of 1628 gastric cancer cases undergoing total gastrectomy from 10 RCTs were eligible for inclusion, among whom 728 received jejunal interposition reconstruction and 954 Roux-en-Y anastomosis. As compared with Roux-en-Y anastomosis, jejunal interposition reconstruction significantly decreased the incidence of dumping syndrome (OR=0.19, 95%CI:0.11-0.34, P<0.01), increased the prognostic nutritional index (WMD=6.02, 95%CI:1.82-10.22, P<0.01), and improved the body weight postoperatively (WMD=-2.45, 95%CI:-3.81--1.71, P<0.01). Meanwhile, jejunal interposition reconstruction did not prolong operative time and hospital stay (both P>0.05). Jejunal interposition has better efficacy than Roux-en-Y in dumping syndrome and quality of life, and is a reasonable and effective digestive tract reconstruction for long-term survival of gastric cancer patients.


Adsorption of Trichoderma reesei cellulase on cellulose: experimental data and their analysis by different equations.
The adsorption of cellulase from Trichoderma reesei MCG 77 on Avicel was measured at varying cellulase (2-8 g/L) and Avicel (10-200 g/L) concentrations at pH 4.8 and 50 degrees C. Different mathematical equations were derived for the evaluation of the experimental data. The fraction of cellulase protein that can maximally be adsorbed is 0.96, and 1 g Avicel can bind maximally 0.092 g cellulase protein. The Michaelis constant for the adsorption equilibrium [cellulase] + [Avicel] right harpoon over left harpoon [cellulase Avicel] complex is between 2.0 and 2.3 . 10(-5) mol/L. This value is based on the assumption that cellulase has an average molecular weight of 48.000. The apparent molecular weight of Avicel, i.e., that amount in grams that can bind 1 mol cellulase, is 520,000. Under maximum binding the enzyme covers on Avicel a surface of 42 m(2)/g, and the occupied volume is 0.186 cm(3)/g Avicel.


Rivastigmine in the treatment of hypersexuality in Alzheimer disease.
Inappropriate sexual behaviors (ISB) represent uncommon and often misdiagnosed clinical disorders among patients with Alzheimer disease. So far, no randomized clinical trials regarding the treatment of ISB in demented people have been conducted, but available data from case series and isolated case reports suggest the efficacy of selective serotonin reuptake inhibitors (SSRIs), antipsychotics, antiandrogens, and H2-receptor antagonists. Controversial data exist on the therapeutic influence of cholinesterase inhibitors on sexual disorders. In the present article, we describe the case of an Alzheimer disease patient presenting hypersexuality, successfully treated with rivastigmine. Thus, we perform a revision of the existing literature regarding the therapeutical effect of cholinesterase inhibitors in the treatment of ISB.


[A revolution forever occulted].
In the history of the analytic movement, the application for the recognition of the S.F.P by the I.P.A. served to reveal the ideological, political and institutional imperialism inherent in Lacanism, and doubtless present in a latent state within Freudianism: the training analysis, the necessity of which has been accepted without argument since Freud, has always been led in the aim of providing an "end product" having received "the most appropriate conformation" (die geeignetste Ausbildung), and thus in an aim that is extrinsic to the process of analysis itself. Conversely, the modified habilitation procedures adopted by the A.P.F. in 1971 were guided by the idea that the "extraterritoriality" of analysis should be preserved, thus avoiding the presence of unanalysable material: the "order book" through which the institution placed its order for well "conformed" analysts with training analysts. For Freud's discovery is actually eclipsed if one accepts the idea that analysis can be "the most appropriate" (die Geeignetste) "conformation" (Ausbildung) serving to satisfy an aim that is in fact of a professional, ideological or institutional nature, and if one forgets that it is, on the contrary, a "formation" (Bildung) that is "the most proper" (die Eigenste), enabling everyone to make his own this discovery of the unconscious. The notion of training analysis no longer has any meaning within the A.P.F. This manner of operating conflicts with the commonly accepted Freudian line. It is all the more surprising to find that this fact remains unknown to the analytic movement as a whole, and the author questions himself on the reasons for this form of repression.


Exploration of triple-helical fragments: crystallization and preliminary X-ray diffraction of d(TGGCCTTAAGG).
The nonamer d(GCGAATTCG) and decamer d(GGCCAATTGG), containing one and two overhanging guanines, respectively, form G x GC triplets in their crystal packing. In order to introduce a third subsequent T x AT triplet, the decamer was further extended by one overhanging thymine residue. Two different crystal morphologies of the sequence d(TGGCCTTAAGG) were obtained by hanging-drop vapour diffusion and diffracted to 2.5 and 2.3 A resolution, respectively. However, both crystals belong to the orthorhombic space group P2(1)2(1)2(1), with similar unit-cell parameters. Therefore, the two data sets could be merged to a resolution of 2.4 A with unit-cell parameters a = 26.97, b = 41.12, c = 52.72 A.


[Azithromycin combined with pyrimethamine in the treatment of neurotoxoplasmosis, in an AIDS patient].
We report one case of successful treatment of cerebral toxoplasmosis in acquired immunodeficiency syndrome (AIDS) with azithromycin combined with pyrimethamine. Toxoplasmic encephalitis had been diagnosed on the basis of multiple lesions exhibiting ring like contrast enhancement on double contrast Computed Tomographic (CT) scan of the brain. Thereby our patient had been treated with pyrimethamine 25 mg/die, after an attack dose of 100 mg in the first day, and clindamycin 2400 mg/die, because of sulfa-drug allergy, but clindamycin had to be discontinued because of rash development. At this point azithromycin, at a dose of 1000 mg/die for 21 days and 1500 mg a week for the following 50 days of follow-up, was added to pyrimethamine. Follow-up CT scan after 20 days of treatment (10 with clindamycin+pyrimethamine and 10 with azithromycin+pyrimethamine) revealed partial resolution of the brain lesions and subsequently (after 50 and 80 days of treatment) complete resolution.


Imaging fine structures of the human trabecular meshwork in vivo using a custom design goniolens and OCT gonioscopy.
The trabecular meshwork (TM), located within the iridocorneal angle, is a target for many glaucoma treatments aimed at controlling intraocular pressure. However, structural variations between individuals are poorly understood. We propose a newly designed gonioscopic lens optimized for high-resolution imaging to image fine structures of the human TM in vivo. The body of the new lens is index-matched to the human cornea and includes a choice of two gonioscopic mirrors (59° and 63°) and matching air-spaced doublets placed on the anterior surface of the goniolens. The new design allows a diffraction-limited image plane at the iridocorneal angle structures. The goniolens design was built and then placed on the subjectś eyes coupled to the cornea with goniogel and a 3D adjustable mount. Images were obtained using a commercially available OCT device (Heidelberg Spectralis). The optical resolution was measured in a model eye as 40.32 and 45.25 cy/mm respectively for each mirror angle. In humans, dense OCT scans with minimum spacing oriented tangential to the iris and ICA were performed on 7 healthy subjects (23-73 yrs). The TM was successfully imaged in all subjects. The custom goniolens improved the contrast of the uveoscleral meshwork structures and corneoscleral meshwork revealing limbus parallel striations, not visible with previous goniolens designs. Transverse OCT images were constructed along the segmentation line, providing an enface image of the TM structures including corneoscleral beams, previously only imaged in vivo using custom adaptive optics systems.


[Acute colonic pseudo-obstruction with complication--case report].
This case report examines the surgical treatment of megacolon and its complications in a 17-year-old male patient. He was examined in the surgical emergency unit because of severe abdominal pain and absence of stool for one week. Detailed history revealed that the patient had difficulties in defecation from the early childhood. Sphincter control was not established by the age of five. During hospitalzation as a child, the diagnosis of congenital megacolon was excluded (pathohistological examination of rectal biopsy material showed normal findings). He was followed-up regulary, had stool every four to five days and few times received laxatives to relieve constipation. The patient was hospitalized at the Department of Abdominal Surgery and primarily treated with conservative methods trying to induce intestinal peristaltics. As the patient's condition worsened, Hartmann's procedure was performed (sigmoid colon resection). Postoperative recovery was successful and after nine months we established colon continuity. The patient reports for check-ups without any difficulty in defecation.


The Rorschach and diagnosis of neurotic conditions in children and adolescents: a case study.
The diagnosis of neurotic disturbance in children and adolescents can be an exceedingly complex decision given the impact of developmental and situational factors on aspects of personality organization and personality style. The potential for rapid regression, rapid development, and incomplete structuralization of personality organization and style complicates our understanding of the meaning of particular symptoms or behavior. The Rorschach offers help in sorting through these issues because it can uniquely assess aspects of personality organization, personality style, and the impact of developmental or situational factors.


[Benign maxillofacial tumours. Odontogenic tumours].
Regarding the 2004 actualization of the classification of benign odontogenic tumours published by IARC and WHO, we have reviewed our files in order to explain the new parameters established in this actualization. Histologically tree groups can be considered depending on the tissue involved: a) odontogenic epithelium with mature fibrous stroma without odontogenic ectomesenchyme, b) odontogenic epithelium with odontogenic ectomesenchyme, with or without tissue formation, and c) mesenchyme and/or odontogenic ectomesenchyme, with or without odontogenic epithelium. Every tumour appears with clinical features, radiographical and specific epidemiology data to complete the cases, in adittion to recurrences and appropriate surgical resection.


Comparative study of different enzyme immunoassays for measurement of IgM and IgA rheumatoid factors.
To compare the value of various IgM and IgA rheumatoid factor (RF) tests for the diagnosis of rheumatoid arthritis (RA). Firstly, the latex test, one global assay (for IgM, IgA, and IgG RF), six IgM, and four IgA RF assays were compared in a particularly challenging situation-that is, with 67 patients with RA, many of whom were latex negative, and 91 non-RA controls, many of whom were latex positive. More detailed evaluation followed with three IgM RF tests (two commercially available kits and one assay developed in our laboratory) and two IgA RF tests (one commercially available and one from our laboratory) in two more representative samples of rheumatological patients (146 RA and 75 non-RA controls). Diagnostic performance differed considerably between the assays. For IgM RF detection the highest sensitivity (88%) was obtained with the Diamedix kit (specificity 67%) and for IgA RF with the Inova kit (sensitivity 65%, specificity 88%). Combining one IgM and one IgA RF test improved diagnostic performance when both tests were in agreement, but at the cost of yielding 15-27% of discrepant results which did not help in ruling RA in or out. Mean concentration values differed significantly among IgM RF tests, and in most cases concentrations were not correlated. Available tests for IgM RF isotype vary in accuracy, and none is uniformly better than all the others. For IgA RF isotype, the Inova kit appears to be the best. Quantitative results cannot be compared across tests. Combination of one IgM and one IgA RF test may improve diagnostic accuracy.


Postmenopausal osteoporosis.
It is the responsibility of nurses to be informed about osteoporosis, especially about measures which may protect against rapid and early bone loss, and to share this knowledge with patients. The role of the nurse is to educate: to present known data about diet, exercise, and calcium and vitamin D supplementation. It is also appropriate to share knowledge relating to both the benefits and risks of estrogen replacement therapy. Only by being well informed will a woman be able to decide intelligently what therapy would best protect her from osteoporosis. The role of the nurse in not to advise women on what measure to choose but to give information and encouragement so women will feel confident enough to make an informed choice.


Morning levels of C-reactive protein in children with obstructive sleep-disordered breathing.
Obstructive sleep-disordered breathing is associated with cardiovascular disease in adults, and elevated C-reactive protein (CRP) has been proposed as a link between the two disorders. We hypothesized that children with sleep-disordered breathing have higher CRP values than do control subjects. CRP was measured in 39 children (mean age +/- SD: 6.9 +/- 3.2 years) without snoring (controls) and in 102 children (6.2 +/- 2.2 years) with habitual snoring who underwent polysomnography. No significant differences were found in mean CRP values between control subjects (0.12 +/- 0.16 mg/dl; n = 39) and snorers with an apnea-hypopnea index of less than 1 episode/hour (0.15 +/- 0.26; n = 18), snorers with an index of 1 or more and less than 5 (0.15 +/- 0.26; n = 54), and snorers with an index of 5 or more (0.22 +/- 0.43; n = 30; p > 0.05). There was no correlation between CRP or log-transformed CRP values and apnea-hypopnea index, respiratory movement/arousal index, Sa(O(2)) nadir, oxygen desaturation (>/= 4%) of hemoglobin index, or percentage of sleep time with saturation less than 95% (p > 0.05). Thus, findings of higher CRP values in adults with sleep-disordered breathing and correlations of these values with polysomnography indices were not confirmed in children.


Update on Diagnosis and Treatment of Adult Pulmonary Alveolar Proteinosis.
Pulmonary alveolar proteinosis (PAP) is a rare pulmonary surfactant homeostasis disorder resulting in buildup of lipo-proteinaceous material within the alveoli. PAP is classified as primary (autoimmune and hereditary), secondary, congenital and unclassifiable type based on the underlying pathogenesis. PAP has an insidious onset and can, in some cases, progress to severe respiratory failure. Diagnosis is often secured with bronchoalveolar lavage in the setting of classic imaging findings. Recent insights into genetic alterations and autoimmune mechanisms have provided newer diagnostics and treatment options. In this review, we discuss the etiopathogenesis, diagnosis and treatment options available and emerging for PAP.


Genomic characterization of carbapenem-resistant Klebsiella oxytoca complex in China: a multi-center study.
Carbapenem-resistant (CR) Klebsiella oxytoca complex can be associated with high mortality, emerging as a new threat to the public health. K. oxytoca complex is phylogenetically close to K. pneumoniae, one of most common species associated with multidrug resistance in Enterobacterale. The latest research showed that K. oxytoca is a complex of six species. Currently, the epidemiological and genomic characteristics of CR K. oxytoca complex in China are still unclear. Here, we conducted a multi-center study on 25 CR K. oxytoca complex collected from five representative regions in China. These isolates were, respectively, recovered from respiratory tract (12 cases, 48.0%), abdominal cavity (5 cases, 20.0%), blood (4 cases, 16.0%), urine tract (3 cases, 12.0%) and skin or soft tissue (1 cases, 4.0%). Among them, 32.0% (8/25) of patients infected with K. oxytoca complex had a poor prognosis. In this study, three K. oxytoca complex species were detected, namely K. michiganensis, K. oxytoca and K. pasteurii, among which K. michiganensis was the most common. Three carbapenemase genes were identified, including blaNDM-1 (10, 38.5%), blaKPC-2 (9, 34.6%) and blaIMP (6 blaIMP-4 and 1 blaIMP-8; 7, 26.9%). Subsequent multilocus sequence typing identified various sequence types (STs), among which ST43, ST92 and ST145 were relatively common. Different from the clonal dissemination of high-risk carbapenem-resistant K. pneumoniae strains, our research revealed a polyclonal dissemination characteristic of CR K. oxytoca complex in China. S1-nuclease PFGE and Southern blot experiment showed that carbapenemase genes were encoded in plasmids of different sizes. Two blaNDM-harboring plasmids were subsequently sequenced, and were characterized to be IncX3 and IncC incompatibility groups, respectively. This is the first multi-center study of CR K. oxytoca complex in China, which improved our understanding of the prevalence and antimicrobial resistance characteristics of CR K. oxytoca complex in China.


Tropical storm and hurricane recovery and preparedness strategies.
The goal of this article is to present lessons learned from the devastating effects of two specific natural disasters in Texas: Tropical Storm Allison, which flooded Houston in June 2001, and Hurricane Ike, which caused severe damage in Galveston in September 2008. When a disaster is predictable, good predisaster planning can help to save animals lives. However, as disasters are usually not predictable and tend not to follow a script, that plan needs to be easily adaptable and flexible. It should address all aspects of the program and include an evacuation strategy for the animals, data backup, and identification of emergency equipment such as generators and communication systems. Media communication must also be considered as the general public may become emotional about animal-related issues; adverse attention and public scrutiny can be expected if animals die. The psychological impact of the disaster on the lives of those it directly affects may require attention and accommodation in the postdisaster recovery period. Following an overview of each disaster we describe plans for recovery, impacts on research, business continuity programs, and planning and preparation strategies developed against future natural disasters. Long-term planning includes building design as an important factor in protecting both the animals and the research equipment. Lessons learned include successful responses, evaluation for improvements, and preparedness plans and procedures to guard against future disaster-related destruction or loss of facilities, research programs, and animal lives.


Dear Dr. Peabody.
Reading the following brief piece depends on having some knowledge of the famous essay to which it refers, Francis W. Peabody's "The Care of the Patient," published 90 years ago in the Journal of the American Medical Association (JAMA 88: 877-82). Peabody's essay was based on a talk he gave to Harvard medical students in 1925, and it was published shortly before his premature death in 1927. At the time, he was highly regarded as a consummate clinician and teacher, and in his essay, he laments problems he already saw affecting medical practice, such as the overvaluation of science relative to clinical medicine and a diminishing spirit of attentiveness to the most deeply human needs of patients. He deals in an especially astute and compassionate way with the care of patients suffering from what is now known as somatization disorder. Peabody's essay has been widely anthologized, is often an assigned reading for medical students, and has been revered by practitioners and students for almost 100 years. But times are changing . . .


Neuroimmunomodulative properties of dipeptidyl peptidase IV/CD26 in a TNBS-induced model of colitis in mice.
Causal connections between dipeptidyl peptidase IV, also known as CD26 molecule (DPP IV/CD26) and inflammatory bowel disease (IBD) have been shown, but mechanisms of these interactions are unclear. Our hypothesis was that DPP IV/CD26 could affect the neuroimmune response during inflammatory events. Therefore, we aimed to evaluate its possible role and the relevance of the gut-brain axis in a model of IBD in mice. Trinitrobenzenesulfonic acid-induced (TNBS) colitis was induced in CD26-deficient (CD26(-/-) ) and wild-type (C57BL/6) mice. Pathohistological and histomorphometrical measurements were done. Concentrations and protein expressions of DPP IV/CD26 substrates neuropeptide Y (NPY) and vasoactive intestinal peptide (VIP) were determined. Concentrations of IL-6 and IL-10 were evaluated. Investigations were conducted at systemic and local levels. Acute inflammation induced increased serum NPY concentrations in both mice strains, more enhanced in CD26(-/-) mice. Increased NPY concentrations were found in colon and brain of C57BL/6 mice, while in CD26(-/-) animals only in colon. VIP and IL-6 serum and tissue concentrations were increased in both mice strains in acute inflammation, more pronouncedly in CD26(-/-) mice. IL-10 concentrations, after a decrease in serum of both mice strains, increased promptly in CD26(-/-) mice. Decreased IL-10 concentration was found in brain of C57BL/6 mice, while it was increased in colon of CD26(-/-) mice in acute inflammation. DPP IV/CD26 deficiency affects the neuroimmune response at systemic and local levels during colitis development and resolution in mice. Inflammatory changes in the colon reflected on investigated parameters in the brain, suggesting an important role of the gut-brain axis in IBD pathogenesis.


Rack-1, GAPDH3, and actin: proteins of Myzus persicae potentially involved in the transcytosis of beet western yellows virus particles in the aphid.
Beet western yellows virus (BWYV) is a Polerovirus that relies on the aphid Myzus persicae for its transmission, in a persistent-circulative mode. To be transmitted, the virus must cross the midgut and the accessory salivary glands (ASG) epithelial barriers in a transcytosis mechanism where vector receptors interact with virions. In this paper, we report in vitro interaction experiments between BWYV and aphid components. Using the M. persicae clone from Colmar, we showed that a set of aphid polypeptides, separated by SDS-PAGE or 2D electrophoresis (2DE), can bind in vitro to purified wild type or mutant particles. Using subcellular fractionation, we showed that the 65-kDa polypeptide identified as symbionin is a soluble protein whereas the other polypeptides seem to be associated more or less strongly to the membrane. We hypothesize that three polypeptides, identified by mass spectrometry as Rack-1, GAPDH3, and actin, may be involved in the epithelial transcytosis of virus particles in the aphid vector.


Exosomes in Parkinson's Disease: Current Perspectives and Future Challenges.
Exosomes, which are lipid bilayer membrane vesicles, have been implicated as carriers of biological macromolecules. In recent years, the functions of exosomes in the spreading of pathological conversion of proteins among neurons have drawn particular attention in Parkinson's disease research. Extracellular α-synuclein is proven to be associated with exosomes in vivo and in vitro. The contents of these exosomes may be altered during the pathological and clinical processes, serving as a potential target for biomarker development in Parkinson's disease. This Review highlights the current understanding of biogenesis and pathophysiological roles of exosomes. Meanwhile, exosomes are promising delivery vehicles. Artificial exosomes can be loaded with defined therapeutically active molecules, such as drugs, small interfering RNAs, long noncoding RNAs, and proteins to the brain, ensuring the site-specific targeting strategy to the recipient cells. Therefore, we will also discuss the potential applications of exosomes in developing modified exosome-based drug carrier systems to halt the pathologic propagation of Parkinson's disease.


Perioperative Intravenous Lidocaine and Metastatic Cancer Recurrence - A Narrative Review.
Cancer is a major global health problem and the second leading cause of death worldwide. When detected early, surgery provides a potentially curative intervention for many solid organ tumours. Unfortunately, cancer frequently recurs postoperatively. Evidence from laboratory and retrospective clinical studies suggests that the choice of anaesthetic and analgesic agents used perioperatively may influence the activity of residual cancer cells and thus affect subsequent recurrence risk. The amide local anaesthetic lidocaine has a well-established role in perioperative therapeutics, whether used systemically as an analgesic agent or in the provision of regional anaesthesia. Under laboratory conditions, lidocaine has been shown to inhibit cancer cell behaviour and exerts beneficial effects on components of the inflammatory and immune responses which are known to affect cancer biology. These findings raise the possibility that lidocaine administered perioperatively as a safe and inexpensive intravenous infusion may provide significant benefits in terms of long term cancer outcomes. However, despite the volume of promising laboratory data, robust prospective clinical evidence supporting beneficial anti-cancer effects of perioperative lidocaine treatment is lacking, although trials are planned to address this. This review provides a state of the art summary of the current knowledge base and recent advances regarding perioperative lidocaine therapy, its biological effects and influence on postoperative cancer outcomes.


Reliability of the CPRS between the disciplines of psychiatry, general practice, nursing and psychology in depressed patients.
To test the reliability and robustness of the CPRS in use by different disciplines we obtained 49 pairs of ratings on depressed patients in England and Sweden during treatment. Each rater pair consisted of a psychiatrist trained as a rater plus either a psychologist, a general practitioner, or a nurse, who had not been trained as a rater. The 17 most commonly rated items in depressive illness showed good inter-rater reliability for all groups and demonstrated the robustness of the scale even in training sessions. The implications of this for future interdisciplinary research are discussed along with suggestions for the use of the CPRS for teaching purposes.


Optimization of fermentation conditions of pectin production from Aspergillus terreus and its partial characterization.
Figures of persimmons for the world's top ten persimmon producing countries are about 4000,000 tons in 2011 and are increasing every year according to FAO statistics. However, there is not any report on pectin production by microbial with persimmon peel as the source. Optimization of fermentation conditions of pectin production from Aspergillus terreus in submerged culture and partial characterization of pectin were carried out in the work. An optimum fermentation condition for pectin production was obtained through a central composite rotatable design in response surface methodology as follows: fermentation time, 30.09 h, temperature, 25.00 °C and the initial pH in the fermentation medium, 6.90, respectively and the pectin yield reached the maximal value 0.449 g/g. Persimmon peel pectin had highly methoxylated (62.51%), high galacturonic acid content (82.28%) than citrus pectin, and was classified as the highly methoxylated pectin, the results indicated that persimmon peel had potential good resources for pectin production. The investigation can make it available to utilize persimmon peel to produce high methoxyl pectin for food industry, pharmacy and cosmetic manufacture.


Cervical myelopathy due to complex Atlanto-axial malformation including partial atlantal dorsal arch aplasia in a domestic rabbit.
A 1-year-old dwarf rabbit was presented with sub-acute progressive tetraparesis. Radiography, CT and MRI revealed compressive cervical myelopathy secondary to a complex atlanto-axial malformation including partial aplasia of the atlantal dorsal arch, dens malformation, malarticulation and lateral atlanto-occipital displacement. Owners decided against surgical treatment and elected conservative treatment including analgesia with non-steroidal anti-inflammatory drugs, cage rest and physiotherapy. Within 2 months clinical signs deteriorated and the owner elected euthanasia. Subsequent necropsy confirmed imaging findings. Similar cases described in humans and dogs suggest that partial aplasia of the dorsal arch of the atlas might often be an asymptomatic radiologic finding in these species. In contrast, this first description of a similarly affected rabbit demonstrates that complex atlanto-axial malformations can cause severe clinical signs.


Safety and severity of accelerations delivered from whole body vibration exercise devices to standing adults.
Whole body vibration devices are used as a means to augment training, and their potential to treat a range of musculoskeletal diseases and injuries is now being considered. The goal of this work is to determine the degree to which acceleration delivered by whole body vibration devices at the plantar surfaces of a standing human is transmitted through the axial and appendicular skeleton, and how this mechanical challenge corresponds to the safety threshold limit values established by the International Standards Organization ISO-2631. Non-blinded laboratory assessment of a range of whole body vibration devices as it pertains to acceleration transmission to healthy volunteers. Using skin and bite-bar mounted accelerometers, transmissibility to the tibia and cranium was determined in six healthy adults standing on a programmable whole body vibration device as a function of frequency and intensity. Measures of transmissibility were then made from three distinct types of whole body vibration platforms, which delivered a 50-fold range of peak-to-peak acceleration intensities (0.3-15.1 gp-p; where 1g is Earth's gravitational field). For a given frequency, transmissibility was independent of intensity when below 1g. Transmissibility declined non-linearly with increasing frequency. Depending on the whole body vibration device, vibration ranged from levels considered safe by ISO-2631 for up to 8h each day (0.3 gp-p @ 30 Hz), to levels that were seven times higher than what is considered a safe threshold for even 1 min of exposure each day (15.1 gp-p @ 30 Hz). Transmissibility to the cranium was markedly attenuated by the degree of flexion in the knees. Vibration can have adverse effects on a number of physiologic systems. This work indicates that readily accessible whole body vibration devices markedly exceed ISO guidelines for safety, and extreme caution must be practiced when considering their use.


Gastrointestinal transit through esophagus, stomach, small and large intestine in patients with progressive systemic sclerosis.
Liquid esophageal transit and gastric emptying, mouth-to-cecum transit, and whole gut transit of a solid-liquid meal were measured in 14 patients with PSS, 16 control subjects (esophageal transit), and 20 control subjects (gastrointestinal transit), respectively, by using scintigraphic techniques, the hydrogen breath test, and stool markers. In patients with PSS, the glucose hydrogen breath test for detection of small intestinal overgrowth was performed and various gastrointestinal symptoms were determined. Esophageal transit and gastric emptying were significantly prolonged in PSS patients with 11 of 14 PSS patients (79%) disclosing delayed esophageal transit and eight of 14 PSS patients (57%) disclosing delayed gastric emptying. All PSS patients with prolonged gastric emptying also had delayed esophageal transit and there was a significant positive correlation between esophageal transit and gastric emptying (r = 0.696, P < 0.01). No significant differences between PSS patients and controls were detected concerning mouth-to-cecum transit and whole gut transit, but abnormally delayed mouth-to-cecum transit was found in four of 10 PSS patients (40%) and abnormally prolonged whole gut transit was detected in three of 13 PSS patients (23%). Small bacterial overgrowth was diagnosed in three of 14 PSS patients (21%). Delayed esophageal transit and gastric emptying were associated with dysphagia, retrosternal pain, and epigastric fullness, while prolonged whole gut transit was associated with constipation. It is concluded that delayed gastric emptying is frequently associated with esophageal transit disorders in PSS patients and may be one important factor for the development of gastroesophageal reflux disease in these patients.


Recognition advantage of happy faces: tracing the neurocognitive processes.
The present study aimed to identify the brain processes-and their time course-underlying the typical behavioral recognition advantage of happy facial expressions. To this end, we recorded EEG activity during an expression categorization task for happy, angry, fearful, sad, and neutral faces, and the correlation between event-related-potential (ERP) patterns and recognition performance was assessed. N170 (150-180 ms) was enhanced for angry, fearful and sad faces; N2 was reduced and early posterior negativity (EPN; both, 200-320 ms) was enhanced for happy and angry faces; P3b (350-450 ms) was reduced for happy and neutral faces; and slow positive wave (SPW; 700-800 ms) was reduced for happy faces. This reveals (a) an early processing (N170) of negative affective valence (i.e., angry, fearful, and sad), (b) discrimination (N2 and EPN) of affective intensity or arousal (i.e., angry and happy), and (c) facilitated categorization (P3b) and decision (SPW) due to expressive distinctiveness (i.e., happy). In addition, N2, EPN, P3b, and SPW were related to categorization accuracy and speed. This suggests that conscious expression recognition and the typical happy face advantage depend on encoding of expressive intensity and, especially, on later response selection, rather than on the early processing of affective valence.


Structural studies and anticancer activity of a novel class of β-peptides.
Functionalized oligomeric organic compounds with well-defined β-proline scaffold have been synthesized by a cycloadditive oligomerization approach in racemic and enantiopure forms. The structure of the novel β-peptides was investigated by NMR spectroscopic and X-ray methods determining the conformational shapes of the β-proline oligomers in solution and solid states. The main structural elements subject to conformational switches are β-peptide bonds between 5-arylpyrrolidine-2-carboxylic acid units existing in Z/E configurations. The whole library of short β-peptides and intermediate acrylamides has been tested on antiproliferative activity towards the hormone-refractory prostate cancer cell line PC-3 revealing several oligomeric compounds with low micromolar and submicromolar activities. Bromine-substituted dimeric and trimeric acrylamides induced caspase-dependent apoptosis of PC-3 cells through cell-cycle arrest and mitochondrial damage.