Spectral tissue sensing to identify intra- and extravascular needle placement - A randomized single-blind controlled trial.
Safe vascular access is a prerequisite for intravenous drug admission. Discrimination between intra- and extravascular needle position is essential for procedure safety. Spectral tissue sensing (STS), based on optical spectroscopy, can provide tissue information directly from the needle tip. The primary objective of the trial was to investigate if STS can reliably discriminate intra-vascular (venous) from non-vascular punctures. In 20 healthy volunteers, a needle with an STS stylet was inserted, and measurements were performed for two intended locations: the first was subcutaneous, while the second location was randomly selected as either subcutaneous or intravenous. The needle position was assessed using ultrasound (US) and aspiration. The operators who collected the data from the spectral device were blinded to the insertion and ultrasonographic visualization procedure and the physician was blinded to the spectral data. Following offline spectral analysis, a prediction of intravascular or subcutaneous needle placement was made and compared with the "true" needle tip position as indicated by US and aspiration. Data for 19 volunteers were included in the analysis. Six out of 8 intended vascular needle placements were defined as intravascular according to US and aspiration. The remaining two intended vascular needle placements were negative for aspiration. For the other 11 final needle locations, the needle was clearly subcutaneous according to US examination and no blood was aspirated. The Mann-Whitney U test yielded a p-value of 0.012 for the between-group comparison. The differences between extra- and intravascular were in the within-group comparison computed with the Wilcoxon signed-rank test was a p-value of 0.022. In conclusion, STS is a promising method for discriminating between intravascular and extravascular needle placement. The information provided by this method may complement current methods for detecting an intravascular needle position.


Decreased motor unit number estimates in juvenile myoclonic epilepsy.
In this study, motor unit number estimate (MUNE) analysis with McComa's technique was used to detect any change in lower motor neuron count in juvenile myoclonic epilepsy (JME). The study included 10 JME patients, 8 idiopathic generalized epilepsy (IGE) patients, 7 patients with mesial temporal sclerosis (MTS), and 15 normal subjects. All the patients and normal subjects were subjected to MUNE analysis on the abductor pollicis brevis and tibialis anterior muscles, as well as needle electromyography and nerve conduction studies. Electromyographic and nerve conduction studies were normal in all groups. MUNEs in the JME group and were significantly lower than those of normal subjects (P < 0.001). MUNEs of IGE and MTS patients also tended to be lower than that of normal subjects with no significant difference from normal subjects. MUNEs of abductor pollicis brevis and tibialis anterior muscles were 114 +/- 24 and 90 +/- 15 for normal subjects, 59 +/- 18 and 50 +/- 23 for JME patients, 91 +/- 22 and 75 +/- 19 for IGE patients, and 84 +/- 42 and 80 +/- 29 for MTS patients respectively. It may be reasonable to suggest that a genetic origin is responsible for a tendency to contract epilepsy, and the disorganization of lower motor neurons may be shared in JME.


Gas- and Particle-Phase Products from the Chlorine-Initiated Oxidation of Polycyclic Aromatic Hydrocarbons.
The chlorine atom (Cl)-initiated oxidation of three polycyclic aromatic hydrocarbons (PAHs; namely, naphthalene, acenaphthylene, and acenaphthene) was investigated. Experiments were performed in an atmospheric simulation chamber using a proton transfer reaction time-of-flight mass spectrometer (TOF-MS) and an aerosol TOF-MS to characterize the oxidation products in the gas and particle phases, respectively. The major products identified from the reaction of Cl atoms with naphthalene were phthalic anhydride and chloronaphthalene, indicating that H atom abstraction and Cl addition reaction pathways are both important. Acenaphthenone was the principal product arising from reaction of Cl with acenaphthene, while 1,8-naphthalic anhydride, acenaphthenone, acenaphthenequinone, and chloroacenaphthenone were all identified as products of acenaphthylene oxidation, confirming that the cylcopenta-fused ring controls the reactivity of these PAHs toward Cl atoms. Possible reaction mechanisms are proposed for the formation of these products, and favored pathways have been suggested. Large yields of secondary organic aerosol (SOA) were also observed in all experiments, and the major products were found to undergo significant partitioning to the particle-phase. This work suggests that Cl-initiated oxidation could play an important role in SOA formation from PAHs under specific atmospheric conditions where the Cl atom concentration is high, such as the marine boundary layer.


Prospective Evaluation of Sleep Apnea as Manifestation of Heart Failure in Children.
In adults with heart failure, central sleep apnea (CSA), often manifested as Cheyne-Stokes respiration, is common, and has been associated with adverse outcome. Heart failure in children is commonly caused by dilated cardiomyopathy (DCM). It is unknown whether children with heart failure secondary to DCM have CSA, and whether CSA is related to the severity of heart failure. In this prospective observational study, 37 patients (<18 year) with heart failure secondary to DCM were included. They underwent polysomnography, clinical and laboratory evaluation and echocardiographic assessment. After a median follow-up time of 2 years, eight patients underwent heart transplantation. CSA (apnea-hypopnea index [AHI] ≥1) was found in 19 % of the patients. AHI ranged from 1.2 to 4.5/h. The occurrence of CSA was not related to the severity of heart failure. Three older patients showed a breathing pattern mimicking Cheyne-Stokes respiration, two of whom required heart transplantation. CSA was found in 19 % of the children with heart failure secondary to DCM. No relation was found with the severity of heart failure. In a small subset of children with severe DCM, a pattern mimicking Cheyne-Stokes respiration was registered.


[RISK GROUPS FOR TUBERCULOSIS IN JAPAN: ANALYSIS OF RELATIVE RISK AND POPULATION ATTRIBUTABLE FRACTION].
Despite the decreasing trend in tuberculosis (TB) cases reported within the general population, TB incidence remains high in certain high-risk groups in Japan. Many of the previous discussions and studies have concentrated mainly on the elderly and those with clinical risks; however, no comprehensive evaluation has been conducted to date. Our study thus sought to estimate the relative risk (RR) and the population attributable fraction (PAF) of selected risk groups in Japan and discuss their relevance to programming future research needs and policies. PAF and RR were calculated for patients with human immunodeficiency virus infection, diabetes, rheumatoid arthritis, those on dialysis, the elderly, health care workers, the homeless, people receiving public assistance, foreigners, prisoners, smokers, and those with alcohol problems, and were grouped into "high PAF" (PAF ≥ 5%), "middle PAF" (5% > PAF ≥ 1%), and "low PAF" (PAF < 1%) groups. The elderly and patients with diabetes showed the highest PAF and RR and should thus be prioritized for policies.


Development and preliminary validation of the Postpartum Psychotic Experiences Scale (PPES).
Despite the emerging research interest in postpartum psychotic experiences, there is still a lack of measures for specifically measuring this construct. The contribution of this paper is to design and validate a novel self-report measure, the Postpartum Psychotic Experiences Scale (PPES), to screen for attenuated psychotic symptoms during postpartum. This cross-sectional study was conducted from September 2022 until June 2023, enrolling 438 women 4-6 weeks after delivery. Starting from an initial pool of 22 items, both Exploratory Factor Analysis and Confirmatory Factor Analysis suggested that remaining 15 items loaded on one factor (α = 0.95). The PPES showed good convergent validity with the Prodromal Questionnaire-Brief scale (correlations >0.8) and good concurrent validity with postpartum depression and anxiety scales. A PPSE score of 8.5 (sensitivity=85.2%, specificity=78.6%) was defined as the optimal cutoff point. At this cutoff, 47% of participating women were considered at possible risk for postpartum psychosis. This study provides, for the first time, a specific self-report measure to assess postpartum PEs reliably and validly. We hope that the PPES will facilitate routine screening for PEs after childbirth among women who are predisposed to developing postpartum psychosis.


[Primary retroperitoneal tumor--extraadrenal paraganglioma--a case review].
Primary retroperitoneal tumors are extremely rare tumors of this location. The authors present a case review of a 53-year-old patient operated for unexplained retroperitoneal neoplasm. No complications were recorded during the postoperative course and histology demonstrated extraadrenal paraganglioma structures, ranked among the above neoplasms. Preoperative hypertension subsided postoperatively, following the active neuroendocrinne tumor removal. The aim of this work is to present clinical and histopathological characteristics of this rare retroperitoenal neoplasm.


Cross-reactivity between halogenated platinum salts in an immediate-type respiratory hypersensitivity model.
Halogenated platinum salts can trigger the development of occupational asthma. Until recently, laboratory research into the development and manifestation of platinum hypersensitivity responses were hindered by the lack of an animal model suitable for assessing the functional consequences of allergic sensitization. We employed a newly developed mouse model to assess the potential allergenicity of ammonium tetrachloroplatinate (ATCP), compare the relative potency of ATCP and another platinum salt, ammonium hexachloroplatinate (AHCP) and assess potential cross-reactivity. Mice were topically sensitized with ATCP before being challenged by intratracheal aspiration (IA) with ATCP. Ventilatory responses were assessed using whole-body plethysmography (WBP). An immediate response (IR) was observed in ATCP-sensitized and challenged mice. Two days later, responsiveness to the nonspecific stimuli methacholine (Mch) was detected in ATCP-sensitized mice using WBP. Bronchoalveolar lavage fluid collected from sensitized mice contained an average of 3.3% eosinophils compared to less than 0.5% in non-sensitized mice (p<.05). Serum harvested from sensitized mice also contained increased total serum immunoglobulin E (p<.05). These data are the first to demonstrate that topical exposure to ATCP is sufficient to develop immediate type hypersensitivity and that a single intra-airway challenge is capable of triggering pulmonary responses. To investigate potential cross-reactivity, mice were sensitized to AHCP and, challenged by a single IA with a second platinum compound, ATCP. Compared to non-sensitized mice challenged with ATCP, these mice exhibited an IR, responsiveness to Mch, and eosinophilic infiltration in the lungs similar to that achieved with AHCP challenge, thus demonstrating cross-reactivity.


GPs' experiences of phosphatidylethanol in treatment of hypertension: a qualitative study.
Hazardous alcohol use increases the risk of hypertension but is underdetected in primary healthcare (PHC) patients. Use of the biomarker phosphatidylethanol (PEth), which reflects the last 2-3 weeks of alcohol consumption, is increasing in Swedish PHC, but studies exploring its use for hypertension are scarce or missing. To explore GPs' experiences of using PEth to identify hazardous alcohol use in the context of managing hypertension. A qualitative study of GPs (n = 12) experienced in using PEth in hypertension management who were recruited at Swedish primary healthcare centres (PHCC) in 2021. The GPs participated in five focus group interviews. A questioning route was used. The interviews were audio-recorded, transcribed verbatim, and analysed with inductive qualitative content analysis. 'I don't hesitate anymore' was the overall theme, which reflected both the disappearance of GPs' fear that the PEth result might upset the patient, as this rarely occurred, and that the positive effects of PEth predominated in the findings. The theme is underpinned by the following four sub-themes: serving as an eye-opener; improving the dialogue; using with care; and learning by doing. PEth is a useful tool that changed GPs' routines for addressing alcohol and identifying hazardous alcohol use in patients with hypertension managed in PHC. The GPs advocated adopting PEth as a routine test in the treatment of hypertension. However, PEth needs to be used with care to maximise benefit and minimise harm.


Autoxidation kinetic analysis of docosahexaenoic acid ethyl ester and docosahexaenoic triglyceride with oxygen sensor.
The application of omega-3 polyunsaturated fatty acids (PUFAs) as food additives is restricted by their chemically quite reactive properties. However, quantitative analyses of the oxidative kinetics of PUFAs are very few compared to other studies on food chemistry. In this study, the autoxidation kinetics of ethyl docosahexaenoate (DHAEE), docosahexaenoic triglyceride (DHA oil), and emulsified DHA oil were investigated with an oxygen sensor. The autocatalytic reaction rate constants for DHAEE, DHA oil, and the emulsified DHA oil with 20% (w/v) GA, 20% SSPS, or 20% SSPS containing 5% soy protein were obtained at 35, 50, and 70 degrees C. A plot of the natural logarithm of the frequency factor, In ka0, vs. the activation energy, Ea, demonstrated that In ka0 against Ea fitted well with a single straight line both for the data from this study and for other reported results. This implies that the chemical compensation relationship holds between ka0 and Ea for PUFA and emulsified DHA oil.


Application of 128-slice spiral CT combination scanning in the diagnosis of embolisms in pulmonary arteries and lower extremity veins.
The aim of this study was to evaluate the significance of using multi-row spiral computed tomography (CT) to scan for pulmonary artery thrombosis and lower limb deep vein thrombosis (LVT) in patients with suspected LVT. A total of 110 patients underwent a contrast-enhanced spiral CT inspection of the pulmonary artery and lower extremity veins. Three-dimensional digital image processing, including multi-planar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR), was also conducted; two groups of experienced radiologists analyzed the CT images to evaluate the postprocessing techniques of these CT images. Seventy-five patients were diagnosed with LVT with or without pulmonary embolism (PE); out of these 75, 34 patients were diagnosed with PE and LVT together and 41 patients were diagnosed with LVT alone. A further 31 patients were diagnosed with iliac vein compression syndrome (IVCS), and no embolisms were detected in the remaining four patients. With regard to PE, MPR and MIP demonstrated an accuracy of 100%, while MPR also showed images of LVT with an accuracy of 100%. The follow-up results at 12 months were consistent with the CT scan results. The clinical use of 128-slice spiral CT combination scanning in the detection of PE and LVT has significant potential to improve upon the present methods of diagnosis.


[Individual resistance card in health care for patients with urogenital diseases].
Currently, practical health care does not have a means to transfer patients health data when they change the place of residence and employment. In this regard, there was a need to develop a health-related instrument to accompany an individual when he/she changes the place of residence and work. The aim of the study was to develop an "individual resistance card" to use in health care for patients with diseases of the genitourinary system. We developed an "individual resistance card" proposed to implement in the practice of health care, as an information document on the state of reactivity and resistance (health) of the organism in terms of urologic diseases. The degree (index) of relative organism resistance is calculated based on impaired individual reactivity and power (intensity) of the environmental pathogenic factors. Its application allows for significant improvement in the effectiveness of periodic health checks, primary and secondary prevention of diseases, because it takes into account both a primary (genotypic) and secondary (acquired) reactivity. The developed Card can be used to record the state of the organism reactivity and resistance regarding urologic diseases and monitor these indicators when the patients change the place of residence and employment. This e-card (in encrypted form) and paper versions may accompany the individuals throughout their lives and will be used for to effectively organize primary and secondary disease prevention by a general practitioner and an urologist.


Where next for partial randomisation of research funding? The feasibility of RCTs and alternatives.
We outline essential considerations for any study of partial randomisation of research funding, and consider scenarios in which randomised controlled trials (RCTs) would be feasible and appropriate. We highlight the interdependence of target outcomes, sample availability and statistical power for determining the cost and feasibility of a trial. For many choices of target outcome, RCTs may be less practical and more expensive than they at first appear (in large part due to issues pertaining to sample size and statistical power). As such, we briefly discuss alternatives to RCTs. It is worth noting that many of the considerations relevant to experiments on partial randomisation may also apply to other potential experiments on funding processes (as described in The Experimental Research Funder's Handbook. RoRI, June 2022).


Genetics of arrhythmogenic right ventricular cardiomyopathy.
Recent advances in molecular genetics of arrhythmogenic right ventricular cardiomyopathy (ARVD) are reviewed. In particular, the finding of mutations in the gene coding for cardiac ryanodine receptor (hRYR2), both in patients affected with ARVD2 and in patients affected with catecholaminergic ventricular arrhythmias or with familial ventricular tachyarrhythmia, is discussed. Novel data support the hypothesis that apoptosis may be a key step in molecular pathogenesis of ARVDs. A series of studies on drugs with apparent protective effect against apoptosis in myocardial cells might open new perspectives in the therapeutic approach.


Effect of Various Degrees of Chronic Kidney Disease on Long-term Outcome of Patients with Percutaneous Coronary Intervention.
We aimed to identify the association of degree of renal failure in chronic kidney disease patients who underwent percutaneous coronary intervention (PCI) at our center with 5-year major adverse cardiac events (MACE). In this cohort study, we enrolled all patients who underwent primary or elective PCI and completed their 5-year followup unless they developed events related to study end-points. Demographic, angiographic and clinical data of the participants were retrieved from our databank. Glomerular filtration rate (GFR) was calculated based on the Cockcroft-Gault equation for men and women, separately. Accordingly, our patients were classified into three groups: GFR ≥ 60, GFR < 60 and ≥30 and GFR < 30 mL/ min. Then, the demographic and clinical data, as well as the frequency of MACE and its elements, were compared between the study groups. We included the data for 5,510 patients. MACE occurred in 891 (16.1%) of the patients. A total of 632 cases (16.7%) occurred in patients with GFR > 60 while 224 cases (18.8%) and 35 events (43.7%) occurred in patients with 30 ≤ GFR < 60 and GFR < 30 mL/min, respectively. So, GFR < 30 mL/min was significant predictor for MACE (hazard ratio [HR] = 3.74, 95% CI: 2.64-5.28; P < 0.001). The prediction effect of GFR < 30 remained significant after adjustment for the confounding variables (HR = 3.43, 95% CI: 2.38-4.94; P < 0.001). GFR <30 mL/min was a strong predictor for 5-year MACE. Moreover, in patients with GFR > 30 mL/min, PCI is a more applicable approach.


SNAI2-Induced CircMTO1 Promotes Cell Proliferation and Inhibits Apoptosis Through the miR-320b/MCL1 Axis in Human Granulosa-Like Tumor Cells.
Polycystic ovary syndrome (PCOS), one of the most common types of endocrine diseases, is characterized by a high prevalence among women of reproductive-age. However, its pathogenesis and molecular mechanisms remain unclear. CircMTO1 has been reported to participate in numerous biological processes, but, its role in PCOS progression remains unknown. In the current study, we elucidated the expression and circRNA characterization of circMTO1 in human granulosa-like tumor cells. We found that circMTO1 knockdown promoted human granulosa-like tumor cell proliferation and inhibited its apoptosis rate. Next, we explored the underlying molecular mechanisms by using a series of experiments. Our results revealed the effect of the novel circMTO1/miR-320b/MCL1 axis in human granulosa-like tumor cells. Furthermore, we found that the expression of circMTO1 was induced by Snail family transcriptional repressor 2 (SNAI2) in human granulosa-like tumor cells. Our results may provide potential targets for PCOS research and a novel direction for the diagnosis and treatment of PCOS.


Hemilabile Amine-Functionalized Efficient Azo-Aromatic Cu-Catalysts Inspired by Galactose Oxidase: Impact of Amine Sidearm on Catalytic Aerobic Oxidation of Alcohols.
A series of azo-aromatic copper(II) complexes, [1a-g] and a Cu(I) complex, [1h], with varying amine-functionalized hemilabile pincer-like [HL1-3] and [L1,2], methyl-substituted azo [L3], and imine [L4] ligands, were synthesized and characterized. These complexes were investigated for aerobic oxidation of a variety of aromatic alcohols in the presence of 2.0 mol % precatalysts [1a-g], cobaltocene (2.0 mol %), N-methyl imidazole (NMI) (8.0 mol %), and TEMPOH (2.0 mol %) at room temperature. The Cu(I) complex (1h) acted as a catalyst in the absence of cobaltocene. To understand the mechanism, detailed experimental and theoretical studies have been performed with the representative complex [1a], which has suggested a new kind of mechanism involving a Cu(II)/Cu(I) redox couple. Cobaltocene acts as a reductant to [1a] to generate a Cu(I) complex, which activates dioxygen in the presence of NMI. TEMPOH transfers a hydrogen atom to the activated dioxygen with the generation of TEMPO•, which further participates in α-C-H bond activation in the Cu(II)-alkoxide intermediate in an intermolecular fashion in the catalytic cycle. The amine sidearm in the ligand backbone of the complexes has a significant role in catalytic activity. Complexes with amine sidearms are more effective than complexes without them. Moreover, the aliphatic secondary amine sidearm is more efficient among the amine sidearm than the aromatic secondary amine and tertiary amines. The amine sidearm that remained coordinated to the Cu(II) center is hemilabile, and it facilitates alcohol coordination in the catalytic process. Alcohol coordination was the rate-limiting step, and it was supported by the isotope effect study on benzyl alcohol, substitution effect on the amine moiety of the ligands, and DFT calculation. The hemilabile amine sidearm of the coordinated ligand also acted as a base in deprotonating the alcoholic O-H proton and acted as an acid in releasing H2O2 during the catalysis.


Pain and functional outcomes following vertebroplasty for vertebral compression fractures - A tertiary centre experience.
There is a dearth of comparative outcome data on vertebroplasty for the treatment of vertebral compression fractures (VCF) according to vertebral level, the number of levels and aetiology. The aim of this study was to investigate the improvement of pain and function following vertebroplasty for a heterogeneous cohort of patients with medically refractory VCF. A prospective observational study was conducted on a cohort of consecutive patients undergoing vertebroplasty following at least 4 weeks of failed medical management, between April 2007 and March 2012 at a single neurosurgical centre. Pain visual analogue scale (VAS) scores, Oswestry Disability Index (ODI) scores, analgesic usage and complications were recorded preoperatively and at day 1, week 1, 1 month, 6 months and 1 year postoperatively. Intraoperative vertebral body biopsy was performed routinely. Two hundred and two levels were augmented in 147 patients. The most common levels augmented were T12 (17%), L1 (18%) and L4 (10%). Significant reductions in pain VAS and ODI scores were evident at day 1 and sustained at up to 1 year postoperatively (p < 0.001). They were not dependent on the level of fracture (T3-10, T11-L2 and L3-S1) (p > 0.05), the number of levels treated (single level, two-level and > two level) (p > 0.05) or aetiology of VCF (p > 0.05). At 1 year postoperatively, 79% (113/142) had no or reduced analgesic usage. The complication rate was 6% (9/147). There were five mortalities, none of which was directly related to surgery. Vertebroplasty for medically refractory VCF may offer sustained improvement in pain and function. The procedure is associated with low morbidity and mortality.


Transgenic mice for conditional gene manipulation in astroglial cells.
Astrocytes are thought to exert diverse functions in the brain, but it has been difficult to prove this in vivo because of a scarcity of tools to manipulate these cells. Here, we report the generation of new transgenic mouse lines that allow for conditional gene ablation in astrocytes using the tamoxifen- (TAM-) inducible CreER(T2)/loxP system and bacterial artificial chromosome (BAC)-based transgenesis. In adult transgenic mice, where CreER(T2) expression is driven by the promoter of the sodium-dependent glutamate/aspartate transporter (Glast/Slc1a3) or of connexin 30 (Cx30/Gjb6), intraperitoneal TAM-injection induced Cre-mediated recombination in astroglial cells throughout the brain. Targeting efficacies varied in a region-specific manner from 20 to 90% as indicated by enzyme-based reporter lines and immunohistochemical staining. In addition, the Glast-line allowed to target retinal Müller cells and adult neural stem/progenitor cells in neurogenic regions of the adult brain. Transgenic mice expressing CreER(T2) under the control of the apolipoprotein e (ApoE) or aquaporin 4 (Aqp4) promoter showed inducible recombination in different areas of the central nervous system (CNS) albeit at low levels. Transgenic lines showed TAM-induced recombination in specific peripheral organs. These new mouse lines should help to further explore the relevance of astrocytes for brain function, as well as their contribution to pathological conditions because of aging, disease or injury.


How do distinct facets of tree diversity and community assembly respond to environmental variables in the subtropical Atlantic Forest?
This study assessed the impact of altitude, precipitation, and soil conditions on species richness (SR), phylogenetic diversity (PD), and functional diversity (FD) standardized effect sizes in subtropical Brazilian Atlantic Forest tree communities. We considered specific trait information (FDs) for FD, reflecting recent adaptive evolution, contrasting with deeper phylogenetic constraints in FD. Three functional traits (leaf area-LA, wood density-WD, and seed mass-SM) were examined for their response to these gradients. Generalized least squares models with environmental variables as predictors and diversity metrics as response variables were used, and a fourth-corner correlation test explored trait-environmental relationships. SR decreased with altitude, while PD increased, indicating niche convergence at higher altitudes. Leaf area and seed mass diversity also decreased with altitude. For LA, both FD and FDs were significant, reflecting filtering processes influenced by phylogenetic inheritance and recent trait evolution. For SM, only the specific trait structure responded to altitude. LA and SM showed significant trait-environmental relationships, with smaller-leaved and lighter-seeded species dominant at higher altitudes. Soil gradients affect diversity. Fertile soils have a wider range of LA, indicating coexistence of species with different nutrient acquisition strategies. WD variation is lower for FDs. SM diversity has different relationships with soil fertility for FDs and FD, suggesting phylogeny influences trait variation. Soil pH influences WD and LA under acidic soils, with deeper phylogenetic constraints (FD). Environmental factors impact tree communities, with evidence of trait variation constraints driven by conditions and resources. Subtropical Atlantic forests' tree assemblies are mainly influenced by altitude, pH, and soil fertility, selecting fewer species and narrower trait spectra under specific conditions (e.g., higher altitudes, pH). Functional diversity patterns reflect both phylogenetic and recent evolution constraints, with varying strength across traits and conditions. These findings highlight the intricate processes shaping long-lived species assembly across diverse environments in the Southern Brazilian Atlantic Forest.


Comparative Evaluation of Metallic and Biodegradable Suture Anchors in Arthroscopic Repair of Anterior Talofibular Ligament Injury: A Short-term Study on Clinical and Functional Outcomes.
BACKGROUND With the development of arthroscopy and suture anchor, the modified Brostrӧm technique has made remarkable progress. However, it is unclear which material is most suitable for treating anterior talofibular ligament injury (ATFL). This study evaluated the short-term efficacy of 2 suture anchors (metal vs biodegradable materials) in arthroscopic ATFL repair. MATERIAL AND METHODS From January 2018 to December 2019, 82 patients with ankle disorders (51 men and 31 women) with ATFL injury received arthroscopic repair with suture anchor through the Brostrӧm-Gould procedure. The mean age was 38.70±9.35 years (range, 18-54 years). Each patient was followed up. American Orthopedic Foot and Ankle Society score (AOFAS), Karlsson Ankle Functional Score (KAFS), and the Visual Analogue Scale (VAS) were used to evaluate functional status and pain. RESULTS All patients were followed up for 21.21±2.19 months (range, 18-25 months). No complications were found either group. Preoperative clinical and functional scores in both groups had no significant difference (P>0.05). The functional score increased significantly in both groups (P<0.001). At the last follow-up, the mean AOFAS score was 93.00 (90.00, 96.00) in the Biodegradable group and 93.50 (91.00, 96.00) in the Metallic group (P=0.31). The mean KAFS score was 91.50 (85.00, 95.00) in the Biodegradable group and 93.00 (90.00, 95.50) in the Metallic group (P=0.10); the mean VAS score was 1.50 (1.00, 1.80) in the Biodegradable group and 1.30 (0.98, 1.70) in the Metallic group (P=0.22). CONCLUSIONS Arthroscopic repair of ATFL injury with suture anchors can improve the prognosis of CAI. There were no statistically significant differences in clinical and functional outcomes with metal or biodegradable suture anchors at short-term follow-up.


Constitutively active rhodopsin mutants causing night blindness are effectively phosphorylated by GRKs but differ in arrestin-1 binding.
The effects of activating mutations associated with night blindness on the stoichiometry of rhodopsin interactions with G protein-coupled receptor kinase 1 (GRK1) and arrestin-1 have not been reported. Here we show that the monomeric form of WT rhodopsin and its constitutively active mutants M257Y, G90D, and T94I, reconstituted into HDL particles are effectively phosphorylated by GRK1, as well as two more ubiquitously expressed subtypes, GRK2 and GRK5. All versions of arrestin-1 tested (WT, pre-activated, and constitutively monomeric mutants) bind to monomeric rhodopsin and show the same selectivity for different functional forms of rhodopsin as in native disc membranes. Rhodopsin phosphorylation by GRK1 and GRK2 promotes arrestin-1 binding to a comparable extent, whereas similar phosphorylation by GRK5 is less effective, suggesting that not all phosphorylation sites on rhodopsin are equivalent in promoting arrestin-1 binding. The binding of WT arrestin-1 to phospho-opsin is comparable to the binding to its preferred target, P-Rh*, suggesting that in photoreceptors arrestin-1 only dissociates after opsin regeneration with 11-cis-retinal, which converts phospho-opsin into inactive phospho-rhodopsin that has lower affinity for arrestin-1. Reduced binding of arrestin-1 to the phospho-opsin form of G90D mutant likely contributes to night blindness caused by this mutation in humans.


Detection of nitric oxide and nitroxyl with benzoresorufin-based fluorescent sensors.
A new family of benzoresorufin-based copper complexes for fluorescence detection of NO and HNO is reported. The copper complexes, CuBRNO1-3, elicit 1.5-4.8-fold emission enhancement in response to NO and HNO. The three sensors differ in the nature of the metal-binding site. The photophysical properties of these sensors are investigated with assistance from density functional theory calculations. The fluorescence turn-on observed upon reaction with HNO is an unexpected result that is discussed in detail. The utility of the new sensors for detecting HNO and NO in HeLa cells and RAW 264.7 macrophages is demonstrated.


Right-Side Acquired Diaphragmatic Hernia in an Adult 15 Years After Living Donor Liver Transplant.
Cases of adult liver transplant recipients with a postoperative right-side acquired diaphragmatic hernia are extremely rare. In this report, we describe an adult case of right-side acquired diaphragmatic hernia 15 years after living donor liver transplant. A 27-year-old woman was diagnosed with pancreatic insulinoma with multiple metastases in the liver. To treat the liver failure, she underwent left lobe living donor liver transplant and distal pancreatectomy with splenectomy 3 years after the transcatheter arterial chemoembolization. As a result of the liver abscesses that reached the diaphragm, the delicate diaphragm was injured, which required repair during the transplant surgery. At the age of 46 years, she developed a cough and intermittent abdominal pain. One month later, she went to another hospital's emergency room with complaints of epigastric pain. The computed tomography scan revealed colon and small intestine prolapse into the right thoracic cavity. She was referred to our hospital and underwent surgery the next day. Two adjacent right diaphragm defects were successfully sutured with nonabsorbable sutures. The patient was discharged on postoperative day 11.


[Mechanism of the decrease in metacarpal bone mineral content due to oophorectomy].
In order to determine the pathogenesis and pathophysiology of post-oophorectomized osteopenia, we have investigated the bone mineral status and the serum levels of calcium regulating hormones in 250 females. The bone mineral status was measured in 250 [173 pre-menopausal females (controls) and 77 who received oophorectomy] females by microdensitometry in the metacarpal bone. Among these subjects, in some cases who were selected randomly, the serum levels of Alp, Ca, Pi, M-PTH, calcitonin (CT), bone gla protein (BGP), estrone, estradiol and delta 4-androstenedione, and the urinary excretion of Ca and hydroxyproline (OH-pro) as a function of the creatinine ratio were measured. The mineralization indices of bone such as GSmax, GSmin, and sigma GS/D in oophorectomized patients were significantly less than those in controls at ages up to 45 years. On the other hand, the index of periosteal bone resorption (MCI) in the oophorectomized group was less than that in controls at ages up to 50 years. Serum levels of Alp, Ca, Pi and BGP were higher in oophorectomized subjects than in controls. Despite these facts, the serum levels of calcium regulating hormones such as M-PTH and CT in these two groups were significantly different. Urinary Ca/cr and OH-pro/cr ratios were significantly higher in oophorectomized subjects at ages 40-44 than those in age matched controls. These data clearly indicate that oophorectomy causes high turn-over osteopenia.


A set of human putative lymphocyte G0/G1 switch genes includes genes homologous to rodent cytokine and zinc finger protein-encoding genes.
Lymphocyte G0/G1 switch genes (G0S genes) are potential oncogenes and may regulate, be regulated by, or be coordinately regulated with, latent lymphotropic viruses. To identify these genes, a cDNA library was prepared from blood mononuclear cells that had been cultured for 2 hr with a T-cell mitogen (lectin) and cycloheximide. Eight differentially hybridizing recombinants were characterized by RNA and DNA blotting and sequencing. One cDNA (G0S7) corresponded to the oncogene c-fos. Another cDNA (G0S19) was homologous (70%) to a cDNA encoding a murine inhibitor of stem cell proliferation (the cytokine MIP1 alpha) and, less closely, to other members of the "small inducible" secreted protein-encoding gene family. Whereas cDNA hybridization to genomic DNA blots indicated a small subfamily of G0S19 genes, simple patterns of bands indicated that most cDNAs, including G0S30 cDNA, corresponded to single-copy genes. The 3' noncoding sequence of G0S30 cDNA was homologous (87-89%) to the 3' noncoding sequences of certain rodent genes (NGFI-A, Krox24, EGR1) that encode zinc finger proteins (putative transcriptional regulators). This degree of evolutionary conservation suggests an important function for the 3' noncoding region. The 3' noncoding regions of some cDNAs contained the TTATTTAT (mRNA destabilization) element. The corresponding RNAs each formed doublets in agarose gels. Previous studies of c-fos RNA from HeLa cells indicate that this is due to cycloheximide-dependent stabilization of poly(A) tails. Our results reveal the power of cycloheximide enrichment in isolating what would appear to be significant low-abundance mRNAs.


[Analysis of kojic acid in Aspergillus oryzae ferment by ion-pair reversed-phase high performance liquid chromatography].
A new and an efficient method for analyzing kojic acid in aspergillus oryzae ferment by ion-pair reversed-phase high performance liquid chromatography was developed. The kojic acid was well separated on a C18 column using methanol-0.01 mol/L disodium hydrogen phosphate and 2 mmol tetrabutylammonium bromide (4:96) as the mobile phase, followed by an UV detection at 226 nm. The detection limit was 0.012 microgram/ml. The spiked recoveries in wort-yeast culture, wort-peptone culture and potato-yeast-sugar culture were 98.2%, 103.4% and 97.2%, respectively. The RSD values were 0.51%, 0.45% and 0.43% respectively.


Validity of procedure codes in International Classification of Diseases, 9th revision, clinical modification administrative data.
Administrative hospital discharge data are widely used to assess quality of care in patients undergoing certain procedures. However, little is known about the validity of administrative coding of procedure data. We conducted a detailed chart review to evaluate the accuracy and completeness of information on procedures in administrative data. We randomly selected 1200 hospital separations in the period April 1, 1996, to March 31, 1997, from administrative discharge data of 3 acute adult hospitals in Calgary, Alberta, Canada. Each separation record in administrative data contains up to 10 procedure coding fields. The corresponding medical charts were reviewed for recording presence or absence of procedures. We then determined sensitivity to quantify the accuracy of coding presence of procedures in administrative data when these are present in the chart data (criterion standard). The agreement between the 2 databases varied greatly across 35 procedures studied. The sensitivity ranged from 0% to 94%. Of 6 major procedures studied, validity of coding was generally good, with 5 procedures having coding sensitivity of 69% and over and only 1 (lysis of peritoneal adhesion) with a low sensitivity of 41%. In contrast, many minor procedures had low sensitivities. Of 29 minor procedures studied, sensitivity was lower than 50% for 15 procedures, between 50% and 79% for 10, and 80% and over for 4. Validity of information on procedures in administrative discharge data appears to be related to type of procedures. Major procedures that are usually performed in operating rooms are reasonably well-coded. Meanwhile, minor procedures that are routinely performed on wards or in radiology departments are generally undercoded.


Radical hysterectomy with or without preoperative radium for stage IB squamous cell carcinoma of the cervix.
A retrospective study of 119 patients ranging from 30 to 69 years of age was undertaken to evaluate the effectiveness of preoperative radium treatment for patients with Stage IB (FIGO 1971) squamous cell carcinoma of the cervix undergoing radical hysterectomy. Results in 61 patients who had radical hysterectomy without preoperative radium treatment were compared to those in 58 patients who had received radium preoperatively. The patients receiving radium systems had an uncorrected 5-year survival rate of 89.7%, while the patients without preoperative radium treatment had a 75.1% 5-year rate of survival. This difference in survival rate was judged to be secondary to the greater incidence of lymphatic invasion and residual tumor in the surgical specimens of the patients who did not receive preoperative radium. The occurrence of significant gastrointestinal and urinary tract complications was identical in the 2 groups.


Association between serum paraoxonase (PON1) gene promoter T(-107)C polymorphism, PON1 activity and HDL levels in healthy Sicilian octogenarians.
Age is associated with an enhanced low density lipoprotein (LDL) oxidation and atherosclerosis, thus, subjects over 80 years without cardiovascular disease provide a model to investigate the protective factors against atherosclerosis. Serum paraoxonase (PON1), an high density lipoprotein (HDL)-bound enzyme, prevents LDL oxidation. The aim of the present study was to evaluate the contribution of the PON1 promoter T(-107)C and coding region Gln192Arg (Q192R) and Leu55Met (L55M) polymorphisms to the resistance to develop cardiovascular events in Sicilian healthy octogenarians. Distribution of PON1 genotypes and activity, and biochemical parameters, were compared between 100 octogenarians and 200 adults. Individuals in the elderly group displayed significant higher levels of HDL-C (P < 0.001) and PON1 activity (P < 0.001). The analysis of PON1 genotypes distribution showed an higher percentage of (-107)CC among octogenarians compared with controls. A significant difference among T(-107)C genotypes respect to PON1 activity and HDL-C levels occurred in both groups. The CC genotype was associated with higher PON1 activity and HDL levels compared to the TT genotypes. In conclusion, our results provide a strong evidence that in healthy Sicilians ageing may be characterized by a low frequency of PON1 (-107)T 'risk' allele and by an high frequency of favourable genotypes such as (-107)CC, influencing PON1 activity and HDL-C levels.


Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment.
Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV) after primary rhegmatogenous retinal detachment (RRD). Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual acuity (BCVA). The primary outcome measures were anatomical (primary and final) and functional success (visual acuity better than 6/60). Results. This study evaluated 422 eyes of 411 patients with a mean age of 57.7 ± 11.2 years. The single-operation reattachment rate (primary anatomical success) was 89.8%. The final anatomical success rate was 100% after 2-6 operations (mean = 3.14 ± 1.03). Functional success rate after the primary reattachment operation was 96.7%, while it was 97.2% at the end of the follow-up. Multiple logistic regression analysis of the possible risk factors for the primary anatomical failure showed a significant relation with the 25 G instruments (P = 0.002) and the presence of multiple tears (P = 0.01). Conclusion. The primary anatomical success of PPV for primary uncomplicated RRD was 89.8% and the final anatomical success rate was 100%.


Variations in immunohistochemical detection of p53 protein overexpression in cervical carcinomas with different antibodies and methods of detection.
Immunocytochemical detection of p53 protein products in paraffin sections is possible with a number of antisera, monoclonal and polyclonal. Few corroborative results amongst different laboratories have been published due to variations in the antibodies, the fixation protocols, and the immunocytochemical methods applied. Antigen unmasking methods employing microwaves or proteolytic enzymes add to the disparity in the percentage of positive cases reported. In this study, paraffin sections of 55 cases of cervical carcinoma were immunostained with monoclonal antibodies p53-DO7 and p53-1801 (a) without section pretreatment, (b) with pronase digestion, and (c) with microwave antigen retrieval in citric acid buffer. Specimens fixed in buffered formalin required antigen unmasking to show positive staining. Pronase digestion caused false-negative immunostaining. Microwave pretreatment with p53-DO7 yielded 100 per cent positivity for p53 proteins but only 7/55 cases with more than 50 per cent positive cells. Monoclonal antibody p53-DO7 detected more positive cases than p53-1801. Immunostaining with antibodies to p53 proteins must be interpreted cautiously as variations in fixation, antibodies, and section pretreatment will significantly affect results.


The control of conjunctival fibrosis as a paradigm for the prevention of ocular fibrosis-related blindness. "Fibrosis has many friends".
The processes involved in ocular fibrosis after disease or ocular tissue injury, including surgery play an important part in the development or failure of treatment of most blinding diseases. Ocular fibrosis is one of the biggest areas of unmet need in ophthalmology. Effective anti-scarring therapies could potentially revolutionise the management of many diseases like glaucoma worldwide. The response of a quiescent or activated conjunctiva to glaucoma surgery and aqueous flow with different stimulatory components and the response to different interventions and future therapeutics is a paradigm for scarring prevention in other parts of the eye and orbit. Evolution in our understanding of molecular and cellular mechanisms in ocular fibrosis is leading to the introduction of new and re-purposed therapeutic agents, targeting a wide range of key processes. This review provides current and futures perspectives on different approaches to conjunctival fibrosis following glaucoma surgery and highlights the challenges faced in implementing these therapies with maximal effect and minimal side effects.


Accessory left gastric artery from left hepatic artery shown on MDCT and conventional angiography: correlation with CT hepatic arteriography.
The objective of our study was to evaluate the diagnostic accuracy of MDCT and conventional angiography in the detection of an accessory left gastric artery using CT hepatic arteriography as the standard of reference. The study group consisted of 118 patients who underwent MDCT with a triple-phase liver protocol with a slice thickness of 5 mm, conventional angiography, and CT hepatic arteriography. The early-phase images of MDCT and conventional angiography were retrospectively reviewed. The presence or absence of an accessory left gastric artery was evaluated using CT hepatic arteriography as the standard of reference. The sensitivity, specificity, and accuracy of MDCT and conventional angiography were calculated. CT hepatic arteriography revealed an accessory left gastric artery in 25 (21.2%) of 118 cases, including 15 proximal- and 10 distal-type accessory left gastric arteries. On MDCT, there were seven false-negative cases and one false-positive case. Six of the seven false-negative cases were a proximal-type accessory left gastric artery, and nine of 10 distal-type accessory left gastric arteries were correctly diagnosed using MDCT. The sensitivity, specificity, and accuracy of MDCT were 72.0%, 98.9%, and 93.2%, respectively. On conventional angiography, there were three false-negative and two false-positive cases, none of whom underwent selective left hepatic arteriography. Two of the three false-negative cases were the distal-type accessory left gastric artery, but eight of the 10 distal-type accessory left gastric arteries were correctly diagnosed. The sensitivity, specificity, and accuracy of conventional angiography were 88.0%, 97.8%, and 95.8%, respectively. Approximately 70% of accessory left gastric arteries can be diagnosed at the early phase of MDCT even with a slice thickness of 5 mm.


[Bacterial vaginosis and premature membrane rupture: an open study. Preliminary data].
We tried to identify a correlation between bacterial vaginosis and PROM with the aim of proposing a future screening for pregnant women at risk for premature rupture of membranes. We made two vaginal bacteriological tests on women pregnant at 24th and 34th week, and we repeated the same test when it proved positive for infection after therapy. We did 375 tests and our study group was composed of 249 pregnant women, aged between 24 and 35. We also evaluated some variable factors as ultrasonographic gestational age redetermination, number pregnancies of oral contraceptives or IUD use, presence of risk factors presence (recurrent abortion, previous PROM, glucose metabolism alteration, immunosuppression, condylomatosis). 171 tests proved positive (total positivity percentage: 47.2%). The most common micro-organism was Ureaplasma urealyticum (49.1%) that was related to PROM in 66.7%. This result contracts with affirmations of some England authors who think that Ureaplasma hasn't an important role in PROM. This fact, if related to the other data we obtained with our study, actually current, shows a strict correlation between PROM and bacterial vaginosis, but also a different distribution of vaginal infections in our country in comparison with English countries.


hSSB1 (NABP2/OBFC2B) is regulated by oxidative stress.
The maintenance of genome stability is an essential cellular process to prevent the development of diseases including cancer. hSSB1 (NABP2/ OBFC2A) is a critical component of the DNA damage response where it participates in the repair of double-strand DNA breaks and in base excision repair of oxidized guanine residues (8-oxoguanine) by aiding the localization of the human 8-oxoguanine glycosylase (hOGG1) to damaged DNA. Here we demonstrate that following oxidative stress, hSSB1 is stabilized as an oligomer which is required for hSSB1 to function in the removal of 8-oxoguanine. Monomeric hSSB1 shows a decreased affinity for oxidized DNA resulting in a cellular 8-oxoguanine-repair defect and in the absence of ATM signaling initiation. While hSSB1 oligomerization is important for the removal of 8-oxoguanine from the genome, it is not required for the repair of double-strand DNA-breaks by homologous recombination. These findings demonstrate a novel hSSB1 regulatory mechanism for the repair of damaged DNA.


Prognostic significance of the estrogen-regulated proteins, cathepsin-D and pS2, in breast cancer.
The evaluation of prognostic factors for breast cancers is important for therapeutic decisions both at the time of surgery and during postoperative surveillance. Cathepsin-D (cath-D) is an estrogen inducible aspartyl protease. Studies have demonstrated two biological activities, at an acidic PH, of the protein: a mitogenic and a proteolytic activity; both the growth promoting activity and the extracellular proteolytic activity suggest that cathepsin D (cath-D) may have prognostic significance in breast cancer. Measurement of cath-D in breast tissue, in fact, is highly significant in predicting recurrence as well as disease free interval and overall survival. The pS2 is a small cysteine-rich protein specifically expressed under estrogen transcriptional control. Expression of the pS2 protein in breast carcinoma is a useful guide to prognosis and response to tamoxifen: appropriate adjuvant therapy can be selected on the pS2 status of the tumor; patients with pS2 expression had better overall survival and a longer survival time after the first recurrence than those without pS2 expression. For these reasons, these two new prognostic markers could be suggested as habit factors in breast cancer.


Phase-resolved Doppler optical coherence tomography--limitations and improvements.
We describe how the simple phase difference averaging causes a systematic bias in the velocity estimation obtained by phase-resolved Fourier domain optical coherence tomography (FdOCT). The magnitude of this bias depends on the signal-to-noise ratio as well as proximity of the measured velocity to the limits of the velocity range. We demonstrate the proper way of data processing, which enables obtaining velocity values free of this error. We validate the improved technique by measurements of flow velocity in glass capillaries, in human retinal vessels, and we compare the results with those obtained by standard phase-resolved FdOCT.


Potentiation of exocytosis by phospholipase C-coupled G-protein-coupled receptors requires the priming protein Munc13-1.
The vesicle priming protein Munc13-1 is regulated by diacylglycerol (DAG) and is therefore hypothesized to play a role in the control of neurotransmitter release by phospholipase C (PLC)-coupled receptors. We combined voltage-clamp recordings of voltage-gated Ca2+ channels (VGCCs) and high-resolution capacitance measurements to investigate the mechanism of receptor-mediated modulation of exocytosis in bovine chromaffin cells. Activation of endogenous H1 G(q)-protein-coupled receptors (G(q)PCRs) by histamine potentiated stimulus-coupled secretion despite concurrently inhibiting Ca2+ influx through VGCCs. Histamine increased the size of the readily releasable pool of vesicles and in particular a subpool of fusion-competent vesicles localized in close proximity to VGCCs. Pharmacological characterization showed that potentiation of exocytosis depended on the activation of PLC but not protein kinase C. Overexpression of wild-type Munc13-1 by adenoviral infection had no effect on histamine-induced potentiation per se, whereas DAG-insensitive Munc13-1(H567K) completely abolished it. This is the first endogenous mammalian G(q)PCR signaling pathway identified that engages Munc13-1 to increase stimulus-coupled secretion by recruiting vesicles to the immediately releasable pool. G(q)PCRs are therefore able to control exocytosis at the level of SNARE (soluble N-ethylmaleimide-sensitive factor attachment protein receptor) complex formation to produce rapid, short-term potentiation of the secretory output of neurons and endocrine cells.


Dynamics of nonautonomous discrete rogue wave solutions for an Ablowitz-Musslimani equation with PT-symmetric potential.
Starting from a discrete spectral problem, we derive a hierarchy of nonlinear discrete equations which include the Ablowitz-Ladik (AL) equation. We analytically study the discrete rogue-wave (DRW) solutions of AL equation with three free parameters. The trajectories of peaks and depressions of profiles for the first- and second-order DRWs are produced by means of analytical and numerical methods. In particular, we study the solutions with dispersion in parity-time ( PT) symmetric potential for Ablowitz-Musslimani equation. And we consider the non-autonomous DRW solutions, parameters controlling and their interactions with variable coefficients, and predict the long-living rogue wave solutions. Our results might provide useful information for potential applications of synthetic PT symmetric systems in nonlinear optics and condensed matter physics.


A reevaluation of neuronal zinc measurements: artifacts associated with high intracellular dye concentration.
The emergence of zinc as a potent neurotoxin has prompted the development of techniques suitable for the measurement of intracellular free zinc ([Zn(2+)](i)) in cultured cells. Accordingly, a new family of Zn(2+)-sensitive fluorophores has become available. Using ionophore-induced elevations of [Zn(2+)](i) in cultured neurons, we measured [Zn(2+)](i)-induced changes in the novel dyes FuraZin-1 and FluoZin-2 and compared them with the established [Zn(2+)](i)-sensitive fluorophores mag-fura-2 and Newport Green. All of these dyes effectively detected [Zn(2+)](i), and FuraZin-1, FluoZin-2, and Newport Green showed selectivity for [Zn(2+)](i) over [Ca(2+)](i) and [Mg(2+)](i). However, the dyes showed little difference in their apparent sensitivity to [Zn(2+)](i), even though their in vitro affinities for Zn(2+) varied from 20 nM to 3 microM. We show herein that this is a consequence of the relatively high concentrations of intracellular dye used in experiments of this nature. Thus, for the measurement of [Zn(2+)](i), the sensitivity of the reporting system is dominated by the intracellular dye concentration, whereas dye affinity is unimportant. We extend these findings to show that calibration of dye signal to ion concentration is critically dependent on precise measurement of intracellular dye concentration.


Tunneling dendrimers. Enhancing charge transport through insulating layer using redox molecular objects.
Charge transport through an insulating layer was probed using ferrocenyl-terminated dendrimers and scanning electrochemical microscopy. Experiments show that the passage through the layer is considerably enhanced when the transferred charges are brought globally to the surface by the ferrocenyl dendrimer instead of a single ferrocene molecule. This result shows that charge tunneling through an insulator could be promoted by a purely molecular nano-object.


[Clinical characteristics of hypertrophic cardiomyopathy and restricted cardiomyopathy patients complicating with intracardiac thrombosis].
Objective: To investigate the clinical characteristics of patients with hypertrophic cardiomyopathy (HCM) and restrictive cardiomyopathy (RCM) complicating with intracardiac thrombosis. Methods: This is a retrospective observational study. Consecutive patients diagnosed with HCM or RCM and complicated with intracardiac thrombosis (including left and right atrium or ventricular thrombosis), who were admitted to the Heart Failure Care Unit of Fuwai Hospital, Chinese Academy of Medical Sciences, from September 2008 to September 2018, were enrolled in this study. Patients with myocardial infarction were excluded. The general clinical data of the enrolled patients, including demographic data, major complications, laboratory indicators, echocardiographic indicators, drug application and distribution of intracardiac thrombosis, were collected from electronic medical record system and analyzed. Results: A total of 98 patients were enrolled in this study, including 52 patients (53.1%) with HCM and 46 patients (46.9%) with RCM. The most common comorbidity was atrial fibrillation/flutter: 40 patients (76.9%) in HCM group and 36 patients (78.3%) in RCM group. Majority of patients received oral anticoagulants treatment: 43 patients (82.7%) in HCM group and 35 patients (76.1%) in RCM group. Intracardiac thrombosis was mainly located in the left atrium in both HCM group (39 cases (75.0%)) and RCM group (32 cases (69.6%)). Thrombosis was found in ≥ 2 chambers in 7 patients (7.1%). Rate of left atrial thrombosis was the highest (81.6% (62/76)) in HCM and RCM patients complicating with atrial fibrillation/flutter. Intra-aneurysmal thrombosis occurred in 4 out of 5 patients complicated with apical left ventricular aneurysm. The rate of left ventricular thrombosis in patients with left ventricular ejection fraction≥50% was 7.4% (4/54), which was significantly lower than that in patients with left ventricular ejection fraction<50% (34.5%(10/29)) (P<0.01). Conclusion: There are certain distribution characteristics of HCM and RCM patients with intracardiac thrombosis, and the left atrium is the most common site of thrombosis, more attention should be paid in HCM and RCM patients on the diagnosis and treatment of intracardiac thrombosis.


Gardnerella vaginalis vaginitis in Cu T 200 users.
Vaginal samples obtained from intrauterine contraceptive device (IUD) users with and without vaginitis and from healthy non-users were studied for presence of G. vaginalis and cytological changes. Vaginitis was present in 29.5 per cent IUD users and most of them (76%) yielded G. vaginalis. G. vaginalis was also recovered from asymptomatic IUD users and from non-users, but heavy colonisation was infrequent. The presence of clue cells and many small Gram negative bacilli and scanty lactobacilli were associated with G. vaginalis recovery. Inflammation was more frequent in IUD users than in non-users (P less than 0.001). A significant correlation was also found between inflammatory changes and G. vaginalis colonisation among all groups of patients.


[Implementation of the curriculum for specialist training in Emergency Medicine: room for improval on details].
To investigate what aspects of the new curriculum for specialist training in Emergency Medicine are actually implemented in daily practice. Descriptive study. The curriculum was implemented as a pilot in 4 teaching hospitals, where a total of 32 residents in training in Emergency Medicine and 20 Emergency Medicine Program directors and Emergency physicians were surveyed using a web-based questionnaire querying the use of the different aspects of the curriculum in daily practice. Responses were received from 29 residents in training and 15 program directors and Emergency physicians. Both residents in training and program directors rated the patient mix seen during the training programme adequate to excellent. No great differences were observed in how residents in training, trainers and physicians working in the Emergency Department assessed the curriculum. However, the results showed that the training plan should be discussed explicitly with each residents in training. More attention should be focussed on the Society Awareness, Knowledge and Science and Organisation competencies and the Disability and Dermatology themes. Competence-based assessment methods, such as multi-source feedback, specific to this type of curriculum have not yet been sufficiently implemented. The responses to the questionnaire demonstrated how the curriculum is handled in daily practice and provided information on the progress of the implementation of the curriculum. This will enable focussed feedback to teaching hospitals.


Low T lymphocyte responsiveness to Mycobacterium leprae antigens in association with HLA-DR3.
The type of leprosy which develops after infection with Mycobacterium leprae is influenced by the presence or absence of HLA-DR3, as has been demonstrated in an ethnic group originating from Surinam. In the present study we investigated in this same ethnic group the role of HLA-DR, and of HLA-DR3 in particular, in monocyte-T cell interactions during leprosy specific proliferative responses in vitro. HLA-DR3 heterozygous T cells from tuberculoid leprosy patients were cultured with antigen and either HLA-DR3 positive or HLA-DR3 negative homozygous HLA-DR compatible allogeneic monocytes as antigen presenting cells (APCs). T cell proliferative responses with DR3 homozygous monocytes as APCs, were observed to be decreased as compared to T cell proliferative responses with DR3 negative homozygous monocytes as APCs. Furthermore, although the leprosy specific monocyte-T cell interactions were shown to be restricted for HLA-DR, in the anti-MLW-1 response HLA-DR3 appeared to function as a restricting element poorly or not at all. These observations may imply, that an in vitro correlate has been found for an (HLA associated) genetic control of leprosy in vivo.


[Diuretics and their potential effect on breath-alcohol concentration--a case report].
Many objections were raised to breath-alcohol analysis upon its introduction in the field of traffic law enforcement in Germany, but in the meantime this issue has become less relevant in forensic routine work. In the present case, the defending lawyer claimed that the ethanol concentration in the blood and hence in the breath of his client, which was 0.35 mg/l according to the Dräger Alcotest 7110® Evidential and thus above the legal limit of 0.25 mg/l, had been changed by diuretics taken 4 hours before the breath alcohol test, viz. 10 mg of torasemide, a loop diuretic, and 50 mg of spironolactone, a competitive aldosterone antagonist. According to the literature, the maximum urinary output in healthy subjects within the first 4 hours after 10 mg torasemide was 1450 ml. In patients suffering from heart failure, the urinary volume was reduced by a factor of 2.5-3; after chronic intake of torasemide, water loss did not differ from placebo. Spironolactone, which acts on the distal tubule, has little effect on urinary output. In a publication, the loss of water in excess within 24 hours was 90 ml. Co-administration of 100 mg spironolactone and 20 mg furosemide, which roughly compares to 10 mg torasemide, resulted in a mean urinary volume of 1566 ml within the first 4 hours. In terms of the reported case and provided that no compensatory fluid had been taken, a purely theoretical maximum shift of 0.007 mg/ may occur in the breath-alcohol concentration due to the smaller distribution volume even considering maximum urinary excretion values. On the other hand, already mild levels of dehydration may be associated with negative symptoms affecting driving ability.


Cortical surface area reduction in identification of subjects at high risk for post-traumatic stress disorder: A pilot study.
Victims of motor vehicle accidents often develop post-traumatic stress disorder, which causes significant social function loss. For the difficulty in treating post-traumatic stress disorder, identification of subjects at high risk for post-traumatic stress disorder is essential for providing possible intervention. This paper aims to examine the cortical structural traits related to susceptibility to post-traumatic stress disorder. To address this issue, we performed structural magnetic resonance imaging study in motor vehicle accident victims within 48 hours from the accidents. A total of 70 victims, available for both clinical and magnetic resonance imaging data, enrolled in our study. Upon completion of 6-month follow-up, 29 of them developed post-traumatic stress disorder, while 41 of them didn't. At baseline, voxelwise comparisons of cortical thickness, cortical area and cortical volume were conducted between post-traumatic stress disorder group and trauma control group. As expected, several reduced cortical volume within frontal-temporal loop were observed in post-traumatic stress disorder. For cortical thickness, no between-group differences were observed. There were three clusters in left hemisphere and one cluster in right hemisphere showing decreased cortical area in post-traumatic stress disorder patients, compared with trauma controls. Peak voxels of the three clusters in left hemisphere were separately located in superior parietal cortex, insula and rostral anterior cingulate cortex. The finding of reduced surface area of left insula and left rostral anterior cingulate cortex suggests that shrinked surface area in motor vehicle accident victims could act as potential biomarker of subjects at high risk for post-traumatic stress disorder.


Cost of disorders of the brain in Ireland.
The "Cost of Disorders of the Brain in Europe" (CBDE) study was conducted by the European Brain Council (EBC) to estimate prevalence and cost of the twelve leading disorders encountered in Neurology, Neurosurgery, and Psychiatry. The data for Ireland are presented here. Prevalence and costing information was obtained by structured review of published literature for each country. Where such information was lacking, figures were estimated from European data. Costs included direct medical, direct non-medical, and indirect costs. None of the costs presented here are directly from Irish data and the prevalence figures are mostly estimated from known European rates. In 2004, 1.1 million people in Ireland were affected by a disorder of the brain. Total cost of included disorders in Ireland was 3.0 billion Euro, representing 3% of gross national product, and costing each Irish citizen Euro 775 per year. Brain disorders are prevalent and pose significant economic burden in Ireland.


Serum lipocalin-2 levels are positively associated with not only total body fat but also visceral fat area in Chinese men.
Serum lipocalin-2 (LCN2) plays an important role in the regulation of the obesity-associated dysmetabolic state and cardiovascular disease. However, relatively little is known about the relationship between serum LCN2 levels and body fat content and distribution. We examined the associations of total body fat content and abdominal fat distribution with serum LCN2 levels in Chinese men.The study was based on a cross-sectional analysis of data for 1203 Chinese men aged 22 to 78 years from the Shanghai Obesity Study. Body fat percentage (fat%) was assessed by bioelectrical impedance analysis, and magnetic resonance imaging was adopted to quantify the visceral fat area (VFA) and subcutaneous fat area (SFA). Serum levels of LCN2 were measured with a standard enzyme-linked immunosorbent assay method.Subjects with a high fat% had higher serum LCN2 levels than those with a normal fat% regardless of their body mass index category (<25 and ≥25 kg/m). The frequency of isolated high VFA was increased with increasing quintiles of serum LCN2 levels (P < 0.001), but the frequency of isolated high SFA did not differ between quintiles of serum LCN2 levels. A trend of increasing VFA was observed with increasing serum LCN2 levels (P < 0.001). Multiple stepwise regression analysis showed that VFA was positively associated with serum LCN2 levels, independent of overall obesity and other confounding factors (standardized β = 0.082, P = 0.008).Serum LCN2 levels are positively correlated with body fat content and independently associated with VFA in Chinese men.


Identification of Osr2 Transcriptional Target Genes in Palate Development.
Previous studies have identified the odd-skipped related 2 (Osr2) transcription factor as a key intrinsic regulator of palatal shelf growth and morphogenesis. However, little is known about the molecular program acting downstream of Osr2 in the regulation of palatogenesis. In this study, we isolated palatal mesenchyme cells from embryonic day 12.5 (E12.5) and E13.5 Osr2RFP/+ and Osr2RFP/- mutant mouse embryos and performed whole transcriptome RNA sequencing analyses. Differential expression analysis of the RNA sequencing datasets revealed that expression of 70 genes was upregulated and expression of 61 genes was downregulated by >1.5-fold at both E12.5 and E13.5 in the Osr2RFP/- palatal mesenchyme cells, in comparison with Osr2RFP/+ littermates. Gene ontology analysis revealed enrichment of signaling molecules and transcription factors crucial for skeletal development and osteoblast differentiation among those significantly upregulated in the Osr2 mutant palatal mesenchyme. Using quantitative real-time polymerase chain reaction (RT-PCR)and in situ hybridization assays, we validated that the Osr2-/- embryos exhibit significantly increased and expanded expression of many osteogenic pathway genes, including Bmp3, Bmp5, Bmp7, Mef2c, Sox6, and Sp7 in the developing palatal mesenchyme. Furthermore, we demonstrate that expression of Sema3a, Sema3d, and Sema3e, is ectopically activated in the developing palatal mesenchyme in Osr2-/- embryos. Through chromatin immunoprecipitation, followed by RT-PCR analysis, we demonstrate that endogenous Osr2 protein binds to the promoter regions of the Sema3a and Sema3d genes in the embryonic palatal mesenchyme. Moreover, Osr2 expression repressed the transcription from the Sema3a and Sema3d promoters in cotransfected cells. Since the Sema3 subfamily of signaling molecules plays diverse roles in the regulation of cell proliferation, migration, and differentiation, these data reveal a novel role for Osr2 in regulation of palatal morphogenesis through preventing aberrant activation of Sema3 signaling. Together, these data indicate that Osr2 controls multiple molecular pathways, including BMP and Sema3 signaling, in palate development.


The evolving role of DNA damage response in overcoming therapeutic resistance in ovarian cancer.
Epithelial ovarian cancer (EOC) is treated in the first-line setting with combined platinum and taxane chemotherapy, often followed by a maintenance poly (ADP-ribose) polymerase inhibitor (PARPi). Responses to first-line treatment are frequent. For many patients, however, responses are suboptimal or short-lived. Over the last several years, multiple new classes of agents targeting DNA damage response (DDR) mechanisms have advanced through clinical development. In this review, we explore the preclinical rationale for the use of ATR inhibitors, CHK1 inhibitors, and WEE1 inhibitors, emphasizing their application to chemotherapy-resistant and PARPi-resistant ovarian cancer. We also present an overview of the clinical development of the leading drugs in each of these classes, emphasizing the rationale for monotherapy and combination therapy approaches.


Giardia lamblia regulates the production of proinflammatory cytokines through activating the NOD2-Rip2-ROS signaling pathway in mouse macrophages.
Giardia lamblia is a zoonotic protozoan that causes the diarrheal illness giardiasis, with the highest prevalence reported in the tropics and subtropics. Giardia is currently the most frequently identified pathogen in waterborne outbreaks in the United States. Nucleotide oligomerization domain (NOD) 1 and NOD2, intracellular NOD-like receptors, recognize pathogens to induce proinflammatory and antimicrobial responses. However, the roles of NOD1 and NOD2 signaling in Giardia infection have not yet been investigated. In the present study, the activation of NOD1 and NOD2 signaling pathways and the production of proinflammatory cytokines, reactive oxygen species (ROS) and nitric oxide in mouse macrophages stimulated with G. lamblia or parasite excretory-secretory products (ESPs) were examined. The results showed that G. lamblia and ESPs activated NOD2 and its downstream adaptor protein kinase, Receptor-interacting protein 2 (Rip2), in mouse macrophages. Blocking NOD2-Rip2 signaling significantly reduced the production of ROS and subsequently decreased the phosphorylation of nuclear factor-κB p65 and extracellular signal-regulated kinase, which in turn inhibited the production of four proinflammatory cytokines, namely, interleukin (IL)-1β, IL-6, IL-12p40 and tumor necrosis factor-α. In summary, our results indicate that the NOD2-Rip2 signal, which is activated by G. lamblia, contributes to the production of proinflammatory cytokines and ROS in mouse macrophages.


What happens to the pylorus after pyloromyotomy?
The rate of return to normal of the pylorus muscle in infantile hypertrophic pyloric stenosis was measured by ultrasound, using a simple pyloric volume calculation and a pyloric muscle index. The muscle hypertrophy took from two to 12 weeks to resolve.


Extensive petechiae in attempted self-strangulation.
A 29-year-old Korean man reported to have been robbed, bound, and gagged by a stranger in his apartment. Clinical findings included extensive petechiae to his face and tramline patterned abrasions and ligature furrows to his neck and face as well as his wrists. Initially, no other leads in the investigation existed and a robbery was assumed to have taken place. The man eventually confessed to fabricating the story and to having self-induced the ligature marks by subluxating his jaw at the temporomandibular joint and hooking the rope closest to the back of his neck on the corner of table. The man demonstrated this unsuspected ability to law enforcement officers. As a motive for his unconventional behavior, he confessed to engaging in autoaggressive behavior as punishment for "losing face" after his ex-girlfriend terminated her pregnancy. This case demonstrates that petechiae due to neck compression also may occur in the living and are due to vascular compression and not lethal hypoxia.


ROK and Arteriolar Myogenic Tone Generation: Molecular Evidence in Health and Disease.
The myogenic response is an inherent property of resistance arteries that warrants a relatively constant blood flow in response to changes in perfusion pressure and protect delicate organs from vascular insufficiencies and excessive blood flow. This fundamental phenomenon has been extensively studied aiming to elucidate the underlying mechanisms triggering smooth muscle contraction in response to intraluminal pressure elevation, particularly, Rho-associated kinase (ROK)-mediated Ca2+-independent mechanisms. The size of the resistance arteries limits the capacity to examine changes in protein phosphorylation/expression levels associated with ROK signaling. A highly sensitive biochemical detection approach was beneficial in examining the role of ROK in different force generation mechanisms along the course of myogenic constriction. In this mini review, we summarize recent results showing direct evidence for the contribution of ROK in development of myogenic response at the level of mechanotransduction, myosin light chain phosphatase inhibition and dynamic actin cytoskeleton reorganization. We will also present evidence that alterations in ROK signaling could underlie the progressive loss in myogenic response in a rat model of type 2 diabetes.


Retinal Vascular Abnormalities in Different Types of Inherited Retinal Dystrophies Assessed by Optical Coherence Tomography Angiography.
To investigate the retinal vascular characteristics among patients with different types of inherited retinal dystrophies (IRDs). This comparative cross-sectional study was conducted on 59 genetically confirmed cases of IRD including 37 patients with retinitis pigmentosa (RP) (74 eyes), 13 patients with Stargardt disease (STGD) (26 eyes), and 9 patients with cone-rod dystrophy (CRD) (18 eyes). Both eyes of 50 age- and sex-matched healthy individuals were investigated as controls. All participants underwent optical coherence tomography angiography to investigate the vascular densities (VDs) of superficial and deep capillary plexus (SCP and DCP) as well as foveal avascular zone area. In RP, significantly lower VD in whole image (P = 0.001 for DCP), fovea (P = 0.038 for SCP), parafovea (P < 0.001 for SCP and DCP), and perifovea (P < 0.001 for SCP and DCP) was observed compared to controls. In STGD, VD of parafovea (P = 0.012 for SCP and P = 0.001 for DCP) and fovea (P = 0.016 for DCP) was significantly lower than controls. In CRD, the VD of parafovea (P = 0.025 for DCP) was significantly lower than controls. Whole image density was significantly lower in RP compared to STGD (P < 0.001 for SCP) and CRD (P = 0.037 for SCP). VD in parafovea (P = 0.005 for SCP) and perifovea (P < 0.001 for SCP and DCP) regions was significantly lower in RP compared with STGD. Also, foveal VD in STGD was significantly lower than RP (P = 0.023 for DCP). Our study demonstrated lower VDs in three different IRDs including RP, STGD, and CRD compared to healthy controls. Changes were more dominant in RP patients.


Effect of cetuximab treatment in squamous cell carcinomas.
The purpose of this study was to assess the effects of the monoclonal antibody cetuximab in a panel of cultured squamous cell carcinoma cell lines. This antibody, targeting the epidermal growth factor receptor (EGFR), is emerging as a promising agent for treatment of several cancers. As this antibody comes into clinical use, the identification of predictive markers of therapeutic benefit remains a pressing issue. Cells were first characterized according to EGFR expression, cell doubling time, and BRAF and K-ras mutations. The effects of cetuximab on cell-cycle distribution, proliferation, as well as cell growth rate were then evaluated. Cetuximab decreased cell proliferation in three out of four cell lines in a time-dependent manner, and all cell lines were found to exhibit wild type K-ras and BRAF genes. A possible correlation between EGFR expression and cetuximab effect on growth inhibition rate was observed, whereas reduction of cell doubling time seemed to be more dependent on initial growth rate. In addition, other factors may further influence the long-term treatment response of cetuximab. Moreover, the time-dependent manner of cetuximab response demonstrates the importance of long-term measurements for this substance.


Signal transduction in hypertension: Part II.
Essential hypertension is characterized by various cell membrane abnormalities associated with receptor characteristics, enzymatic activity, and transmembrane ion exchange. These processes are interrelated with cellular signal transduction. Defects in the tightly controlled intracellular signaling pathways and their implications in the pathogenesis of hypertension are reviewed.


Plasma trans-fatty acid concentrations continue to be associated with metabolic syndrome among US adults after reductions in trans-fatty acid intake.
No study examined and compared the association between intake of trans-fatty acids (TFAs) and risk of metabolic syndrome before and after significant reduction of TFA intakes in the US population. We hypothesized that the relationship might remain significant after substantial reduction of TFA intakes in the population. We used data on 1442 and 2233 adults aged ≥20 years from the National Health and Nutrition Examination Survey 1999-2000 and 2009-2010, respectively. Multivariable logistic regression analysis was used to assess the association between plasma TFA concentrations and metabolic syndrome, including each of its 5 components. The median plasma TFA concentrations were reduced from 79.8 μmol/L in 1999-2000 to 36.9 μmol/L in 2009-2010. The fully adjusted prevalence ratios comparing the highest vs the lowest quintile of plasma TFA concentrations in 1999-2000 were 3.43 (95% confidence interval, 2.39-4.92) for metabolic syndrome, 1.72 (1.38-2.14) for large waistline, 8.25 (6.34-10.74) for high triglycerides, 1.96 (1.46-2.62) for low high-density lipoprotein cholesterol, 1.14 (0.85-1.55) for high blood pressure, and 1.48 (1.19-1.85) for high fasting glucose, respectively. The corresponding prevalence ratios in 2009-2010 were 2.93 (2.41-3.54), 1.62 (1.39-1.89), 14.93 (9.28-24.02), 3.09 (2.18-4.37), 1.27 (1.11-1.46), and 1.24 (1.06-1.46), respectively. The pattern of association between TFAs and metabolic syndrome and its components did not differ by cycles. The observed associations were consistent across the subgroups examined. Despite a 54% decline in plasma TFA concentrations from 1999-2000 to 2009-2010, it was positively associated with risk of metabolic syndrome and its individual components except for blood pressure in 1999-2000. Our findings support Food and Drug Administration initiatives to remove TFAs from the industrially-produced foods.


Sensitivity and specificity of an antigen detection ELISA for malaria diagnosis.
Enzyme-linked immunosorbent assays (ELISAs) allow for the testing of large numbers of samples within a short time frame. We tested the sensitivity and specificity of a histidine-rich protein 2 (HRP2)-based, commercially available ELISA antigen detection assay for Plasmodium falciparum (Malaria Antigen CELISA; Cellabs, Sydney, Australia). A total of 700 whole blood samples obtained from symptomatic outpatients of malaria clinics along the Thai-Myanmar border were tested relative to blinded duplicate expert microscopy adjusted with species-specific polymerase chain reaction (PCR). PCR-adjusted microscopy showed that 79 (11.3%) were infected with P. falciparum, 118 (16.9%) with P. vivax, 1 (0.1%) with P. malariae, 7 (1.0%) with mixed infections (P. falciparum and P. vivax), and 495 (70.7%) were negative. The geometric mean parasite density for P. falciparum was 7547/muL (range: 12-363,810/muL). The overall sensitivity of the HRP2 ELISA for P. falciparum malaria was 98.8% (95% CI, 93.6-100%) and the specificity was 100% (95% CI, 99.5-100%). The positive and negative predictive values for the ELISA were 100% (95% CI, 96.5-100%) and 99.8% (95% CI, 99.1-100%), respectively. The results for P. falciparum were clearly superior to expert microscopy alone, particularly in mixed infections. Microscopy combined with ELISA reaches a sensitivity and specificity similar to PCR-adjusted microscopy for the diagnosis of P. falciparum while being considerably less expensive and faster. We conclude that ELISA serves as an excellent tool to augment microscopy as the gold standard for P. falciparum diagnosis in research settings and should be further evaluated for screening in blood banks.


'Hidden identities': perceptions of sexual identity in Beijing.
This article draws upon responses given by volunteers who work in the Beijing LGBT Centre regarding perceptions of sexual identity, and how Chinese culture affects hidden or open sexual identities of Chinese lesbian and gay people in this region. The insights gained from those working carefully to create social change offers an important and original contribution to the field of gay and lesbian studies in China. The findings indicate the volunteers at the Beijing LGBT Centre are frustrated by the lack of acceptance of non-heterosexual relationships among Chinese culture and society, and by the disregard of lesbian gay and bisexual (LGB) people by the Chinese government. The findings also illustrate stigmatization of homosexuality in China is enacted in structural terms (such as in the lack of policy, legislation and positive endorsement by governmental and socio-political organizations), public expression (such as negative attitudes, beliefs or reactions towards LGB people) and internalized repression (through fear of stigmatization, and subsequent abuse due to negative societal attitudes and discrimination). Influenced by the Chinese tradition of conforming to group values, the findings from this study show that volunteers at the Beijing LGBT Centre believe LGB people in China are generally hesitant to disclose their sexual identities, and reject the idea that there had been a collective shift in Chinese culture regarding increased acceptance of LGB people. It also finds volunteers at the LGBT Centre in Beijing blame Chinese culture for its lack of acceptance of non-heterosexual relationships, and state stigmatization of homosexuality in China is due to deep-rooted cultural homophobia.


Skipping breakfast is associated with dysmenorrhea in young women in Japan.
To evaluate the effects of breakfast habits on the quality of life in young women in Japan, the relation between breakfast habits and menstrual and intestinal disorders was estimated by responses to a questionnaire. Subjects were recruited from young Japanese female students of Ashiya College ranging in age from 18 to 20 years. Breakfast habits were classified into three groups (group I, having breakfast every morning, n=289; group II, having breakfast one to six times per week, n=106; group III, having breakfast less than once a week, n=44). The intensity of dysmenorrhea was classified into three grades (score 1, free of pain or painful, but without need for analgesic; score 2, painful, requiring analgesic; score 3, painful, not relieved by analgesic). The grades of bowel movement were classified into three groups (score 1, no more than once a week; score 2, two to six times a week; score 3, every day). Group II and group III had significantly higher scores for dysmenorrhea compared with group I. Students in group III showed a tendency toward constipation. Since dysmenorrhea is a risk factor for psychological disorders as well as gynecological diseases, the present study suggests the importance of eating breakfast to the quality of life of young women.


Effects of insulin, recombinant bovine somatotropin, and their interaction on insulin-like growth factor-I secretion and milk protein production in dairy cows.
This trial was designed to test the effects of insulin, recombinant bovine somatotropin (rbST), and their interaction on milk protein and selected blood parameters in dairy cows. Eight Holstein cows (86 +/- 10 d in milk) were divided in two groups and used in two replicates of a Latin square design with four animals, four periods, and four treatments: 1) intravenous infusion of saline, 2) infusion of saline and subcutaneous administration of 40 mg of rbST per day, 3) intravenous infusion of 12 mg of insulin per day coupled with glucose infusion, and 4) rbST administration combined with insulin and glucose infusion. The glucose infusion rate was adjusted to maintain euglycemia. Each experimental period lasted 14 d: treatments were administered during the first 6 d, and no treatment was administered during the following 8-d resting phase. The average daily amount of glucose infusion needed to avoid hypoglycemia was 2.8 kg/cow when only insulin was infused as opposed to 2.2 kg/cow when both insulin and rbST were administered, indicating that either rbST causes a peripheral resistance to insulin or rbST increased liver gluconeogenesis or both. Data from the last 3 d of infusion were analyzed by using the SAS system for mixed models. Percent protein of milk tended to be lower (2.84 vs. 2.79%) and milk urea content was lower (16.6 vs. 14.8 mg/dl) during rbST administration, regardless of insulin infusion. Insulin infusion increased percent protein (2.78 vs. 2.85%) and percent casein (2.36 vs. 2.46%) and decreased milk urea content (17.1 vs. 14.3 mg/dl) regardless of rbST administration. For milk yield, protein yield, casein yield, lactose percent, and lactose yield, there were significant interactions between insulin and rbST administration. For example, casein yield averaged 1.17, 1.12, 1.20, and 1.28 kg/d for saline, insulin, rbST, and insulin combined with rbST, respectively. Similarly, there was a significant interaction between insulin and rbST on IGF-I levels, which were 122.5, 181.3, 342.3, and 492.2 ng/ml for saline, insulin, rbST, and insulin combined with rbST, respectively. In conclusion, these results clearly demonstrated that insulin interacts with bST in early lactation to improve milk protein synthesis and yield in dairy cows. These effects are probably mediated through a combination of bST nutrient mobilization, bST-induced gluconeogenesis, bST-induced insulin peripheral resistance, and bST/insulin synergism on insulin-like growth factor-I secretion and on mammary epithelial tissue.


Mycoplasma agassizii causes upper respiratory tract disease in the desert tortoise.
The desert tortoise is listed by the United States government as a threatened species in part of its range. A major contributing factor in the decline of this animal has been the presence of an upper respiratory tract disease (URTD) which is characterized by a chronic disease which eventually leads to severe occlusion of the nares with viscous exudate and destruction of the respiratory epithelium. Electron microscopy of infected tissues demonstrated the presence of a mycoplasma-like organism attached to the respiratory surfaces. The mycoplasma was isolated and designated as a new species, with the proposed name Mycoplasma agassizii. The current study was designed to fulfill Koch's postulates and determine if M. agassizii was the etiologic agent of URTD. Clinically healthy animals with known antibody status were infused intranasally with pooled exudate (n = 8) from ill donor animals, with M. agassizii alone (n = 9) or in combination with Pasteurella testudinis (n = 8), with P. testudinis alone (n = 9), or with sterile broth (n = 12). The pooled exudate was culture positive for M. agassizii. Tortoises which received exudate or M. agassizii alone or in conjunction with P. testudinis were significantly more likely to develop clinical disease (P < 0.0004) than animals which received P. testudinis alone or the broth controls. Tortoises demonstrated a strong immune response to M. agassizii, and seroconversion was seen in all groups with clinical disease. M. agassizii was isolated from the upper respiratory tracts of clinically ill animals up to 6 months postinfection. On the basis of the results of these transmission studies, we conclude that M. agassizii is an etiologic agent of URTD in the desert tortoise.


Bacteriological Profile and Antimicrobial Susceptibility Patterns of Bacteria Isolated from Pus/Wound Swab Samples from Children Attending a Tertiary Care Hospital in Kathmandu, Nepal.
In Nepal, little is known about the microbiological profile of wound infections in children and their antimicrobial susceptibility patterns. Total of 450 pus/wound swab samples collected were cultured using standard microbiological techniques and the colonies grown were identified with the help of biochemical tests. The antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion technique. Methicillin-resistant Staphylococcus aureus isolates were detected by using cefoxitin disc and confirmed by determining minimum inhibitory concentrations (MIC) of oxacillin. 264 (59%) samples were culture positive. The highest incidence of bacterial infections was noted in the age group of less than 1 year (76%). Out of 264 growth positive samples, Gram-positive bacteria were isolated from 162 (61%) samples and Gram-negative bacteria were found in 102 (39%) samples. Staphylococcus aureus (99%) was the predominant Gram-positive bacteria isolated and Pseudomonas aeruginosa (44%) was predominant Gram-negative bacteria. About 19% of S. aureus isolates were found to be methicillin-resistant MIC of oxacillin ranging from 4 μg/mL to 128 μg/mL. Among the children of Nepal, those of age less than 1 year were at higher risk of wound infections by bacteria. Staphylococcus aureus followed by Pseudomonas aeruginosa were the most common bacteria causing wound infections in children.


Individualized Immunological Data for Precise Classification of OCD Patients.
Obsessive⁻compulsive disorder (OCD) affects about 2% of the general population, for which several etiological factors were identified. Important among these is immunological dysfunction. This review aims to show how immunology can inform specific etiological factors, and how distinguishing between these etiologies is important from a personalized treatment perspective. We found discrepancies concerning cytokines, raising the hypothesis of specific immunological etiological factors. Antibody studies support the existence of a potential autoimmune etiological factor. Infections may also provoke OCD symptoms, and therefore, could be considered as specific etiological factors with specific immunological impairments. Finally, we underline the importance of distinguishing between different etiological factors since some specific treatments already exist in the context of immunological factors for the improvement of classic treatments.


Robot-assisted transumbilical laparoendoscopic single-site pyeloplasty: technique and perioperative outcomes from a single institution.
Transumbilical laparoendoscopic single-site (U-LESS) pyeloplasty may provide improved cosmesis compared with conventional laparoscopic pyeloplasty. However, U-LESS pyeloplasty can be challenging because of the need for extensive suturing. The wristed instrumentation of robot-assisted laparoendoscopic single-site (R-LESS) pyeloplasty provides improved dexterity to facilitate intracorporeal suturing. We therefore present our technique and experience with R-LESS pyeloplasty for ureteropelvic junction obstruction (UPJO). The da Vinci(®) S or Si Surgical System (Intuitive Surgical, Sunnyvale, CA) was used in all cases. Ureteral stents were placed cystoscopically at the start of each case. A 3-cm skin incision was made adjacent to the umbilicus. Three ports (12 mm, 8 mm, and 5 mm) were placed either through separate fascial incisions or into a GelPort(®) (Applied Medical, Rancho Santa Margarita, CA). Key techniques included port staggering, a "chopstick" arrangement of the instruments, and use of a 30° lens in an upward configuration. Traditional dismembered pyeloplasty procedures were performed in all cases. Patients less than 45 years of age with no prior abdominal surgery were offered this approach. Eight patients (4 female; 5 right-sided; median age, 22 years) underwent R-LESS pyeloplasty without the need for additional ports. All patients were discharged by the third postoperative day, and 5 were discharged on Day 1. One patient experienced urine leakage, which was managed with a temporary nephrostomy tube. Length of follow-up ranged from 29 to 46 months. No patients have developed symptoms or radiographic evidence of recurrent UPJO. R-LESS pyeloplasty can be safely performed for selected patients with currently available robotic equipment. Careful patient selection and case setup are key to successfully performing these procedures.


A Case of Post-COVID-19-Associated Paracentral Acute Middle Maculopathy and Giant Cell Arteritis-Like Vasculitis.
A 47-year-old man with a history of COVID-19 infection 2 months before presentation, presented with a scotoma of the paracentral visual field of the right eye. After thorough testing and evaluation, a diagnosis of paracentral acute middle maculopathy (PAMM) was established. Two months later, the patient developed temporal headache and jaw claudication. High-dose steroids were initiated, and workup for giant cell arteritis (GCA) was undertaken. The patient experienced resolution of the symptoms within 24 hours of steroid initiation. ESR, CRP, and temporal artery biopsy results were normal, although all were obtained more than 2 weeks after steroid initiation. To the best of our knowledge, our patient represents the first individual to date to potentially implicate COVID-19 in both small and large vessel vasculitis in the ophthalmic setting.