Evaluation of Adaptive Noise Management Technologies for School-Age Children with Hearing Loss.
Children with hearing loss experience significant difficulty understanding speech in noisy and reverberant situations. Adaptive noise management technologies, such as fully adaptive directional microphones and digital noise reduction, have the potential to improve communication in noise for children with hearing aids. However, there are no published studies evaluating the potential benefits children receive from the use of adaptive noise management technologies in simulated real-world environments as well as in daily situations. The objective of this study was to compare speech recognition, speech intelligibility ratings (SIRs), and sound preferences of children using hearing aids equipped with and without adaptive noise management technologies. A single-group, repeated measures design was used to evaluate performance differences obtained in four simulated environments. In each simulated environment, participants were tested in a basic listening program with minimal noise management features, a manual program designed for that scene, and the hearing instruments' adaptive operating system that steered hearing instrument parameterization based on the characteristics of the environment. Twelve children with mild to moderately severe sensorineural hearing loss. Speech recognition and SIRs were evaluated in three hearing aid programs with and without noise management technologies across two different test sessions and various listening environments. Also, the participants' perceptual hearing performance in daily real-world listening situations with two of the hearing aid programs was evaluated during a four- to six-week field trial that took place between the two laboratory sessions. On average, the use of adaptive noise management technology improved sentence recognition in noise for speech presented in front of the participant but resulted in a decrement in performance for signals arriving from behind when the participant was facing forward. However, the improvement with adaptive noise management exceeded the decrement obtained when the signal arrived from behind. Most participants reported better subjective SIRs when using adaptive noise management technologies, particularly when the signal of interest arrived from in front of the listener. In addition, most participants reported a preference for the technology with an automatically switching, adaptive directional microphone and adaptive noise reduction in real-world listening situations when compared to conventional, omnidirectional microphone use with minimal noise reduction processing. Use of the adaptive noise management technologies evaluated in this study improves school-age children's speech recognition in noise for signals arriving from the front. Although a small decrement in speech recognition in noise was observed for signals arriving from behind the listener, most participants reported a preference for use of noise management technology both when the signal arrived from in front and from behind the child. The results of this study suggest that adaptive noise management technologies should be considered for use with school-age children when listening in academic and social situations.


Muscular dystrophies and motoneuron diseases. A comparative electrophysiologic study.
Electrophysiologic investigations were carried out in 15 patients with limb-girdle muscular dystrophy, two patients with Becker's muscular dystrophy, and 22 patients with dystrophia myotonica. The results were compared with those obtained in 18 patients who had chronic progressive motoneuron disease and in 39 control subjects. These results were within normal limits in muscular dystrophies, with the exception of dystrophia myotonica, in which a neural disturbance is evident in the majority of patients. The results in motoneuron diseases were as expected for neurogenic disorders, loss of motor axons and compensatory increase of the amplitude of muscle potentials. There is no evidence of motoneuron dysfunction in muscular dystrophies, but in dystrophia myotonica, the muscles and nerves are affected independently by the pleiotropic gene of the disease.


Human intramyocardial oxygen detected through chronic polarographic electrodes.
The intramyocardial PO2 was studied in 7 patients after cardiac surgery, by means of a long-term electrode implanted subepicardically in the free wall of the left or the right ventricle, utilizing the polarographic method. Inhalation of 100% O2 or 5% CO2 +95% O2 provoked maximal increases in the myocardial PO2. In most cases intense exercise, and the Valsalva manoeuvre caused a decrease in the PO2. Intravenous propranolol slightly increased the PO2 in one case. Other drugs used in coronary patients caused inconstant effects. Sleeping decreased the heart PO2 in one case. This technique appears to be a useful tool for studying the human intramyocardial PO2 during a period of several weeks.


Making good on the promise of genomics in healthcare: the NSW Health perspective.
NSW Health is implementing genomics as a mainstream component of clinical care. The strategic, holistic approach is considering infrastructure, data governance and management, workforce, education, service planning and delivery. This work is generating insights about how to realise the promise of genomics in healthcare, highlighting the need for strong foundations, real-world application, accessibility and a focus on people using genomic information in clinical care.


Testosterone stimulates proliferation and inhibits interleukin-6 production of normal and hereditary gingival fibromatosis fibroblasts.
Hereditary gingival fibromatosis (HGF) is a rare oral condition characterized by a slow and progressive enlargement of the gingiva, involving both the maxilla and mandible. In vitro, HGF fibroblasts demonstrate a proliferative index significantly higher than fibroblasts from normal gingiva (NG). The objective of this study was to determine the effect of dihydrotestosterone on the proliferation of gingival fibroblasts derived from patients with HGF (n = 4) and from four healthy individuals. Additionally, we analyzed the effect of dihydrotestosterone on interleukin-6 (IL-6) production and determined the expression levels of androgen receptors in NG and HGF fibroblasts. Gingival fibroblasts from NG and HGF were incubated with increasing concentrations of dihydrotestosterone with or without androgen blockers, and cultured for 24 h, and the proliferation index was determined by automated cell counter. IL-6 production, in this system, was quantified using a "capture" enzyme-linked immunosorbent assay (ELISA). Semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) was performed to measure the mRNA expression of androgen receptors. The results indicated that dihydrotestosterone simultaneously downregulates the production of IL-6 and upregulates the cell proliferation. Finasteride and cyprosterone acetate, two anti-androgens, partially reversed these effects. Androgen receptor mRNA expression was identified in both NG and HGF fibroblasts; however, the levels in NG were higher than those observed in HGF. These results show that testosterone coordinates the proliferation and production of IL-6 of normal and HGF fibroblasts.


Does the reaction of abstaining smokers to the smell of other people's cigarettes predict relapse?
Recent ex-smokers report a range of reactions to other people's cigarette smoke. We examined the hypothesis that those who find the smell of smoke pleasant and tempting are more likely to relapse than those who have a neutral or even negative reaction to it. A total of 1110 consecutive patients who attended for smoking cessation treatment and achieved at least 1 week of validated abstinence provided weekly ratings of their reactions to other people's cigarette smoke together with routine baseline measures and weekly ratings of withdrawal discomfort [measured on the Mood and Physical Symptom Scale (MPPS)]. Twenty-three per cent of the sample found the smell of other people's cigarette smoke during their first week of abstinence pleasant, and 54% found it tempting. There was only a modest correlation between the two variables. Finding the smoke pleasant was not related to smoking status in the following week, but finding the smoke tempting predicted relapse. Ratings of temptation were related to the severity of withdrawal discomfort and to dependence. Entering MPPS ratings of urges to smoke in the given week into regression analysis resulted in the general urges to smoke, rather than urges elicited by other people's smoke, becoming a significant predictor of smoking status in the following week. In patients who maintained continuous abstinence throughout 4 weeks of treatment the pleasantness ratings remained stable, while the ratings of temptation steadily decreased. In abstaining smokers, the like or dislike of other people's smoke is not related to relapse. The temptation to smoke elicited by other people's smoke is related to outcome, but only as an indicator of a general 'temptation threshold'. Patients who find other people's smoke tempting can be reassured that this reaction will gradually decrease.


Hepatic DNA Methylation Is Affected by Hepatocellular Carcinoma Risk in Patients with and without Hepatitis Virus.
Several studies revealed that the proportion of hepatocellular carcinoma (HCC) without hepatitis virus infection (NBNC-HCC) is increasing. On the other hand, epigenetic alterations are reportedly responsible for HCC development. Here, we identified HCC risk factors that are associated with DNA methylation in the background liver tissue of NBNC-HCC patients. We performed methylation analysis in 37 pairs of virus-positive and 22 pairs of NBNC-HCC and non-cancerous livers using a HumanMethylation450 BeadChip array. After the selection of differentially methylated CpGs (DM-CpGs) in cancerous and non-cancerous livers, we analyzed DNA methylation of DM-CpGs within the adjacent non-cancerous liver tissue that is affected by specific HCC risk factors. A total of 38,331 CpGs were selected as DM-CpGs using the following criteria: difference of β-value between HCC and non-cancerous liver ≥0.15 and false discovery rate (FDR) q < 1.0E-12. We subsequently selected the DM-CpGs that had methylation differences with the background liver tissue (that has FDR q < 0.35). Among the virus-positive patients, the type of hepatitis virus was mostly associated with differences in methylation within the background liver tissues. However, we found that background methylation patterns were most significantly associated with aging in NBNC patients. Interestingly, age-related methylation differences in DM-CpGs were also observed in NBNC-HCC tissues. Hepatitis viruses affect the methylation profiles within background liver tissues. However, difference in background methylation was mostly associated with age in NCBC-HCC patients; some age-related methylation events could contribute to emergence of NBNC-HCC in elderly individuals.


Rational design and synthesis of a novel BODIPY-based probe for selective imaging of tau tangles in human iPSC-derived cortical neurons.
Numerous studies have shown a strong correlation between the number of neurofibrillary tangles of the tau protein and Alzheimer's disease progression, making the quantitative detection of tau very promising from a clinical point of view. However, the lack of highly reliable fluorescent probes for selective imaging of tau neurofibrillary tangles is a major challenge due to sharing similar β-sheet motifs with homologous Amyloid-β fibrils. In the current work, we describe the rational design and the in silico evaluation of a small-size focused library of fluorescent probes, consisting of a BODIPY core (electron acceptor) featuring highly conjugated systems (electron donor) with a length in the range 13-19 Å at C3. Among the most promising probes in terms of binding mode, theoretical affinity and polarity, BT1 has been synthesized and tested in vitro onto human induced pluripotent stem cells derived neuronal cell cultures. The probe showed excellent photophysical properties and high selectivity allowing in vitro imaging of hyperphosphorylated tau protein filaments with minimal background noise. Our findings offer new insight into the structure-activity relationship of this class of tau selective fluorophores, paving the way for boosting tau tangle detection in patients possibly through retinal spectral scans.


Evidence on reporting guidelines for surgical technique in clinical disciplines: a scoping review protocol.
The reporting of surgical techniques is of mixed quality, with most at a very minimal level. Reporting guidelines that could be applied to guide surgical technique reporting vary in methodology for development, discipline coverage, dimension coverage and detail requested. However, a scoping review that could indicate the gaps and efforts needed in surgical technique reporting guidelines is lacking and warranted. This study aims to design a methodological rigour protocol to guide the development of a scoping review of surgical technique reporting guidelines. This protocol is designed following the 2020 manual proposed by the Joanna Briggs Institute. To further ensure the soundness of the protocol, we also included multidisciplinary professionals (including methodologists, clinicians, and journal editors) to refine the protocol. Seven key steps for developing the scoping review are identified and presented in detail, including (I) identifying the research questions; (II) inclusion criteria; (III) search strategy; (IV) source of evidence selection; (V) data extraction; (VI) analysis of the evidence; and (VII) presentation of the results. Guided by this protocol, the subsequent scoping review will inform us the overview of surgical technique reporting guidelines and precisely guide our direction and next steps in improving surgical technique reporting guidelines. This protocol is not registered as the PROSPERO database only accepts registration of systematic review protocols while does not accept registration of scoping review protocols.


Sexually abused boys: awareness, assessment, and intervention.
The prevalence and consequences of the sexual victimization of young boys is tragically underestimated. The author provides data on the incidence of sexual abuse in boys and girls, ages 3-10, in an inpatient psychiatric children's unit. A retrospective chart review is presented including variables of coexisting maltreatment and symptomatology. Commonly found nursing diagnoses are identified with appropriate nursing interventions. Assessing a sexually abused boy, developing a comprehensive nursing care plan, and intervening effectively in assisting a child to assimilate and cope with his abuse experience are discussed in depth.


Clinical utility of circulating tumor DNA as a response and follow-up marker in cancer therapy.
Response evaluation for cancer treatment consists primarily of clinical and radiological assessments. In addition, a limited number of serum biomarkers that assess treatment response are available for a small subset of malignancies. Through recent technological innovations, new methods for measuring tumor burden and treatment response are becoming available. By utilization of highly sensitive techniques, tumor-specific mutations in circulating DNA can be detected and circulating tumor DNA (ctDNA) can be quantified. These so-called liquid biopsies provide both molecular information about the genomic composition of the tumor and opportunities to evaluate tumor response during therapy. Quantification of tumor-specific mutations in plasma correlates well with tumor burden. Moreover, with liquid biopsies, it is also possible to detect mutations causing secondary resistance during treatment. This review focuses on the clinical utility of ctDNA as a response and follow-up marker in patients with non-small cell lung cancer, melanoma, colorectal cancer, and breast cancer. Relevant studies were retrieved from a literature search using PubMed database. An overview of the available literature is provided and the relevance of ctDNA as a response marker in anti-cancer therapy for clinical practice is discussed. We conclude that the use of plasma-derived ctDNA is a promising tool for treatment decision-making based on predictive testing, detection of resistance mechanisms, and monitoring tumor response. Necessary steps for translation to daily practice and future perspectives are discussed.


Cognitive therapy versus fluoxetine in the treatment of dysthymic disorder.
We studied the effects of a fixed dose of fluoxetine (20 mg) or cognitive psychotherapy in a 16 week trial of patients with dysthymic disorder. More patients assigned to fluoxetine dropped out of the 16 week treatment (33%) than those assigned to cognitive therapy (9%), but this difference did not attain statistical significance. Both treatments showed improvement over baseline conditions at 8 weeks and further improvement at 16 weeks. There were no statistically significant group differences in treatment response. No follow-up data were collected so the enduring effects of the treatments are unknown. An optimal treatment for dysthymic disorder may be combined psychotherapy and pharmacotherapy for a longer period of time.


Glyoxal fixation: An approach to solve immunohistochemical problem in neuroscience research.
The gold-standard fixative for immunohistochemistry is 4% formaldehyde; however, it limits antibody access to target molecules that are buried within specialized neuronal components, such as ionotropic receptors at the postsynapse and voltage-gated ion channels at the axon initial segment, often requiring additional antigen-exposing techniques to detect their authentic signals. To solve this problem, we used glyoxal, a two-carbon atom di-aldehyde. We found that glyoxal fixation greatly improved antibody penetration and immunoreactivity, uncovering signals for buried molecules by conventional immunohistochemical procedures at light and electron microscopic levels. It also enhanced immunosignals of most other molecules, which are known to be detectable in formaldehyde-fixed sections. Furthermore, we unearthed several specific primary antibodies that were once judged to be unusable in formaldehyde-fixed tissues, allowing us to successfully localize so far controversial synaptic adhesion molecule Neuroligin 1. Thus, glyoxal is a highly effective fixative for immunostaining, and a side-by-side comparison of glyoxal and formaldehyde fixation is recommended for routine immunostaining in neuroscience research.


An Organocobalt-Carbon Nanotube Chemiresistive Carbon Monoxide Detector.
A chemiresistive detector for carbon monoxide was created from single-walled carbon nanotubes (SWCNTs) by noncovalent modification with diiodo(η5: η1-1-[2-(N,N-dimethylamino)ethyl]-2,3,4,5-tetramethylcyclopentadienyl)-cobalt(III) ([Cp^CoI2]), an organocobalt complex with an intramolecular amino ligand coordinated to the metal center that is displaced upon CO binding. The unbound amino group can subsequently be transduced chemiresistively by the SWCNT network. The resulting device was shown to have a ppm-level limit of detection and unprecedented selectivity for CO gas among CNT-based chemiresistors. This work, the first molecular-level mechanistic elucidation for a CNT-based chemiresistive detector for CO, demonstrates the efficacy of using an analyte's reactivity to produce another chemical moiety that is readily transduced as a strategy for the rational design of chemiresistive CNT-based detectors.


Ocular trauma treated with pars plana vitrectomy: early outcome report.
To evaluate demographic variables and visual outcomes, among patients with ocular injuries involving the posterior segment, managed with pars plana vitrectomy. The records of patients were studied retrospectively from March to September 2010, to determine the age, gender, place of occurrence of trauma, visual acuity, anatomical site, nature of injury, wound length, the presence of an afferent pupillary defect, and the timing of vitrectomy. The Ocular Trauma Score was measured. The minimum follow-up from presentation was 6mo. Ninety patients (77 males, 13 females), with a mean age of 32.7±15.8y were included over the 6-month period. The majority of cases occurred in the workplace (47 patients), followed by home (14 patients). The mean visual acuity (logMAR) of patients significantly improved from 2.36±0.72 preoperatively to 1.50±1.14 postoperatively. Twenty-three patients had preoperative vision better than 2.0 logMAR, the postoperative visual acuity was significantly better among these patients than patients with worse than 2.0 logMAR (P<0.001). Visual improvement between groups with early vitrectomy (<7d) and delayed vitrectomy (>7d) was not significantly different (P=0.66). Postoperative visual acuity was not significantly different between patients with injury in Zone I and II (P=0.64), but patients with injury in Zone III had significantly poorer visual acuity (P=0.02). Patients with relative afferent pupillary defect had significantly poorer postoperative visual acuity (P=0.02). Preoperative visual acuity, the difference of preoperative and postoperative visual acuity, and postoperative visual acuity were significantly different between groups with different ocular trauma scores (P<0.001). Trauma is more likely to occur in men under 40y of age and in the workplace. The favorable final visual outcome is associated with the absence of afferent pupillary defect, ocular trauma score and presenting visual acuity as well as the zone of injury, and not associated with the timing of vitrectomy.


Ectopic Adrenocorticotropic Hormone-Producing Metastatic Gastrinoma: A Case Report.
Pancreatic neuroendocrine tumors secreting gastrin and adrenocorticotropic hormone (ACTH) are rare. The presentation of the cases can be varied, making the diagnosis challenging and often delayed. Here, we present a patient who presented with severe hypokalemia and was found to have ectopic Cushing's syndrome. An abdominal CT scan showed a pancreatic lesion with metastatic liver disease. A biopsy of the liver lesion confirmed a metastatic neuroendocrine tumor. The final diagnosis was ectopic ACTH-producing metastatic gastrinoma. Twenty-four-hour urinary cortisol was significantly elevated at 9,790 mcg/24 hours. The excess hormonal secretion was successfully treated with ketoconazole and somatostatin analogs. She was further started on chemotherapy with capecitabine plus temozolomide, which has become the preferred chemotherapy treatment after the results of the recently completed trial. She also received Y90 therapy for metastatic liver disease. The prognosis of metastatic pancreatic neuroendocrine tumors is poor. Multidisciplinary combined therapies can help control disease and improve prognosis. We present an 18-month-long patient follow-up and a literature review of ectopic ACTH-producing metastatic gastrinomas.


Fusion to a homo-oligomeric scaffold allows cryo-EM analysis of a small protein.
Recent technical advances have revolutionized the field of cryo-electron microscopy (cryo-EM). However, most monomeric proteins remain too small (<100 kDa) for cryo-EM analysis. To overcome this limitation, we explored a strategy whereby a monomeric target protein is genetically fused to a homo-oligomeric scaffold protein and the junction optimized to allow the target to adopt the scaffold symmetry, thereby generating a chimeric particle suitable for cryo-EM. To demonstrate the concept, we fused maltose-binding protein (MBP), a 40 kDa monomer, to glutamine synthetase, a dodecamer formed by two hexameric rings. Chimeric constructs with different junction lengths were screened by biophysical analysis and negative-stain EM. The optimal construct yielded a cryo-EM reconstruction that revealed the MBP structure at sub-nanometre resolution. These findings illustrate the feasibility of using homo-oligomeric scaffolds to enable cryo-EM analysis of monomeric proteins, paving the way for applying this strategy to challenging structures resistant to crystallographic and NMR analysis.


Novel conformational states of peptide deformylase from pathogenic bacterium Leptospira interrogans: implications for population shift.
Peptide deformylase is an attractive target for developing novel antibiotics. Previous studies at pH 3.0 showed peptide deformylase from Leptospira interrogans (LiPDF) exists as a dimer in which one monomer is in a closed form and the other is in an open form, with different conformations of the CD-loop controlling the entrance to the active pocket. Here we present structures of LiPDF at its active pH range. LiPDF forms a similar dimer at pH values 6.5-8.0 as it does at pH 3.0. Interestingly, both of the monomers are almost in the same closed form as that observed at pH 3.0. However, when the enzyme is complexed with the natural inhibitor actinotin, the conformation of the CD-loop is half-open. Two pairs of Arg109-mediated cation-pi interactions, as well as hydrogen bonds, have been identified to stabilize the different CD-loop conformations. These results indicate that LiPDF may be found in different structural states, a feature that has never before been observed in the peptide deformylase family. Based on our results, a novel substrate binding model, featured by an equilibrium between the closed and the open forms, is proposed. Our results present crystallographic evidence supporting population shift theory, which is distinguished from the conventional lock-and-key or induced-fit models. These results not only facilitate the development of peptide deformylase-targeted drugs but also provide structural insights into the mechanism of an unusual type of protein binding event.


Inclusion Complexes of β-Cyclodextrin with Salvia officinalis Bioactive Compounds and Their Antibacterial Activities.
In the present study, the formation of molecular inclusion complexes of Salvia officinalis (sage) bioactive compounds with β-cyclodextrin (β-CD) was evaluated. Sage essential oil (SEO)/β-CD inclusion complexes (ICs) were prepared by co-precipitation at iso-molecular concentrations, and Fourier transform infrared spectroscopy (FT-IR) was applied for the confirmation of the ICs' formation. Quantification of the SEO in the inclusion complexes was performed spectrophotometrically at 273 nm using an SEO standard curve. The SEO and its inclusion complexes were evaluated for their antimicrobial activity against Escherichia coli, Staphylococcus aureus and Listeria monocytogenes. The results showed that β-CD effectively formed inclusion complexes with SEO in satisfactory yields. The antimicrobial activity of the SEO in prepared complexes with β-CD was exhibited against L. monocytogenes and S. aureus and was proportional to their concentrations but was less pronounced.


Reactions of the tetraoxidosulfate(˙-) and hydroxyl radicals with poly(sodium α-methylstyrene sulfonate).
Poly(α-methylstyrene sulfonic acid) (PAMS) represents a class of polymers that can form the protogenic constituent in electrolyte membranes for fuel cells. Oxidative stress is thought to play an important role in the degradation of the fuel cell membranes. Having previously established that damage may be mediated via abstraction of a benzylic hydrogen, we examined model compounds similar to those used before, but with a methyl group at the α-position. We studied the reaction of HO˙ and SO4(˙-), generated by pulse radiolysis, with model compounds in aqueous solution, and measured k = (2 ± 0.5) × 10(10) M(-1) s(-1) and (2 - 3) × 10(10) M(-1) s(-1) for the reaction of HO˙ with PAMS with average molecular weights of 2640 Da (PAMS-2640) and 6440 Da (PAMS-6440), respectively, at room temperature. At low pH, the decay of the hydroxycyclohexadienyl radical thus formed is accompanied by the formation of an absorption band in the visible region of the spectrum, which we tentatively assign to the radical cation of PAMS-2640 and -6440. The radical cation of PAMS-2640, formed by the reaction of SO4(˙-) with k = (6 ± 1) × 10(8) M(-1) s(-1), has a local absorption maximum at 560 nm, with ε560 ≥ 1400 M(-1) cm(-1). For the reaction of HO˙ and SO4(˙-) with the model compound benzenesulfonate, we measured k = (4-5) × 10(9) M(-1) s(-1) and (1.0 ± 0.3) × 10(8) M(-1) s(-1), respectively, while the reaction of SO4(˙-) with PAMS-6440 proceeds with (0.8-1) × 10(9) M(-1) s(-1). The 4-sulfophenoxyl radical was generated via the reaction of N3˙ with 4-hydroxybenzenesulfonate; ε410 ≥ 2300 M(-1) cm(-1). Not unexpectedly, the radical cation of PAMS is longer-lived than that of polystyrene sulfonic acid. Furthermore, fragmentation may result in desulfonation.


Update on malaria.
Despite recent successful efforts to reduce the global malaria burden, this disease remains a significant global health problem. Only in 2018, malaria caused 228 million clinical episodes, 2-4 million of which were severe malaria cases, and 405,000 were fatal. Most of the malaria attributable mortality occurred among children in sub-Saharan Africa. Nowadays, rapid diagnostic tests and artemisinin derivatives are two of the main pillars for the management of malaria. However, considering the current situation, these strategies are not sufficient to maintain a reducing trend in malaria incidence and mortality. New insights into the pathophysiology of malaria have highlighted the importance of the host response to infection. Understanding this response would help to develop new diagnostic and therapeutic tools. Vector and parasite drug resistance are two major challenges for malaria control that require special attention. The most advanced malaria vaccine (RTS,S) is currently being piloted in 3 African countries.


Evaluation of cervical spinal cord injuries with metrizamide myelography-CT scanning.
In the past, patients with injuries of the cervical spine and spinal cord have been diagnosed by means of myelography and polytomography. In an attempt to improve the radiographic evaluation of patients with cervical spinal cord injuries the authors performed computerized tomography (CT) scanning of the cervical spine following injection of metrizamide into the spinal subarachnoid space. In 23 patients with cervical spinal cord injuries, metrizamide myelography was performed via a C1-2 puncture. Myelography was used only for localization of the lesion and to determine the site of CT scanning. After myelography, CT scanning of the cervical spine in the transaxial plane was effective in determining the exact nature of compressive lesions and distinguishing the etiology among hematoma, disc, bone fragments, osteophytes, or ossification of the posterior longitudinal ligament. In several patients, metrizamide could be seen entering the spinal cord and was indicative of anatomical spinal cord disruption. In patients with fractures, CT scanning identified the site and nature of the injury without the need for turning the patient to the lateral position. In several patients with an apparently stable cervical spine, the CT scan showed apophyseal joint widening indicative of instability. The authors conclude that CT scanning of the cervical spine after the introduction of metrizamide into the subarachnoid space provides a definitive evaluation of the cervical spinal cord, the bone structures of the cervical spine, and their relationship to each other.


Primary Peritoneal Hydatid Cyst Presenting as Ovarian Cyst Torsion: A Rare Case Report.
Hydatid cyst disease is a zoonotic disease caused by Echinococcus granulosus, E.multilocularis or E.Vogli. The most common primary site is liver (75%) followed by lungs (5-15%) and other organs constitute 10-20%. Peritoneal hydatid cysts are very rare especially primary peritoneal hydatid. Secondary peritoneal hydatid cysts are relatively common, which usually occurs due to rupture of primary hepatic hydatid cyst. We present a rare case of large primary peritoneal hydatid cyst misdiagnosed as torsion of ovarian cyst that underwent Laparotomy with cyst excision and postoperative Albendazole therapy.


Retrobulbar hemorrhage nine days after cosmetic blepharoplasty resulting in permanent visual loss.
A healthy 45-year-old man had a retrobulbar hemorrhage 9 days after cosmetic upper eyelid blepharoplasty that resulted in permanent visual loss. After performing a left lateral canthotomy and cantholysis, intraocular pressure returned to normal and vision improved from no light perception to 20/40; however, the patient did have permanent visual field loss. To our knowledge, this is the longest period of time after blepharoplasty that a retrobulbar hemorrhage occurred. Ophthalmologists should have a heightened level of suspicion 1 to 2 weeks after surgery.


The impact of cranioplasty on neurological function.
To assess changes in neurological function after cranioplasty. Functional and neurocognitive assessments including activities of daily living assessment, functional independence measure (FIM) and the Cognitive assessment report (COGNISTAT) were conducted on all patients within 72 h before and 7 days after cranioplasty. A change in the total FIM score of 2 points was taken to be clinically significant. Assessments were performed on 25 patients. The functional status was unchanged in eighteen patients (72%), four patients (16%) demonstrated a significant improvement and three patients (12%) deteriorated significantly. Those with deterioration after cranioplasty had some forms of complications including pneumocephalus or seizure. After excluding the three patients who had immediate medical or surgical complications after surgery, there was a mild overall improvement in the mean FIM score (2.1, 95% confidence interval 0.1-4.3, p = 0.049), mainly due to an improvement in their motor function. A small but significant number of patients appear to improve clinically following cranioplasty. The so-called syndrome of the trephined may be more common than had been previously appreciated.


Mechanism of eIF6-mediated inhibition of ribosomal subunit joining.
During the process of ribosomal assembly, the essential eukaryotic translation initiation factor 6 (eIF6) is known to act as a ribosomal anti-association factor. However, a molecular understanding of the anti-association activity of eIF6 is still missing. Here we present the cryo-electron microscopy reconstruction of a complex of the large ribosomal subunit with eukaryotic eIF6 from Saccharomyces cerevisiae. The structure reveals that the eIF6 binding site involves mainly rpL23 (L14p in Escherichia coli). Based on our structural data, we propose that the mechanism of the anti-association activity of eIF6 is based on steric hindrance of intersubunit bridge formation around the dynamic bridge B6.


A pathway for entry of reoviruses into the host through M cells of the respiratory tract.
Many microorganisms gain access to the systemic circulation after entering the respiratory tract. The precise pathways used to cross the mucosal barriers of the lungs have not been clearly described. We have used the mammalian reoviruses in order to determine the pathway that a systemic virus uses to penetrate the mucosal barrier and enter the systemic circulation after entering the airways of the lungs. Reoviruses enter through pulmonary M cells, which overlie bronchus-associated lymphoid tissue, and subsequently spread to regional lymph nodes. Thus, the pathway through M cells represents a strategy by which viruses and probably other microorganisms can penetrate the mucosal surface of the respiratory tract and thereby enter the systemic circulation.


Salmon calcitonin in the treatment of elderly women with type 2 diabetes complicated with osteoporosis.
To explore the reasonable treatment scheme of salmon calciteonin in the treatment of elderly women with type 2 diabetes complicated with osteoporosis, patients were randomly divided into Group A, B and C, and they were given the salmon calcitonin every time 50 IU, subcutaneous injection. The Group A were 1 time a day, for 15 days; Group B were 1 time every 2 days, for 30 days; Group C, one time three days for 90 days. Then to observe the symptoms have efficiency, bone density T value change, incidence rate, incidence of side effects and treatment of loss rate of fracture. Efficiency of symptoms: Group A is lower and there is no difference in Group B and C. T Degree: Group C was significantly increased and Group A was the lowest. Fracture incidence of Group B and C were significantly lower than Group A, and there is no difference in Group B and C. Turnover rate: Group A was significantly lower than B and C, and there is no difference in Group B and C. There is low incidence of side effects in the three groups and they three have no significant difference. It is effective and safe to use salmon calcitonin in the treatment of elderly women with type 2 diabetes complicated with osteoporosis. 50 IU each time, subcutaneous injection, 1 time every 3 days, for 3 months is a reasonable solution.


Biodegradation of 3-Chloronitrobenzene and 3-Bromonitrobenzene by Diaphorobacter sp. Strain JS3051.
Halonitrobenzenes are toxic chemical intermediates used widely for industrial synthesis of dyes and pesticides. Bacteria able to degrade 2- and 4-chloronitrobenzene have been isolated and characterized; in contrast, no natural isolate has been reported to degrade meta-halonitrobenzenes. In this study, Diaphorobacter sp. strain JS3051, previously reported to degrade 2,3-dichloronitrobenzene, grew readily on 3-chloronitrobenzene and 3-bromonitrobenzene, but not on 3-fluoronitrobenzene, as sole sources of carbon, nitrogen, and energy. A Rieske nonheme iron dioxygenase (DcbAaAbAcAd) catalyzed the dihydroxylation of 3-chloronitrobenzene and 3-bromonitrobenzene, resulting in the regiospecific production of ring-cleavage intermediates 4-chlorocatechol and 4-bromocatechol. The lower activity and relaxed regiospecificity of DcbAaAbAcAd toward 3-fluoronitrobenzene is likely due to the higher electronegativity of the fluorine atom, which hinders it from interacting with E204 residue at the active site. DccA, a chlorocatechol 1,2-dioxygenase, converts 4-chlorocatechol and 4-bromocatechol into the corresponding halomuconic acids with high catalytic efficiency, but with much lower Kcat/Km values for fluorocatechol analogues. The results indicate that the Dcb and Dcc enzymes of Diaphorobacter sp. strain JS3051 can catalyze the degradation of 3-chloro- and 3-bromonitrobenzene in addition to 2,3-dichloronitrobenzene. The ability to utilize multiple substrates would provide a strong selective advantage in a habitat contaminated with mixtures of chloronitrobenzenes. IMPORTANCE Halonitroaromatic compounds are persistent environmental contaminants, and some of them have been demonstrated to be degraded by bacteria. Natural isolates that degrade 3-chloronitrobenzene and 3-bromonitrobenzene have not been reported. In this study, we report that Diaphorobacter sp. strain JS3051 can degrade 2,3-dichloronitrobenzene, 3-chloronitrobenzene, and 3-bromonitrobenzene using the same catabolic pathway, whereas it is unable to grow on 3-fluoronitrobenzene. Based on biochemical analyses, it can be concluded that the initial dioxygenase and lower pathway enzymes are inefficient for 3-fluoronitrobenzene and even misroute the intermediates, which is likely responsible for the failure to grow. These results advance our understanding of how the broad substrate specificities of catabolic enzymes allow bacteria to adapt to habitats with mixtures of xenobiotic contaminants.


Cystic adventitial disease of femoral vein presenting as enlarging lower limb swelling and pain: Two case reports and review of the literature.
Cystic adventitial disease (CAD) is a condition that mainly affects the arterial system but rarely involves the venous system. The present study reported on two cases of CAD of femoral veins. The clinical manifestations in the two patients included pain and swelling of the lower limbs, but they had no risk factors for venous thrombosis. Color ultrasonography indicated cystic space-occupying lesions around the femoral veins, and enhanced computed tomography (CT) revealed vascular compression and space-occupying properties of the femoral veins. The two patients underwent open surgery, the postoperative treatment was uneventful, and swelling and tenderness were completely resolved. The pathological examination confirmed CAD of femoral vein in the two patients. The enhanced CT venography scan indicated patency of the femoral vein in the two patients following the operation. The circumferences of the two patients' lower limbs had returned to normal at the 2-month follow-up. A review of the literature was performed, and the presentation, diagnosis, treatment and pathology of this rare condition were discussed.


Measurements of light scattering from glass substrates by total integrated scattering.
A total integrated scattering (TIS) measurement was performed to investigate the surface and volume scattering of K9 glass substrates with low reflectance. Ag layers with thicknesses of 60 nm were deposited on the front and back surfaces of the K9 glass substrates by the magnetron sputtering technique. Surface scattering of the K9 glass substrate was obtained by the TIS measurement of the Ag layers on the assumption that the Ag layers and the K9 substrate had the same surface profile. Volume scattering of the substrates was deduced by subtracting the front and back surface scattering from the total scattering of the substrates.


Computer-aided tissue engineering of a human vertebral body.
Tissue engineering is developing into a less speculative science involving the careful interplay of numerous design parameters and multidisciplinary professionals. Problem solving abilities and state of the art research tools are required to develop solutions for a wide variety of clinical issues. One area of particular interest is orthopedic biomechanics, a field that is responsible for the treatment of over 700,000 vertebral fractures in the United States alone last year. Engineers are currently lacking the technology and knowledge required to govern the subsistence of cells in vivo, let alone the knowledge to create a functional tissue replacement for a whole organ. Despite this, advances in computer-aided tissue engineering are continually growing. Using a combinatory approach to scaffold design, patient-specific implants may be constructed. Computer-aided design, optimization of geometry using voxel finite element models or other optimization routines, creation of a library of architectures with specific material properties, rapid prototyping, and determination of a defect site using imaging modalities highlight the current availability of design resources. This study proposes a novel methodology from start to finish which could, in the future, be used to design a tissue-engineered construct for the replacement of an entire vertebral body.


The risks of thromboembolism vs. recurrent gastrointestinal bleeding after interruption of systemic anticoagulation in hospitalized inpatients with gastrointestinal bleeding: a prospective study.
Anticoagulants carry a significant risk of gastrointestinal bleeding (GIB). Data regarding the safety of anticoagulation continuation/cessation after GIB are limited. We sought to determine the safety and risk of continuation of anticoagulation after GIB. We conducted a prospective observational cohort study on consecutive patients admitted to the hospital who had GIB while on systemic anticoagulation. Patients were classified into two groups at hospital discharge after GIB: those who resumed anticoagulation and those who had anticoagulation discontinued. Patients in both groups were contacted by phone 90 days after discharge to determine the following outcomes: (i) thromboembolic events, (ii) hospital readmissions related to GIB, and (iii) mortality. Univariate and multivariate Cox proportional hazards were used to determine factors associated with thrombotic events, rebleeding, and death. We identified 197 patients who developed GIB while on systemic anticoagulation (n=145, 74% on warfarin). Following index GIB, anticoagulation was discontinued in 76 patients (39%) at discharge. In-hospital transfusion requirements, need for intensive care unit care, and etiology of GIB were similar between the two groups. During the follow-up period, 7 (4%) patients suffered a thrombotic event and 27 (14%) patients were readmitted for GIB. Anticoagulation continuation was independently associated on multivariate regression with a lower risk of major thrombotic episodes within 90 days (hazard ratio (HR)=0.121, 95% confidence interval (CI)=0.006-0.812, P=0.03). Patients with any malignancy at time of GIB had an increased risk of thromboembolism in follow-up (HR=6.1, 95% CI=1.18-28.3, P=0.03). Anticoagulation continuation at discharge was not significantly associated with an increased risk of recurrent GIB at 90 days (HR=2.17, 95% CI=0.861-6.67, P=0.10) or death within 90 days (HR=0.632, 95% CI=0.216-1.89, P=0.40). Restarting anticoagulation at discharge after GIB was associated with fewer thromboembolic events without a significantly increased risk of recurrent GIB at 90 days. The benefits of continuing anticoagulation at discharge may outweigh the risks of recurrent GIB.


[Ill due to amalgam? 10 rules for managing the symptomatic patient].
Over the past two decades, mercury released by amalgam fillings has been held responsible for a number of mental and somatic health complaints. However, a systematic relation between increased mercury levels and the severity of the reported symptoms has never been demonstrated in any of the present well-controlled multidisciplinary studies. These studies, however, have found a high prevalence of mental disorders, especially somatization syndromes, among patients with self-diagnosed "amalgam illness". Additionally, our own studies indicate that amalgam anxiety is often merely one aspect of a general environmental anxiety. Overall, the present findings suggest a psychological etiology for amalgam-related complaints. Our psychosomatic model of "amalgam illness" integrates external factors, individual predispositions and specific processes of perception, awareness, evaluation and attribution. Practical management strategies for primary care physicians can be derived from this model.


Mycetoma: a contemporary concept.
Mycetoma is a localized noncontagious infection that involves cutaneous and subcutaneous tissue, fascia, and bone. The disease is caused by either aerobic actinomycetes or fungi that are normally associated with soil and plant material. In the past, actinomycosis, botryomycosis, fungus balls, and some forms of Majocchi's granuloma trichophyticum have been confused with mycetoma. Antimicrobic chemotherapy and surgery are management approaches used to resolve this disease.


Lead Induced Hepato-renal Damage in Male Albino Rats and Effects of Activated Charcoal.
Lead is a multi-organ toxicant implicated in various cancers, diseases of the hepatic, renal, and reproductive systems etc. In search of cheap and readily available antidote this study has investigated the role of activated charcoal in chronic lead exposure in albino rats. Eighteen mature male albino rats were used, divided into three groups of six rats per group. Group 1 (control rats) received deionised water (10 ml/kg), group 2 was given lead acetate solution 60 mg/kg and group 3 rats were given lead acetate (60 mg/kg) followed by Activated charcoal, AC (1000 mg/kg) by oral gavage daily for 28 days. Rats in group 2 showed significant increases in serum Aspartate aminotransferase, Alkaline phosphatase, Alanine aminotransferase, urea, bilirubin, total cholesterol, triglycerides, Low Density Lipoprotein, Very Low Density Lipoproteins, Total White Blood Cell Counts, Malondialdehyde, Interleukin-6, and decreases in Packed Cell Volume, hemoglobin concentration, Red blood cell count, total proteins, albumins, superoxide dismutase, glutathione peroxidase and total glutathione. Co-administration of AC significantly decreased these biomarkers with the exception of the sperm parameters. Histopathology of liver and kidney also confirmed the protective effective of AC against lead induced hepato-renal damage. AC may be beneficial in chronic lead induced liver and kidney damage.


Medical Performance and the Alchemy of Plants in the Ventures of Leonhard Thurneisser zum Thurn.
Among the cross currents of social and intellectual life in the early modern era, wonder, utility, and playfulness combined to inspire curiosity and to give value to novel alchemical procedures and chemical remedies. One of the most skilful alchemical and medical performers, who brought theatrical techniques to bear upon an economy of alchemical secrets and magic, was the self-trained Paracelsian physician, mining expert, and alchemical adept, Leonhard Thurneisser zum Thurn (1531-1596). In creatively designed and illustrated books produced for a luxury market, he constructed, in words and images, theatres of procedure, instrumentation, and chemical curiosity based in traditions of Renaissance magic and Paracelsian natural philosophy. Thurneisser's books combined strategies of spectacle and performance within the context of chemical analysis, and in one text especially brought the dramatic technique of "making strange" to bear upon promoting alchemical procedures for purposes of exposing the hidden powers within plants. In staging analytical spectacles involving measurement, instrumentation, and distillation as part of the analysis of minerals, waters, and plants, Thurneisser brought together laboratory-based procedures and theoretically grounded performances within the alchemical marketplace and engaged the agency of readers in establishing the credibility of the philosophy of nature that underscored the products he produced and sold.


Langerhans cells in dermoid cysts: transmission electron microscopic, cytochemical and immunofluorescent observations.
Langerhans cells were detected in squamous, stratified epithelia lining human dermoid cysts. Their presence was assayed by ATPase staining and reactivity with heteroantisera against "Ia-like" antigens. Transmission electron microscopic studies demonstrated variations in the numbers of cells showing Birbeck granules in epithelia with different degrees of keratinization. Indeterminate cells (i.e. lacking granules), were more frequent in epithelia showing combined mucous and keratinizing differentiation. Membrane-coating-granules and keratohyalin granules were present in epithelia containing Langerhans cells with clearly identifiable Birbeck granules. Interepithelial mast cells were observed in epithelia with mucous differentiation. A relationship between Langerhans cells and keratinization was suggested. Such non-immune functions are compatible with the known macrophage characteristics of the cell.


Increased regional ventilation as early imaging marker for future disease progression of interstitial lung disease: a feasibility study.
Idiopathic pulmonary fibrosis (IPF) is a disease with a poor prognosis and a highly variable course. Pathologically increased ventilation-accessible by functional CT-is discussed as a potential predecessor of lung fibrosis. The purpose of this feasibility study was to investigate whether increased regional ventilation at baseline CT and morphological changes in the follow-up CT suggestive for fibrosis indeed occur in spatial correspondence. In this retrospective study, CT scans were performed at two time points between September 2016 and November 2020. Baseline ventilation was divided into four categories ranging from low, normal to moderately, and severely increased (C1-C4). Correlation between baseline ventilation and volume and density change at follow-up was investigated in corresponding voxels. The significance of the difference of density and volume change per ventilation category was assessed using paired t-tests with a significance level of p ≤ 0.05. The analysis was performed separately for normal (NAA) and high attenuation areas (HAA). The study group consisted of 41 patients (73 ± 10 years, 36 men). In both NAA and HAA, significant increases of density and loss of volume were seen in areas of severely increased ventilation (C4) at baseline compared to areas of normal ventilation (C2, p < 0.001). In HAA, morphological changes were more heterogeneous compared to NAA. Functional CT assessing the extent and distribution of lung parenchyma with pathologically increased ventilation may serve as an imaging marker to prospectively identify lung parenchyma at risk for developing fibrosis. • Voxelwise correlation of serial CT scans suggests spatial correspondence between increased ventilation at baseline and structural changes at follow-up. • Regional assessment of pathologically increased ventilation at baseline has the potential to prospectively identify tissue at risk for developing fibrosis. • Presence and extent of pathologically increased ventilation may serve as an early imaging marker of disease activity.


High rate of benign histology in radiologically suspect renal lesions.
The objective of this study was to determine the incidence of benign renal lesions for clinically localised renal masses and the need for new diagnostic procedures to assess these lesions. This retrospective study included patients who underwent partial or radical nephrectomy between November 2010 and July 2013. All patients underwent a multiphase helical computed tomography (CT), which revealed suspected renal malignancy. The exclusion criteria were cystic tumours, biopsy before surgery, and disseminated and locally advanced disease. Lesions were defined as follows: small ≤ 4 cm, intermediate > 4 and ≤ 7 cm, and large > 7 cm. A total of 226 patients underwent radical or partial nephrectomy; of these 75 patients were excluded. In all, 151 had masses suspected of being malignant tumours on CT. The mean age was 62.9 years. The male: female ratio was 3:1. The distribution of small, intermediate and large lesions were 75 (49.7%), 47 (31.1%) and 29 (19.2%), respectively. Among the three types of lesions, 15 (20%), 5 (10.6%) and 3 (10.3%) were benign, respectively (p = 0.27). Partial nephrectomy was performed in 69.3% of patients with small tumours versus 23.4% of patients with intermediate tumours, p < 0.001. Benign lesions were observed in 20% of small renal masses ≤ 4 cm even though CT revealed a suspect renal lesion. The need for new diagnostic approaches for clinically localised renal lesions is evident. not relevant. not relevant.


CD4-Dependent Modulation of HIV-1 Entry by LY6E.
Lymphocyte antigen 6E (LY6E) is a GPI-anchored, interferon-inducible protein that has been shown to modulate viral infection in a cell type-dependent manner. Our recent work showed that LY6E promotes HIV-1 infection in some high-CD4-expressing cells, including human peripheral blood mononuclear cells (PBMCs) and the SupT1 cell line. In this work, we provide evidence that LY6E inhibits HIV-1 entry and spread in low-CD4-expressing Jurkat cells and human monocyte-derived macrophages (MDMs) through downregulation of the viral receptor CD4. We found that knockdown of LY6E in Jurkat cells and MDMs increases HIV-1 infection, yet overexpression of LY6E in Jurkat cells inhibits HIV-1 entry and replication. LY6E was found to be colocalized with CD4 on the plasma membrane of Jurkat cells and MDMs and enhances CD4 internalization. We artificially manipulated the CD4 level in Jurkat and SupT1 cells and found that overexpression of CD4 in Jurkat cells overcomes the inhibitory effect of LY6E; conversely, blocking the function of CD4 in SupT1 with a neutralizing antibody eliminates the enhancement of LY6E on HIV-1 entry. The CD4-dependent inhibitory phenotype of LY6E in low-CD4-expressing human MDMs can be recapitulated for a panel of transmitted founder viruses and laboratory-adapted HIV-1 strains. Given that HIV-1 can target low-CD4-expressing cells during acute infection yet replicates efficiently in high-CD4-expressing T cells at the late stage of disease, our observation that LY6E differentially modulates HIV-1 replication in a CD4-dependent manner has implications for understanding the complex roles of interferon (IFN)-induced proteins in AIDS pathogenesis.IMPORTANCE The role of IFN-induced genes (ISGs) in viral infection remains incompletely understood. While most ISGs are antiviral, some ISGs have been shown to promote viral infection, including HIV-1 infection. We previously showed that IFN-inducible LY6E protein promotes HIV-1 infection in human PMBCs and high-CD4-expressing SupT1 cells. Here we found that LY6E inhibits HIV-1 entry and replication in low-CD4-expressing MDMs and Jurkat cells. Mechanistically, we demonstrated that LY6E downregulates the cell surface receptor CD4, thus impairing the virus binding to target cells. This is in contrast to the situation of high-CD4-expressing cells, where LY6E predominantly promotes viral membrane fusion. The opposing role of IFN-inducible LY6E in modulating HIV-1 infection highlights the complex roles of ISGs in viral infection and viral pathogenesis.


Range of Motion and Plantar Pressure Evaluation for the Effects of Self-Care Foot Exercises on Diabetic Patients with and Without Neuropathy.
We aimed to investigate whether a home exercise for self-care program that consists of range of motion (ROM), stretching, and strengthening exercises could improve ROM for foot joints and plantar pressure distribution during walking in diabetic patients to prevent diabetic foot complications. Seventy-six diabetic patients were recruited (38 with neuropathy and 38 without neuropathy). Neuropathy and nonneuropathy groups were randomly divided into a home exercise group (n = 19) and a control group (n = 19). Exercise groups performed their own respective training programs for 4 weeks, whereas no training was done in the control group. Total contact area and plantar pressure under six foot areas before and after the exercise program were measured. Ankle and first metatarsophalangeal joint ROM were measured before and after the exercise program. In the exercise group, there were significant improvements in ROM for the ankle and first metatarsophalangeal joints (P < .001); static pedobarographic values showed significant reduction in right forefoot-medial pressure (P = .010); and significant decreases were seen in dynamic pedobarographic values of peak plantar pressure at the left forefoot medial (P = .007), right forefoot lateral (P = .018), left midfoot (P < .001), and right hindfoot (P = .021) after exercise. No significant positive or negative correlation was found between the neuropathy and nonneuropathy groups (P > .05). A home exercise program could be an effective preventive method for improving ROM for foot joints and plantar pressure distribution in diabetic patients independent of the presence of neuropathy.


[New vector control measures implemented between 2005 and 2011 on Reunion Island: lessons learned from chikungunya epidemic].
A major chikungunya outbreak concerned 38% of people living in Reunion Island in 2005-2006. Chikungunya is an arthropod-born-virus disease conveyed by mosquitoes called Aedes albopictus. The health agency in Indian Ocean is responsible for vector control. Previously, in the early 40s, vector control concerned only malaria prophylaxis in La Réunion. Then, during the chikungunya outbreak, a new vector control team was installed and learned from this epidemic. The lessons drawn from chikungunya outbreak in La Réunion are about global executive management and organization linked the local partners and population. The lessons also concern technical topics such as the need of scientific research about vectors and vector-control methods. Finally, the regional cooperation in Indian Ocean (Réunion, Maurice, Seychelles, Comoros, Madagascar) has to be developed to share epidemiologic and entomologic data in order to prevent new chikungunya or dengue outbreak.


Laparoscopic vs conventional Nissen fundoplication. A prospective randomized study.
Laparoscopic Nissen fundoplication has gained wide acceptance among surgeons, but the results of the laparoscopic procedure have not been compared to the results of an open fundoplication in a randomized study. Some 110 consecutive patients with prolonged symptoms of grade II-IV esophagitis were randomized, 55 to laparoscopic (LAP) and 55 to an open (OPEN) Nissen fundoplication. Postoperative recovery, complications, and outcome at 3- and 12-month follow-up were compared in the two groups. Five LAP operations were converted to open laparotomy due to esophageal perforation (two), technical difficulties (two), and bleeding (one). In the OPEN group (two) patients underwent splenectomy. There was no mortality. The mean hospital stay was 3.2 days in the LAP group and 6.4 in the OPEN group. Dysphagia and gas bloating were the most common complaints 3 months after the operation in both groups. These symptoms had disappeared at the 12-month follow-up examination. All patients in the LAP group and 86% in the OPEN group were satisfied with the result. Laparoscopic Nissen fundoplication is a safe and feasible procedure. Complications are few and functional results are good if not better than those of conventional open surgery.


On the Role of Additional [4Fe-4S] Clusters with a Free Coordination Site in Radical-SAM Enzymes.
The canonical CysXXXCysXXCys motif is the hallmark of the Radical-SAM superfamily. This motif is responsible for the ligation of a [4Fe-4S] cluster containing a free coordination site available for SAM binding. The five enzymes MoaA, TYW1, MiaB, RimO and LipA contain in addition a second [4Fe-4S] cluster itself bound to three other cysteines and thus also displaying a potentially free coordination site. This review article summarizes recent important achievements obtained on these five enzymes with the main focus to delineate the role of this additional [4Fe-4S] cluster in catalysis.


3D Hydrogel Scaffolds for Articular Chondrocyte Culture and Cartilage Generation.
Human articular cartilage is highly susceptible to damage and has limited self-repair and regeneration potential. Cell-based strategies to engineer cartilage tissue offer a promising solution to repair articular cartilage. To select the optimal cell source for tissue repair, it is important to develop an appropriate culture platform to systematically examine the biological and biomechanical differences in the tissue-engineered cartilage by different cell sources. Here we applied a three-dimensional (3D) biomimetic hydrogel culture platform to systematically examine cartilage regeneration potential of juvenile, adult, and osteoarthritic (OA) chondrocytes. The 3D biomimetic hydrogel consisted of synthetic component poly(ethylene glycol) and bioactive component chondroitin sulfate, which provides a physiologically relevant microenvironment for in vitro culture of chondrocytes. In addition, the scaffold may be potentially used for cell delivery for cartilage repair in vivo. Cartilage tissue engineered in the scaffold can be evaluated using quantitative gene expression, immunofluorescence staining, biochemical assays, and mechanical testing. Utilizing these outcomes, we were able to characterize the differential regenerative potential of chondrocytes of varying age, both at the gene expression level and in the biochemical and biomechanical properties of the engineered cartilage tissue. The 3D culture model could be applied to investigate the molecular and functional differences among chondrocytes and progenitor cells from different stages of normal or aberrant development.


Application of Machine Learning in the Reliability Evaluation of Pipelines for the External Anticorrosion Coating.
The purpose of this research is to enhance the analysis of the reliability status for external anticorrosive coatings. With the limitation and insufficiency of the static evaluation method, we study and construct an evaluation method of dynamic reliability for the anticorrosive layer, integrating the trend analysis of the Markov chain and the set pair theory. This method is implemented by the machine learning software of PyCharm community edition, based on Python language. The algorithm utilizes the connection degree in the set pair theory to determine the risk levels of the anticorrosive coating systems. According to the characteristics of the dynamic change of the anticorrosive layer with time, we built the mathematical evaluation model by combining it with the nonaftereffect property of the Markov chain. Therefore, we can make a dynamic and useful analysis for the reliability grade of the anticorrosive coating and assess the effectiveness grade of the changed reliability for the anticorrosive coating after some time. This method can effectively evaluate the reliability level of the anticorrosion coating through the example of big data of detection points. Under national standards, we provide the theoretical basis for pipeline maintenance within detection cycle requirements.


A high-throughput strategy for COVID-19 testing based on next-generation sequencing.
COVID-19 testing as sufficient as needed is essential for healthcare workers, patients, and authorities to make informed decisions to confront and eventually defeat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, diagnosis of COVID-19 relies on quantitative reverse-transcription PCR, which is low-throughput, laborious, and often false-negative, making it overwhelmingly challenging to meet testing needs even in industrialized countries. Here we propose a new strategy, which employs a modified loop-mediated isothermal amplification (LAMP) assay, a simple procedure requiring no sophisticated instruments, to index and amplify viral genes from individual specimens, of which the products are readily available for construction of multiplexed libraries for next-generation sequencing. Our strategy would allow precise diagnosis of thousands of specimens in 1-2 days with significantly lower operating expenses. Furthermore, this strategy will make it possible for patients to collect, process, and mail their own samples to facilities for a quick, reliable diagnosis at a population scale.


Computer printing and filing of microbiology reports. 2. Evaluation and comparison with a manual system, and comparison of two manual systems.
A manual system of microbiology reporting with a National Cash Register (NCR) form with printed names of bacteria and antiboitics required less time to compose reports than a previous manual system that involved rubber stamps and handwriting on plain report sheets. The NCR report cost 10-28 pence and, compared with a computer system, it had the advantages of simplicity and familarity, and reports were not delayed by machine breakdown, operator error, or data being incorrectly submitted. A computer reporting system for microbiology resulted in more accurate reports costing 17-97 pence each, faster and more accurate filing and recall of reports, and a greater range of analyses of reports that was valued particularly by the control-of-infection staff. Composition of computer-readable reports by technicians on Port-a-punch cards took longer than composing NCR reports. Enquiries for past results were more quickly answered from computer printouts of reports and a day book in alphabetical order.


Adjunctive therapy for severe malaria: a review and critical appraisal.
Despite recent efforts and successes in reducing the malaria burden globally, this infection still accounts for an estimated 212 million clinical cases, 2 million severe malaria cases, and approximately 429,000 deaths annually. Even with the routine use of effective anti-malarial drugs, the case fatality rate for severe malaria remains unacceptably high, with cerebral malaria being one of the most life-threatening complications. Up to one-third of cerebral malaria survivors are left with long-term cognitive and neurological deficits. From a population point of view, the decrease of malaria transmission may jeopardize the development of naturally acquired immunity against the infection, leading to fewer total cases, but potentially an increase in severe cases. The pathophysiology of severe and cerebral malaria is not completely understood, but both parasite and host determinants contribute to its onset and outcomes. Adjunctive therapy, based on modulating the host response to infection, could help to improve the outcomes achieved with specific anti-malarial therapy. In the last decades, several interventions targeting different pathways have been tested. However, none of these strategies have demonstrated clear beneficial effects, and some have shown deleterious outcomes. This review aims to summarize evidence from clinical trials testing different adjunctive therapy for severe and cerebral malaria in humans. It also highlights some preclinical studies which have evaluated novel strategies and other candidate therapeutics that may be evaluated in future clinical trials.


Development and characterization of monoclonal antibodies to detect klotho.
Although antibodies are commercially available to allow investigation into the biology of the age-regulating protein Klotho, problems with antibody specificity and application functionality are significant barriers to progress. Chief among these limitations is the inability of current tools to allow in vivo validation of binding partners originally identified through transfection of tagged proteins. To overcome this barrier, we generated a series of hybridoma cell lines by immunizing rats with a GST-KL1 fusion protein. Purified antibodies generated from these cell lines differentially detect human or mouse Klotho protein via Western blot, immunocyto/histochemistry, and immunoprecipitation. Specificity of antibody binding to Klotho was confirmed by mass spectrometry following immunoprecipitation. With this confidence in antibody specificity, co-immunoprecipitation was utilized to validate the interaction of Klotho/FGFR and Klotho/wnt7a in mouse kidney lysates.


Improved Total Synthesis of Tubulysins and Design, Synthesis, and Biological Evaluation of New Tubulysins with Highly Potent Cytotoxicities against Cancer Cells as Potential Payloads for Antibody-Drug Conjugates.
Improved, streamlined total syntheses of natural tubulysins such as V (Tb45) and U (Tb46) and pretubulysin D (PTb-D43), and their application to the synthesis of designed tubulysin analogues (Tb44, PTb-D42, PTb-D47-PTb-D49, and Tb50-Tb120), are described. Cytotoxicity evaluation of the synthesized compounds against certain cancer cell lines revealed a number of novel analogues with exceptional potencies [e.g., Tb111: IC50 = 40 pM against MES SA (uterine sarcoma) cell line; IC50 = 6 pM against HEK 293T (human embryonic kidney cancer) cell line; and IC50 = 1.54 nM against MES SA DX (MES SA with marked multidrug resistance) cell line]. These studies led to a set of valuable structure-activity relationships that provide guidance to further molecular design, synthesis, and biological evaluation studies. The extremely potent cytotoxic compounds discovered in these investigations are highly desirable as potential payloads for antibody-drug conjugates and other drug delivery systems for personalized targeted cancer chemotherapies.


Expressing Double-Stranded RNAs of Insect Hormone-Related Genes Enhances Baculovirus Insecticidal Activity.
Baculoviruses have already been used for insect pest control, but the slow killing speed limits their further promotion and application. Here we provide a strategy for improving baculovirus insecticidal activity using Helicoverpa armigera nucleopolyhedrovirus (HearNPV) to express double-stranded RNAs (dsRNAs) targeting cotton bollworm (Helicoverpa armigera) juvenile hormone (JH)-related genes. Droplet-feeding bioassays show that the 50% lethal concentration (LC50) values of recombinant baculoviruses expressing the dsRNA of JH acid methyl transferase gene (HaJHAMT) and the JH acid binding protein gene (HaJHBP) were 1.24 × 10⁴ polyhedral inclusion bodies (PIB)/mL and 2.26 × 10⁴ PIB/mL, respectively. Both were much lower than the control value (8.12 × 10⁴ PIB/mL). Meanwhile, the LT50 of recombinant baculovirus expressing dsRNA of HaJHBP was only 54.2% of the control value, which means that larval death was accelerated. Furthermore, the mRNA level of target genes was reduced in recombinant baculovirus-treated cotton bollworm larvae. Transcription of several key genes involved in hormone signaling pathways-for example, ecdysone receptor gene (HaEcR)-was also altered. This study establishes a new strategy for pest management by interfering with insect hormone-related gene expression via baculoviruses, and the engineered baculoviruses have great potential application in cotton production.


The Coexistence of Colorectal Polyps in the Right Colon Increases the Malignant Risk of Laterally Spreading Tumors.
The coexistence of colorectal polyps with laterally spreading tumors (LSTs) is commonly observed during colonoscopy. However, there are rare studies that assess the malignant risks for LSTs with colorectal polyps, which might largely contribute to further strategies of treatment and follow-up plans in LSTs. We conducted a retrospective cohort study that enrolled 206 patients with LSTs in the Endoscopy Center and Endoscopy Research Institute, Renji Hospital, Shanghai Jiao Tong University, China. The subjects with LSTs were divided into two groups: the nonpolyp group with 89 patients and the polyp group with 117 patients. Binary logistic regression was used to identify the independent predictors of outcomes of interest. The risk of the polyps' coexistence phenomenon increased in males compared with females (OR = 2.138, p = 0.047), especially in those between 50 and 75 years old (OR = 7.074, p = 0.036). Tumor size (3-4 cm), LSTs with tubulovillous types, and history of polyps statistically increased the risk of the polyp coexistence phenomenon (OR = 5.768, p = 0.003; OR = 36.345, p = 0.024; OR = 13.245, p < 0.0001, respectively). LST-NG-PD (OR = 20.982, p = 0.017) and LSTs ≥ 5 cm (OR = 37.604, p = 0.038) notably increased the malignant risk of LSTs. When the simultaneous polyps are located in the right colon, the risk of malignant LSTs (OR = 58.540, p = 0.013) positively increased. The simultaneous colorectal polyps in the right colon were the most important risk factor to predict the malignant risk of LSTs.


Interferon-induced cell cycle changes in human hematopoietic cell lines and fresh leukemic cells.
A panel of 26 human hematopoietic cell lines was tested for sensitivity to growth inhibition towards interferon-alpha (IFN-alpha) by estimating the effects on cell cycle phase distribution using flow cytometry analysis. The proportion of proliferating cells was assessed by studying the fractional increase of cells in mitosis during a 24-hr vinblastine block. Of 26 cell lines tested, 17 were sensitive to IFN-alpha, and the main cell cycle effect was accumulation in the G0-G1 phase. One Burkitt's lymphoma line, Namalwa, showed a decreased rate of progress through S without any G0/G1 accumulation. Three of the cell lines were also tested with IFN-beta and with IFN-alpha 2 produced by recombinant DNA technology. The latter IFN did not affect one of the cell lines; otherwise, the results were similar to those of IFN-alpha. Six of 16 clinical specimens from patients with hematopoietic neoplasias were IFN-sensitive, all displaying a G0-G1 block. Our results indicate that IFN sensitivity is an individually linked property unrelated to cell origin.


Impact of pulsed Nd:YAG laser on the marine biofilm-forming bacteria Pseudoalteromonas carrageenovora: significance of physiological status.
The impact of pulsed Nd:YAG (neodymium-doped yttrium/aluminium garnet) laser irradiation on the marine biofilm-forming bacteria Pseudoalteromonas carrageenovora during two growth stages (log phase and stationary phase) and under two stresses (reduced temperature and nutrient limitation) was investigated. Bacteria were exposed to a laser fluence of 0.1 J x cm(-2) for 5, 10, and 15 min with a peak power of 20 MW x cm(-2), a pulse width of 5 ns, and an average power of 1 W x cm(-2) with a repetition rate of 10 Hz. The mortality of bacteria immediately after the irradiation as well as after a set period of time was determined. Mortality was higher among log-phase bacteria (72%) than bacteria in the stationary phase (51%) and those grown under nutrient limitation (51%). Bacteria grown at reduced temperature had a mortality of 49%. However, the differences in cell density of log-phase, stationary-phase, nutrient-limited, and low-temperature irradiated samples compared with controls after 5 h of incubation were 96, 93, 94, and 86%, respectively. The mortality values suggest that the same laser fluence has different degrees of effectiveness, depending on the physiological state of the bacteria.


The effect of being imitated on empathy for pain in adults with high-functioning autism: Disturbed self-other distinction leads to altered empathic responding.
Autism spectrum disorder is a neurodevelopmental disorder that is associated with problems in empathy. Recent research suggests that impaired control over self-other overlap based on motor representations in individuals with autism spectrum disorder might underlie these difficulties. In order to investigate the relationship of self-other distinction and empathy for pain in high-functioning autism and matched controls, we manipulated self-other distinction by using a paradigm in which participants are either imitated or not by a hand on a computer screen. A strong pain stimulus is then inflicted on the observed hand. Behavioral and physiological results in this study showed that overall affective responses while watching pain movies were the same in adults with high-functioning autism as in controls. Furthermore, controls showed higher affective responding after being imitated during the whole experiment, replicating previous studies. Adults with high-functioning autism, however, showed increased empathic responses over time after being imitated. Further exploratory analyses suggested that while affective responding was initially lower after being imitated compared to not being imitated, affective responding in the latter part of the experiment was higher after being imitated. These results shed new light on empathic abilities in high-functioning autism and on the role of control over self-other representational sharing.


[Effectiveness of Xuebijing in treatment of multiple organ dysfunction syndrome: a Meta analysis].
To systematical evaluate the effect of Xuebijing injection in the treatment of multiple organ dysfunction syndrome (MODS). With the keywords including Xuebijing, multiple organ dysfunction syndrome, multiple organ dysfunction and multiple organ failure, PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), VIP and Wanfang Data from the database start until March 4th, 2018 were searched for relevant randomized controlled trials (RCTs) related to Xuebijing injection combined conventional treatment versus conventional treatment alone for MODS. The control group received conventional western medicine treatment, including etiological treatment, antibiotics, mechanical ventilation, nutritional support, and comprehensive treatment to maintain fluid, electrolyte, acid and alkali balance. The experimental group was given traditional western medicine combined with Xuebijing injection. The observation parameters included 7-day and 28-day mortality, acute physiology and chronic health evaluation II (APACHE II) and Marshall score, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), the number of platelets, activated partial thromboplastin time (APTT) and prothrombin time (PT). According to the inclusion and exclusion criteria, two evaluators independently screened the literature, extracted data and evaluated the methodological quality of the included studies. RevMan 5.3 software was used for Meta analysis. Funnel plot was used to analyze publication bias. A total of 35 RCTs and 2 131 patients were enrolled, including 1 076 in the experimental group and 1 055 in the control group. The results of Meta analysis showed that compared with control group, Xuebijing combined conventional treatment was in favor to decrease the mortality of patients with MODS [7-day mortality: odds ratio (OR) = 0.42, 99% confidence interval (99%CI) = 0.26-0.69, P < 0.000 01; 28-day mortality: OR = 0.31, 99%CI = 0.21-0.45, P < 0.000 01], also could obviously reduce critical condition degree of APACHE II score and the organ function of Marshall score [APACHE II: mean difference (MD) = 3.24, 99%CI = 2.00-4.49, P < 0.000 01; Marshall score: MD = 1.95, 99%CI = 0.50-3.40, P = 0.000 5]. Meanwhile, the results of conventional western medicine combined with Xuebijing in the removal of IL-6 and TNF-α, platelets increase and improvement of PT were better than those of conventional western medicine (IL-6: MD = 5.56, 99%CI = 1.44-9.68, P = 0.000 5; TNF-α: MD = 4.97, 99%CI = 3.44-6.50, P < 0.000 01; platelets: MD = -50.79, 99%CI = -74.84 to -26.74, P < 0.000 1; PT: MD = 4.55, 99%CI = 3.96-5.14, P < 0.000 01), however, there was no obvious advantage in improving APTT (MD = 0.96, 99%CI = -5.08-7.00, P = 0.68). The analysis of funnel map showed that the effect points of various studies were mainly centered on the amount of combined effect, and the "inverted funnel" type was generally symmetrical distribution. However, because the number of the included studies was less, the literature bias could not be completely eliminated. Xuebijing injection may through its strong cytokines clearance, platelet increase and blood coagulation improvement to protect the organ function in patients with MODS, so as to reduce the mortality and improve the prognosis.


[Quantitative structural study of pulmonary artery in patients with pulmonary atresia with ventricular septal defect ].
In order to provide pathologic reference for therapeutic rationale, the pathological changes of the pulmonary vasculature in patients with pulmonary atresia with ventricular defect and patent ductus arteriosus were observed by contrast with normal control group. Lung biopsies were taken in the operation in 10 children suffered from pulmonary atresia with ventricular septal defect associated with patent ductus arteriosus (PA group). Autopsy specimens were obtained from 10 children died of non-cardiovascular diseases as normal control group. The tissue was fixed with buffered formalin, routinely prepared by impregnated in wax. Sections were stained by hematoxylin-eosin, Weigert's elastic stain counter-stained by van Gieoson's method. Seven parameters were obtained including percentage of media thickness (MT%), percentage of media section area (MS%), numbers of vascular per square centimeter (VPSC), mean alveolar number (MAN), mean linear intercept (MLI), proportion of parenchyma area in total area (PPA), and alveolar/vascular ratio per unit area (AVR) by a computer image processor by quantitative analysis. There were significant difference between the two groups in MAN, VPSC, and AVR (P < 0.05). VPSC was significantly lower in PA group than in control group (P < 0.01). Other parameters had no significant difference. The mean alveolar diameter had an increased trend in PA group, although there was no significant difference. MS% of nearly 50% patients was closed to the normal value in PA group. The shape of pulmonary arteriole was irregular. There were few muscular arteries in a field of vision. The density of muscular arteries decreases in patients with pulmonary atresia with ventricular septal defect and patent ductus arteriosus, but percentage of media thickness and percentage of media section area of pulmonary arterioles are close to the normal value. Diminished flow in pulmonary circulation has a significant effect on numbers of pulmonary arterioles per square centimeter that impact the selection of surgical method and the effect of operation because of the reduction pulmonary arterioles. The decrease of mean alveolar number results in compensatory enlargement of alveolar diameter. The impaired lung development is a major cause of abnormal lung function. Feasible and earlier operation, which can increase pulmonary flow and promote development of pulmonary vasculature will be helpful to restore lung function.


Novel anti-carbohydrate autoantibodies in patients with inflammatory bowel disease: are they useful for clinical practice?
The objective of this study was to test the diagnostic accuracy of novel anti-carbohydrate assays in patients with inflammatory bowel disease, namely in Crohn's disease. These carbohydrate assays are based on oligosaccharide chitobioside carbohydrate - anti-chitobioside carbohydrate antibodies (ACCA), laminaribioside carbohydrate anti-laminaribioside carbohydrate antibodies (ALCA), and mannobioside carbohydrate - anti-mannobioside carbohydrate antibodies (AMCA). We compared these assays with the anti-Saccharomyces cerevisiae antibodies (ASCA) assay. The results of this study suggest that ASCA are still the best serological marker for Crohn's disease. Further studies are required to explore the clinical utility of ACCA, ALCA and AMCA.


Vascular oxidant stress and inflammation in hyperhomocysteinemia.
Elevated plasma levels of homocysteine are a metabolic risk factor for atherosclerotic vascular disease, as shown in numerous clinical studies that linked elevated homocysteine levels to de novo and recurrent cardiovascular events. High levels of homocysteine promote oxidant stress in vascular cells and tissue because of the formation of reactive oxygen species (ROS), which have been strongly implicated in the development of atherosclerosis. In particular, ROS have been shown to cause endothelial injury, dysfunction, and activation. Elevated homocysteine stimulates proinflammatory pathways in vascular cells, resulting in leukocyte recruitment to the vessel wall, mediated by the expression of adhesion molecules on endothelial cells and circulating monocytes and neutrophils, in the infiltration of leukocytes into the arterial wall mediated by increased secretion of chemokines, and in the differentiation of monocytes into cholesterol-scavenging macrophages. Furthermore, it stimulates the proliferation of vascular smooth muscle cells followed by the production of extracellular matrix. Many of these events involve redox-sensitive signaling events, which are promoted by elevated homocysteine, and result in the formation of atherosclerotic lesions. In this article, we review current knowledge about the role of homocysteine on oxidant stress-mediated vascular inflammation during the development of atherosclerosis.


Government Communication, Perceptions of COVID-19, and Vaccination Intention: A Multi-Group Comparison in China.
Government communication has been playing an important role in mass vaccination to conduct the largest vaccination campaign of the world for COVID-19 and to counter vaccine hesitancy. This study employs the health belief model to examine the association between government communication and the COVID-19 vaccination intention. A survey of Chinese adults (N = 557) was conducted in March 2021, and partial least squares structural equation modeling was employed to estimate the multi-construct relationships. The findings indicate that government communication has both direct positive association with vaccination intention and indirect association with vaccination intention through the mediation of perceived severity, benefits, and barriers. Multi-group comparisons suggest that individuals from private sectors are more easily mobilized to receive COVID-19 vaccination by government communication than those from public sectors. Similarly, the correlation between government communication and the vaccination intention of individuals with a good health status was stronger than that of those with a poor health status. The theoretical and practical implications of these findings are further discussed.


Short review of potential synergies of immune checkpoint inhibition and radiotherapy with a focus on Hodgkin lymphoma: radio-immunotherapy opens new doors.
Radiotherapy is an established local treatment in patients with various malignancies. Systemic responses following local irradiation have been described as abscopal effects. Modern cancer immunotherapy with immune checkpoint inhibitors has shown impressive response rates and prolongation of survival even in heavily pretreated patients with advanced solid malignancies and lymphomas. Radiotherapy has been shown to modulate immune response, and its application in the context of immune checkpoint inhibition has recently evolved into an active field of research. Prospective studies investigating combination treatment are currently ongoing and will answer questions as to the optimal schedule and radiation dosing. This short review focuses on the immunomodulatory role of radiotherapy and the use of immune checkpoint inhibition with a special focus on Hodgkin lymphoma.


Relationship of the angiographic extent of peripheral arterial disease with coronary artery involvement.
To determine the co-incidence of coronary artery disease (CAD) in patients investigated for peripheral arterial disease (PAD), and to establish the relationship between the risk factors in the two groups of patients. The prospective study, done from January 2005 and April 2009, at the Cardiology Clinic of Rize Education and Research Hospital, Rize and John F. Kennedy Hospital, Istanbul, Turkey, had a cohort of 307 patients who had been diagnosed with peripheral artery disease either clinically or by ultrasonography for the arteries of the lower extremities and had undergone coronary angiography and peripheral angiography in the same or different sessions. The patients were evaluated in terms of age, gender and atherosclerotic risk factors. Relationship of the extent of peripheral arterial disease with coronary artery involvement was investigated. Of the 307 patients, 251 (81.8%) were male, and the mean age was 62.1 +/- 9.5 years. In the study population, 178 (58.0%) patients were diagnosed as hypertensive, 84 (27.4%) patients were diabetic, 18 (5.9%) patients had a family history of coronary artery disease, 111 (36.2%) were smokers, 149 (48.5%) were hypercholesterolemic, and 20 (6.5%) had cerebrovascular/carotid disease. In 92.3% of patients with peripheral arterial disease, various levels of coronary stenosis (P = 0.007) was noticed. Hypertension was a risk factor for both coronary and peripheral artery diseases (p = 0.012 and 0.027, respectively). Univariate logistic regression analysis demonstrated that the presence of peripheral artery disease was related to the coronary variety (Odds ratio [OR]: 6, 95% CI: 1.4-25.5, P = 0.016) and severe cases (diffused atherosclerotic stenosis and complete occlusion in all segments) significantly indicated the presence of some coronary pathology (OR: 8, 95% CI: 1.7-37.4, P = 0.008). This relationship maintained its significance after adjustment for age, gender, hypercholesterolaemia, smoking, hypertension, diabetes, family history, and the presence of cerebrovascular/carotid disease (p = 0.010). Peripheral coronary artery diseases had similar risk factors. The extent of peripheral arterial disease observed during peripheral lower extremity angiography was significantly associated with the presence and severity of coronary artery disease. Particular attention should be focused on the possibility of coronary artery disease in patients with established and extensive peripheral arterial disease. Non-invasive, as well as invasive tests, should be performed to decrease morbidity and mortality risk of such patients.


Efficacy of a Brief Mindfulness Intervention in Underserved Individuals Receiving Inpatient Treatment for Opioid Use Disorder: A Pilot Study.
Introduction A mindfulness intervention is a mind-body complementary health approach that focuses on the relationships between mind, body, brain, and behavior. Mindfulness-Based Stress Reduction (MBSR) and similar mindfulness programs have been shown to decrease drug craving and relapse and improve emotional regulation, stress, pain, and anxiety. To our knowledge, a very limited number of studies have examined its efficacy in individuals from underserved populations. Underserved populations experience disparities in healthcare access, and as a result, see poorer addiction-related outcomes. The goal of this pilot study was to utilize an evidence-based, neuroscience-informed brief mindfulness intervention to improve mental health and decrease substance use behavior in a vulnerable, underserved population in New Jersey suffering from opioid use disorder (OUD). Methods We implemented a brief MBSR intervention in 15 underserved individuals undergoing inpatient medication-assisted treatment (MAT) for OUD. Individuals received weekly intervention sessions lasting one hour over six weeks. Furthermore, they practiced mindfulness for 10 minutes daily. Participants completed pre-and post-mindfulness intervention surveys to examine their mental well-being, drug craving, perceived stress, and emotional regulation. Results Within-subjects t-test results showed that compared to pre-intervention, participants showed significantly decreased perceived stress (t(14) =2.401, p=.015) and significantly decreased difficulty in emotional regulation (t(13) =3.426, p=.002 ) at post-intervention. They also showed significantly decreased drug craving post-intervention (t(14) =5.501, p=.<001). Anxiety decreased post-intervention but was not statistically significant (t(14) =1.582, p=.068). Conclusion This pilot study demonstrates that a brief mindfulness intervention can be effective for underserved individuals with OUD. Consistent with our hypothesis, results showed that a six-week mindfulness intervention could reduce everyday stress, drug craving, and difficulties in emotional regulation. In the future, a large-scale randomized control trial should be conducted with a control group to demonstrate the efficacy of this useful intervention.


Oral etoposide.
Etoposide, a semisynthetic derivative of podophyllotoxin, has been commercially available for intravenous use for a number of years, and has been used as part of first-line combination chemotherapy programs for small cell lung cancer (SCLC). It has also been used to treat testicular cancer, non-small cell lung cancer, and a variety of other malignancies. Etoposide for oral use has become commercially available and is approved for use in the treatment of SCLC. Although no clinical trials comparing intravenous and oral etoposide in SCLC have been reported, several pharmacokinetic studies have been described. These studies have demonstrated a mean bioavailability of 50 percent, with a wide range among patients. Other pharmacokinetic parameters are similar for both the intravenous and oral methods of administration. Based on these results, the recommended dose of oral etoposide is twice the intravenous dose. Oral etoposide has been demonstrated to be effective in the treatment of SCLC. It offers a reasonable and cost-effective outpatient alternative for this group of patients.


Post-traumatic syringomyelia resolution following surgical treatment: the moniliform syrinx with a better prognosis.
Post-traumatic syringomyelia (PTS) presented as a serious delayed complication after spinal cord injury (SCI). In our preliminary pathological investigation of PTS in an animal model, the endogenous repair was activated during the early stage of the central canal expansion. We thought about whether there might be an "early syringomyelia state" with a better outcome. This study aimed to further understand the pathophysiological basis of PTS's occurrence, development, and outcome. A cross-sectional observational study from a single-center syringomyelia database prospectively maintained at China International Neuroscience Institute (CHINA-INI). A consecutive series of 28 PTS patients at our institution for surgical treatment met the inclusion criteria of this study. Their clinical and imaging data in a long-term follow-up were reviewed retrospectively. We compared the surgical outcome between moniliform and distended syringomyelia based on high‑resolution MRI and syringomyelia-related symptoms. American Spinal Injury Association (ASIA) impairment scale (AIS) grade to assess their neurological status. Through a series of phenotypic comparisons, we found that moniliform-like syrinx belongs to a special morphological state with a shorter natural history. The patients in the moniliform group had a better surgical outcome compared with those in the distended group (P = 0.028): more obvious symptom improvement as shown in Kaplan-Meier analysis (P = 0.033, Chi square = 4.523) and a higher syringomyelia resolution rate (P = 0.024). We consider the delayed post-traumatic syringomyelia with moniliform type with a better surgical outcome and emphasize the importance of timely intervention to restore cerebrospinal fluid circulation.


A reason to rhyme: phonological and semantic influences on lexical access.
During on-line language production, speakers rapidly select a sequence of words to express their desired meaning. The current study examines whether this lexical selection is also dependent on the existing activation of surface properties of the words. Such surface properties clearly matter in various forms of wordplay, including poetry and musical lyrics. The experiments in this article explore whether language processing more generally is sensitive to these properties. Two experiments examined the interaction between phonological and semantic features for written and verbal productions. In Experiment 1, participants were given printed sentences with a missing word, and were asked to generate reasonable completions. The completions reflected both the semantic and the surface features of the preceding context. In Experiment 2, listeners heard sentence contexts, and were asked to rapidly produce a word to complete the utterance. These spontaneous completions again incorporated surface features activated by the context. The results suggest that lexical access in naturalistic language processing is influenced by an interaction between the surface and semantic features of language.