Transforming growth factor beta inhibits Leydig cell functions.
The role of transforming growth factor beta (TGF-beta) on the functions of pig Leydig cells cultured in a chemically defined medium was investigated. TGF-beta reduced the number of hCG receptors, without modification of the binding affinity, and reduced the cAMP and testosterone response to this hormone. These effects were dose-dependent. The minimal effective dose was 10 pg/ml (4 X 10(-13) M) and half-maximal inhibition for the three effects was observed at about 100 pg/ml. At maximal effective concentration (1 ng/ml), the inhibitory effect was time-dependent, the first effects were observed after a lag period of 12 h and the maximal effect after 72 h. At maximal concentrations TGF-beta reduced by 70% the number of hCG receptors and the steroidogenic response to this hormone and reduced by 50% the cAMP response to hCG. Moreover, TGF-beta also reduced the cAMP response to forskolin and the steroidogenic effects of this diterpene and 8-Bromo-cAMP. In contrast, the conversion of exogenous pregnenolone to testosterone was increased in TGF-beta-treated cells. The inhibition of Leydig cell steroidogenesis can be dissociated from any effect on cell proliferation and is related to modifications located at the membrane level and beyond cAMP formation, but before pregnenolone formation. The results suggest that in the testis, as in other steroidogenic tissues, TGF-beta may play a role in the development and maintenance of differentiated function.


Acarboxy prothrombin in cord plasma from normal neonates.
Acarboxy prothrombin was detected in the plasma of 48 of 128 umbilical cord plasma samples and in all of 65 patients receiving coumadin. None was found in 20 normal adults. Although the prevalence was the same in blacks, whites, and neonates of mixed origin, levels were significantly higher in blacks. There was a negative correlation between the level of acarboxy prothrombin and the prothrombin index. There was no correlation between maternal age, birth weight, gestational age, obstetrical complications, race, socioeconomic status, albumen, or alpha-foetoprotein and the incidence of cord plasma acarboxy prothrombin.


Social and professional support needs of families after perinatal loss.
Perinatal loss has been associated with depression, anxiety, obsessive-compulsive disorder, suicide, marital conflict, and post-traumatic stress disorder. Nurses may provide professional support through teaching, role modeling, encouragement, counseling, problem solving, and other interventions. Nurses also may encourage more effective social support by helping significant others to provide willing, well-intentioned action that will produce a positive response in the bereaved couple. Interventions to increase professional and social support after perinatal loss are described.


Rapid progression of band-shaped keratopathy with early central localisation in a patient on chronic dialytic treatment.
This clinical study reports on an unusual start of a band-shaped keratopathy in a patient with diabetic nephropathy on dialytic treatment. The earliest corneal manifestations were centrally located small greyish-white disc-shaped lesions evenly distributed in the interpalpebral area in the left eye. Later a typical peripheral band-shaped keratopathy developed. In the course of the observation period the peripheral keratopathy rapidly spread towards the centre, finally resulting in a complete band-shaped keratopathy in which only the most central original disc-shaped lesions could be identified. Serum calcium and phosphorus concentrations were markedly elevated at the time of the progression of the band-shaped keratopathy but no tertiary hyperparathyroidism was present.


Testing a Novel Wearable Device for Motor Recovery of the Elbow Extensor Triceps Brachii in Chronic Spinal Cord Injury.
After corticospinal tract damage, reticulospinal connections to motoneurons strengthen preferentially to flexor muscles. This could contribute to the disproportionately poor recovery of extensors often seen after spinal cord injury (SCI) and stroke. In this study, we paired electrical stimulation over the triceps muscle with auditory clicks, using a wearable device to deliver stimuli over a prolonged period of time. Healthy human volunteers wore the stimulation device for ∼6 h and a variety of electrophysiological assessments were used to measure changes in triceps motor output. In contrast to previous results in the biceps muscle, paired stimulation: (1) did not increase the StartReact effect; (2) did not decrease the suppression of responses to transcranial magnetic brain stimulation (TMS) following a loud sound; (3) did not enhance muscle responses elicited by a TMS coil oriented to induce anterior-posterior current. In a second study, chronic cervical SCI survivors wore the stimulation device for ∼4 h every day for four weeks; this was compared with a four-week period without wearing the device. Functional and electrophysiological assessments were repeated at week 0, week 4, and week 8. No significant changes were observed in electrophysiological assessments after paired stimulation. Functional measurements such as maximal force and variability and speed of trajectories made during a planar reaching task also remained unchanged. Our results suggest that the triceps muscle shows less potential for plasticity than biceps; pairing clicks with muscle stimulation does not seem beneficial in enhancing triceps recovery after SCI.


A Protocol to Evaluate Retinal Vascular Response Using Optical Coherence Tomography Angiography.
Optical coherence tomography angiography (OCT-A) is a novel diagnostic tool with increasing applications in ophthalmology clinics that provides non-invasive high-resolution imaging of the retinal microvasculature. Our aim is to report in detail an experimental protocol for analyzing both vasodilatory and vasoconstriction retinal vascular responses with the available OCT-A technology. A commercial OCT-A device was used (AngioVue®, Optovue, CA, United States), and all examinations were performed by an experienced technician using the standard protocol for macular examination. Two standardized tests were applied: (i) the hypoxia challenge test (HCT) and (ii) the handgrip test, in order to induce a vasodilatory and vasoconstriction response, respectively. OCT-A was performed at baseline conditions and during the stress test. Macular parafoveal vessel density of the superficial and deep plexuses was assessed from the en face angiograms. Statistical analysis was performed using STATA v14.1 and p < 0.05 was considered for statistical significance. Twenty-four eyes of 24 healthy subjects (10 male) were studied. Mean age was 31.8 ± 8.2 years (range, 18-57 years). Mean parafoveal vessel density in the superficial plexus increased from 54.7 ± 2.6 in baseline conditions to 56.0 ± 2.0 in hypoxia (p < 0.01). Mean parafoveal vessel density in the deep plexuses also increased, from 60.4 ± 2.2 at baseline to 61.5 ± 2.1 during hypoxia (p < 0.01). The OCT-A during the handgrip test revealed a decrease in vessel density in both superficial (55.5 ± 2.6 to 53.7 ± 2.9, p < 0.001) and deep (60.2 ± 1.8 to 56.7 ± 2.8, p < 0.001) parafoveal plexuses. In this work, we detail a simple, non-invasive, safe, and non-costly protocol to assess a central nervous system vascular response (i.e., the retinal circulation) using OCT-A technology. A vasodilatory response and a vasoconstriction response were observed in two physiologic conditions-mild hypoxia and isometric exercise, respectively. This protocol constitutes a new way of studying retinal vascular changes that may be applied in health and disease of multiple medical fields.


Cell Voltage-Dependent Structural Dichotomy: Electrochemical C-H Acyloxylation and N-Acylation of 2H-Indazoles.
A simple and efficient electrochemical method that utilizes modulation of the cell voltage to cause structural alterations in 2H-indazole is introduced. This method enables the C-3 acyloxylation of 2H-indazole and promotes the transfer of the acyl group from C-3 to N-1, allowing the N-acylation of 2H-indazoles. Additionally, the application of the μ-electro flow reactor was demonstrated, showcasing its effectiveness in achieving gram-scale production of 3x within a short residence time.


Enantioselective synthesis of planar-chiral 1,n-dioxa[n]paracyclophanes via catalytic asymmetric ortho-lithiation.
Highly enantioselective ortho-lithiation and dilithiation of 1,n-dioxa[n]paracyclophanes were realized with the use of sec-butyllithium and a catalytic or stoichiometric amount of sparteine. Quenching with various electrophiles, such as iodine, iodomethane, and chlorodiphenylphosphine, afforded chiral mono- and disubstituted paracyclophanes with good to excellent ee.


A unifying theory for general multigenic heterosis: energy efficiency, protein metabolism, and implications for molecular breeding.
Hybrids between genetically diverse varieties display enhanced growth, and increased total biomass, stress resistance and grain yield. Gene expression and metabolic studies in maize, rice and other species suggest that protein metabolism plays a role in the growth differences between hybrids and inbreds. Single trait heterosis can be explained by the existing theories of dominance, overdominance and epistasis. General multigenic heterosis is observed in a wide variety of different species and is likely to share a common underlying biological mechanism. This review presents a model to explain differences in growth and yield caused by general multigenic heterosis. The model describes multigenic heterosis in terms of energy-use efficiency and faster cell cycle progression where hybrids have more efficient growth than inbreds because of differences in protein metabolism. The proposed model is consistent with the observed variation of gene expression in different pairs of inbred lines and hybrid offspring as well as growth differences in polyploids and aneuploids. It also suggests an approach to enhance yield gains in both hybrid and inbred crops via the creation of an appropriate computational analysis pipeline coupled to an efficient molecular breeding program.


IL-2 inhibits the induction of systemic antitumour immunity by IL-4 in the peritumoural treatment of experimental melanoma.
We have examined the relative abilities of interleukin-4 (IL-4) and interleukin-2 (IL-2) to inhibit the growth of the B.16 melanoma in C57BL/6 mice. Tumours were allowed to become established and then treated peritumourally with either IL-4 or IL-2, or a combination of IL-4 plus IL-2. Treatment was continued for 7 days and then the tumours were removed and weighed. The results showed that IL-4 strongly inhibited tumour growth in 83% of individuals, but complete resolution was observed in only 18%. In the IL-2 treated groups, the percentage of growth-inhibited tumours was markedly less (50%), with 14% complete resolutions. In the IL-4+IL-2 treated tumours resolution was again different, such that only 57% of tumours were smaller than those seen in the controls but there was a high number bearing no measurable tumour (25%). In addition, of the three treatments described, only peritumoural administration of IL-4 alone could mediate the induction of systemic protection from tumour growth. These results suggest that IL-4 and IL-2 have different mechanisms of action and that IL-2 may antagonise the effect of IL-4 such that the action of the two materials when combined is highly unpredictable.


Twelve-month outcome of patients with an established indication for oral anticoagulation undergoing coronary artery stenting and stratified by the baseline risk of bleeding: Insights from the Warfarin and Coronary Stenting (War-Stent) Registry.
To evaluate the outcome of patients with an established indication for oral anticoagulation (OAC) undergoing coronary stent implantation (PCI-S) and stratified by the baseline risk of bleeding. The database of the prospective, multicentre, observational WAR-STENT registry (ClinicalTrials.gov identifier NCT00722319) was analyzed and patients with atrial fibrillation and CHA2DS2-VASc score ≥2, mechanical heart valve, prior cardiac embolism, intra-cardiac thrombus and recent venous thromboembolism who were treated with either triple (warfarin, aspirin and clopidogrel) or dual (warfarin and clopidogrel) or dual antiplatelet (aspirin and clopidogrel) therapy, identified. Patients were then sorted into two groups at non-low and low risk of bleeding, as defined by an ATRIA score >3 and ≤3 respectively, and compared regarding major adverse cardiac and vascular events (MACVE) and bleeding. At 12-month follow up, MACVE were comparable in the two groups, whereas total, major and minor bleeding, as well as combined MACVE and total bleeding, were significantly more frequent in the non-low bleeding risk group. Upon Cox univariate and multivariable analysis, non-low bleeding risk category confirmed as an independent predictor of major bleeding. The choice of antithrombotic therapy however, appeared not to be influenced by the bleeding risk category at baseline. In patients with an established indication for OAC undergoing PCI-S, non-low bleeding risk category is the most potent independent predictor of major bleeding. Stratification of the bleeding risk at baseline should therefore be regarded as an indispensable process to be carried out before selection of the antithrombotic therapy.


Hyperuricosuria and hypercalciuria, probable etiologies of functional abdominal pain: A case-control study.
Functional abdominal pain (FAP) is a common complaint causing several referrals to pediatricians. On the other hand, the most common presentation of hyperuricosuria and also hypercalciuria is chronic/recurrent abdominal pain. Therefore, a hypothesis has been raised; abdominal pain due to hyperuricosuria and/or hypercalciuria may be misdiagnosed as FAP. The current study has aimed to respond to this theory. This is a case-control study conducted on children diagnosed with FAP based on Rome IV criteria and age-matched normal controls. Blood and random urine samples were taken from healthy children and those with FAP. Random urine samples were examined for calcium, uric acid, oxalate, and creatinine concentrations. Random urine calcium to urine creatinine above 0.2 mg/mg was considered hypercalciuria and random urine uric acid above 0.56 mg/dl, GFR as hyperuricosuria. The data were analyzed using logistic models. Hypercalciuric children had a significantly lower chance of FAP (odds ratio [OR] =0.425, 95% confidence interval [CI] =0.204-0.886). Although an inverse association was seen between hyperuricosuria and FAP (OR = 0.693, 95% CI = 0.395-1.214), it was not statistically significant. In stratified analyses by gender for both hyperuricosuria and hypercalciuria, a marginal inverse significant association was seen in male gender (P < 0.1). Our study showed that hypercalciuria is significantly in inverse association with FAP but not hyperuricosuria. Therefore, these disorders, particularly hyperuricosuria may not be considered as the possible causes of FAP. Further studies with larger sample size for providing more reliable evidence are recommended.


Dementia-specific risks of scabies: retrospective epidemiologic analysis of an unveiled nosocomial outbreak in Japan from 1989-90.
Although senile dementia patients in long-term care facilities are at leading risk of scabies, the epidemiologic characteristics of this disease have yet to be fully clarified. This study documents the findings of a ward-scale nosocomial outbreak in western Japan from 1989-90, for which permission to publish was only recently obtained. A retrospective epidemiologic study was performed to identify specific risk factors of scabies among patients with dementia. Analyses were based on a review of medical and nursing records. All inpatients in the affected ward at the time of the outbreak were included in the study. Observational and analytical approaches were employed to assess the findings. Twenty of 65 inpatients in the ward met the case definition of scabies. The outbreak lasted for almost 10 months and as a result, the spatial distribution of infections showed no localized patterns in the latter phase of the outbreak. The duration of illness significantly decreased after initiation of control measures (P = 0.0067). Movement without assistance (Odds Ratio [OR] = 11.3; 95% Confidence Interval [CI]: 2.9, 44.8) and moving beyond the room (but within the ward) (OR = 4.1; 95% CI: 1.4, 12.5) were significantly associated with infection, while types of room (Western or Japanese) and sleeping arrangement (on beds or futons laid directly on the floor) appeared not to be risk factors. Univariate analysis demonstrated the importance of patients' behaviours during daily activities in controlling scabies among senile dementia patients. The findings also support previous evidence that catching scabies from fomites is far less common. Moreover, since cognitive disorders make it difficult for individuals to communicate and understand the implications of risky contacts as well as treatment method, and given the non-specific nature of individual contacts that are often unpredictable, real-time observations might help improve control practices.


Topological insulator state in gated bilayer silicene.
We investigate the topological insulator state of gated bilayer silicene in the presence of extrinsic Rashba spin-orbit (SO) coupling. The system exhibits a band insulator (BI) phase for small Rashba SO coupling, and then translate to a strong topological insulator (TI) phase with both spin and valley filtered at large Rashba SO coupling. The strong TI phase is robust in the presence of intrinsic SO and intrinsic Rashba SO couplings. When a titled electric field is introduced, the in-plane component of the electric field gives rise to an interlayer Rashba SO coupling, and the system turns to a BI phase no matter how large the Rashab SO coupling and bias voltage are. This will provide potential application in nanoelectronics based on silicene.


On-Road Chemical Transformation as an Important Mechanism of NO2 Formation.
Nitrogen dioxide (NO2) not only is linked to adverse effects on the respiratory system but also contributes to the formation of ground-level ozone (O3) and fine particulate matter (PM2.5). Our curbside monitoring data analysis in Detroit, MI, and Atlanta, GA, strongly suggests that a large fraction of NO2 is produced during the "tailpipe-to-road" stage. To substantiate this finding, we designed and carried out a field campaign to measure the same exhaust plumes at the tailpipe-level by a portable emissions measurement system (PEMS) and at the on-road level by an electric vehicle-based mobile platform. Furthermore, we employed a turbulent reacting flow model, CTAG, to simulate the on-road chemistry behind a single vehicle. We found that a three-reaction (NO-NO2-O3) system can largely capture the rapid NO to NO2 conversion (with time scale ≈ seconds) observed in the field studies. To distinguish the contributions from different mechanisms to near-road NO2, we clearly defined a set of NO2/NO x ratios at different plume evolution stages, namely tailpipe, on-road, curbside, near-road, and ambient background. Our findings from curbside monitoring, on-road experiments, and simulations imply the on-road oxidation of NO by ambient O3 is a significant, but so far ignored, contributor to curbside and near-road NO2.


[The value of comparison of echography and sialo-tomography in the preoperative evaluation of parotid tumors].
Studying information provided by sialo-tomography and parotid ultrasonography in the pre-operative investigation of parotid tumors, the authors compare results provided by the two types of investigation. Whilst ultrasonography, a non-invasive technique, provides more detail concerning the topography and appearance of the tumor than sialography, it cannot yet be used as a substitute for this radiological investigation. The two would appear to be complementary, leading the last word to histopathology.


Unicompartmental knee arthroplasty, is it superior to high tibial osteotomy in treating unicompartmental osteoarthritis? A meta-analysis and systemic review.
Debate remains whether high tibial osteotomy (HTO) or unicompartmental knee arthroplasty (UKA) is more beneficial for the treatment of unicompartmental knee osteoarthritis. The purpose of this study was to compare the functional results, knee scores, activity levels, and complications between the two procedures. We performed a systematic review of published literature from August 1982 through January 2017. Fifteen papers reporting three prospective randomized trials were subjected to a meta-analysis. No significant difference between the two groups was noted with respect to free walking (velocity), knee score, deterioration of the contralateral or patellofemoral knee, or revision rate and total knee arthroplasty. However, UKA produced better outcomes compared to HTO in terms of the functional results, pain assessment, and complications, although patients who underwent HTO tended to have slightly better range of motion. Valgus HTO provides better physical activity for younger patients whereas UKA is more suitable for older patients due to shorter rehabilitation time and faster functional recovery. Although UKA patients tended to have improved overall long-term outcomes, which may be due to accurate indications and patient selection, both treatment options yielded pleasing results. Therefore, we are unable to conclude that either method is superior.


Recovery of cardiac function after ablation of atrial tachycardia arising from the tricuspid annulus.
Tachycardia-induced cardiomyopathy is a reversible form of heart failure. An early diagnosis and an effective cure of the underlying tachycardia are crucial for a favorable outcome. Different kinds of atrial and ventricular arrhythmias may induce tachycardiomyopathy. Focal atrial tachycardia may be easily suppressed by means of transcatheter ablation. Relationships between focal atrial tachycardia and tachycardiomyopathy have not been deeply analyzed. In the present paper we report a case of a 76-year-old man with tachycardia-induced cardiomyopathy caused by recurrences of focal atrial tachycardia arising from the tricuspid annulus. The arrhythmia was successfully treated with transcatheter ablation. In the follow-up no recurrences of the arrhythmia occurred and a significant improvement in myocardial function was observed.


Reversible retinopathy associated with oral deferasirox therapy.
A 17-year-old girl with a history of sickle cell anaemia undergoing chronic blood transfusions and iron-chelation therapy presented for multiple ophthalmic examinations. During treatment with deferoxamine, her examination remained stable but 2 years after changing to deferasirox she presented with decreased visual acuity and only mild funduscopic changes. Marked electrophysiological abnormalities were also evident. After cessation of deferasirox, her visual acuity improved and electrophysiological responses improved. No prior reports of deferasirox-related retinopathy are available. We suggest that oral deferasirox caused a reversible retinopathy in our patient and clinicians be aware of this entity.


[Humeral lengthening with a monolateral external fixator in achondroplasia].
In achondroplasia patients the shortening of upper limb (mainly the arms) is an important part of pathology in addition to low stature. Not all patients who are treated for increasing their height decided to have humeral lengthening and the indication for treatment is not only for cosmetic, psychological aspects but also limitation of upper limb function like self-services and personal hygiene. 5 patients were evaluated (4 girls and 1 boy) at age of 14 to 18 years (mean 15.7) in whom 10 humeral lengthening were do-ne using monolateral external fixator "Pumed". All patients have lower limb lengthening with the Ilizarov method 4-5 years before humeral lengthening. Observation time was 6 to 34 months (mean 20). In all cases the Pumed external fixator was fixed to humerus by 4 Schanz screws, open humeral distraction osteotomy was done below the insertion of deltoid muscle. In one case 15 degrees anteflexion correction was done intraoperatively. Distraction began at 5-6th day postoperatively with rate of 1 mm/day. Because of hypertrophic bone regenerate the distraction rate was often increased up to 1.5 mm/day. 8 to 9 cm lengthening was achieved (mean 8.5) which represents more than 50% of the primary segmental length. The average time of fixator application was 7 months and the lengthening index ranged from 0.8 to 1.1 months/cm (average 0.85). No shoulder and elbow joint range of motion deterioration was observed. At the follow-up transient radial nerve palsy was observed in one case after acute limb axis correction. Humerus lengthening, in achondroplasia patients with the use of monolateral external fixator is an effective and reliable method of treatment, with relatively low lengthening index. Monolateral External Fixator are well tolerated by patients.


Recombinant Salmonella enterica OmpX protein expression and its potential for serologically diagnosing Salmonella abortion in mares.
Salmonella abortion in mares is caused by Salmonella enterica subspecies enterica serovar abortus equi infection and is characterized by premature (abortion) or non-viable fetus birth. Although all horses are susceptible to infection, the condition is more often clinically manifested in pregnant mares, with most abortions recorded in young females. In addition, nonspecific clinical disease signs and poorly sensitive and effective bacteriological diagnostic methods hinder rapid and reliable infection diagnoses. Immunochemical methods such as enzyme-linked immunosorbent assay (ELISA) and immunochromatography assays can facilitate effective and rapid diagnoses. However, they require highly specific and active antigens and antibodies. This study aimed to generate a recombinant S. enterica outer membrane protein X (OmpX) and evaluate its suitability for serological diagnosis of Salmonella abortion in mares. Outer membrane protein X from the S. enterica antigen was synthesized de novo and expressed in Escherichia coli using the pET28 vector. Transformed E. coli cells were cultured under different conditions to detect recombinant OmpX (rOmpX) expression, and rOmpX purification and refolding were both conducted using metal affinity chromatography. Refolded and purified rOmpX was characterized by western blotting, liquid chromatography with tandem mass spectrometry, and ELISA. After optimized rOmpX expression, a 23 kDa molecular weight protein was identified. Amino acid sequence analysis using Mascot program suggested that these peptides were the OmpX protein from S. enterica. High specificity and diagnostic efficiency were recorded when rOmpX was used in ELISA against 89 serum samples from aborted and contact mares. Recombinant outer membrane protein, in comparison to the O antigen, demonstrated better diagnostic characteristics against sera from mares who aborted and contact horses.


Dysthymic disorder: a comparison of DSM-IV and ICD-10 and issues in differential diagnosis.
Dysthymic disorders are a major category among the mood disorders but the concept is not widely understood in many parts of the world, where it is often considered as a new name for familiar categories, such as neurotic depression, depressive personality or even neurasthenia (which is still a frequent diagnosis in many Far East countries). The purpose of this chapter is to compare the definitions of Dysthymic Disorder that are contained in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) with the definitions in the International Classification of diseases Tenth Edition (ICD-10). The two systems are in fact quite congruent both in their overall approach and their specific contents; this has resulted from the fact that many of the DSM-IV Task Force and Work Group members have participated in the ICD-10 expert committees and many of the ICD-10 experts have been advisors to the DSM-IV revision process.


Pesticide acute toxicity is a better correlate of U.S. grassland bird declines than agricultural intensification.
Common agricultural birds are in decline, both in Europe and in North America. Evidence from Europe suggests that agricultural intensification and, for some species, the indirect effects of pesticides mediated through a loss of insect food resource is in part responsible. On a state-by-state basis for the conterminous Unites States (U.S.), we looked at several agronomic variables to predict the number of grassland species increasing or declining according to breeding bird surveys conducted between 1980 and 2003. Best predictors of species declines were the lethal risk from insecticide use modeled from pesticide impact studies, followed by the loss of cropped pasture. Loss of permanent pasture or simple measures of agricultural intensification such as the proportion of land under crop or the proportion of farmland treated with herbicides did not explain bird declines as well. Because the proportion of farmland treated with insecticides, and more particularly the lethal risk to birds from the use of current insecticides feature so prominently in the best models, this suggests that, in the U.S. at least, pesticide toxicity to birds should be considered as an important factor in grassland bird declines.


CytoGPS: a web-enabled karyotype analysis tool for cytogenetics.
Karyotype data are the most common form of genetic data that is regularly used clinically. They are collected as part of the standard of care in many diseases, particularly in pediatric and cancer medicine contexts. Karyotypes are represented in a unique text-based format, with a syntax defined by the International System for human Cytogenetic Nomenclature (ISCN). While human-readable, ISCN is not intrinsically machine-readable. This limitation has prevented the full use of complex karyotype data in discovery science use cases. To enhance the utility and value of karyotype data, we developed a tool named CytoGPS. CytoGPS first parses ISCN karyotypes into a machine-readable format. It then converts the ISCN karyotype into a binary Loss-Gain-Fusion (LGF) model, which represents all cytogenetic abnormalities as combinations of loss, gain, or fusion events, in a format that is analyzable using modern computational methods. Such data is then made available for comprehensive 'downstream' analyses that previously were not feasible. Freely available at http://cytogps.org.


Determinants of women's decision making on whether to treat nausea and vomiting of pregnancy pharmacologically.
Nausea and vomiting of pregnancy (NVP) affects up to 80% of all women to some degree during their pregnancies. Diclectin (doxylamine and pyridoxine [vitamin B6]) has been on the Canadian market for many years and is indicated as the drug of choice for the treatment of NVP. However, some women choose not to treat NVP with pharmacologic measures, perhaps due to a persistent fear of teratogenic risk. The objective of this study was to determine the factors that influence a woman's decision not to treat NVP with pharmacologic measures. Fifty-nine women recruited from the Motherisk Nausea and Vomiting Helpline completed a questionnaire. All were informed that Diclectin was considered safe for use during pregnancy. At a follow-up telephone call, 34% were not using any pharmacologic treatment, and of those who were taking the drug, 26% were using less than the recommended dose. Reasons cited for not using the medication were insufficient safety data, preference for non-pharmacologic methods, and being made to feel uncomfortable by the physician. Of the women who did use Diclectin, the most convincing reassuring information that it was safe to use came from friends and family. Many other factors play a large role in a women's decision making.


Ultrasonography of gastric tumours.
The visualization of the different parts of the stomach in ultrasonography was ascertained, and the information obtained by upper abdominal ultrasonography of patients with gastric tumour was evaluated in a retrospectively collected series. Normally, the whole stomach is not visualized in ultrasonography. A sonography examination can never exclude the possibility of gastric carcinoma, but the carcinoma is often detectable by ultrasound. Ultrasonography also provides some idea of the extent of infiltration. Those performing epigastric ultrasonographies should attach increasing attention to the stomach.


Feral Swine in the United States Have Been Exposed to both Avian and Swine Influenza A Viruses.
Influenza A viruses (IAVs) in swine can cause sporadic infections and pandemic outbreaks among humans, but how avian IAV emerges in swine is still unclear. Unlike domestic swine, feral swine are free ranging and have many opportunities for IAV exposure through contacts with various habitats and animals, including migratory waterfowl, a natural reservoir for IAVs. During the period from 2010 to 2013, 8,239 serum samples were collected from feral swine across 35 U.S. states and tested against 45 contemporary antigenic variants of avian, swine, and human IAVs; of these, 406 (4.9%) samples were IAV antibody positive. Among 294 serum samples selected for antigenic characterization, 271 cross-reacted with ≥1 tested virus, whereas the other 23 did not cross-react with any tested virus. Of the 271 IAV-positive samples, 236 cross-reacted with swine IAVs, 1 with avian IAVs, and 16 with avian and swine IAVs, indicating that feral swine had been exposed to both swine and avian IAVs but predominantly to swine IAVs. Our findings suggest that feral swine could potentially be infected with both avian and swine IAVs, generating novel IAVs by hosting and reassorting IAVs from wild birds and domestic swine and facilitating adaptation of avian IAVs to other hosts, including humans, before their spillover. Continued surveillance to monitor the distribution and antigenic diversities of IAVs in feral swine is necessary to increase our understanding of the natural history of IAVs.IMPORTANCE There are more than 5 million feral swine distributed across at least 35 states in the United States. In contrast to domestic swine, feral swine are free ranging and have unique opportunities for contact with wildlife, livestock, and their habitats. Our serological results indicate that feral swine in the United States have been exposed to influenza A viruses (IAVs) consistent with those found in both domestic swine and wild birds, with the predominant infections consisting of swine-adapted IAVs. Our findings suggest that feral swine have been infected with IAVs at low levels and could serve as hosts for the generation of novel IAVs at the interface of feral swine, wild birds, domestic swine, and humans.


[Histochemical study on disuse atrophy of skeletal muscle in rabbit (author's transl)].
Histological and histochemical study was carried out to investigate disuse atrophy on skeletal muscle in adult albino rabbits. Untreated anterior tibial muscle and gastrocnemius muscle were studied. Three fiber types were recognized with myosin ATPase reaction, viz. type I, IIA and IIB fibers under a positive correlation with succinate dehydrogenase, phosphorylase, lactate dehydrogenase and NADH. TR stain. Statistical analysis in histogram of fiber diameter was also done. Soleus muscle mainly consisted of type I and type IIA fibers. As to developing skeletal muscle after birth in rabbits, especially in neonatal periods, type IIC fiber and also myotubes were demonstrated, with a gradual decrease in the process of growth. Fiber type ratio were examined in the anterior tibial and soleus muscle. In soleus muscle, type I fiber increased in numbers along with growth. Fibers, reacting with both ATPase pH 9.4 and SDH stain decreased in number. In the anterior tibial muscle, on the other hand, numbers of type I fiber were unremarkable, but all of the fibers were stained moderately with succinate dehydrogenase in neonatal periods, and fibers, with evident ATPase (pH 9.4) and SDH stain, decreased in numbers with growth. Instead, type IIB fibers appeared. Cast immobilization were applied on the legs of rabbits under three different positions, namely in so-called neutral, relaxed and stretched, in order to examine anterior tibial and gastrocnemius muscle respectively. In the neutral posture, three to four weeks after immobilization, decrease in size of type IIA fibers in the anterior tibial muscle was remarkable, whereas, in gastrocnemius muscle less than three weeks after immobilization type IIA and also type I fibers were involved predominantly. In gastrocnemius muscle under relaxed posture, type IIA and also type I fiber were decreased in fiber diameter only two weeks after immobilization, whereas, under stretched posture only type IIA fibers were involved three to four weeks after immobilization. In the anterior tibial muscle under stretched posture, same results were not obtained as in the gastrocnemius muscle. Less significant change of fiber type ratio was recognized in the anterior tibial muscle after four weeks immobilization.


Molecular basis of the antineoplastic activity of 3'-amino-3'-deoxythymidine.
3'-Amino-3'-deoxythymidine decreased the incorporation of [2-14C]thymidine into DNA of L1210 cells in vitro, and produced an accumulation of [2-14C]thymidine di- and triphosphate. The extent of these effects varied with the amount of recovery time after removal of 3'-amino-3'-deoxythymidine prior to addition of labeled thymidine. The distribution of radioactivity in the acid-soluble fraction derived from [3H]3'-amino-3'-deoxythymidine was as follows: 50% as 3'-amino-3'-deoxythymidine, 20% as the monophosphate, 10% as the diphosphate, and 20% as the triphosphate derivatives. No incorporation of [3H]3'-amino-3'-deoxythymidine into L1210 DNA could be detected. 3'-Amino-3'-deoxythymidine-5'-triphosphate is a competitive inhibitor against dTTP with a Ki of 3.3 microM, whereas the Km for dTTP was 8 microM using activated calf thymus DNA as the template and DNA polymerase-alpha. These data indicate that a major site of inhibition by 3'-amino-3'-deoxythymidine is inhibition of the DNA polymerase reaction.


Long-term outcome of eight cats with non-lymphoproliferative nasal tumours treated by megavoltage radiotherapy.
A retrospective study was undertaken to evaluate the long term survival of eight cats with non-lymphoproliferative nasal tumours treated by megavoltage radiotherapy alone. Adenocarcinoma was the most commonly diagnosed tumour. Megavoltage radiotherapy was given to eight cats in 4-6 fractions of 4-8 Gys over a 16 to 28 day period. Seven cats completed the radiotherapy schedule and only two cases developed mild acute radiotherapy side effects. Median survival time after the completion of the radiotherapy course as calculated by Kaplan-Meier survival analysis was 382 days. The 1 year survival rate was 63%. All cats were euthanased because of either a poor response to radiotherapy or recurrence of the nasal tumour. This study demonstrates that a coarse fractionation regime of megavoltage radiotherapy can provide effective long-term palliative treatment for feline nasal tumours. The coarse fractionation schedule has the advantages of requiring only four to six treatments.


Effect of periodontal treatment on adipokines in type 2 diabetes.
The association between adipokines and inflammatory periodontal diseases has been studied over the last two decades. This review was intended to explore the observation that periodontal therapy may lead to an improvement of adipokines in diabetic patients. In summary, substantial evidence suggests that diabetes is associated with increased prevalence, extent and severity of periodontitis. Numerous mechanisms have been elucidated to explain the impact of diabetes on the periodontium. However, current knowledge concerning the role of major adipokines indicates only some of their associations with the pathogenesis of periodontitis in type 2 diabetes. Conversely, treatment of periodontal disease and reduction of oral inflammation may have positive effects on the diabetic condition, although evidence for this remains somewhat equivocal.


Communicating the risks of handling bats: analysing approaches used by Australian stakeholders in the context of Australian bat lyssavirus.
Australian bat lyssavirus (ABLV) is a member of the Lyssavirus genus of the Rhabdoviridae family and is found in Australian bat species. It is of public health concern because of the rabies-like syndrome it causes in humans, resulting in government health and wildlife agencies using varied communication approaches to inform targeted audiences about zoonotic risks associated with handling bats. Despite these warnings, the number of reports of human-bat interactions remains high. This paper details a survey conducted to analyse the approaches utilised by a range of stakeholders to educate and communicate warnings to their target audiences. The survey focused on identifying the target audiences, communication methods used, along with the message frequency, content, and perceived effectiveness. Analysis of the top three messages delivered by stakeholders revealed that over half were information-focused messages and over a third, instruction-focused. Stakeholders identified the need to balance messaging about bat handling risks with information regarding the vulnerable status of bats and their environmental significance. Whilst the most common and (perceived) effective method of communication was one-on-one discussions, it was also identified to be ineffective for targeting mass audiences leading stakeholders to recognise the need to adapt to more efficient means of communication. The outcomes of this study may be useful to improve risk communication strategies regarding ABLV in Australia.


Anisotropic nano-imprinting technique for fabricating a patterned optical film of a liquid crystalline polymer.
We developed an anisotropic nano-imprinting technique, which combines the exposure of ultraviolet light, to fabricate a patterned optical film of a liquid crystalline polymer (LCP). The nano-imprinted LCP film has two-fold functionality of an in-cell retarder and an alignment layer of liquid crystal (LC) molecules. In addition to the geometrically generated microgrooves, the anisotropic surface interactions of the LCP acquired at a nano-scale level during the imprinting process results in the LC alignment on the patterned LCP film without any surface treatment. The nano-imprinted, quarter wave LCP was implemented into a LC cell which produces half-wave retardation under crossed polarizers.


Retrieval inhibition of trauma-related words in women reporting repressed or recovered memories of childhood sexual abuse.
Several authors have argued that survivors of childhood sexual abuse (CSA) who report to have repressed their traumatic memories are more skilled in forgetting emotional stimuli than survivors who have always remembered the abuse. The current experiment employed a list-wise directed forgetting task to investigate whether women reporting repressed (n = 16) or recovered (n = 23) memories of CSA are better at forgetting disturbing material, relative to women reporting having always remembered their abuse (n = 55) or reporting no history of abuse (n = 20). We found no support for the hypothesis that women reporting repressed or recovered memories of CSA are especially versed in inhibiting retrieval of trauma-related words. Additional analyses revealed that participants characterized by a repressive coping style did not display a superior retrieval inhibition mechanism for negative material.


Combination therapy with an angiotensin-converting enzyme inhibitor and a calcium channel blocker.
More than 1 medication is required in many hypertensive patients to reach blood pressure (BP) goals, and initial treatment with 2 agents has been recommended for patients whose BP level is >20/10 mm Hg above target. Diuretics reduce BP levels and the incidence of target organ complications and together with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers, which are recommended in patients with comorbid cardiovascular disease, nephropathy, or diabetes, are effective antihypertensive combinations. Calcium channel blockers (CCBs) are also effective antihypertensive agents, and evidence suggests that a CCB/ACEI combination is well tolerated and also decreases the risk of cardiovascular and renal disease. Some evidence suggests that this combination may improve endothelial function more than either agent alone, and its use could potentially lead to better cardiovascular outcomes than a diuretic/ACEI or diuretic/ARB combination. The ongoing Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH) trial compares these 2 effective combinations (ie, an ACEI/diuretic and ACEI/CCB) as initial treatment for reducing cardiovascular morbidity and mortality in older high-risk hypertensive patients. The results of this trial, when reported, should help to clarify the relative benefits of these different therapies.


[Acute hemolysis crisis revealed a Wilson disease].
Wilson disease is a rare inherited disorder of copper metabolism that affects liver and brain due to copper tissue accumulation. The mechanism involved is based on mutations of the ATP7B gene. Children have predominant hepatic manifestations while adult are more often diagnosed by neurological and psychiatric symptoms. However, others features are tubulopathy, articular disorders and hemolytic anemia. We report the diagnostic of Wilson disease in a 14 years old girl and her sibling after investigation of hemolytic anemia, hepatic insufficiency, and hypophosphatemia.


Deletion mapping and X inactivation analysis of a non-specific mental retardation gene at Xp21.3-Xp22.11.
We report on deletion mapping and X inactivation analysis of a gene for X linked non-specific mental retardation (MRX) at Xp21.3-Xp22.11, on the basis of molecular studies in two families with Xp microdeletions involving the DAX-1 gene. In family A, mental retardation (MR) was profound in the older brother with an episode of adrenal crisis, severe in the younger brother with no episode of adrenal crisis, and mild to moderate in the sister and the mother with no signs of adrenal hypoplasia. In family B, MR was absent in the male patient with adrenal hypoplasia. Polymerase chain reaction for 16 loci in the middle of Xp showed that the brothers of family A had a small Xp deletion between DXS7182 and DXS1022, and that the patient of family B had a tiny Xp deletion between DXS319 and DXS1022. Microsatellite analysis for tetranucleotide repeats in the promoter region of the DAX-1 gene and Southern blotting for DAX-1 and DXS28 showed that the sister and the mother of family A were heterozygous for the interstitial deletion. X inactivation analysis for the methylation status of the AR gene and the HPRT gene indicated that the normal X and the deleted X chromosome underwent random X inactivation in both the sister and the mother. The results imply that an MRX gene subject to X inactivation is present in a roughly 4 Mb region between DXS7182 and DAX-1, and that reduced expression of the normal MRX gene caused by random X inactivation results in MR in carrier females.


A randomised trial: effects of different anesthesia methods on early perioperative pain sensitivity and cellular immune function in patients undergoing radical mastectomy.
This study sought to investigate the effects of transversus thoracic muscle plane-pectoral nerves (TTP-PECS) block combined with propofol anesthesia on early perioperative pain sensitivity and cellular immune function in patients undergoing radical mastectomy. A total of 115 patients who underwent radical mastectomy for breast cancer at our hospital from January 2019 to January 2021 were selected as the study subjects. The patients were allocated to the control group (n=57) or observation group (n=58) using a random number method. The control group was given simple general anesthesia, and the observation group was given TTP-PECS block combined with propofol anesthesia. The recovery time, pain [visual analogue scoring (VAS)] scores, and incidences of adverse reactions were compared between the 2 groups. Hemodynamic indicators [i.e., heart rate (HR), mean arterial pressure (MAP)], stress indicators [i.e., blood glucose (GLU), epinephrine (E), cortisol (Cor)], and the cellular immune function ofthe2 groups before anesthesia (T0), at the end of operation (T1), 1day after operation (T2) and 3days after operation (T3) were recorded. The spontaneous respiration recovery time, time to full wakefulness and the extubation time of the observation group were shorter than those of the control group (P<0.05). The observation group had lower VAS scores than the control group at 2, 8, 12, and 24 h after operation (P<0.05). The levels of MAP, HR, GLU, E and Cor in the observation group at T1, T2, and T3 were lower than those in the control group (P<0.05). Compared to the control group, the observation group had increased cluster of differentiation (CD)3+, CD4+, and CD4+/CD8+ cells (P<0.05), but there were no significant differences in CD8+ and natural killer (NK) cells between the 2 groups (P>0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (8.62% vs. 24.56%) (P<0.05). TTP-PECS block combined with propofol anesthesia can relieve pain, shorten the recovery time, stabilize the hemodynamic level, and alleviate the stress responses of patients undergoing radical mastectomy with a slight suppression of cellular immune function and high safety. Chinese Clinical Trial Registration Center ChiCTR2100048438.


Prevalence of dental caries and quality of restorations among new immigrants to Israel.
The purpose of the present investigation was to gather information on the prevalence of dental caries and the quality of restorations of new immigrants to Israel, and to compare those two categories among immigrants from different regions of origin. New immigrants, residents of four absorption centers in Israel, were included in the study. Altogether, 1,031 immigrants (417 Eastern European, 338 Western European/North American and 276 South American) were examined. The results indicate that new immigrants to Israel from Eastern Europe are affected with more carious teeth (D), are missing more teeth (M), and have received quantitatively less treatment (F) than immigrants from Western Europe/North American and South America. The South America are an intermediate group. A similar distribution was found between the groups by their respective ages. The quality of dental restoration was found to be statistically higher among immigrants from Western European/North American and South American origins with the latter group exhibiting an intermediate level of quality of dental restorations.


Peritumoral CpG oligodeoxynucleotide treatment inhibits tumor growth and metastasis of B16F10 melanoma cells.
Although melanoma mostly affects the skin, it is notorious for its propensity to easily develop metastasis. Metastatic melanoma is highly resistant to a variety of therapies. We examined the anti-metastatic potential of peritumoral monotherapy against murine cutaneous B16F10 melanoma with synthetic oligodeoxynucleotides (ODN) containing unmethylated CpG motifs. We demonstrated that repeated peritumoral injections of CpG ODN significantly reduced skin tumor size. Peritumoral CpG ODN-treatment of skin tumors prevented the development of pulmonary B16F10 colonies. Adoptive transfer of splenocytes obtained from CpG ODN-treated mice markedly reduced the number of previously established pulmonary colonies in recipient naïve mice. T-lymphocyte depletion studies indicated that the anti-metastatic effect was dependent on both CD4+ and CD8+ T cells. These results suggest that CpG ODN are promising as a preventive and therapeutic anti-metastatic measure against melanoma.


Allometry for sexual size dimorphism: testing two hypotheses for Rensch's rule in the water strider Aquarius remigis.
Within any given clade, male size and female size typically covary, but male size often varies more than female size. This generates a pattern of allometry for sexual size dimorphism (SSD) known as Rensch's rule. I use allometry for SSD among populations of the water strider Aquarius remigis (Hemiptera, Gerridae) to test the hypothesis that Rensch's rule evolves in response to sexual selection on male secondary sexual traits and an alternative hypothesis that it is caused by greater phenotypic plasticity of body size in males. Comparisons of three populations reared under two temperature regimes are combined with an analysis of allometry for genital and somatic components of body size among 25 field populations. Contrary to the sexual-selection hypothesis, genital length, the target of sexual selection, shows the lowest allometric slope of all the assayed traits. Instead, the results support a novel interpretation of the differential-plasticity hypothesis: that the traits most closely associated with reproductive fitness (abdomen length in females and genital length in males) are "adaptively canalized." While this hypothesis is unlikely to explain Rensch's rule among species or higher clades, it may explain widespread patterns of intraspecific variation in SSD recently documented for many insect species.


Alternative poly(A) site-selection regulates the production of alternatively spliced vesl-1/homer1 isoforms that encode postsynaptic scaffolding proteins.
The vesl-1/homer1 gene encodes a scaffold protein that interacts with several receptors to modulate synaptic functions. The gene also encodes two shorter forms that counteract the functions of the long form of Vesl. Expression of the shorter forms is driven by neural activities such as long-term potentiation. Here we analyzed the mechanism regulating vesl-1 alternative splicing. Each functional poly(A) site was in a different part of the 3'-terminal exon, with promoter-proximal and promoter-distal sites at the end of exons corresponding to the short and long form Vesl-1, respectively. 3'-End-processing at proximal poly(A) site, specifically at the vesl-1M poly(A) site, was enhanced by extracellular stimuli, thereby switching transcription termination from promoter-distal to -proximal poly(A) site. This switch was not specifically coupled to the vesl-1 promoter and was independent of de novo protein synthesis. Analysis of transcripts from mini-genes that mimic the structure of endogenous vesl-1 revealed that the vesl-1M poly(A) region plays a crucial role in switching to the alternative pre-mRNA splicing that is triggered by extracellular stimuli. Therefore, a 3'-end-processing event regulates the neural activity-dependent alternative splicing of vesl-1. This is the first report of a gene in which alternative poly(A) site-selection regulates alternative splicing in a protein synthesis-independent manner.


Single Image Rain Streak Decomposition Using Layer Priors.
Rain streaks impair visibility of an image and introduce undesirable interference that can severely affect the performance of computer vision and image analysis systems. Rain streak removal algorithms try to recover a rain streak free background scene. In this paper, we address the problem of rain streak removal from a single image by formulating it as a layer decomposition problem, with a rain streak layer superimposed on a background layer containing the true scene content. Existing decomposition methods that address this problem employ either sparse dictionary learning methods or impose a low rank structure on the appearance of the rain streaks. While these methods can improve the overall visibility, their performance can often be unsatisfactory, for they tend to either over-smooth the background images or generate -images that still contain noticeable rain streaks. To address the problems, we propose a method that imposes priors for both the background and rain streak layers. These priors are based on Gaussian mixture models learned on small patches that can accommodate a variety of background appearances as well as the appearance of the rain streaks. Moreover, we introduce a structure residue recovery step to further separate the background residues and improve the decomposition quality. Quantitative evaluation shows our method outperforms existing methods by a large margin. We overview our method and demonstrate its effectiveness over prior work on a number of examples.


Design and Synthesis of a Chitodisaccharide-Based Affinity Resin for Chitosanases Purification.
Chitooligosaccharides (CHOS) have gained increasing attention because of their important biological activities. Enhancing the efficiency of CHOS production essentially requires screening of novel chitosanase with unique characteristics. Therefore, a rapid and efficient one-step affinity purification procedure plays important roles in screening native chitosanases. In this study, we report the design and synthesis of affinity resin for efficient purification of native chitosanases without any tags, using chitodisaccharides (CHDS) as an affinity ligand, to couple with Sepharose 6B via a spacer, cyanuric chloride. Based on the CHDS-modified affinity resin, a one-step affinity purification method was developed and optimized, and then applied to purify three typical glycoside hydrolase (GH) families: 46, 75, and 80 chitosanase. The three purified chitosanases were homogeneous with purities of greater than 95% and bioactivity recovery of more than 40%. Moreover, we also developed a rapid and efficient affinity purification procedure, in which tag-free chitosanase could be directly purified from supernatant of bacterial culture. The purified chitosanases samples using such a procedure had apparent homogeneity, with more than 90% purity and 10⁻50% yield. The novel purification methods established in this work can be applied to purify native chitosanases in various scales, such as laboratory and industrial scales.


DNA replication regulated by the priming promoter.
ColE1 derivative plasmids were constructed in which the natural promoter that primes replication or, in addition, the region coding for the RNA I control element had been deleted. In all of these molecules priming of the origin was effected by read-through transcription from constitutive or inducible (lacUV5) promoters inserted farther upstream. In the latter case, regulation of lac repressor activity with IPTG resulted in controlled plasmid levels in vivo. These results indicated that, at least in the absence of other control elements, regulation of the priming promoter was sufficient to control DNA replication and determine plasmid copy number.


Retracted: Ultrasound-Guided Sialendoscopy with Holmium: Yttrium Aluminum Garnet (YAG) Laser Treatment of Parotid Sialolithiasis.
This article is hereby RETRACTED from the American Journal of Case Reports because the case, the manuscript, and the figure images were previously published as: Nguyen Hong Loi, Tran Xuan Phu, Nguyen Kim Tuan, Nguyen Van Tien Duc, Nguyen Van Khanh. Case Study: YAG - Holmium Laser Sialendoscopy Treatment of Parotid Sialolithiasis with Ultrasound-Assisted. Journal of Clinical Medicine (JoCM). Tạp Chí Y Học Lâm Sàng 2020; DOI: 10.38103/jcmhch.2020.61.19. Reference: Loi Nguyen Hong: Ultrasound-Guided Sialendoscopy with Holmium: Yttrium Aluminum Garnet (YAG) Laser Treatment of Parotid Sialolithiasis. Am J Case Rep 2021; 22: e929883. DOI: 10.12659/AJCR.929883.


Anticoagulation Management during First Five Days of Infant-Pediatric Extracorporeal Life Support.
Anticoagulation during infant-pediatric extracorporeal life support (ECLS) has been a topic of study for many years, but management of anticoagulation is still only partially understood. Adequate anticoagulation during ECLS is imperative for successful outcomes and understanding the individual variables that play part is crucial for properly implementing anticoagulation management strategies. The purpose of our study was to compare the relationships between the variables of activated partial thromboplastin time (aPTT), activated clotting time, international normalized ratio, bleeding, thrombus formation, kaolin + heparinase thromboelastograph alpha angle, kaolin thromboelastograph reaction time (KTEG R-time), heparin dose rates (HDR), antithrombin (AT), anti-Xa, bivalirudin dose rate, argatroban dose rate, interventions, and transfusions. We hypothesized that the relationship between measures of anticoagulation would be influenced by the AT levels, and a therapeutic aPTT (60-80 seconds) could be achieved by increasing, or maintaining, the overall AT above a specific threshold for infant-pediatric patients on ECLS. Thirty-five infant-pediatric patients underwent ECLS between January 2013 and January 2016. The median age was 39 days with an average weight of 3.9 ± 4.3 kg. ECLS parameters collected at least every 24 hours for the first five ECLS days. Parameters recorded by retrospective chart review were analyzed using linear regression and receiver operator characteristic (ROC) analysis. We were unable to report a significant correlation between optimal aPTT and HDR at various AT levels. However, ROC analysis suggested that to maintain an aPTT above 60 seconds, an AT threshold of 42% or higher was observed when the HDR was >12 U/kg/h ROC analysis also determined that no thrombus was associated with an aPTT >64 seconds and decreased bleeding was associated with a KTEG R-time below 30 minutes. Based on these findings, we report multiple correlations that may help develop future standardized infant-pediatric ECLS anticoagulation protocols.


A Short Report on the Markov Property of DNA Sequences on 200-bp Genomic Units of ENCODE/Broad ChromHMM Annotations: A Computational Perspective.
The non-coding DNA in eukaryotic genomes encodes a language which programs chromatin accessibility, transcription factor binding, and various other activities. The objective of this short report was to determine the impact of primary DNA sequence on the epigenomic landscape across 200-base pair genomic units by integrating nine publicly available ChromHMM Browser Extensible Data files of the Encyclopedia of DNA Elements (ENCODE) project. The nucleotide frequency profiles of nine chromatin annotations with the units of 200 bp were analyzed and integrative Markov chains were built to detect the Markov properties of the DNA sequences in some of the active chromatin states of different ChromHMM regions. Our aim was to identify the possible relationship between DNA sequences and the newly built chromatin states based on the integrated ChromHMM datasets of different cells and tissue types.


Primary primitive neuroectodermal tumour of the kidney in adults.
Primitive neuroectodermal tumour (PNET) is a neural crest tumour derived from neuroectoderm. Renal PNET is a very rare tumour occurring during childhood or adolescence. We report two cases of PNET involving kidney in adults. Presenting signs and symptoms include abdominal/flank pain and/or haematuria. Microscopy reveals the tumour consisted of small round cells with round nuclei and scant cytoplasm. Diagnosis was confirmed by immunohistochemistry with diffuse membranous positivity of tumour cells with CD99. As these tumours have an aggressive clinical course with rapid death in many reported cases, it is important to differentiate them from other small round-cell tumours.


The early-onset febrile reaction following vaccination and associated factors: An exploratory sub-study based on the Ebola vaccine clinical trial.
A phase-1 clinical trial aimed to assess the safety and immunogenicity of the type-5 adenovirus vector based Ebola vaccine (Ad5-EBOV) was conducted in China. To provide more evidence for the safety evaluation and dose-selection, an exploratory sub-study using a wireless automatic temperature measuring platform was done based on the phase-1 clinical trial. The main aim of the sub-study was to obtain more information about the occurrence of fever and detect the potential associated factors, second was to assess the feasibility of the temperature measuring platform in vaccine clinical trials. Temperature data of 3 treatment groups all presented a rising tendency during the first 6 hours after vaccination, the incidence of elevated temperature and possible associated factors were analyzed. For the incidence of elevated temperature, no marked dose-response relationship was found in 6 hours with wireless thermometers; the information from mercury thermometers showed that the grade-1 fever proportion peaked at 6 hours and there was no difference between groups, while grade-2 fever proportion peaked at 24 hours and was significantly higher in high-dose group than those in the other 2 groups. Significant differences were found between sex groups (males vs. female, incidence rate ratios (IRR) = 2.93 and 7.62 for any-grade, grade-2 fever respectively, P<0.001); a decline in grade-2 fever incidence was found with the increasing age groups (IRR = 0.78, P = 0.003) and body mass index (BMI, IRR = 0.67, P<0.001) .Our findings show that the dose-dependent manner between fever and the dose of Ad5-EBOV in this study might emerge after 6 hours, and which is slight and transient. Wireless thermometers secured on the skin surface are not suitable for a long time (longer than 6 hours) measurement, new methods for temperature monitoring, like ear temperature measurement, should be tested in the further research.


Immigration, coping, and well-being: Implications for communities' roles in promoting the well-being of immigrants and refugees.
Promoting the well-being of immigrants and refugees is a critical social justice issue for many communities in the United States. The current study investigated how coping strategies and social support promote the well-being of immigrants and refugees. Participants were foreign-born individuals (N = 90) in a Midwestern state. The effects of coping strategies (i.e. forward- and trauma-focus coping, instrumental and emotional support seeking) and social support (i.e. personal and community support) on three levels of well-being (i.e. physical, psychological, and relationship) were examined using multivariate analyses of covariance (MANCOVA) and a path analysis. Results showed main effects of forward-focus coping and support seeking on wellbeing. Additionally, community support significantly predicted different coping strategies. Discussion focuses on the roles of coping and social support, as well as the study's implications for the roles of communities in promoting the well-being of immigrants and refugees.


Isolation and Characterization of Pseudomonas aeruginosa and its Virulent Bacteriophages.
Pseudomonas aeruginosa is a free living bacterium in widely different areas such as plants, soil, water and other moist locations. It is pathogenic to plants and humans. P. aeruginosa causes several disease symptoms to plants such as wet rot and curved leaves. The virulent bacterial viruses of P. aeruginosa were found to be of widespread occurrence in nature and isolated from widely different sources. Bacterial viruses were applied to control pathogenic bacteria in different fields and successfully. Therefore, this work aimed to study the different characteristics of P. aeruginosa lytic phage isolates. Moreover, the bio-control of P. aeruginosa by lytic phage isolates was also studied. Different physical and molecular characteristics were assayed and determined of P. aeruginosa lytic bacteriophages. Also, the effect of phage isolates on P. aeruginosa as a bio-control under lab condition was studied. Pseudomonas aeruginosa pathogenic bacterium was isolated from a sewage water sample. Two lytic bacteriophages specific to P. aeruginosa were isolated from same sewage water sample and designated Pa1 and Pa2. Both phage isolates (Pa1 and Pa2) found to be stable in 90°C and different pH low and high levels. The total count of P. aeruginosa decreased after 48 h in broth treated with lytic phages. RAPD-PCR amplification was indicated that the two phage isolates (Pa1 and Pa2) are belonging to two different phage types. The results of this study indicated that both lytic phage isolates could be used as a biological control agents against the plant pathogen P. aeuroginosa.


Power Morcellation Using a Contained Bag System.
The well-known advantages of minimally invasive surgery make the approach well suited for hysterectomy and other gynecological procedures. The removal of specimens excised during surgery has been a challenge that has been answered by the use of power morcellation. With this study we sought to assess the feasibility of power morcellation within a specimen bag. This was a retrospective cohort study including patients from a private practice in suburban Chicago, Illinois, who underwent contained electromechanical power morcellation during a laparoscopic or robot-assisted hysterectomy or myomectomy from May 2014 through December 2015. Contained power morcellation was performed with the Espiner EcoSac 230 (Espiner Medical Ltd., North Somerset, United Kingdom) specimen bag. Descriptive statistics were performed for both categorical and continuous data. Of the 187 procedures performed, 73.8% were myomectomies, and 26.2% were hysterectomies. The patients' mean age was 40 (range, 25-54) years and mean body mass index was 28.7 (range, 17.3-57.6). The average specimen weight was 300 g, with the largest weighing 2134 g. Estimated blood loss averaged 98.4 mL. The postoperative admission rate was 12.3%, most of which were due to nausea and urinary retention. Seventeen patients (9.1%) had postoperative complications, most of which were minor, and 4 (2.1%) were readmitted. There were no bag failures or complications that were due to the use of the specimen bag or to power morcellation. Performing electromechanical power morcellation within the Espiner EcoSac 230 specimen bag was successfully performed in 187 patients with no bag-related complications. This method of contained power morcellation is feasible, reliable, and reproducible, even for a large specimen.


Regulatory interplay between soybean root and soybean cyst nematode during a resistant and susceptible reaction.
Plant-parasitic nematodes (PPNs) are obligate parasites that feed on the roots of living host plants. Often, these nematodes can lay hundreds of eggs, each capable of surviving without a host for as long as 12 years. When it comes to wreaking havoc on agricultural yield, few nematodes can compare to the soybean cyst nematode (SCN). Quantifying soybean (Glycine max) transcription factor binding sites (TFBSs) during a late-stage SCN resistant and susceptible reaction can shed light onto the systematic interplay between host and pathogen, thereby elucidating underlying cis-regulatory mechanisms. We sequenced the soybean root transcriptome at 6 and 8 days upon independent inoculation with a virulent and avirulent SCN population. Genes such as β-1,4 glucanase, chalcone synthase, superoxide dismutase and various heat shock proteins (HSPs) exhibited reaction-specific expression profiles. Several likely defense-response genes candidates were also identified which are believed to confer SCN resistance. To explore magnitude of TFBS representation during SCN pathogenesis, a multivariate statistical software identified 46 over-represented TFBSs which capture soybean regulatory dynamics across both reactions. Our results reveal a set of soybean TFBSs which are over-represented solely throughout a resistant and susceptible SCN reaction. This set furthers our understanding of soybean cis-regulatory dynamics by providing reaction-specific levels of over-representation at 6 and 8 days after inoculation (dai) with SCN.


Physicochemical processes and the formulation of dosimetry models.
The major physical and chemical processes involved in the transport and absorption of O3 or NO2 in the lower respiratory tract are discussed. This includes the development of respiratory tract models, flow patterns, and transport in tube networks, the mucous, surfactant, and tissue layers, and chemical reactions and transport of O3 or NO2 within these layers. Descriptions of the individual processes are simplified and integrated to illustrate the formulation of dosimetry models. Data from a dosimetry model, formulated from the concepts discussed, are used to illustrate the types of information obtained by modeling.


Impact of social media on the continuous education of the general surgeon, a new experience, @Cirbosque: A Latin American example.
Social media has gained widespread recognition for its importance in the medical field. Such platforms play an important role for learning and teaching, because knowledge can be transmitted instantly and massively, and specialists in different world-wide locations can discuss experiences instantaneously. The present article presents our experience of using social media to facilitate surgical learning while encouraging leadership and global mentoring. This retrospective descriptive study was initiated at the time of the creation of our social media handle on Twitter, February 22, 2019. Since that time, we have posted 10,587 academic tweets; the monthly growth rate has been 9% (393 new followers per month). Currently, we have 4,213 followers, 11,241,000 impressions, 121,105 visits, and 121,105 mentions. We have reviewed 59 topics of interest in general surgery and 132 clinical cases in trauma, as well as in hepatobiliary, gastrointestinal, thoracic, and acute-care surgery. We have made 13 image challenges using illustrations of diagnostic and intraoperative images. Although the evidence is uncertain to promote education performed entirely through social media, we show that @Cirbosque has been effective, and the impact of this initiative on Twitter is appreciated by many surgeons worldwide, including renowned teachers in each of the topics addressed. Furthermore, the number of participants in the discussions increased each day, as did all impact indicators according to Twitter Analytics. Thus, we conclude that the educational message of @Cirbosque is having a positive effect and reaching thousands of people worldwide, suggesting that others can develop similar outreach programs in education and communication.


Impaired scaling of responses to vestibular stimulation in incomplete SCI.
Patients with incomplete spinal cord injury (iSCI) have impaired postural control leading to a high danger of falling. Clinically, it is impossible to assess the extent to which postural instability due to sensorimotor deficit is influenced by a disturbance in the vestibulospinal pathways. Galvanic vestibular stimulation (GVS) was applied to investigate changes in the vestibular spinal responses and their potential influence on postural stability in iSCI patients. Six chronic iSCI patients and age-matched controls were stimulated with a bipolar binaural stimulus. The centre of pressure (CoP) and soleus EMG responses during free standing with closed eyes on firm and compliant ground were measured. The impairment in postural stability was assessed by the mean amplitude of CoP deflections during two minutes undisturbed standing. Although iSCI patients were significantly less stable than controls, direct GVS responses of the soleus EMG and postural sways tended to be increased on firm ground. The GVS responses increased when changing from firm to compliant ground, showing a close correlation between the extent of postural instability and the response amplitudes. Therefore, challenging proprioceptive feedback induced a significant up-modulation of the GVS responses. However, when we took the postural instability in iSCI patients into account, the EMG and CoP responses to GVS were reduced compared to controls. The combined assessment of EMG and CoP responses to GVS complements the clinical examination and permits evaluation of the preservation and modulation of vestibulospinal responses in iSCI.


Simple model for training in the laparoscopic vesicourethral running anastomosis.
To create a simple model for training in the complex technique of laparoscopic vesicourethral anastomosis after radical prostatectomy. A model simulating the performance of a laparoscopic running urethrovesical anastomosis was fashioned using skin of a supermarket chicken set in a laparoscopic training box. A circular continuous anastomosis was performed, following exactly the technique we use in vivo for performing a vesicourethral anastomosis after laparoscopic radical prostatectomy. Details regarding the use of the right or the left needle holder, needle positioning, precise stitch position, and use of forehand or backhand stitch were strictly respected in order to reproduce the continuous stitch currently done in vivo in our department. The learning curve was analyzed in terms of the time necessary to perform the task and the quality of the anastomosis. The model was created and used by the junior authors during their year of fellowship in advanced laparoscopic urology. The authors had no previous experience with hands-on laparoscopic suturing but have assisted in a great number of laparoscopic radical prostatectomies. The time required for performing the anastomosis on the model declined from 75 minutes initially to 20 minutes after the trainees had performed 20 anastomoses each. After this training, it was possible to create a watertight running laparoscopic vesicourethral anastomosis in patients in a mean time of 40 minutes (range 30-55 minutes). This simple model allows the trainee in laparoscopic urology to acquire the skills necessary to perform a laparoscopic vesicourethral anastomosis, one of the most complex steps in laparoscopic radical prostatectomy, as well as to develop dexterity and facility in laparoscopic manipulation of needles, sutures, and fragile tissues.


Variations in Surface Morphologies, Properties, and Electrochemical Responses to Nitro-Analyte by Controlled Electropolymerization of Thiophene Derivatives.
Herein, we reported the fabrication of conjugated microporous polymer (CMP) films based on three thiophene derivatives using a one-step templateless electropolymerization in dichloromethane without any surfactants. The formation of hydrophilic or hydrophobic films with specific morphology is a comprehensive result of the polymerization sites in each monomer, the polymerization rate, and the gas bubble produced in situ during the polymerization process, which can be easily controlled by the experimental conditions, such as electropolymerization method, electrolyte, and "trace water" existed in the organic solvent. Moreover, the electrochemical reduction of metronidazole as a prototypical nitro-analyte at CMP-modified glassy carbon (GC) electrode shows remarkably increased current response compared to nonmodified GC electrode. The process is demonstrated to be typical adsorption-controlled, and the hydrophobic surface of the electrode coating film is more favorable to the absorption and thus reduction of metronidazole. This work provides a new perspective and a breakthrough point for the application of CMPs in the electrochemical sensors.


81-beam coherent combination using a programmable array generator.
We have generated 81 independently controllable beams using a spatial light modulator and combined them on a diffractive combiner, to characterize the combiner and develop a fast phase error detection scheme. A key parameter of the diffractive combiner is measured in a new way, enabling an efficient combination when programming calibrated phases of each beam. This testbed provides a platform for development of advanced feedback phase control of high channel-count beam combination.


CATALASE2 functions for seedling postgerminative growth by scavenging H2 O2 and stimulating ACX2/3 activity in Arabidopsis.
Increased fatty acid β-oxidation is essential for early postgerminative growth in seedlings, but high levels of H2 O2 produced by β-oxidation can induce oxidative stress. Whether and how catalase (CAT) functions in fine-tuning H2 O2 homeostasis during seedling growth remain unclear. Here, we report that CAT2 functions in early seedling growth. Compared to the wild type, the cat2-1 mutant, with elevated H2 O2 levels, exhibited reduced root elongation on sucrose (Suc)-free medium, mimicking soils without exogenous sugar supply. Treatment with the H2 O2 scavenger potassium iodide rescued the mutant phenotype of cat2-1. In contrast to the wild type, the cat2-1 mutant was insensitive to the CAT inhibitor 3-amino-1,2,4-triazole in terms of root elongation when grown on Suc-free medium, suggesting that CAT2 modulates early seedling growth by altering H2 O2 accumulation. Furthermore, like cat2-1, the acyl-CoA oxidase (ACX) double mutant acx2-1 acx3-6 showed repressed root elongation, suggesting that CAT2 functions in early seedling growth by regulating ACX activity, as this activity was inhibited in cat2-1. Indeed, decreased ACX activity and short root of cat2-1 seedlings grown on Suc-free medium were rescued by overexpressing ACX3. Together, these findings suggest that CAT2 functions in early seedling growth by scavenging H2 O2 and stimulating ACX2/3 activity.


Monitoring chemical and biological recovery at a confined aquatic disposal site, Oslofjord, Norway.
The recovery of the confined aquatic disposal (CAD) facility located at Malmøykalven in Oslofjord, Norway, has been assessed using an array of field measurement techniques. These methods were used prior to the disposal of dredged sediments as well as during 3 annual postdisposal monitoring campaigns. Traditional sampling to assess chemical recovery indicates that an immediate reduction in total sediment concentrations and surface sediments can be characterized as having good quality. Deposition of new material indicates that the quality of depositing material at the CAD is stabile and representative of the natural background quality in the area. Continued deposition of this material will improve the long-term chemical recovery of the CAD. A positive biological recovery of the benthic community has been observed and is expected to continue along a typical benthic succession pattern. To supplement traditional sampling, passive samplers were deployed at the CAD. Results suggest that the flux and concentrations of polycyclic aromatic hydrocarbon 16 and polychlorinated biphenyl 7 released from the CAD will continue to decrease over time. The combined results from these multiple lines of evidence indicate that the CAD and capping layer function as predicted 3 yr after the construction was completed. There is not only an improvement in the efficacy of the CAD itself but also a general improvement of the area, compared with the situation prior to disposal. Environ Toxicol Chem 2017;36:2552-2559. © 2017 SETAC.


Changes of pH and energy state in subacute human ischemia assessed by multinuclear magnetic resonance spectroscopy.
In vivo changes in tissue pH and energy metabolism are key to understanding stroke pathophysiology. Our goal was to study pH changes in subacute ischemic stroke and their relation to energy metabolism, which, unlike acidosis in acute stroke, are not yet well understood. We measured tissue pH and phospholipid as well as cell energy markers, including creatine, phosphocreatine, and N-acetyl-aspartate in subacute stroke with combined (1)H and (31)P magnetic resonance spectroscopy. We included 19 patients with first-ever ischemic stroke (mean time after stroke, 6 days). We then compared metabolite concentrations in the ischemic tissue to contralateral (healthy) tissue using multivariate ANOVA to assess significant differences in metabolite levels between both tissue compartments. In subacute stroke, a tissue fraction with significantly increased tissue pH was observed as compared with healthy contralateral tissue (pH, 7.09 versus 7.03; P=0.002) concurrent with splitting of the pH signal with 1 peak being more alkalotic. Furthermore, only a moderate decrease of energy-rich metabolites (phosphocreatine reduced by 17%, ATP reduced by 19%) was present, whereas total creatine was reduced by 51%. The finding of an alkalotic pH split in subacute ischemia is unprecedented. The pH split and only incomplete energy loss in subacute stroke suggest 2 differently viable cellular moieties, best explained by active compensatory mechanisms after acute cerebral ischemia.


Analytic Solution of an Active Brownian Particle in a Harmonic Well.
We provide an analytical solution for the time-dependent Fokker-Planck equation for a two-dimensional active Brownian particle trapped in an isotropic harmonic potential. Using the passive Brownian particle as basis states we show that the Fokker-Planck operator becomes lower diagonal, implying that the eigenvalues are unaffected by the activity. The propagator is then expressed as a combination of the equilibrium eigenstates with weights obeying exact iterative relations. We show that for the low-order correlation functions, such as the positional autocorrelation function, the recursion terminates at finite order in the Péclet number, allowing us to generate exact compact expressions and derive the velocity autocorrelation function and the time-dependent diffusion coefficient. The nonmonotonic behavior of latter quantities serves as a fingerprint of the nonequilibrium dynamics.


Automatic checking of the correctness of clinical guidelines in GLARE.
Representing clinical guidelines is a very complex knowledge-representation task, requiring a lot of expertise and efforts. Nevertheless, guideline representations often contain several kinds of errors. Therefore, checking the well-formedness and correctness of a guideline representation is an important task, which can be drastically improved with the adoption of computer programs. In this paper, we discuss the advanced facilities provided by the GLARE system to assist physicians to produce correct representations of clinical guidelines.


Biosynthesis of deuterated riboflavin: structure determination by NMR and mass spectrometry.
The riboflavin-producing fungus Eremothecium ashbyii was cultured in various growth media containing high concentrations of deuteriuj, and the product was isolated. The structures of highly deuterated riboflavin, in which at least 13 of 15 nonexchangeable hydrogens were replaced by deuterium, and fully deuterated riboflavin, in which all 15 nonexchangeable sites contained deuterium, were established by NMR and mass spectrometry. The aromatic protons (C-5 and C-8) wer partially substituted in the highly deuterated molecule. Information regarding three areas of the biosynthetic pathway within the microorganism was obtained as a result of the formation of these compounds. Extensive solvent interaction, possibly due to passage of sugar through the transaldolase-transketolase pathway, occurs during formation of the ribityl chain. Limited solvent participation takes place during formation of 6,7-dimethyl-8-ribityllumazine, the immediate precursor of riboflavin. Deuteration of the riboflavin C-6 and C-7 methyl groups indicates significant solvent exchange during the final step of the biosynthetic process.


Trajectories of peer victimization and perceptions of the self and schoolmates: precursors to internalizing and externalizing problems.
Evidence indicates that peer victimization is predictive of later maladjustment, but the mechanisms by which harassment impairs development have yet to be identified. The objectives of this study were (a) to discern normative trends in peer victimization experiences and self- and peer perceptions during preadolescence and (b) to investigate associations between individual differences in these trajectories and changes in psychosocial adjustment. A sample of 381 children (196 girls; 185 boys) was followed longitudinally between the ages of 9 and 11 years. Latent growth curve analyses revealed that, although children's self-appraisals became increasingly positive during preadolescence, their appraisals of peers became more negative. Moreover, analyses supported the contention that self- and peer beliefs act as mechanisms through which victimization is related to psychological dysfunction.


Perceived stress in patients with migraine: a case-control study.
Perceived stress is the most common trigger for migraine. The objective of this study was to examine the clinical significance of perceived stress in migraine patients. This is a case-control study. Consecutive migraine patients who visited a tertiary care hospital were enrolled for this study. They completed self-reported questionnaires including Perceived Stress Scale (PSS), 12-item Allodynia Symptom Checklist (ASC-12), Migraine Disability Assessment Scale (MIDAS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and Migraine-Specific Quality of Life Questionnaire (MSQ). Degree of perceived stress in migraine patients was measured and compared to that in healthy controls. Predictors for perceived stress and their impact on quality of life (QOL) of migraine patients were also determined. A total of 227 migraine patients were eligible for this study, including 103 (45.4%) who had chronic migraine (CM). Mean PSS score was significantly (p < 0.05) higher in CM patients than that in controls after adjusting for education, depression, and anxiety. Although several factors were associated with PSS score, major predictors for PSS were GAD-7 score (β = 0.358, p < 0.001), PHQ-9 score (β = 0.304, p < 0.001), ISI score (β = 0.154, p = 0.005), and CM (β = -0.104, p = 0.027). There was an inverse relationship between PSS scores and three-dimensional scores of MSQ (p < 0.001). Chronic migraine is a critical factor for perceived stress. Perceived stress affects QOL of migraine patients.


The East African Community (EAC) mobile laboratory networks in Kenya, Burundi, Tanzania, Rwanda, Uganda, and South Sudan-from project implementation to outbreak response against Dengue, Ebola, COVID-19, and epidemic-prone diseases.
East Africa is home to 170 million people and prone to frequent outbreaks of viral haemorrhagic fevers and various bacterial diseases. A major challenge is that epidemics mostly happen in remote areas, where infrastructure for Biosecurity Level (BSL) 3/4 laboratory capacity is not available. As samples have to be transported from the outbreak area to the National Public Health Laboratories (NPHL) in the capitals or even flown to international reference centres, diagnosis is significantly delayed and epidemics emerge. The East African Community (EAC), an intergovernmental body of Burundi, Rwanda, Tanzania, Kenya, Uganda, and South Sudan, received 10 million € funding from the German Development Bank (KfW) to establish BSL3/4 capacity in the region. Between 2017 and 2020, the EAC in collaboration with the Bernhard-Nocht-Institute for Tropical Medicine (Germany) and the Partner Countries' Ministries of Health and their respective NPHLs, established a regional network of nine mobile BSL3/4 laboratories. These rapidly deployable laboratories allowed the region to reduce sample turn-around-time (from days to an average of 8h) at the centre of the outbreak and rapidly respond to epidemics. In the present article, the approach for implementing such a regional project is outlined and five major aspects (including recommendations) are described: (i) the overall project coordination activities through the EAC Secretariat and the Partner States, (ii) procurement of equipment, (iii) the established laboratory setup and diagnostic panels, (iv) regional training activities and capacity building of various stakeholders and (v) completed and ongoing field missions. The latter includes an EAC/WHO field simulation exercise that was conducted on the border between Tanzania and Kenya in June 2019, the support in molecular diagnosis during the Tanzanian Dengue outbreak in 2019, the participation in the Ugandan National Ebola response activities in Kisoro district along the Uganda/DRC border in Oct/Nov 2019 and the deployments of the laboratories to assist in SARS-CoV-2 diagnostics throughout the region since early 2020. The established EAC mobile laboratory network allows accurate and timely diagnosis of BSL3/4 pathogens in all East African countries, important for individual patient management and to effectively contain the spread of epidemic-prone diseases.


Immobilization to Positively Charged Cellulose Nanocrystals Enhances the Antibacterial Activity and Stability of Hen Egg White and T4 Lysozyme.
Antibacterial bionanostructures were produced from cellulose nanocrystals (CNC) with immobilized lysozyme from hen egg white (HEW) and T4 bacteriophage, respectively. The nanocrystals were prepared from microcrystalline cellulose by ammonium persulfate oxidation with a yield of 68% and having an average size of 250 nm and low polydispersity index. HEW lysozyme (HEWL) and T4 lysozyme (T4L) were immobilized to CNC by different mechanisms including adsorption and covalent coupling to carbodiimide-activated carboxylate groups and to glutaraldehyde-activated aminated CNC (Am-CNC), respectively. The effect of immobilization on the enzymatic activity (both lytic and hydrolytic) and antibacterial activity of the lysozymes was studied using different methods. Am-CNC-lysozyme conjugates retained the highest lytic activity, 86.3% and 78.3% for HEWL and T4L, respectively. They also showed enhanced bactericidal activity with high potency against Gram-positive as well as Gram-negative bacteria in a relatively shorter time as compared to the free enzymes and resulted in extensive cellular damage, as shown by transmission electron microscopy. The enhanced antibacterial activity was correlated with the increase in zeta potential of Am-CNC-lysozyme conjugates. The immobilized lysozyme preparations further exhibited enhanced storage stability at 4 and 22 °C.


Can Sonography Distinguish a Supraorbital Notch From a Foramen?
Diagnostic tools for evaluating the supraorbital rim in preparation for nerve decompression surgery in patients with chronic headaches are currently limited. We evaluated the use of sonography to diagnose the presence of a supraorbital notch or foramen in 11 cadaver orbits. Sonographic findings were assessed by dissecting cadaver orbits to determine whether a notch or foramen was present. Sonography correctly diagnosed the presence of a supraorbital notch in 7 of 7 cases and correctly diagnosed a supraorbital foramen in 4 of 4 cases. We found that sonography had 100% sensitivity in diagnosing a supraorbital notch and foramen. This tool may therefore be helpful in characterizing the supraorbital rim preoperatively and may influence the decision to use a transpalpebral or endoscopic approach for supraorbital nerve decompression as well as the decision to use local or general anesthesia.


Surgical Treatment of Extracranial Internal Carotid Artery Pseudoaneurysm in an Infant Due to Falling from Height: An Unusual Case.
Pseudoaneurysms of the internal carotid artery (ICA) caused by non-penetrating trauma are extremely rare. Patients with ICA pseudoaneurysms may present with cerebral ischemia, cervical masses, neck swelling, hematoma, rupture, pain, or cranial nerve dysfunction. We present a case of a left ICA pseudoaneurysm that developed in a 7-month-old infant because of a fall from height. The patient developed left-sided neck swelling that caused severe airway obstruction and respiratory arrest. The patient was urgently intubated and underwent emergency surgery under general anesthesia to repair the defect in the left ICA. Primary repair was performed to treat the pseudoaneurysms. The pseudoaneurysm sac was not removed because it was complicated and had extended into the respiratory tract. The patient was extubated on the 2nd day and discharged on the 7th day without complications. Follow-up of the patient after two weeks was unremarkable. Extracranial ICA pseudoaneurysms should be identified in patients presenting with blunt trauma. Emergency surgery should be considered for patients with progressive pseudoaneurysms.


Educational implications of assessing learning outcomes with multiple choice questions and short essay questions.
This study investigates the characteristics of different item types to assess learning outcomes and explore the educational implications that can be obtained from the results of learning outcome assessments. Forty-five second-year premedical students participated in this study. Multiple choice question (MCQ) and short essay question (SEQ) scores and pass rates for 10 learning outcomes were analyzed. Descriptive statistics and correlation analysis were used to analyze the data. The correlation analysis indicated that there was a significant correlation between SEQs and pass rate but there was no significant correlation between MCQs and pass rate. Some students with identical scores on the MCQs had different scores on the SEQs or on the learning outcomes. This study showed that students' achievement of learning outcomes can be assessed using various types of questions in outcome-based education.


Physicochemical and Functional Properties of Yeast-Fermented Cabbage.
Microbial fermentation is often used to improve the functionality of plant-based food materials. Herein, we investigated changes in the physicochemical and functional properties of cabbage during yeast fermentation to develop new products using fermented cabbage. Among the 8 types of food-grade yeast, both Saccharomyces cerevisiae and Saccharomyces boulardii fermented 10% cabbage powder solution (w/w) the most effectively, leaving no soluble sugars after 12 h of fermentation. In addition, the yeast fermentation of cabbage resulted in functionally positive outcomes in terms of sulforaphane content, antioxidant properties, and anti-inflammatory activity. Specifically, the yeast-fermented cabbages contained about 500% more sulforaphane. The soluble fraction (5 μg/ml) of yeast-fermented cabbage had no cytotoxicity in murine RAW 264.7 cells, and the radical-scavenging capacity was equivalent to 1 μg/ml of ascorbic acid. Moreover, cabbage fermented with S. boulardii significantly suppressed both lipopolysaccharides (LPS)-induced nitric oxide production and LPS-induced reactive oxygen species production in RAW 264.7 cells, suggesting a potential anti-inflammatory effect. These results support the idea that yeast fermentation is promising for developing functionally improved cabbage products.