Taxonomic review of Epicadinus Simon, 1895 (Araneae: Thomisidae).
The genus Epicadinus Simon, 1895 can easily be distinguished from the other Neotropical Stephanopines by their abundant and robust setiferous tubercles, topped by elongated macrosetae, which cover most of the tegument. Additionally, the genus can be recognized by a pair of conical ocular mounds above the ALE, the anterior eye row very recurved, posterior one slightly procurved; carapace flattened and without tubercles, and opisthosoma with three conical projections ("tubercles") of variable size and shape. This work is a taxonomic review of the 12 valid species of Epicadinus as listed in version 19 of the World Spider Catalogue (2018), whose hitherto known distribution included few records from Brazil, French Guiana, Bolivia and Peru, and only one from Mexico. Four valid species are recognized: Epicadinus biocellatus Mello-Leitão, 1929; E. trispinosus (Taczanowski, 1872) [with two junior synonyms E. trifidus (Pickard-Cambridge, 1893) syn. nov. and E. cornutus (Taczanowski, 1872) syn. nov.]; E. spinipes (Blackwall, 1862) [with two junior synonyms E. albimaculatus Mello-Leitão, 1929 syn. nov. and E. gavensis Soares, 1946 syn. nov]; and E. villosus [with two junior synonyms E. helenae Piza, 1936 syn. nov. and E. marmoratus Mello-Leitão, 1947 syn. nov.]. Epicadinus polyophthalmus Mello-Leitão, 1929 and Epicadinus tuberculatus Petrunkevitch, 1910 are transferred to Epicadus. Epicadus polyophthalmus (Mello-Leitão, 1929) comb. nov. is considered a nomen dubium. Epicadus tuberculatus (Petrunkevitch, 1910) comb. nov. is a senior synonym of Epicadus pustulosus (Mello-Leitão, 1929) syn. nov.


Comparison of Different TMAO Force Fields and Their Impact on the Folding Equilibrium of a Hydrophobic Polymer.
Trimethylamine N-oxide (TMAO) is a protective osmolyte able to preserve protein folded states in the presence of denaturants like urea and under extreme thermodynamic conditions of high pressure and temperature. The current understanding posits that TMAO exerts its stabilizing effect on proteins by preferential exclusion from the macromolecular hydration shell. Additionally, TMAO is also known to favor the folding of hydrophobic polymers. In this latter case, theoretical and experimental studies support a scenario in which TMAO directly interacts with the macromolecule. While atomistic simulations may potentially elucidate the precise TMAO-induced stabilization mechanism, the comparative accuracy of the different TMAO force field models available in the literature remains elusive. Herein, we compare four different TMAO models, study their structural hydration properties, and validate the models against experimental osmotic coefficients and air-water surface tension data over a broad range of TMAO concentrations. The models were furthermore applied to study the effect of TMAO on the folding equilibrium of a generic hydrophobic polymer in aqueous solution. Interestingly, we find that TMAO increasingly stabilizes the compact globular state of the polymer up to approximately 1 M TMAO, while in turn destabilizing it with further increase in TMAO concentration. Hence, TMAO acts as a stabilizing osmolyte or as a denaturant depending on the TMAO concentration of the solution. TMAO-induced stabilization up to 1 M is accompanied by positive preferential TMAO binding and with an increase in the chain configurational entropy, which is reduced at concentrations higher than 1 M. These results are qualitatively independent of the TMAO force field.


Determinants of health-system efficiency: evidence from OECD countries.
This paper analyzes the most important determinants of healthcare efficiency across OECD countries. As previously documented in the literature, we first provide evidence of significant differences in the cross-country level of efficiency in healthcare provision. We then investigate how improvements in efficiency can be achieved by considering alternative efficiency indices (parametric and non-parametric) and a novel dataset with information on the characteristics of healthcare systems across OECD countries. Our empirical findings suggest a positive correlation between policies such as increasing the regulation of prices billed by providers and reducing the degree of gate keeping and the efficiency of national healthcare systems.


Usefulness of a Low-Dose Sclerosing Agent for the Treatment of Vascular Lesions in the Tongue.
Hemangiomas and vascular malformations are common benign lesions of vessels in the cervical region. However, the lesions may not completely disappear and may require surgical or nonsurgical intervention. Several treatment options, including surgical excision, steroid injection, laser therapy, and sclerotherapy, are available. Surgical excision is a commonly used treatment; however, in cases of hemangiomas of the tongue, excision of the lesion may cause esthetic or functional impairments, including speech and swallowing. Sclerotherapy is a simple and safe method for treating vascular lesions conservatively. In this case report, two patients with a vascular lesion of the tongue underwent conservative sclerotherapy without surgical excision using a sclerosing agent (sodium tetradecyl sulfate). Both patients showed regression of the lesion without complications. As presented in these cases, repeated injections of low-dose 1% sodium tetradecyl sulfate as a sclerosing agent were safe and showed satisfactory outcomes.


Decreased frequency of peripheral blood CD8+CD25+FoxP3+regulatory T cells correlates with IL-33 levels in pre-eclampsia.
We aimed to investigate the role of CD8+CD25+Foxp3+regulatory T (Treg) cells in pre-eclampsia (PE). This was a cross-sectional study of 46 patients with PE and 24 normotensive women within the third trimester of gestation. We analyzed the percentages of CD8+CD25+Foxp3+Treg cells in peripheral blood using flow cytometry and the serum levels of interleukin (IL)-6, IL-17A, IL-10, TGF-β1, IL-1β, and IL-33 by Luminex 200. We found that patients with PE had lower percentages of CD8+CD25+Foxp3+Treg cells than normotensive pregnant women. In addition, the percentage of CD8+CD25+Foxp3+Treg cells was positively correlated with IL-33 concentration and negatively correlated with IL-17A concentration in patients with PE. We also found that IL-33 treatment can induce proliferation of CD8+CD25+Foxp3+Treg cells in vitro. These findings suggest that the reduced CD8+CD25+Foxp3+Treg cells may play a role in the pathogenesis of PE. Abbreviations PE: pre-eclampsia; PBMCs: peripheral blood mononuclear cells; CTLA-4: cytotoxic T-lymphocyteantigen-4; APCs: antigen presenting cells; TGF-β: transforming growth factor-β; IL: interleukin; Treg: cells regulatory T cells; PBS: phosphate-buffered saline; Foxp3: forkhead Box protein 3; HELLPs: hemolysis, elevated liver enzyme and low platelet syndrome.


Core Structure Engineering in Hole-Transport Materials to Achieve Highly Efficient Perovskite Solar Cells.
In this work, the thiadiazolopyridine (PT) unit was introduced as the core structure, with N3 ,N3 ,N6 ,N6 -tetrakis(4-methoxyphenyl)-9-phenyl-9 H-carbazole-3,6-diamine as the peripheral group, to obtain a new compound, JY8, for use as a hole-transport material (HTM) in planar perovskite solar cells (PSCs). Compared with the previously reported JY5 with benzothiadiazole as the core structure, the PT unit with stronger electron-withdrawing ability enhanced the intermolecular dipole-dipole interaction. Moreover, the introduction of the PT unit made the central part in JY8 more planar than its analogue JY5, which is conducive to charge transport. Field-emission (FE)-SEM images suggested a smooth and condense morphology of the JY8 film, which could improve the contact between the perovskite layer and the metal electrode. Space-charge limitation of current results, steady-state, and time-resolved photoluminescence decay curves indicated that JY8 as HTM facilitated hole extraction and hole transport. Consequently, planar PSCs fabricated with JY8 as the HTM exhibited a decent efficiency of 19.14 % with a high fill factor of 81 %.


[High-resolution Estimation of Spatio-temporal Variation in PM2.5 Concentrations in the Beijing-Tianjin-Hebei Region].
This study developed a two-stage statistical model (linear mixed effect (LME) model+geographical weight regression (GWR) model) to determine the spatio-temporal variation of PM2.5 concentrations in the Beijing-Tianjin-Hebei (BTH) region with full-coverage, high resolution, and high accuracy. The model employs multi-angle implementation of atmospheric correction aerosol optical depth (MAIAC AOD) data, with a 1 km spatial resolution, as the main predictor and meteorological data/land-use data as the auxiliary predictors. To determine the characteristics of heavy PM2.5 pollution in the BTH region, unique predictors such as AOD2 were also introduced into the two-stage model. The two-stage model was used to estimate the daily PM2.5 concentrations with a 1 km resolution. After being cross-validated against ground observations, the R2 of PM2.5 was found to be 0.94, with a slope value of 0.95 and RMSPE value of 13.14 μg·m-3. Compared to previous studies such as LME, the two-stage model has much higher accuracy, suitable for estimating PM2.5 concentrations. The PM2.5 concentration in the BTH region ranged from 0 to 89.89 μg·m-3 in 2017, with a mean value of 44.96 μg·m-3. The spatio-temporal variability of PM2.5 over the BTH region was significant, exhibiting high values over the southwestern plain, moderate values over the northeastern plain, and low values over the mountainous plateau. In terms of seasonal variation, PM2.5 concentrations were high in winter, low in summer, and moderate in spring and autumn. The estimated PM2.5 concentrations, with high spatio-temporal resolution, are useful for exposure assessments in epidemiological studies and identifying the spatio-temporal variation of pollution sources at a fine spatial scale. The results show that the locations of vital pollution sources over the severely polluted south-central Hebei piedmont plain may have changed since the implementation of the Air Pollution Prevention and Control Action Plan. This study could provide a scientific basis for the prevention and control of air pollution in the BHT region.


Plasmon-enhanced photocatalytic properties of Cu2O nanowire-Au nanoparticle assemblies.
Cu(2)O-Au nanocomposites (NCs) with tunable coverage of Au were prepared by a facile method of mixing gold nanoparticles (Au NPs) with copper(I) oxide nanowires (Cu(2)O NWs) in various ratios. These Cu(2)O-Au NCs display tunable optical properties, and their photocatalytic properties were dependent on the coverage density of Au NPs. The photocatalytic activity of Cu(2)O-Au NCs was examined by photodegradation of methylene blue. The presence of Au NPs enhanced the photodegradation efficiency of Cu(2)O NCs. The photocatalytic efficiency of Cu(2)O-Au NCs initially increased with the increasing coverage density of Au NPs and then decreased as the surface of Cu(2)O became densely covered by Au NPs. The enhanced photocatalytic efficiency was ascribed to enhanced light absorption (by the surface plasmon resonance) and the electron sink effect of the Au NPs.


Perioperative treatment of the diabetic patient.
The diabetic patient is frequently undergoing surgery for the underlying disease and its complications. Before referring the patient to surgery the diabetologist should carefully evaluate the presence of complications, cardiovascular, renal and neurologic disorders in particular. Generally no problems are posed by patients with NIDDM undergoing elective surgery. For more demanding patients and for those with IDDM the most effective and ready treatment is the continuous intravenous infusion of glucose, insulin and potassium. With this regimen, it is possible to perform major surgery in diabetics with a lower risk.


Effect of seminal plasma from high- and low-fertility bulls on cauda epididymal sperm function.
The aim of this study was to characterise the effect of seminal plasma (SP) from bulls of high or low fertility on sperm function. First, the effect of SP on the motility of fresh cauda epididymal spermatozoa (CES) and frozen-thawed ejaculated spermatozoa was assessed (Experiment 1a). Seminal plasma was then collected from bulls of known high and low fertility. Pooled CES were incubated in the SP from each bull, diluted and assessed for motility and viability on Days 1, 2, 3 and 5 after packaging as fresh semen (Experiment 1b). Also assessed were motility, kinematics, viability and mitochondrial membrane potential after thawing (Experiment 1c) as well as hypotonic resistance (Experiment 2) and fertilisation potential using in vitro fertilisation (Experiment 3). Seminal plasma increased the motility of CES (P<0.05); however, there was no effect of SP on the motility and viability of fresh CES or on CES post-thaw motility, viability and mitochondrial membrane potential (P>0.05). The hypotonic resistance of CES was reduced by SP (P<0.05), irrespective of whether the SP was from high- or low-fertility bulls. Seminal plasma from high- or low-fertility bulls had no effect on cleavage or blastocyst rates (P>0.05). In conclusion, SP affects the physiological function of CES but there is no difference between SP from high- or low-fertility bulls.


Growth Synchronization and Size Control in Magic-Sized Semiconductor Nanocrystals.
"Magic-sized" nanocrystals (MSNCs) grow in discrete jumps between a series of specific sizes. Consequently, MSNCs have been explored as an alternative route to uniform semiconductor particles, potentially with atomic precision. However, because the growth mechanism has been poorly understood, the best strategies to control MSNC syntheses and obtain desired sizes are unknown. Experiments have found that common parameters, such as growth time and temperature, have limited utility. Here, we theoretically and experimentally investigate reactant supersaturation as a tool to control MSNC growth. We compare direct synthesis of CdSe MSNCs with ripening of isolated MSNCs or their mixtures. Surprisingly, we find that MSNCs readily synchronize to the same growth trajectory, even starting from distinct initial conditions, explaining the robustness of MSNC growth. Further, by understanding the synchronization mechanism, we demonstrate methods to control the final MSNC size. These results deepen our knowledge of MSNCs and indicate strategies to tailor their growth.


Lessons from failure: neurosurgical outreach in Managua, Nicaragua.
With respect to the tremendous deficit in surgical care plaguing developing nations, it is critical that medical outreach models be organized in such a fashion that sustainable advancements can be durably imparted beyond the duration of targeted missions. Using a didactic framework focused on empowering host neurosurgeons with an enhanced surgical skillset, a mission was launched in Managua, Nicaragua, after previous success in Kiev, Ukraine, and Lima, Peru. Unfortunately, the failure to critically assess the internal and external state of affairs of the region's medical center compromised the outreach mission. Herein lies the visiting team's lessons from failure and insights on facilitating effective communication with host institutions, circumventing geopolitical instability, and utilizing digital collaboration and video-conferencing tools in the post-COVID-19 era to advance the surgical care of developing regions in a fashion that can be generationally felt.


RRH: envenoming syndrome due to 200 stings from Africanized honeybees.
Envenoming syndrome from Africanized bee stings is a toxic syndrome caused by the inoculation of large amounts of venom from multiple bee stings, generally more than five hundred. The incidence of severe toxicity from Africanized bee stings is rare but deadly. This report reveals that because of the small volume of distribution, having fewer stings does not exempt a patient from experiencing an unfavorable outcome, particularly in children, elderly people or underweight people.


Further evidence of a sensory-tonic interaction in pigeons.
The five pigeons in Group 1 were given successive intradimensional discrimination training in which responses to a line of 49 degrees were reinforced on a variable-interval schedule and responses to a line of 33 degrees were not reinforced. Subsequent generalization testing with other line orientations revealed a peak shift from the positive stimulus in the direction away from the negative stimulus in all subjects. The four pigeons in Group 2 received successive discrimination training with the 49 degrees value on the key during both stimuli. During the negative stimulus, however, the floor was tilted 16 degrees counterclockwise. When tested (with the floor flat) these subjects showed peak shifts similar to those observed with Group 1. A third group of three pigeons, given successive interdimensional discrimination training with the 49 degrees line as the positive stimulus and the absence of the line as the negative, showed no peak shift in a subsequent generalization test. It was concluded that tilting the floor on which the pigeon stood systematically distorted the bird's visual perception of the orientation of the line in a manner consistent with the results of other studies in this laboratory.


Protocols for CRISPR/Cas9 Mutagenesis of the Oriental Fruit Fly Bactrocera dorsalis.
The Oriental fruit fly, Bactrocera dorsalis, is a highly invasive and adaptive pest species that causes damage to citrus and over 150 other fruit crops worldwide. Since adult fruit flies have great flight capacity and females lay their eggs under the skins of fruit, insecticides requiring direct contact with the pest usually perform poorly in the field. With the development of molecular biological tools and high-throughput sequencing technology, many scientists are attempting to develop environmentally friendly pest management strategies. These include RNAi or gene editing-based pesticides that downregulate or silence genes (molecular targets), such as olfactory genes involved in searching behavior, in various insect pests. To adapt these strategies for Oriental fruit fly control, effective methods for functional gene research are needed. Genes with critical functions in the survival and reproduction of B. dorsalis serve as good molecular targets for gene knockdown and/or silencing. The CRISPR/Cas9 system is a reliable technique used for gene editing, especially in insects. This paper presents a systematic method for CRISPR/Cas9 mutagenesis of B. dorsalis, including the design and synthesis of guide RNAs, collecting embryos, embryo injection, insect rearing, and mutant screening. These protocols will serve as a useful guide for generating mutant flies for researchers interested in functional gene studies in B. dorsalis.


Structural and Biochemical Investigation of Selected Pathogenic Mutants of the Human Dihydrolipoamide Dehydrogenase.
Clinically relevant disease-causing variants of the human dihydrolipoamide dehydrogenase (hLADH, hE3), a common component of the mitochondrial α-keto acid dehydrogenase complexes, were characterized using a multipronged approach to unravel the molecular pathomechanisms that underlie hLADH deficiency. The G101del and M326V substitutions both reduced the protein stability and triggered the disassembly of the functional/obligate hLADH homodimer and significant FAD losses, which altogether eventually manifested in a virtually undetectable catalytic activity in both cases. The I12T-hLADH variant proved also to be quite unstable, but managed to retain the dimeric enzyme form; the LADH activity, both in the forward and reverse catalytic directions and the affinity for the prosthetic group FAD were both significantly compromised. None of the above three variants lent themselves to an in-depth structural analysis via X-ray crystallography due to inherent protein instability. Crystal structures at 2.89 and 2.44 Å resolutions were determined for the I318T- and I358T-hLADH variants, respectively; structure analysis revealed minor conformational perturbations, which correlated well with the residual LADH activities, in both cases. For the dimer interface variants G426E-, I445M-, and R447G-hLADH, enzyme activities and FAD loss were determined and compared against the previously published structural data.


MULTIPLE GENETIC MECHANISMS FOR THE EVOLUTION OF SENESCENCE IN DROSOPHILA MELANOGASTER.
We present the results of selection experiments designed to distinguish between antagonistic pleiotropy and mutation accumulation, two mechanisms for the evolution of senescence. Reverse selection for early-life fitness was applied to laboratory populations of Drosophila melanogaster that had been previously selected for late-life fitness. These populations also exhibited reduced early-age female fecundity and increased resistance to the stresses of starvation, desiccation, and ethanol, when compared to control populations. Reverse selection was carried out at both uncontrolled, higher larval rearing density and at controlled, lower larval density. In the uncontrolled-density selection lines, early-age female fecundity increased to control-population levels in response to the reintroduction of selection for early-age fitness. Concomitantly, resistance to starvation declined in agreement with previous observations of a negative genetic correlation between these two characters and in accordance with the antagonistic-pleiotropy mechanism. However, resistance to stresses of desiccation and ethanol did not decline in the uncontrolled-density lines during 22 generations of reverse selection for early-life fitness. The latter results provide evidence that mutation accumulation has also played a role in the evolution of senescence in this set of Drosophila populations. No significant response in early-age fecundity or starvation resistance was observed in the controlled-density reverse-selection lines, supporting previous observations that selection on Drosophila life-history characters is critically sensitive to larval rearing density.


Monocyte-T-cell interactions in pokeweed mitogen-activated cultures.
Monocyte-T-cell interactions were studied in pokeweed mitogen (PWM)-activated cell cultures. We addressed the question of monocyte changes in PWM-stimulated cultures of T cells and monocytes and found, by flow cytometric analysis, that PWM activation led to a loss of cells with monocyte or macrophage phenotype (CD14, HLA-DR, HLA-DQ) within 48 hr of culture in the presence of T cells (CD4+ T cells), but not in cultures of pure monocytes. Chemiluminescence measurements revealed that phagocytic stimulation of monocytic superoxide release was impaired in PWM-stimulated cultures of monocytes plus T cells, but not in PWM-stimulated cultures of pure monocytes. Furthermore, PWM induced the secretion of interferon-gamma (IFN-gamma) in primary cultures of T cells supplemented with 20% of monocytes, whereas in subsequent secondary cultures of these cells PWM induced IFN-gamma only when monocytes were added. We conclude from these flow cytometric and functional analyses that monocytes are efficiently eliminated from PWM-activated T-cell/monocyte cultures by CD4+ T lymphocytes.


A SSVEP-BCI Setup Based on Depth-of-Field.
In optical systems, the range of distance near the point of focus where objects are perceived sharply is referred as depth-of-field; objects outside this region are defocused and blurred. Furthermore, ophthalmology studies state that the amplitude and the latency of visual evoked potentials are affected by defocusing. In this context, this paper evaluates a novel setup for a steady-state visual evoked potential (SSVEP) brain-computer interface, in which two stimuli are presented together in the center of the user's field of view but at different distances ensuring that if one stimulus is focused on, the other one is non-focused, and vice versa. The evaluationwas conductedwith eight healthy subjects who were asked to focus on just one stimulus at a time. An average accuracy rate of 0.93 was achieved for a time window of 4 s by employing well know SSVEP detection methods. Results show that distinguishable SSVEP can be elicited by the focused stimulus regardless of the non-focused one is also present in the field of view. Finally, this approach allows users to send commands through a stimuli selection by focusing mechanism that does not demand neck, head, and/or eyeball movements.


MiR-574-5p mediates the cell cycle and apoptosis in thyroid cancer cells via Wnt/β-catenin signaling by repressing the expression of Quaking proteins.
Thyroid cancer is the most frequently occurring type of endocrine tumor, with a rapidly increasing incidence rate. MicroRNA (miR)-574-5p is a candidate oncogene in various types of cancer. The present study identified that miR-574-5p affected the cell cycle distribution and apoptosis of BCPAP and FTC133 thyroid cancer cells via β-catenin/Wnt signaling by targeting Quaking proteins (QKIs). An MTT assay demonstrated that the knockdown of miR-574-5p suppressed the proliferation of the thyroid cancer cells. Fluorescence-activated cell sorting analysis demonstrated that the inhibition of miR-574-5p induced the G1/S phase arrest and apoptosis of the cells. Reverse transcription-quantitative polymerase chain reaction and western blot analyses revealed that the knockdown of miR-574-5p significantly upregulated the mRNA and protein expression levels of QKIs. Furthermore, western blot analysis identified that the knockdown of miR-574-5p also repressed the Wnt/β-catenin pathway via downregulating the expression of β-catenin, cyclin D1 and survivin, and upregulating the phosphorylation of β-catenin. The further depletion of QKIs in combination with the knockdown of miR-574-5p not only increased the expression of β-catenin, cyclin D1 and survivin, but also rescued the apoptosis of thyroid cancer cells induced by the miR-574-5p knockdown. In conclusion, these findings indicated that the aberrant upregulation of miR-574-5p may be oncogenic, through regulating the Wnt/β-catenin pathway by targeting QKIs.


[Medical treatment of juvenile hemangiomas].
Infantile hemangioma always involute in 5 to 7 years. However, 10% of proliferating hemangiomas will necessitate a therapeutic approach, often medical, in order to avoid life or organ threatening, fonctional or esthetic sequelae. "Which hemangioma need to be treated, when and how" are important questions for the optimal management of infantile hemangiomas. Corticotherapy is still the treatment of choice for these lesions. Other anti-angiogenic molecules have also been successfully used such as interferon alfa-2a and vincristine. This chapter tries to answer these questions and detail the different medical modalities for the treatment of infantile hemangioma.


Rapid detection of chloramphenicol residues in aquatic products using colloidal gold immunochromatographic assay.
A colloidal gold immunochromatographic assay (GICA) was developed for rapid detection of chloramphenicol (CAP) residues in aquatic products. A nitrocellulose (NC) membrane was used as the carrier, and the polyclonal CAP antibody was used as the marker protein. The average diameter of as-prepared colloidal gold nanoparticles (AuNPs) was about 20 nm. The optimal pH value of colloidal gold solutions and the amount of the antibody of CAP were 8.0 and 7.2 μg/mL, respectively. The CAP antibody was immobilized onto the conjugate pad after purification. The CAP conjugate and goat anti-rabbit IgG (secondary antibody) were coated onto the NC membrane. Next, the non-specific sites were blocked with 1% bovine serum albumin. The minimum detectable concentration of CAP in standard solution is 0.5 ng/mL, with good reproducibility. For the real samples from crucian carps injected with a single-dose of CAP in the dorsal muscles, the minimum detectable concentration of CAP residues was 0.5 µg/kg. The chromatographic analysis time was less than 10 min, and the strip had a long storage lifetime of more than 90 days at different temperatures. The strips provide a means for rapid detection of CAP residues in aquatic products.


Global Tendency and Frontiers of Research on Myopia From 1900 to 2020: A Bibliometrics Analysis.
Myopia is one of the most common causes of vision impairment in children and adults and has become a public health priority with its growing prevalence worldwide. This study aims to identify and evaluate the global trends in myopia research of the past century and visualize the frontiers using bibliometric analysis. The literature search was conducted on the Web of Science for myopia studies published between 1900 and 2020. Retrieved publications were analyzed in-depth by the annual publication number, prolific countries and institutions, core author and journal, and the number of citations through descriptive statistics. Collaboration networks and keywords burst were visualized by VOSviewer and CiteSpace. Myopia citation network was visualized using CitNetExplorer. In total, 11,172 publications on myopia were retrieved from 1900 to 2020, with most published by the United States. Saw SM, from the National University of Singapore, contributed the most publications and citations. Investigative Ophthalmology & Visual Science was the journal with highest number of citations. Journal of Cataract and Refractive Surgery with the maximum number of publications. The top 10 cited papers mainly focused on the epidemiology of myopia. Previous research emphasized myopia-associated experimental animal models, while recent keywords include "SMILE" and "myopia control" with the stronger burst, indicating a shift of concern from etiology to therapy and coincided with the global increment of incidence. Document citation network was clustered into six groups: "prevalence and risk factors of myopia," "surgical control of myopia," "pathogenesis of myopia," "optical interventions of myopia," "myopia and glaucoma," and "pathological myopia." Bibliometrics analysis in this study could help scholars comprehend global trends of myopia research frontiers better. Hundred years of myopia research were clustered into six groups, among which "prevalence and risk factors of myopia" and "surgical control of myopia" were the largest groups. With the increasing prevalence of myopia, interventions of myopia control are a potential research hotspot and pressing public health issue.


Cross-validation of commercial enzyme-linked immunosorbent assay and radioimmunoassay for porcine C-peptide concentration measurements in non-human primate serum.
C-peptide concentration is widely used as a marker of insulin secretion and is especially relevant in evaluating islet graft function following transplantation, because its measurement is not confounded by the presence of exogenous insulin. To address the shortage of human islet donors, the use of porcine islets has been proposed as a possible solution and the stringent pig-to-non-human primate (NHP) model is often the most relevant for pre-clinical evaluation of the potential for diabetes reversal resulting from an islet xenograft. The Millipore radioimmunoassay (RIA) was exclusively used to measure porcine C-peptide (PCP) until 2013 when the assay was discontinued and subsequently a commercially available enzyme-linked immunosorbent assay (ELISA) from Mercodia has been widely adopted. Both assays have been used in pre-clinical trials evaluating the therapeutic potential of xenograft products in reversing diabetes in the pig-to-NHP model, to interpret data in a comparable way it may be useful to perform a harmonization of C-peptide measurements. We performed a method comparison by determining the PCP concentration in 620 serum samples collected from 20 diabetic cynomolgus macaques transplanted with adult porcine islets. All analyses were performed according to manufacturer instructions. With both assays, we demonstrated an acceptable detection limit, precision, and recovery. Linearity of the ELISA met acceptance criteria at all concentrations tested while linearity of the RIA only met acceptance criteria at five of the eight concentrations tested. The RIA had a detection limit of 0.16 ng/mL, and recovery ranged from 82% to 96% and met linearity acceptance criteria at 0.35 ng/mL and from 0.78 to 2.33 ng/mL. The ELISA had a detection limit of 0.03 ng/mL, and recovery ranged from 81% to 115% and met linearity acceptance criteria from 0.08 to 0.85 ng/mL. Both assays had intra-assay precision <11% and inter-assay precision <14%. PCP concentration measured by ELISA demonstrated a significant correlation with RIA (R2 =.9721, P<.0001). This strong correlation supports use of the regression equation y=2.029x+0.0897 to transform ELISA data to RIA or inversely y=0.4930x-0.0456 to convert RIA data to ELISA for direct comparison between assays in the concentration range of 0-3.0 ng/mL. Measured C-peptide concentration was lower with the ELISA than with the RIA; individual measurements plotted against the averages of the pair demonstrated that the variability from the mean strongly depended on increasing concentration. Porcine C-peptide can be reliably measured in NHP serum using the Mercodia ELISA, making this assay interchangeable with the Millipore RIA. Inherent differences in antibody affinity and calibration factors may explain the lower ELISA values as compared to the RIA; however without access to a traceable reference standard, it is not possible to determine which assay is most accurate. Regression modeling resulted in a correction factor appropriate for conversion of ELISA data to RIA-equivalent data facilitating comparison of assay results longitudinally and between groups.


Phages and Nanotechnology: New Insights against Multidrug-Resistant Bacteria.
Bacterial infections are a major threat to the human healthcare system worldwide, as antibiotics are becoming less effective due to the emergence of multidrug-resistant strains. Therefore, there is a need to explore nontraditional antimicrobial alternatives to support rapid interventions and combat the spread of pathogenic bacteria. New nonantibiotic approaches are being developed, many of them at the interface of physics, nanotechnology, and microbiology. While physical factors (e.g., pressure, temperature, and ultraviolet light) are typically used in the sterilization process, nanoparticles and phages (bacterial viruses) are also applied to combat pathogenic bacteria. Particularly, phage-based therapies are rising due to the unparalleled specificity and high bactericidal activity of phages. Despite the success of phages mostly as compassionate use in clinical cases, some drawbacks need to be addressed, mainly related to their stability, bioavailability, and systemic administration. Combining phages with nanoparticles can improve their performance in vivo. Thus, the combination of nanotechnology and phages might provide tools for the rapid and accurate detection of bacteria in biological samples (diagnosis and typing), and the development of antimicrobials that combine the selectivity of phages with the efficacy of targeted therapy, such as photothermal ablation or photodynamic therapies. In this review, we aim to provide an overview of how phage-based nanotechnology represents a step forward in the fight against multidrug-resistant bacteria.


Comparison of insertion of the modified i-gel airway for oral surgery with the LMA Flexible: a manikin study.
We previously modified the i-gel airway to enable its use in the field of oral and maxillofacial surgery and reported its fabrication methods. In general, the standard i-gel airway is quick to insert and has a high success rate, but the modified i-gel airway has yet to be assessed for these attributes. We, therefore, set out to compare the ease of insertion of the modified i-gel airway with the LMA Flexible to investigate the usefulness of the modified i-gel airway. The study participants, who included 20 new interns with no experience using either the LMA Flexible or the modified i-gel airway, inserted each device 3 times into an intubation practice manikin. The variables measured in this study were insertion time and rate of successful insertions. Mean insertion time over 3 attempts was significantly shorter for the modified i-gel™ airway (18.9 ± 4.7 seconds) than the LMA Flexible (24.9 ± 5.1 seconds, P < .001). The rate of successful insertions as a total of all 3 attempts was significantly higher for the modified i-gel airway (56/60 times, 93.3%) than the LMA Flexible (45/60 times, 75%; P = .012). When used by an inexperienced operator, the modified i-gel™ airway is faster and has a higher success rate than the LMA Flexible, suggesting that it can be easily manipulated during insertion.


Extra-ocular retinoblastoma: about 12 cases followed at the Mohamed VI university hospital of Marrakech.
Retinoblastoma is the most frequent childhood intraocular tumor. The aim of our study is to evaluate the clinical features and management of extra-ocular retinoblastoma in the Mohamed VI university hospital of Marrakech. Retrospective case series, the patient's records were reviewed for patient and tumor features, ocular management, histopathological findings, and patient survival. Over a period of three years, 35 eyes were diagnosed with retinoblastoma; 12 children (16 eyes) (46%) had extra-ocular retinoblastoma. Mean age was 27 months, 60% were males. Six cases had unilateral tumor, five bilateral and one case of trilateral retinoblastoma. There was no positive family history, proptosis was the mean mode of presentation (41,6%) followed by staphyloma (25%) orbital cellulitis (25%) and hyphema(8,3%). The median lag period was 18 months. On imaging and histopathological analysis, there was extrascleral involvement in 41.6%, involvement of orbital part of optic nerve (75%), of orbital muscles (50%) and eyelids in 16.6%. the surgical treatment included according to the degree of extension enucleation (75%) or exenteration (25%) associated to chemotherapy in all cases and one case of external beam radiation. There were 2 cases of orbital recurrence, one death and no metastases at 30 months follow-up.Orbital retinoblastoma still stands as a tall challenge requiring multi-modal and multi-disciplinary approach. Although the survival has increased over the last few years, lack of access to medical facilities, lack of education about the need for early medical attention and cultural resistance to enucleation continue to contribute to an epidemic of extra ocular disease at diagnosis in the developing world.


Ultrasonographically guided wire localization of nonpalpable breast lesions.
The results of 102 preoperative ultrasonographically guided wire localizations of nonpalpable breast lesions were reviewed. Ultrasonography was used because of nonvisualization during mammography (16 cases), a difficult location of the lesion (3 cases), vasovagal syncope during mammographic guidance (two cases), or the radiologist's preference (81 cases). All localizations were successful. Removal was confirmed by specimen mammography or ultrasonography or both in 85 cases and by macroscopic examination in 10 cases. In seven cases specimen radiography was not performed. One syncope and one wire insertion into the pectoralis fascia occurred. Ultrasonographically guided wire localization is accurate and well tolerated in aiding surgical biopsy of breast lesions.


A computer-based gastrointestinal information management system.
A clinical data base system was developed that integrates gastrointestinal radiologic examinations, endoscopic studies, and pathologic diagnoses. An interrogative language is used, so that data input occurs by response to a series of relevant questions and answers that are constructed by the clinical staff without programmer support. Data are stored in a hierarchical, natural-language (noncoded) format, making them easily understandable by all clinical groups. Since the computer system is interactive, there are on-line capabilities for data input at various times as well as for instantaneous retrieval of all data on a given patient. Retrieval (search) of data uses Boolean logic, allowing for intercorrelative studies among radiology, endoscopy, and pathology. Data can then be isolated in files in which the computer can generate demographic and statistical data by use of a series of programs. Both data search and analysis can be accomplished without programming knowledge. Not only are research functions served by the system, but educational functions such as preparation of conferences and lectures, professional quality assurance, and resident teaching through follow-up and missed-case review can be performed.


Perceptions of neurosurgery: a survey of medical students and foundation doctors.
The ratio of applications per place for the British neurosurgical training programme (ST1 level) is currently significantly less than in many other specialities including competitive surgical and radiological programmes. A survey of medical students and junior doctors prior to speciality selection was conducted to assess their perceptions of neurosurgery as a speciality and identify factors that affect career choice and recruitment. A three domain, 17-item questionnaire with a Likert 5-point scale was produced. Two hundred individual paper questionnaires were randomly distributed across a central London teaching trust. Response rate in both groups was 100% with no exclusions. Data were collected by one group and analysed independently with descriptive methods and independent t-tests to determine statistically significant intra-group variability. Results showed marked differences in opinions at the two stages of medical progression and identified several consistencies. Examples include a tendency to rule out neurosurgical careers on the basis of experience with other surgical specialities and fear of inadequate dexterity or intelligence. The results showed variable persistence of traditional stereotypes including a common view that it is a highly competitive male dominated profession although this view significantly diminished with experience. Neurosurgery is an expanding profession at the cutting edge of technology. This study offers an important and interesting insight into why it is not more popular and what can be done to attract the best candidates.


The role of the AMOP domain in MUC4/Y-promoted tumour angiogenesis and metastasis in pancreatic cancer.
MUC4 is a high molecular weight membrane protein that is overexpressed in pancreatic cancer (PC) and is associated with the development and progression of this disease. However, the exact mechanisms through which MUC4 domains promote these biological processes have rarely been studied, partly because of its high molecular weight, difficulty to overexpress it. Here, we use MUC4/Y, one of the MUC4 transcript variants, as a model molecule to investigate the AMOP-domain of MUC4(MUC/Y). We used cell proliferation, migration, invasion and tube formation assays in vitro to explore the abilities of AMOP domain in PC. In vivo, the matrigel plug assay, orthotopic implantation and Kaplan-Meier survival curves were used to check the results we observed in vitro. Finally, we discovered the underlying mechanism through western blot and immunofluorescence. We found that MUC4/Y overexpression could enhance the angiogenic and metastatic properties of PC cells, both in vitro and in vivo. However, the deletion of AMOP domain could cutback these phenomena. Additionally, Kaplan-Meier survival curves showed that mice injected with MUC4/Y overexpressed cells had shorter survival time, compared with empty-vector-transfected cells (MUC4/Y-EV), or cells expressing MUC4/Y without the AMOP domain (MUC4/Y-AMOP(△)). Our data also showed that overexpression of MUC4/Y could activate NOTCH3 signaling, increasing the expression of downstream genes: VEGF-A, MMP-9 and ANG-2. The AMOP domain had an important role in MUC4/Y (MUC4)-mediated tumour angiogenesis and metastasis of PC cells; and the NOTCH3 signaling was involved. These findings provided new insights into PC therapies. Our study also supplies a new method to study other high molecular membrane proteins.


Risk coupling analysis under accident scenario evolution: A methodological construct and application.
Dynamic processes in various fields exhibit risk coupling phenomena, but existing risk analysis studies tend to ignore the risk coupling effects of dynamic scenarios. Considering the principles of digitization, objective quantification, and the full process that should be adopted in the risk coupling analysis, an integrated risk coupling analysis framework is proposed. Specifically, the weighted Eclat algorithm is used to mine the risk association rules, then the key risk factors are extracted by social network analysis, and the stochastic Petri net is used to complete the construction, simulation, and evolution of accident scenarios. This universal framework can analyze the risk phenomena of accident scenario evolution in a process-oriented manner and decouple risks based on key risk factors and disconnect the chain of the accident scenario evolution process. Finally, the proposed framework is applied to the coupled analysis of fire risk in Chinese urban communities to verify its feasibility and scientific validity.


Adverse effects of antiepileptic drugs.
Adverse effects of antiepileptic drugs (AEDs) are common, can have a considerable impact on quality of life and contribute to treatment failure in up to 40% of patients. The adverse effect profiles of AEDs differ greatly and are often a determining factor in drug selection because of the similar efficacy rates shown by most AEDs. The most common adverse effects are dose dependent and reversible. Cognitive impairment is of particular concern, especially for patients who work or study. Idiosyncratic effects, such as skin rashes, and chronic effects, such as weight gain, can lead to high rates of treatment discontinuation and complicate clinical management. Nearly all conventional AEDs increase the risk of congenital malformations when taken during pregnancy, with valproate posing a potentially greater risk, whereas the potential teratogenicity of new generation AEDs is largely unknown. Most conventional AEDs have a poor record when it comes to drug interactions, largely because of their tendency to interfere with hepatic drug metabolism. Some newer AEDs have no effect on hepatic drug metabolizing enzymes and are renally excreted, resulting in a lower potential for drug interactions. However, further research is needed to confirm the apparent improvement in tolerability offered by some of the newer AEDs.


Percutaneous Tracheostomy under Bronchoscopic Visualization Does Not Affect Short-Term or Long-Term Complications.
Percutaneous tracheostomy is a safe and effective bedside procedure. Some advocate the use of bronchoscopy during the procedure to reduce the rate of complications. We evaluated our complication rate in trauma patients undergoing percutaneous tracheostomy with and without bronchoscopic guidance to ascertain if there was a difference in the rate of complications. A retrospective review of all tracheostomies performed in critically ill trauma patients was performed using the trauma registry from an urban, Level I Trauma Center. Bronchoscopy assistance was used based on surgeon preference. Standard statistical methodology was used to determine if there was a difference in complication rates for procedures performed with and without the bronchoscope. From January 2007, to April 2016, 649 patients underwent modified percuteaneous tracheostomy; 289 with the aid of a bronchoscope and 360 without. There were no statistically significant differences in any type of complication regardless of utilization of a bronchoscope. The addition of bronchoscopy provides several theoretical benefits when performing percutaneous tracheostomy. Our findings, however, do not demonstrate a statistically significant difference in complications between procedures performed with and without a bronchoscope. Use of the bronchoscope should, therefore, be left to the discretion of the performing physician.


The view from the other side of the desk: what an employer looks for during an interview.
It may be helpful for orthopaedic surgeons seeking employment to consider what the recruiting orthopaedic surgeon on the other side of the desk is thinking! Well-managed orthopaedic practices realize how expensive it is to recruit new surgeons only to lose them 2 years later, and these practices will try diligently to ensure that there is a good fit between the candidate and the practice before offering a position. It is also important to realize that many practices cannot promise everything that a starting orthopaedic surgeon will want and ignoring practices that are realistic in their guarantees will cause the candidate to overlook some very good opportunities. Although no one can ever guarantee a perfect decision every time, using common sense and a reasonable due diligence will often result in a good match.


[Human microbiome and chronic prostatitis / chronic pelvic pain syndrome: An update].
The significance of symbiotic microorganisms in the human body was recognized with the advancing of the concept of human microbiome and the development of related studies and technologies. These microorganisms play important roles in metabolism, immune regulation, the maintenance of health, and the development and progression of diseases in the human body. Recent studies show that chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) is related with human microbiome, mainly involving the urogenital tract, intestinal canal, and oral cavity. This review summarizes the studies on the relationship between the human microbiome and CP/CPPS in recent years.


Target cell-restricted apoptosis induction by 528scFv-TRAIL fusion protein specific for human EGFR and expressed in Escherichia coli.
We report the preparation and functional characterization of an Escherichia coli-expressed recombinant fusion protein, 528scFv-TRAIL, specific for the human epidermal growth factor receptor (EGFR) and empowered by the tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). The 528scFv-TRAIL, expressed as insoluble inclusion bodies in E. coli, was solubilized and then refolded by using a modified stepwise dialysis method. Treatment with 528scFv-TRAIL resulted in the specific binding to the cell surface of EGFR-positive cells with concomitant deployment of the TRAIL moiety to DR-5 receptor in a manner comparable to a commercially available form of recombinant TRAIL (cTRAIL). 528scFv-TRAIL, prepared by either of three refolding processes described herein, showed potent cytotoxic activity against EGFR-positive TFK-1 cell line and was superior to its parental 528scFv; a recombinant variable fragment with single specificity against human EGFR. Narrow variations in the cytotoxic potential of 528scFv-TRAIL were ascribed to manipulation of redox conditions during the refolding process. Together, our findings point to the potential value of 528scFv-TRAIL for treatment of EGFR-expressing cancers. Furthermore, preparation of 528scFv-TRAIL from insoluble aggregates in a prokaryotic cell based expression system by means of in vitro refolding introduces a feasible cost-benefit, time-efficient approach for industrial-scale production.


[A case of examination of skeletal remains--how many bodies did they come from?].
We examined skeletal remains, with the main intention of estimating how many bodies they had come from. The samples were a skull with defect of its base, an upper jaw, two lower jaws (No. 1, No. 2) and two skeletal bodies (No. 1: with no skull, No. 2: consisting mainly of the lower extremities). In examining the mutual relationship among them, we utilized adjustability between the skull and the lower jaws at the temporomandibular joint, and between the lower jaws and the upper jaw in the biting manner of their teeth. We concluded that the most probable combination was of two bodies, i.e. [skull + lower jaw No. 1 + skeletal body No. 1] and [upper jaw + lower jaw No. 2 + skeletal body No. 2]. Beside the above presentation, we did comment on several problems in personal identification and estimation of postmortem interval.


Dental attrition models predicting temporomandibular joint disease or masticatory muscle pain versus asymptomatic controls.
To determine whether patients with temporomandibular joint disease or masticatory muscle pain can be usefully differentiated from asymptomatic controls using multifactorial classification tree models of attrition severity and/or rates. Measures of attrition severity and rates in patients diagnosed with disc displacement (n = 52), osteoarthrosis (n = 74), or masticatory muscle pain only (n = 43) were compared against those in asymptomatic controls (n = 132). Cross-validated classification tree models were tested for fit with sensitivity, specificity, accuracy and log likelihood accountability. The model for identifying asymptomatic controls only required the three measures of attrition severity (anterior, mediotrusive and laterotrusive posterior) to be differentiated from the patients with a 74.2 +/- 3.8% cross-validation accuracy. This compared with cross-validation accuracies of 69.7 +/- 3.7% for differentiating disc displacement using anterior and laterotrusive attrition severity, 68.7 +/- 3.9% for differentiating disc displacement using anterior and laterotrusive attrition rates, 70.9 +/- 3.3% for differentiating osteoarthrosis using anterior attrition severity and rates, 94.6 +/- 2.1% for differentiating myofascial pain using mediotrusive and laterotrusive attrition severity, and 92.0 +/- 2.1% for differentiating myofascial pain using mediotrusive and anterior attrition rates. The myofascial pain models exceeded the > or =75% sensitivity and > or =90% specificity thresholds recommended for diagnostic tests, and the asymptomatic control model approached these thresholds. Multifactorial models using attrition severity and rates may differentiate masticatory muscle pain patients from asymptomatic controls, and have some predictive value for differentiating intracapsular temporomandibular disorder patients as well.


Metagenome-Assembled Genomes from a Microbiome Converting Xylose to Medium-Chain Carboxylic Acids.
There is growing interest in producing beneficial products from wastes using microbiomes. We previously performed multiomic analyses of a bioreactor microbiome that converted carbohydrate-rich lignocellulosic residues to medium-chain carboxylic acids. Here, we present draft metagenome-assembled genomes from this microbiome, obtained from reactors in which xylose was the primary carbon source.


Identification, localization, and role of fibronectin in cultured bovine endothelial cells.
We have examined bovine aortic endothelial cell cultures for the presence of fibronectin, a high molecular weight cell-surface glycoprotein. Sparse cultures contain fibronectin only on dorsal cell surfaces at regions of cell-cell contact, as detected by immunofluorescence. In contrast, when the endothelial cells reached confluence as a highly contact-inhibited monolayer, fibronectin was detected in an extracellular matrix underneath the cell monolayer but not on top of the monolayer. Sodium dodecyl sulfate/polyacrylamide gel electrophoresis of isolated extracellular matrix revealed that a predominant component of the matrix is a protein of approximately 2.3 X 10(5) molecular weight, which has been identified as fibronectin.


Team size impact on assessment of teamwork in simulation-based trauma team training.
Non-technical skills (teamwork) assessment is used to improve competence during training for interprofessional trauma teams. We hypothesized non-technical skills assessment is less reliable for large size teams, and evaluated team size effects during teamwork training. Small-teams (n = 5; 5-7 members) and Large-teams (n = 6; 8-9 members) participated in three simulation-based trauma team training scenarios. Following each scenario, teamwork was scored by participating trauma attending physicians (TA), non-participating critical care trauma nurses (CRN), and two expert teamwork debriefers (E), using the Trauma Nontechnical Skills Assessment tool (T-NOTECHS). Large-team scores by TA and CRN were higher than E scores (P < .003); small-team scores did not differ by rater. Small-team inter-observer agreement was substantial (ICC = 0.60); large-team agreement was low (ICC = 0.29). E and TA scores showed no concordance, whereas E and CRN scores showed poor concordance for large teams (ICC = 0.41, r = 0.53, P = .02). By contrast, correlation between E and TA (ICC = 0.52, r = 0.80, P < .001) as well as E and CRN (ICC = 0.57, and r = 0.65, P < .01) for small teams was high. Team size should be considered in team-training design, and when using teamwork rating instruments such as T-NOTECHS for assessment of simulated or actual trauma teams. Modified rating scales and enhanced training for raters of large groups versus small groups may be warranted.


Evaluation of viral interference with MHC class I-restricted antigen processing and presentation using a flow cytometry-based approach.
The peptide content of MHC class I molecules present at the cell surface is monitored by surveilling CD8(+) cytotoxic T cells. In case of a viral infection, a proportion of the MHC class I molecules will carry peptides derived from viral proteins. This allows the CD8(+) T cells to recognize and eliminate virus-infected cells. This highly sensitive detection system of the host is counteracted by viruses, which have acquired functions to downregulate cell surface expression of MHC class I molecules. In this chapter, we describe a flow cytometry-based method to identify viral gene product(s) responsible for evasion from MHC class I-restricted antigen presentation. To this end, cells are transiently transfected using polyethylenimine (PEI) as a transfection reagent, followed by cell surface staining with MHC class I-specific monoclonal antibodies. Once viral proteins responsible for MHC class I downregulation have been identified, their mechanism of action can be characterized. Identification and characterization of virus-encoded MHC class I inhibitors augments our understanding of virus-host interactions and often provides new insights into antigen processing and presentation pathways, including related cellular processes such as protein trafficking and degradation.


Failure in learning task and loss of cortical cholingergic fibers in microsphere-embolized rats.
The present study was undertaken to elucidate the pathological changes in learning and memory functions and in the metabolism of cortical cholinergic neurons following microsphere embolism in the rat. Microspheres (48 microm) were injected into the right internal carotid artery of rats. Learning and memory functions were measured 7 or more days after the embolism by active and passive avoidance, and water maze tasks. In the biochemical study, cortical acetylcholine and choline contents, and choline acetyltransferase activity were measured. Cortical acetylcholinesterase-containing fibers were quantitatively estimated in the embolized rat. The active and passive avoidance, and water maze tasks were impaired in the microsphere-embolized rat. In the histochemical study, the density of cortical acetylcholinesterase-containing fibers of the ipsilateral hemisphere of the microsphere-embolized rat was decreased, but cell density was unchanged. Furthermore, microsphere embolism decreased the cortical acetylcholine concentration and choline acetyltransferase activity and increased the choline concentration. The results suggest that microsphere embolism causes severe damage to cortical cholinergic neurons, which may be, at least in part, related to the impairment of learning and memory functions in the sustained brain ischemia.


An Update on Anticoagulation in Atrial Fibrillation.
Cerebrovascular accidents related to atrial fibrillation (AF) are potentially preventable with anticoagulation. Until recently, warfarin was the only proven anticoagulant to be effective in stroke prevention, however the novel, direct acting oral anticoagulants (DOACs) are now available, triggering a paradigm shift in treatment philosophy. Today, physicians need to consider in which patients anticoagulation should not be used rather than, as in the past, deciding in which patients it should be used. Although warfarin will continue to have a place in managing some patients with AF, in the future, the DOACs should be the predominant therapy for stroke prevention in patients with non-valvular AF.


Various applications of deep temporal fascia in rhinoplasty.
In Asians, nasal dorsal and tip augmentation procedures are usually performed at the same time, and most dorsal augmentations use implants. In this study, dorsal augmentation was given by various types of grafts using deep temporal fascia (DTF) for primary rhinoplasty cases using only autologous tissues to improve the curve of hump noses and depressions. For secondary rhinoplasty cases, DTF was used to improve implant demarcation and transparency. Such effectiveness and utility of DTF is discussed. Between May 2009 and May 2012, we performed rhinoplasty using DTF in 175 patients, which included 78 secondary surgery patients and 128 female patients. The mean age of the patients was 31.4. DTF was utilized with various types of grafts without implants to improve the curve in dorsal augmentation of hump noses and cases that required curve betterment. DTF was used to improve implant demarcation and transparency for secondary cases. The mean follow-up duration was 1.5 years. Of the 175 patients, 81% were satisfied with the natural correction achieved, whereas 19% complained of undercorrection, which was resolved with additional surgery. No specific complications such as nasal inflammation or contractures were observed. DTF can be used with various graft methods for correction of radix, dorsal, and tip irregularities. It can also be used to correct implant contour transparency in secondary rhinoplasty and thus may be considered as a useful supplementary graft material in rhinoplasty for Asians.


Intrapelvic dissemination of early low-grade endometrioid stromal sarcoma due to electronic morcellation.
Endometrioid stromal sarcoma is a rare malignancy that originates from mesenchymal cells. It is classified into low-grade endometrioid stromal sarcoma (LGESS) and high-grade endometrioid stromal sarcoma. Ultrasonographic findings of LGESS resemble those of submucosal myomas, leading to the possible preoperative misdiagnosis of LGESS as uterine leiomyoma. Electronic morcellation during laparoscopic surgery in women with LGESS can result in iatrogenic intraabdominal dissemination and a poorer prognosis. Here, we report a patient with LGESS who underwent a supracervical hysterectomy and electronic morcellation for a presumed myoma in another hospital. Disseminated metastatic lesions of LGESS in the posterior cul-de-sac and rectal serosal surface were absent on primary surgery, but found during reexploration. In conclusion, when LGESS is found incidentally following previous morcellation during laparoscopic surgery for presumed benign uterine disease, we highly recommend surgical reexploration, even when there is no evidence of a metastatic lesion in imaging studies.


Clinical hypotension with co-prescription of macrolide antibiotics and calcium-channel blockers in haemodialysis patients: a retrospective chart review.
Macrolide antibiotics inhibit the cytochrome p450 enzyme system, which metabolizes calcium-channel blockers. This may result in a clinically significant interaction, causing hypotension in patients co-prescribed these two drugs. Since these drugs are frequently used in the haemodialysis population, we studied the effect of their co-prescription on actual blood pressure. A retrospective chart review of all haemodialysis patients was conducted to identify patients co-prescribed a macrolide and a dihydropyridine calcium-channel blocker. Blood pressure measurements before and during the macrolide co-prescription were abstracted and compared using a student's t test. We identified 154 haemodialysis patients concurrently prescribed a macrolide antibiotic and a dihydropyridine calcium-channel blocker. There was no significant difference in episodes of intra-dialytic hypotension or actual blood pressure measurements in the period before macrolide co-prescription and the period during macrolide co-prescription. In contrast to hospitalized patients receiving dihydropyridine calcium-channel blockers, concurrent administration of a macrolide antibiotic for infection did not result in hypotension in haemodialysis outpatients. Further research should be undertaken before a change in clinical practice against their co-prescription is considered.


Is post-treatment standardized uptake value a prognostic factor in unresectable non-small cell lung carcinoma?
Aim Concurrent chemoradiotherapy (CRT) is the standard of care for locally advanced, unresectable non-small cell lung carcinoma (NSCLC). The aim of this study was to assess the prognostic value of maximum standardized uptake values (SUVmax) in patients with unresectable stage III NSCLC treated with concurrent CRT. Method 18F-FDG PET-CT scans were obtained before and after treatment in patients with unresectable stage III NSCLC treated with concurrent CRT. To determine the prognostic value of SUVmax of the primary tumor (PT), univariate and multivariate Cox regression model were carried out. Results Between January 2008 and December 2013, this study included 43 patients (median age 56 years, 95% male). Univariate analysis showed that having a high post-treatment PT-SUVmax was associated with a higher risk of death and having a high post-treatment PT-SUVmax with a higher risk of disease recurrence. Multivariate analysis showed that having a low post-treatment PTSUVmax (cut off 3.9) was associated with longer overall and progression free survival (HR 8.55, 95% CI; 2.56-28.55, p=0.000 and HR 2.854, 95% CI; 1.43-5.67, p=0.003, respectively). Conclusion Post-treatment PT-SUVmax may be an independent prognostic factor in patients with unresectable stage III NSCLC treated with concurrent chemoradiotherapy.


Amino acid modifications on tRNA.
The accurate formation of cognate aminoacyl-transfer RNAs (aa-tRNAs) is essential for the fidelity of translation. Most amino acids are esterified onto their cognate tRNA isoacceptors directly by aa-tRNA synthetases. However, in the case of four amino acids (Gln, Asn, Cys and Sec), aminoacyl-tRNAs are made through indirect pathways in many organisms across all three domains of life. The process begins with the charging of noncognate amino acids to tRNAs by a specialized synthetase in the case of Cys-tRNA(Cys) formation or by synthetases with relaxed specificity, such as the non-discriminating glutamyl-tRNA, non-discriminating aspartyl-tRNA and seryl-tRNA synthetases. The resulting misacylated tRNAs are then converted to cognate pairs through transformation of the amino acids on the tRNA, which is catalyzed by a group of tRNA-dependent modifying enzymes, such as tRNA-dependent amidotransferases, Sep-tRNA:Cys-tRNA synthase, O-phosphoseryl-tRNA kinase and Sep-tRNA:Sec-tRNA synthase. The majority of these indirect pathways are widely spread in all domains of life and thought to be part of the evolutionary process.


Two-dimensional silicon and carbon monochalcogenides with the structure of phosphorene.
Phosphorene has recently attracted significant interest for applications in electronics and optoelectronics. Inspired by this material an ab initio study was carried out on new two-dimensional binary materials with a structure analogous to phosphorene. Specifically, carbon and silicon monochalcogenides have been considered. After structural optimization, a series of binary compounds were found to be dynamically stable in a phosphorene-like geometry: CS, CSe, CTe, SiO, SiS, SiSe, and SiTe. The electronic properties of these monolayers were determined using density functional theory. By using accurate hybrid functionals it was found that these materials are semiconductors and span a broad range of bandgap values and types. Similarly to phosphorene, the computed effective masses point to a strong in-plane anisotropy of carrier mobilities. The variety of electronic properties carried by these compounds have the potential to broaden the technological applicability of two-dimensional materials.


Anterior Trunk Mobility Does Not Predict Disability in Elderly Women With Acute Low Back Pain: Brazilian Back Complaints in the Elders (BACE-Brazil) Study Results.
Cross-sectional, ancillary study of an international multicenter epidemiological study. To investigate the relationship of the anterior trunk mobility with self-report and physical performance measures in elderly women with acute low back pain (LBP). LBP is one of the most prevalent pain complaints in the elderly population. It is postulated that the increased range of motion of limited joints of the trunk may improve LBP and functionality of patients. Recent studies have, however, questioned the association between trunk range of motion and the functional status. The present study included a convenience sample of elderly women from the community aged 60 years and older who presented with a new (acute) episode of LBP. Volunteers with severe diseases and visual, hearing and mobility losses, or cognitive impairment were excluded. Trunk mobility was assessed by the fingertip-to-floor test. Functionality was assessed by the Roland-Morris Questionnaire (RMQ) and gait speed test. Statistical analysis was performed by using hierarchical linear regression model. Data from 459 elderly women, mean age of 69.0 (6.1) years old, were used to describe this report. The additional predictive value for the inclusion of independent variable trunk mobility was only 4.4% in the RMQ score and 1.5% in the gait speed test, respectively. A reduced hierarchical linear regression model showed that the significant predictors for RMQ and gait speed test were body mass index, pain intensity, and trunk mobility. This was the first study to investigate the relationship between trunk mobility and functionality in elderly women with acute LBP. The results suggest that these clinical parameters are independent from each other. N/A.


Effects of intraspecific competition and body mass on diet specialization in a mammalian scavenger.
Animals that rely extensively on scavenging rather than hunting must exploit resources that are inherently patchy, dangerous, or subject to competition. Though it may be expected that scavengers should therefore form opportunistic feeding habits in order to survive, a broad species diet may mask specialization occurring at an individual level. To test this, we used stable isotope analysis to analyze the degree of specialization in the diet of the Tasmanian devil, one of few mammalian species to develop adaptations for scavenging. We found that the majority of individuals were dietary specialists, indicating that they fed within a narrow trophic niche despite their varied diet as a species. Even in competitive populations, only small individuals could be classified as true trophic generalists; larger animals in those populations were trophic specialists. In populations with reduced levels of competition, all individuals were capable of being trophic specialists. Heavier individuals showed a greater degree of trophic specialization, suggesting either that mass is an important driver of diet choice or that trophic specialization is an efficient foraging strategy allowing greater mass gain. Devils may be unique among scavenging mammals in the extent to which they can specialize their diets, having been released from the competitive pressure of larger carnivores.


Voxel-Based Acetylcholinesterase PET Study in Early and Late Onset Alzheimer's Disease.
Alzheimer's disease (AD) is a neurodegenerative disorder characterized by chronic progressive cognitive decline and displays underlying brain cholinergic dysfunction, providing a rationale for treatment with cholinomimetic medication. The clinical presentations and courses of AD patients may differ by age of onset. The objective of the present study was to illustrate the regional differences of brain acetylcholinesterase (AChE) activity as quantified by N-[11C]methylpiperidinyl-4-acetate ([11C]MP4A) and PET using parametric whole brain analysis and clarify those differences as a function of age. 22 early onset AD (EOAD) with age at onset under 65, the remaining 26 as late onset AD (LOAD), and 16 healthy controls (HC) were enrolled. Voxel-based AChE activity estimation of [11C]MP4A PET images was conducted by arterial input and unconstrained nonlinear least-squares method with subsequent parametrical analyses. Statistical threshold was set as Family Wise Error corrected, p-value <0.05 on cluster-level and cluster extent over 30 voxels. Voxel-based group comparison showed that, compared to HC, both EOAD and LOAD showed cortical AChE decrement in parietal, temporal, and occipital cortices, with wider and stringent cortical involvement in the EOAD group, most prominently demonstrated in the temporal region. There was no significant correlation between age and regional cerebral AChE activity except for a small left superior temporal region in the AD group (Brodmann's area 22, Zmax = 5.13, 396 voxels), whereas no significant cluster was found in the HC counterpart. Difference in cortical cholinergic dysfunction between EOAD and LOAD may shed some light on the cholinomimetic drug efficacy in AD.


Symptomatic tachy- and bradyarrhythmias after transcatheter closure of interatrial communications with Amplatzer devices.
The aim of this paper is to present our own experience related to frequency of symptomatic tachy- and bradyarrhythmias in patients after transcatheter closure of interatrial defects (ASD) and patent foramen ovale (PFO) using Amplatzer plugs. Transcatheter closure of interatrial communications with Amplatzer devices was carried out on 739 patients in our center. Only patients with new symptomatic arrhythmias (who required pharmacotherapy, cardioversion or pacemaker implantation) were included in to the study. All patients who had had arrhythmias prior to ASD closure, such as supraventricular tachycardias (SVT) or atrial flutter/fibrillation (AF), were excluded. New tachy- and bradyarrhythmias after implantation of Amplatzer devices were observed in 11 patients (1.5%). There were 9 patients (mean age 36.7 years) with atrial tachyarrhythmias (AF in 8 and SVT in 1 patients), which occurred between the first day and 3 months after implantation. Seven patients were treated initially by pharmacotherapy; in 2 of them sinus rhythm returned just after cardioversion. In other 2 patients cardioversion was performed as an initial therapy. In none of these patients, but one recurrence of tachycardia was observed; however, 7 of them had pharmacotherapy prolonged up to 1 year. In 2 patients, aged 15 and 16, complete atrioventricular (AV) block was observed 4.3 and 1.5 years after Amplatzer implantation, respectively. In the first patient intermittent second-degree AV block (Mobitz II) was observed before ASD closure. In both patients, a DDDR pacemaker was implanted. Transcatheter closure of ASD using Amplatzer devices is associated with a risk of new atrial tachyarrhythmias (usually early after the procedure and in older patients). The risk of conduction disturbances such as complete heart block, which can occur in late followup, is low. Thence, close long-term follow-up of these patients is obligatory.


Percutaneous anterior transarticular screw fixation for atlantoaxial instability: a case series.
We reviewed the outcome of a retrospective case series of eight patients with atlantoaxial instability who had been treated by percutaneous anterior transarticular screw fixation and grafting under image-intensifier guidance between December 2005 and June 2008. The mean follow-up was 19 months (8 to 27). All eight patients had a solid C1-2 fusion. There were no breakages or displacement of screws. All the patients with pre-operative neck pain had immediate relief from their symptoms or considerable improvement. There were no major complications. Our preliminary clinical results suggest that percutaneous anterior transarticulation screw fixation is technically feasible, safe, useful and minimally invasive when using the appropriate instruments allied to intra-operative image intensification, and by selecting the correct puncture point, angle and depth of insertion.


Radiation resistance of biological reagents for in situ life detection.
Life on Mars, if it exists, may share a common ancestry with life on Earth derived from meteoritic transfer of microbes between the planets. One means to test this hypothesis is to isolate, detect, and sequence nucleic acids in situ on Mars, then search for similarities to known common features of life on Earth. Such an instrument would require biological and chemical components, such as polymerase and fluorescent dye molecules. We show that reagents necessary for detection and sequencing of DNA survive several analogues of the radiation expected during a 2-year mission to Mars, including proton (H-1), heavy ion (Fe-56, O-18), and neutron bombardment. Some reagents have reduced performance or fail at higher doses. Overall, our findings suggest it is feasible to utilize space instruments with biological components, particularly for mission durations of up to several years in environments without large accumulations of charged particles, such as the surface of Mars, and have implications for the meteoritic transfer of microbes between planets.


Detecting miRNAs in deep-sequencing data: a software performance comparison and evaluation.
Deep sequencing has become a popular tool for novel miRNA detection but its data must be viewed carefully as the state of the field is still undeveloped. Using three different programs, miRDeep (v1, 2), miRanalyzer and DSAP, we have analyzed seven data sets (six biological and one simulated) to provide a critical evaluation of the programs performance. We selected these software based on their popularity and overall approach toward the detection of novel and known miRNAs using deep-sequencing data. The program comparisons suggest that, despite differing stringency levels they all identify a similar set of known and novel predictions. Comparisons between the first and second version of miRDeep suggest that the stringency level of each of these programs may, in fact, be a result of the algorithm used to map the reads to the target. Different stringency levels are likely to affect the number of possible novel candidates for functional verification, causing undue strain on resources and time. With that in mind, we propose that an intersection across multiple programs be taken, especially if considering novel candidates that will be targeted for additional analysis. Using this approach, we identify and performed initial validation of 12 novel predictions in our in-house data with real-time PCR, six of which have been previously unreported.


Selectively measuring π back-donation in gold(I) complexes by NMR spectroscopy.
Even though the Dewar-Chatt-Duncanson model has been successfully used by chemists since the 1950s, no experimental methodology is yet known to unambiguously estimate the constituents (donation and back-donation) of a metal-ligand interaction. It is demonstrated here that one of these components, the metal-to-ligand π back-donation, can be effectively probed by NMR measurements aimed at determining the rotational barrier of a C-N bond (ΔHr (≠) ) of a nitrogen acyclic carbene ligand. A large series of gold(I) complexes have been synthesized and analyzed, and it was found that the above experimental observables show an accurate correlation with back-donation, as defined theoretically by the appropriate charge displacement originated upon bond formation. The proposed method is potentially of wide applicability for analyzing the ligand effect in metal catalysts and guiding their design.


Chronic fistulation and cannulation of the rabbit caecum.
A PTFE cannula was introduced into the rabbit abdomen through the right flank. A purse string suture was used to fix a small plastic flange within the caecum. A larger flange was sutured under the skin to fix the cannula. Caecal contents could be collected from the chronic fistula via a threaded stainless steel cap on the cannula. Animals tolerated the fistulation well and sepsis was never seen.


Visual disturbances in a population-based survey of 6962 subjects: the German National Health Examination Survey 1998.
Available prevalence estimates of visual disturbances (excluding blindness) in Germany are based on data from highly selective populations. This report describes the prevalence of visual disturbances and potential determinants based on the German National Health Examination Survey from 1998. A population-based cross-sectional study of the non-institutionalized population in unified Germany. People aged 18-79 years were eligible and were contacted by a multi-mode approach. The response proportion was 61%, resulting in a sample of 7124 subjects who participated in the study. Visual disturbances were assessed by a self-administered questionnaire. Prevalance rates are higher among women in unified as well as in East- and West Germany. The higher overall prevalence rates among women is mostly driven by higher prevalance rates at ages 18-49 years, especially for shortsightedness. The prevalence rates are higher in West Germany than East Germany. Visual disturbances are more prevalent among the middle and upper social class than the lower social class. Above the age group 40-44, the prevalence of visual disturbances considerably increases, to approximately 100% in the age group 55 years or older for both sexes and in both parts of Germany. Nearly 100% of German adults aged 50-79 years have some degree of visual disturbance that requires refractive correction. Prevalence rates of visual disturbances are higher among people from West Germany, people of higher social status and among women. Uncorrected visual disturbances are most prevalent in the age group 18-34 years and more often among males and subjects of lower social status.


Developing a New Generic Health and Wellbeing Measure: Psychometric Survey Results for the EQ-HWB.
The development of measures such as the EQ-HWB (EQ Health and Wellbeing) requires selection of items. This study explored the psychometric performance of candidate items, testing their validity in patients, social carer users, and carers. Article and online surveys that included candidate items (N = 64) were conducted in Argentina, Australia, China, Germany, United Kingdom, and the United States. Psychometric assessment on missing data, response distributions, and known group differences was undertaken. Dimensionality was explored using exploratory and confirmatory factor analysis. Poorly fitting items were identified using information functions, and the function of each response category was assessed using category characteristic curves from item response theory (IRT) models. Differential item functioning was tested across key subgroups. There were 4879 respondents (Argentina = 508, Australia = 514, China = 497, Germany = 502, United Kingdom = 1955, United States = 903). Where missing data were allowed, it was low (UK article survey 2.3%; US survey 0.6%). Most items had responses distributed across all levels. Most items could discriminate between groups with known health conditions with moderate to large effect sizes. Items were less able to discriminate across carers. Factor analysis found positive and negative measurement factors alongside the constructs of interest. For most of the countries apart from China, the confirmatory factor analysis model had good fit with some minor modifications. IRT indicated that most items had well-functioning response categories but there was some evidence of differential item functioning in many items. Items performed well in classical psychometric testing and IRT. This large 6-country collaboration provided evidence to inform item selection for the EQ-HWB measure.


Ultrafast and Energy-saving Synthesis of Nitrogen and Chlorine Co-doped Carbon Nanodots via Neutralization Heat for Selective Detection of Cr(VI) in Aqueous Phase.
In this work, it is presented for the first time that nitrogen and chlorine co-doped carbon nanodots (N,Cl-CDs) were synthesized by simply mixing glucose, concentrated hydrochloric acid (HCl), and 1,2-ethylenediamine (EDA). No external heat was employed; the neutralization reaction served as the heat source. The glucose served as the carbon source while EDA and HCl were the N and Cl dopants, respectively. The fluorescence of N,Cl-CDs was adequately quenched by hexavalent chromium Cr(VI) based on a combination of dynamic quenching and inner filter effect (IFE). Accordingly, an efficient N,Cl-CDs-based fluorescence probe was established for sensitive and selective detection of Cr(VI). The proposed fluorescence sensor provides a linear recognition range for Cr(VI) determination from 3 to 40 µM with a limit of detection (LOD) of 0.28 µM (14.6 µg/L). The proposed fluorescence method was successfully utilized to detect Cr(VI) in different water samples with satisfactory results. The spike recoveries vary from 97.01% to 103.89% with relative standard deviations (RSDs) of less than 0.82%. This work highlights the development of a simple, ultrafast, and energy-saving one-step synthetic route to fabricate N,Cl-CDs for highly selective and sensitive detection of Cr(VI) in real water samples. It is anticipated that the proposed fluorescence method could be further explored and widely used for Cr(VI) detection in the environmental industry.


Feasibility and reproducibility of echo planar spectroscopic imaging on the quantification of hepatic fat.
1H-MRS is widely regarded as the most accurate noninvasive method to quantify hepatic fat content (HFC). When practical period of breath holding, and acquisition of HFC over multiple liver areas is considered, a fast MR spectroscopic imaging technique is desired. The aim of this study is to examine the feasibility and reproducibility of echo planar spectroscopic imaging (EPSI) on the quantification of HFC in subject with various HFCs. Twenty two volunteers were examined in a 3T MR system. The acquisition time of proposed EPSI protocol was 18 seconds. The EPSI scans were repeated 8 times for each subject to test reproducibility. The peak of water and individual peaks of fat including methyl, methylene, and allylic peaks at 0.9, 1.3, and 2.0 ppm were fitted. Calculated amount of water and fat content were corrected for T2 relaxation. The total HFC was defined as the combination of individual peaks. Standard deviation (SD), coefficient of variance (COV) and fitting reliability of HFC quantified by LCModel were calculated. Our results show that the SDs of total HFC for all subjects are less than 2.5%. Fitting reliability is mostly under 10% and positively correlates with COV. Subjects separated into three subgroups according to quantified total HFC show that improved fitting reliability and reproducibility can be achieved on subjects with higher total HFC. We have demonstrated feasibility of the proposed EPSI protocols on the quantification of HFC over a whole slice of liver with scan time in a single breath hold.


[Efficacy of extracorporeal membrane oxygenation in patients with complex high risk coronary artery disease undergoing percutaneous coronary intervention].
Objective: To explore the safety and efficacy of venous-arterial extracorporeal membrane oxygenation (VA-ECMO) in complex high-risk and indicated patients (CHIP). Methods: This is a single-center retrospective study. Patients who underwent percutaneous coronary intervention (PCI) supported by VA-ECMO in the Second Hospital of Jilin University from June 2018 to January 2020 were enrolled. General clinical data, laboratory examination results, PCI and ECMO process, postoperative complications and prognosis were collected through the electronic medical record system. The endpoint of the study was major adverse cardiovascular events (MACE), defined as complex events including cardiac death, recurrent myocardial infarction, heart failure and malignant arrhythmia. All patients were followed up for 12 months after discharge. Kaplan-Meier method was used for survival analysis. Results: A total of 31 patients, aged (64.6±10.1) years, including 19 males were included. All patients were treated with VA-ECMO before PCI. The ProGlide vascular suture device was embedded by local anesthesia to quickly establish circulation. There were 9 (29.0%) patients with ST-segment elevation myocardial infarction, 10 (32.3%) patients with non-ST-segment elevation myocardial infarction and 12 (38.7%) patients with unstable angina. The number of stents implanted during the operation were 2.8±1.8. The VA-ECMO weaning time was 24.0 (2.0, 88.5) hours. Compared with the results of pre-operation, the patient's postoperative left ventricular ejection fraction was significantly improved (49% (42%, 55%) vs. 43% (35%, 52%), P<0.01], hemoglobin and platelet count levels decreased, the level of creatinine and urea nitrogen was increased (P<0.05). Within 24 hours after operation, hemoglobin decreased>20 g/L was observed in 18 cases (58.1%), puncture site bleeding was found in 2 cases (6.5%), pseudoaneurysm occurred in 1 case (3.2%) and postoperative cerebral infarction occurred in 1 case (3.2%). There were no deaths during the operation, 2 patients died during hospitalization. All discharged patients were followed up for 12 months. The incidence of MACE was 13.8% (4/29). During the follow-up period, 2 patients died. One patient was hospitalized with recurrent myocardial infarction and one patient with heart failure. Survival analysis was performed 12 months after intervention and the cumulative survival rate was 80.0%. Conclusion: The application of VA-ECMO in CHIP interventional therapy is safe, effective and feasible.


Interactive Magnetic Catheter Steering With 3-D Real-Time Feedback Using Multi-Color Magnetic Particle Imaging.
Magnetic particle imaging (MPI) is an emerging tomographic method that enables sensitive and fast imaging. It does not require ionizing radiation and thus may be a safe alternative for tracking of devices in the catheterization laboratory. The 3-D real-time imaging capabilities of MPI have been demonstrated in vivo and recent improvements in fast online image reconstruction enable almost real-time data reconstruction and visualization. Moreover, based on the use of different magnetic particle types for catheter visualization and blood pool imaging, multi-color MPI enables reconstruction of separate images for the catheter and the vessels from simultaneously measured data. While these are important assets for interventional imaging, MPI field generators can furthermore apply strong forces on a magnetic catheter tip. It is the aim of this paper to give a first demonstration of the combination of real-time multi-color MPI with online reconstruction and interactive field control for the application of forces on a magnetic catheter model in a phantom experiment.


Fibrinogen reduction and bleeding complications in plasma exchange, immunoadsorption and a combination of the two.
Immunoadsorption (IAS) and therapeutic plasma exchange (TPE) are considered safe although fibrinogen is removed. To date no comparison of fibrinogen reduction and associated risk of bleeding in apheresis exists. Retrospective analysis of TPE, three IAS adsorbers, and combined TPE/IAS regarding fibrinogen reduction and bleeding incidence in 67 patients (1,032 treatments). TPE and TPE/IAS reduced fibrinogen by 64 ± 11% and 58 ± 9%, leading to concentrations <100 mg/dl in 20 and 17% of treatments, respectively. IAS decreased fibrinogen less than TPE (26 ± 6%, p < 0.0001), resulting in fibrinogen concentrations <100 mg/dl in 1% of treatments. The processed volume correlated with reduction in TPE (r = 0.64, p < 0.01), but not in IAS. Bleeding occurred in 1.3% (IAS), 2.3% (TPE) and 3.1% (TPE/IAS) of treatments. Hypofibrinogenemia occurs in 20% of patients after TPE and TPE/IAS, but rarely after IAS. IAS removes fibrinogen independently of volume processed. Overall, bleeding is rare in apheresis.


Adolescents' attributions of parental power: a re-examination of the 'theory of resources in cultural context'.
Using a multidimensional parental power framework, power bases derived from adolescent descriptions of parent-child interactions and family decision making were regressed on a multidimensional power construct and showed differential importance of predictor variables. Rodman's (1972) modified 'theory of resources in cultural context' is supported. Father's education alone does not lead to loss of paternal power; paternal power retention or loss must be considered in relation to such variables as maternal age and education and paternal age, and within relevant power categories. Mother's education affects her power bases; she increasingly shares culturally prescribed maternal and paternal power as her education increases. Her decreases in traditionally prescribed maternal power are not offset by an equivalent increase in traditionally prescribed paternal power; she may actually lose power with increased education. Relative education of husband and wife explains power differentials across power bases more clearly than does education of either spouse.


Evidence for regulation of protein synthesis at the translation level in response to dietary alterations.
Rats were maintained for several days on a protein-free diet which, approximately 14 hr before decapitation, was changed to a protein-rich diet. Microsomal subfractions of liver were obtained by sucrose density gradient centrifugation. The sedimentation patterns of the microsomal subfractions and of the polysomes were found to be unchanged after the alteration of the diet whereas the ability to incorporate amino acid was markedly enhanced. No significant differences in the RNA/protein ratio of the microsomal subfractions were observed. The changes in amino acid incorporation which were unrelated to concurrent changes in the amount of polysomes are discussed.


ENDOCRINE COMPLICATIONS IN PATIENTS WITH GVHD.
Objective: Graft-versus-host disease (GVHD) is an immune phenomenon that occurs in 30 to 70% of patients after allogeneic hematopoietic stem cell transplantation (HST). Chronic GVHD is a state of immune dysregulation wherein, depending on the severity and organ involved, patients may require prolonged treatment with additional or higher corticosteroids and other immunosuppressive agents. The objective of this study was to review the endocrine manifestations following HST that can arise as a consequence of the primary disease or its treatment, including chemotherapeutic agents, corticosteroids, radiation, or GVHD. Methods: We performed a narrative review of GVHD after HST. An English-language search for relevant studies was conducted on PubMed from inception to August 1, 2018, using the following search terms: "endocrine complications," "bone marrow transplantation," "graft-versus-host disease," and "GVHD." The reference lists of relevant studies were also reviewed. Results: Chronic GVHD may be associated with considerable pediatric growth impairment and may also contribute to thyroid gland dysfunction and thyroid cancer. These patients may also be at increased risk for low bone mineral density, reduced fertility, metabolic syndrome, and suppression of the pituitary-adrenal axis with adrenal insufficiency. Conclusion: This review indicates the importance of monitoring, diagnosing, and properly treating the endocrine complications in this population. More studies are needed to investigate the independent impact of GVHD on the endocrine system and treatment for complications. Abbreviations: BMD = bone mineral density; GH = growth hormone; GVHD = graft-versus-host disease; HST = hematopoietic stem cell transplantation; IGF-1 = insulin-like growth factor 1.


Subtemporal amygdalohippocampectomy for treating medically intractable temporal lobe epilepsy.
A SUBTEMPORAL AMYGDALOHIPPOCAMPECTOMY technique has been developed for mesial temporal lobe epilepsy. The conventional subtemporal approach has been modified to diminish temporal lobe retraction and the risk of damage to the temporal lobe. In the new technique, the surgeons' position has moved from above to below and the approach has been changed from anterolateral to posterolateral, thereby avoiding the voluminous and steeply inclined anterior temporal lobe. By this modified approach, it was unnecessary to remove the roof of the external auditory meatus and it was estimated that both the retraction pressure and the extent of temporal lobe retraction were reduced. To date, surgeons using this approach have operated on four patients with temporal lobe epilepsy whose epileptic foci were in the mesial temporal structure; the inferior temporal gyrus, the temporal tip, the vein of Labbé, and the ventral bridging veins were preserved. After surgery, two patients became completely free of seizures and the other two showed over 90% reduction in seizure frequency without neurological sequelae. Postoperative visual field examination revealed full visual fields without quadrantanopsia. This approach can preserve the temporal stem and lateral temporal lobe, it can be used to remove as much of the posterior hippocampus as necessary, and it can be extended to conventional lobectomy if it is indicated.


Pyroglutamic acid stimulates DNA synthesis in rat primary hepatocytes through the mitogen-activated protein kinase pathway.
We purified pyroglutamic acid from human placental extract and identified it as a potent stimulator of rat primary hepatocyte DNA synthesis. Pyroglutamic acid dose-dependently stimulated DNA synthesis, and this effect was inhibited by PD98059, a dual specificity mitogen-activated protein kinase kinase 1 (MAP2K1) inhibitor. Therefore, pyroglutamic acid stimulated DNA synthesis in rat primary hepatocytes via MAPK signaling.