Incidence and Risk of Fatal Vehicle Crashes Among Professional Drivers: A Population-Based Study in Taiwan.
Fatal vehicle crashes (FVCs) are among the leading causes of death worldwide. Professional drivers often drive under dangerous conditions; however, knowledge of the risk factors for FVCs among professional drivers remain scant. We investigated whether professional drivers have a higher risk of FVCs than non-professional drivers and sought to clarify potential risk factors for FVCs among professional drivers. We analyzed nationwide incidence rates of FVCs as preliminary data. Furthermore, by using these data, we created a 1:4 professionals/non-professionals preliminary study to compare with the risk factors between professional and non-professional drivers. In Taiwan, the average crude incidence rate of FVCs for 2003-2016 among professional drivers was 1.09 per 1,000 person-years; professional drivers had a higher percentage of FVCs than non-professional drivers among all motor vehicle crashes. In the 14-year preliminary study with frequency-matched non-professional drivers, the risk of FVCs among professional drivers was significantly associated with a previous history of involvement in motor vehicle crashes (adjustment odds ratio [OR] = 2.157; 95% confidence interval [CI], 1.896-2.453), previous history of benzodiazepine use (adjustment OR = 1.385; 95% CI, 1.215-1.579), and speeding (adjustment OR = 1.009; 95% CI, 1.006-1.013). The findings have value to policymakers seeking to curtail FVCs.


Early recognition and management of septic shock in children.
Septic shock remains a major cause of morbidity and mortality among children, mainly due to acute hemodynamic compromise and multiple organ failures. In the last decade, international guidelines for the management of septic shock, as well as clinical practice parameters for hemodynamic support of pediatric patients, have been published. Early recognition and aggressive therapy of septic shock, by means of abundant fluid resuscitation, use of catecholamines and other adjuvant drugs, are widely considered of pivotal importance to improve the short and long-term outcome of these patients. The aim of this paper is to summarize the modern approach to septic shock in children, particularly in its very initial phase, when pediatric healthcare providers may be required to intervene in the pre-intensive care unit setting or just on admission in the pediatric intensive care unit.


hSOD1 promotes tau phosphorylation and toxicity in the Drosophila model.
Tau hyperphosphorylation has been found in several neurodegenerative diseases such as Alzheimer's disease (AD), Down syndrome, and amyotrophic lateral sclerosis (ALS). However, factors affecting tau hyperphosphorylation are not yet clearly understood. SOD1, a Cu/Zn superoxide dismutase whose mutations can cause adult-onset ALS, is believed to be involved in the pathology of Down syndrome. In this work, the model organism Drosophila was used to study the possible link between hSOD1 and tau. Our results show that hSOD1, and to a higher degree hSOD1(A4V), can increase tau toxicity in Drosophila and exacerbate the corresponding neurodegeneration phenotype. The increased tau toxicity appears to be explainable by elevated tau phosphorylation. Tau(S2A), a tau mutant with impaired phosphorylation capabilities, does not respond to expression of hSOD1 and hSOD1(A4V). We suggest that increased SOD1 expression can lead to tau hyperphosphorylation, which might serve as an important contributing factor to the etiology of Down syndrome and SOD1-related ALS disease.


Earthquake-related stressors associated with suicidality, depression, anxiety and post-traumatic stress in adolescents from Muisne after the earthquake 2016 in Ecuador.
The Ecuadorian earthquake in April 16th was the second strongest and deadliest in 2016 worldwide, with approximately one million people affected. In this paper, we analyzed the psychological impact and the relationship between mental health events and various earthquake-related stressors related to the earthquake, 9 months after the event. We conducted an analytical cross-sectional study, applying an anonymous survey to 316 adolescents (13-19 years old) from Muisne, Ecuador. Suicidal tendency, depression, anxiety and post-traumatic stress (PTSD) were evaluated via the Child PTSD Symptom Scale (CPSS), Spence Children's Anxiety Scale, Okasha Suicidality Scale, and the Center for Epidemiologic Studies Depression Scale (CES-D) and the adapted seven-questions earthquake-related stressors survey. We found a high prevalence of suicidal ideations and behavior, posttraumatic stress, depression and anxiety compared to international studies. Even though adolescents currently living in shelters had higher levels of anxiety, their suicidal tendency was significantly lower than those living in their own or their relatives' home. Finally, the earthquake-related stressors were not associated with suicidality and mental health events, with the exception of economic damage suffered by the family. High levels of depression, post-traumatic stress and anxiety among high-school students were found, especially among those who have suffered serious economic damage. The economic impact in their families and high unemployment rates among their parents seems to be related to lack of hope and favorable perspectives for their future, situation that might lead to lead to emotional disturbances and psychological disorders. Although prolonged homelessness experience in shelters may be a stressful occurrence, might also be related with spiritual growth among adolescents, and may work as a protective factor against suicidal ideations and attempts.


Infrared matrix-assisted laser desorption/ionization orthogonal-time-of-flight mass spectrometry employing a cooling stage and water ice as a matrix.
Although water ice has been utilized in the past as a matrix for infrared matrix-assisted laser desorption/ionization mass spectrometry (IR-MALDI-MS), it has not found a wider use due to limitations in the analytical performance and technical demands on the employment of the necessary cooling stage. Here, we developed a temperature-controlled sample stage for use with an orthogonal time-of-flight mass spectrometer (MALDI-o-TOF-MS). The stage utilizes a combination of liquid nitrogen cooling and counterheating with a Peltier element. It allows adjustment of the sample temperature between ~-120 °C and room temperature. To identify optimal irradiation conditions for IR-MALDI with the water ice matrix, we first investigated the influence of excitation wavelength, varied between 2.7 and 3.1 μm, and laser fluence on the signal intensities of molecular substance P ions. These data suggest the involvement of transient melting of the ice during the laser pulse and primary energy deposition into liquid water. As a consequence, the best analytical performance is obtained at a wavelength corresponding to the absorption maximum of liquid water of about 2.94 μm. The current data significantly surpass the previously reported analytical features. The particular softness of the method is, for example, exemplified by the analysis of noncovalently bound holo-myoglobin and of ribonuclease B. This is also the first report demonstrating the analysis of an IgG monoclonal antibody (MW ~ 150 kDa) from a water ice matrix. Untypical for MALDI-MS, high charge states of multiply protonated species were moreover observed for some of the investigated peptides and even for lacto-N-fucopentaose II oligosaccharides. Using water ice as matrix is of particular interest for MALDI MS profiling and imaging applications since matrix-free spectra are produced. The MS and tandem MS analysis of metabolites directly from frozen food samples is demonstrated with the example of a strawberry fruit.


Applications of Lawesson's reagent in the synthesis of naturally occurring steroids and terpenoids.
Steroids and terpenoids are among the most biologically significant classes of natural products possessing a variety of biological activities. The replacement of one or more oxygen atoms in a steroid or terpenoid molecule by a heteroatom affects the chemical properties of that particular steroid or terpenoid, and that replacement often results in alterations of its biological properties, which is sometimes valuable. One possible modification is the thionation that could have some influence on such activity. Among the various thionating reagents, Lawesson's reagent was found to be most suitable and showed versatile properties, including chemoselectivity and functional group tolerance. In this review, we present the role of Lawesson's reagent in the synthesis of thioanalogues of natural steroids and terpenoids.


Impact of an increase in the inhaled corticosteroid dose on blood eosinophils in asthma.
Here, we report that increasing treatment with inhaled corticosteroids (ICS) in patients with not well-controlled asthma from a medium to a high dose results in a profound reduction of blood eosinophils (median fall in blood eosinophil concentrations from 560 to 320 cells/µL). Therefore, 'normal values' of blood eosinophils in patients with asthma need to be considered in view of the individual ICS doses of the patients. In addition, increases in the dose of ICS may result in blood eosinophil concentrations which would formally preclude treatment with biologics targeting the interleukin-5 pathway.


Appetite Regulations After Sprint Exercise Under Hypoxic Condition in Female Athletes.
Kojima, C, Kasai, N, Ishibashi, A, Murakami, Y, Ebi, K, and Goto, K. Appetite regulations after sprint exercise under hypoxic condition in female athletes. J Strength Cond Res 33(7): 1773-1780, 2019-The present study determined changes in appetite-regulating hormones and energy intake after high-intensity interval exercise (HIIT) under hypoxic conditions (HYP) in trained female athletes. Fifteen female athletes completed 3 trials on different days of either HIIT under HYP, HIIT under normoxic conditions (NOR), or rest in normoxia (CON). Exercise trials consisted of 2 successive sets of 8 repeated bouts of a 6-second maximal sprint separated by a 30-second rest. Blood samples were obtained to measure plasma acylated ghrelin, glucagon-like peptide-1 (GLP-1), and metabolite concentrations. Energy intake during an ad libitum buffet meal test was evaluated 30 minutes after exercise or rest. Plasma acylated ghrelin concentrations decreased significantly after exercise (p ≤ 0.001), but no difference was observed between the HYP and NOR. Plasma GLP-1 concentrations did not differ after exercise, with no difference between the HYP and NOR. Although absolute energy intake in the HYP (634 ± 67 kcal) and NOR (597 ± 63 kcal) was significantly lower than that in the CON (756 ± 63 kcal, p = 0.006), no difference was observed between the HYP and NOR. These results show that HIIT under hypoxic and NOR lowered plasma acylated ghrelin concentrations and energy intake.


Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management.
Diabetes mellitus has a number of long-term effects on the genitourinary system. These effects predispose to bacterial urinary tract infections (UTIs) in the patient with diabetes mellitus. Complicated UTIs are also common and potentially life-threatening conditions. They include emphysematous pyelonephritis, emphysematous pyelitis/cystitis, xanthogranulomatous pyelonephritis, renal/perirenal abscess, and renal papillary necrosis. Improved outcomes of these entities may be achieved by early diagnosis, knowledge of common predisposing factors, appropriate clinical and radiological assessment, and prompt management. Herein we review complicated UTIs associated with diabetes mellitus in terms of pathogenesis, clinical manifestations, radiological features, and current management options.


Evidence of selection on the domesticated ERVWE1 env retroviral element involved in placentation.
The human endogenous retrovirus HERV-W multicopy family includes a unique proviral locus, termed ERVWE1, which contains gag and pol pseudogenes and has retained a full-length envelope open reading frame (ORF). This Env protein (syncytin) is a highly fusogenic membrane glycoprotein and has been proposed to be involved in hominoid placental physiology. To track the hallmarks of natural selection acting on the ERVWE1 env gene, the pattern of substitutions and indels was analyzed within all human HERV-W elements and along the ERVWE1 orthologous loci in chimpanzee, gorilla, orangutan, and gibbon. The comparison of ERVWE1 and paralogous HERV-W copies revealed an ERVWE1-specific signature consisting of a four amino acid deletion in the intracytoplasmic tail of the glycoprotein. We show that this deletion is crucial for the envelope fusogenic activity. The comparison of the human ERVWE1 locus with its orthologs demonstrates the existence of a selective pressure to maintain the env reading frame open. Notably, the 3' part of the env gene, encoding regions required for the fusion process, is under purifying selection. The identification of selective constraints on env ERVWE1 confirms that this retroviral locus has been recruited in the hominoid lineage to become a bona fide gene.


Tools for the genetic manipulation of Zygosaccharomyces rouxii.
A set of tools for the genetic manipulation of the osmotolerant yeast Zygosaccharomyces rouxii was developed. Auxotrophic mutants (ura3 leu2, ura3 ade2, ura3 leu2 ade2) derived from the CBS 732 type strain were prepared. Centromeric and episomal Z. rouxii/Escherichia coli shuttle plasmids with different marker genes (ScURA3, ZrLEU2, ZrADE2) and with multiple cloning sites were constructed, together with a plasmid enabling green fluorescent protein-tagging. A system for repeatable targeted gene deletion in Z. rouxii was established, involving first the integration of a PCR-generated loxP-kanMX-loxP cassette and second the removal of kanMX from the genome using a Z. rouxii plasmid harbouring cre recombinase.


Generalized linear modeling with regularization for detecting common disease rare haplotype association.
Whole genome association studies (WGAS) have surged in popularity in recent years as technological advances have made large-scale genotyping more feasible and as new exciting results offer tremendous hope and optimism. The logic of WGAS rests upon the common disease/common variant (CD/CV) hypothesis. Detection of association under the common disease/rare variant (CD/RV) scenario is much harder, and the current practices of WGAS may be under-power without large enough sample sizes. In this article, we propose a generalized linear model with regularization (rGLM) approach for detecting disease-haplotype association using unphased single nucleotide polymorphisms data that is applicable to both CD/CV and CD/RV scenarios. We borrow a dimension-reduction method from the data mining and statistical learning literature, but use it for the purpose of weeding out haplotypes that are not associated with the disease so that the associated haplotypes, especially those that are rare, can stand out and be accounted for more precisely. By using high-dimensional data analysis techniques, which are frequently employed in microarray analyses, interacting effects among haplotypes in different blocks can be investigated without much concern about the sample size being overwhelmed by the number of haplotype combinations. Our simulation study demonstrates the gain in power for detecting associations with moderate sample sizes. For detecting association under CD/RV, regression type methods such as that implemented in hapassoc may fail to provide coefficient estimates for rare associated haplotypes, resulting in a loss of power compared to rGLM. Furthermore, our results indicate that rGLM can uncover the associated variants much more frequently than can hapassoc.


Collimated Propagation of Fast Electron Beams Accelerated by High-Contrast Laser Pulses in Highly Resistive Shocked Carbon.
Collimated transport of ultrahigh intensity electron current was observed in cold and in laser-shocked vitreous carbon, in agreement with simulation predictions. The fast electron beams were created by coupling high-intensity and high-contrast laser pulses onto copper-coated cones drilled into the carbon samples. The guiding mechanism-observed only for times before the shock breakout at the inner cone tip-is due to self-generated resistive magnetic fields of ∼0.5-1 kT arising from the intense currents of fast electrons in vitreous carbon, by virtue of its specific high resistivity over the range of explored background temperatures. The spatial distribution of the electron beams, injected through the samples at different stages of compression, was characterized by side-on imaging of hard x-ray fluorescence.


A Novel IEEE 802.15.4e DSME MAC for Wireless Sensor Networks.
IEEE 802.15.4e standard proposes Deterministic and Synchronous Multichannel Extension (DSME) mode for wireless sensor networks (WSNs) to support industrial, commercial and health care applications. In this paper, a new channel access scheme and beacon scheduling schemes are designed for the IEEE 802.15.4e enabled WSNs in star topology to reduce the network discovery time and energy consumption. In addition, a new dynamic guaranteed retransmission slot allocation scheme is designed for devices with the failure Guaranteed Time Slot (GTS) transmission to reduce the retransmission delay. To evaluate our schemes, analytical models are designed to analyze the performance of WSNs in terms of reliability, delay, throughput and energy consumption. Our schemes are validated with simulation and analytical results and are observed that simulation results well match with the analytical one. The evaluated results of our designed schemes can improve the reliability, throughput, delay, and energy consumptions significantly.


Investigation of the possible dopaminergic toxicity of 1-methyl-3-phenyl-1,2,3,6-tetrahydropyridine, an isomer to the neurotoxin MPTP.
1-Methyl-3-phenyl-1,2,3,6-tetrahydropyridine (M-3-PTP) is an analogue to the Parkinson-producing dopaminergic toxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), M-3-PTP, and simple analogues thereof, are versatile intermediates in organic synthesis. The present study was undertaken to investigate the possible dopaminergic toxicity of M-3-PTP. Male albino mice were injected with 50 mg/kg of either MPTP or M-3-PTP and dopamine (DA) and its metabolites were determined 2 hr and 7 days after the administration. Two hr after MPTP profound acute changes in brain DA metabolism were found, i.e. an approximately 50% reduction in the concentration of DA together with a 10-fold increase in the level of 3-methoxytyramine. Seven days after MPTP, DA and metabolites were markedly reduced which is consistent with a degeneration of the dopaminergic neurones. In contrast M-3-PTP produced no acute or long-term alterations in the concentrations of DA and its metabolites in mouse brain. Furthermore, in vitro experiments show that M-3-PTP does not inhibit monoamine oxidase B. Thus, the present data show that M-3-PTP is devoid of dopaminergic toxicity in mouse brain and is not likely to produce Parkinson's disease in humans. The lack of toxicity is probably explained by the low affinity of M-3-PTP for monoamino oxidase B.


Demographic, morphologic and aetiological profile of uveitis patients presenting in a tertiary eye hospital in Eastern India.
This prospective study was performed to find out the profile of newly diagnosed uveitis patients in a tertiary eye hospital in Eastern India over one year from August 2006 to July 2007. One hundred and sixty-one patients were included; 58 patients (36.02%) had anterior uveitis, 21 (13.04%) had intermediate uveitis, 56 (34.78%) had posterior uveitis and 26 (16.15%) had panuveitis. A specific diagnosis could be made in 50 patients (31.06%). The profile of uveitis patients in this study from Eastern India correlated with those published in studies from North and South India.


The High Expression of Minichromosome Maintenance Complex Component 5 Is an Adverse Prognostic Factor in Lung Adenocarcinoma.
Minichromosome maintenance (MCM) genes are crucial for genomic DNA replication and are important biomarkers in tumor biology. In this study, we aimed to identify the diagnostic, therapeutic, and prognostic value of the MCM2-10 genes in patients with lung cancer. We examined the expression levels, gene networks, and protein networks of lung cancer using data from the ONCOMINE, GeneMANIA, and STRING databases. We conducted a functional enrichment analysis of MCM2-10 using the clusterProfiler package using TCGA data. The correlation between the MCM2-10 expression and lung cancer prognosis was evaluated using Cox regression analysis. The influence of clinical variables on overall survival (OS) was evaluated using univariate and multivariate analyses. The TIMER database was used to evaluate the correlation between tumor infiltrating levels and lung cancer. Kaplan-Meier Plotter pan-cancer RNA sequencing was used to estimate the correlation between the MCM5 expression and OS in different immune cell subgroups in patients with lung adenocarcinoma (LUAD). Finally, the 1-, 3-, and 5-year predictions of LUAD were performed using nomogram and calibration analysis. The expression of MCM2, 3, 4, 5, 6, 7, 8, and 10 in lung cancer was higher than that for normal samples. The MCM5 expression was associated with poor OS in patients with LUAD, and prognosis was related to TNM stage, smoking status, and pathological stage. The MCM5 expression is correlated with immune invasion in LUAD and may affect prognosis due to immune infiltration. MCM5 may serve as a molecular biomarker for LUAD prognosis.


Non-cardiogenic pulmonary oedema following accidental electrocution in a toddler.
Non-cardiogenic pulmonary oedema due to electrocution is an underdiagnosed clinical entity. The authors report a toddler who presented with symptoms and signs of respiratory failure following accidental electrocution. His chest radiography showed bilateral diffuse infiltrates and cardiac involvement was ruled out by echocardiography. The child was managed symptomatically and discharged in a stable condition. The cause of pulmonary oedema in this child was thought to be neurogenic in origin as cardiac and pulmonary causes were ruled out. Non-cardiogenic pulmonary oedema is an uncommonly recognised entity which occurs with any neurological or non-neurological event stimulating the vasomotor centres. There are divergent theories to explain the cause for this rare phenomenon but none has been proved. The authors chose to report this case to highlight this uncommon complication of electrocution hitherto unreported in children.


Comparison of lorcainide and quinidine in the treatment of ventricular ectopy.
Lorcainide, a new type I antiarrhythmic agent, was compared to quinidine in respect to antiarrhythmic efficacy and clinical safety. Thirteen subjects completed an open, randomized, crossover study with analysis of 24-hour ambulatory ECG monitoring and drug blood levels. The QRS and Q-T intervals increased with both lorcainide and quinidine. The mean reduction in total ventricular premature beats (VPBs) with quinidine was 16 percent compared to 68 percent with lorcainide (p less than .05). With lorcainide eight of 13 subjects had a significant (greater than 82 percent) reduction in VPBs compared to only three of 13 subjects taking quinidine (p less than .05). This same relationship was observed when mean VPB/1,000 heartbeats was analyzed. Ventricular tachycardia was no longer present in five of nine subjects taking lorcainide and in two of nine taking quinidine. No relationship could be established between drug level and arrhythmia suppression in this small population. Some CNS effects were reported in both groups, but no significant hematologic, chemical, or urinary adverse effects were seen with either drug. Thus, lorcainide compares favorably to quinidine in regard to arrhythmia suppression, but was limited in its clinical utility by CNS side effects.


Peritoneal clearances, protein losses and ultrafiltration in diabetic patients after four years on CAPD.
Peritoneal clearances of urea (C(urea)) and creatinine (Ccr), peritoneal protein losses (PL) and ultrafiltration (UF) were retrospectively evaluated in 12 diabetic patients on continuous ambulatory peritoneal dialysis (CAPD) during a four year study. The average of three determinations each year was calculated. There were not significant differences in C(urea) (ml/24 hours), Ccr (ml/24 hours), PL (g/24 hours) and UF (ml/24 hours) between the four years and basal values or in the year to year studies. Seven patients did not modify their CAPD schedule during the four years study and we did not find any statistical differences in this group in the parameters studied. There was an average incidence of peritonitis of 4.7 episodes, higher in the 2 first years (p less than 0.05). The peritonitis incidence did not affect any of the functional parameters evaluated. The results of our study suggest that C(urea), Ccr, PL and UF in diabetic patients are not affected by long-term CAPD or by the peritonitis incidence.


Effect of immunization of rams against bovine inhibin alpha 1-26 on semen characteristics, scrotal size, FSH, LH and testosterone concentrations.
The effects of inhibin immunization on inhibin antibody titres, semen characteristics, scrotal size, fertility, FSH, LH and testosterone concentrations were determined by immunizing adult rams against bovine inhibin alpha 1-26-Gly-Tyr conjugated to human serum albumin (n = 16) in non-ulcerative Freund's adjuvant and DEAE:dextran (1:1) or adjuvant alone (n = 16) on days 0 (29 June), 30, 60, 191, 303 and 394. Blood samples were collected and bovine inhibin alpha 1-26-Gly-Tyr antibody titres and serum testosterone concentrations were determined. Each month, between days 174 and 417, semen was collected every 30 min to a maximum of 15 ejaculates over 7 h and scrotal circumference was measured. Ram fertility was recorded during natural service. FSH, LH and testosterone concentrations and GnRH-induced FSH and LH release were measured in a subgroup of immunized (n = 5) and control (n = 5) rams at frequent intervals. Antibody titres were variable among immunized rams (0-46% 125I-labelled bovine inhibin alpha 1-26-Gly-Tyr at 1:1600 serum dilution) but mean titres were consistently higher than in control rams (P < or = 0.001). Immunization did not alter the semen volume, output or quality of spermatozoa or ram fertility, but increased the mean scrotal circumference (37.6 +/- 0.8 cm versus 34.4 +/- 0.7 cm, P < 0.001). Mean FSH concentrations were higher in immunized rams during two intensive blood sampling periods (in June and August) (5.8 +/- 0.7 ng ml-1 versus 3.0 +/- 0.3 ng ml-1, P < 0.001 in June; and 4.8 +/- 0.9 ng ml-1 versus 2.0 +/- 0.3 ng ml-1, P < 0.02 in August), and were correlated with antibody titres (r2 = 0.3, P < 0.05 in June; and r2 = 0.8, P < 0.001 in August). Discrete FSH pulses were not detected. Immunization did not alter mean or basal testosterone or LH concentrations, or LH pulse frequency; LH pulse amplitude was increased (1.6 +/- 0.2 ng ml-1 versus 0.8 +/- 0.2 ng ml-1, P < 0.02) and was correlated with antibody titres (r2 = 0.6, P < 0.01). Immunization enhanced GnRH-induced FSH (P < 0.05) but not LH release. In conclusion, immunization of adult rams against bovine inhibin alpha 1-26 Gly-Tyr increased scrotal circumference, mean FSH concentrations and LH pulse amplitude, without altering semen characteristics, fertility, mean LH concentrations, LH pulse frequency or mean testosterone concentrations.


Functional treatment of closed segmental fractures of the tibia.
PURPOSE OF THE STUDY Segmental tibial fractures are commonly believed to be more difficult to manage, requiring surgical treatment. Our experience with forty-eight segmental tibial fractures suggests that these fractures, if closed and with shortening of an acceptable initial degree and a corrected deformity, may be successfully treated with functional braces. MATERIAL AND METHODS Forty-eight closed segmental fractures of the tibia that had initial shortening .12 mm and angular deformity manually corrected to .7 degrees were stabilized in an above-the-knee cast for a median time of 33 days and a mode of 15 days. They were subsequently stabilized in a functional brace that allowed unencumbered motion of all joints. All other segmental fractures outside the established parameters were managed by other methods. RESULTS All fractures healed at a median time of 15.3 weeks. The final shortening was 4.7 millimeters with a mode of 12 millimeters. The maximum shortening was 14 millimeters. Fractures healed with a medial-lateral (M.L) angular deformities ranging zero to 19 degrees, a median of 5.9 degrees and a mode of 3.4 degrees. CONCLUSION The relatively early introduction of weight bearing and the freedom of motion of all joints that the brace permits seem to result in motion at the fracture site, which in turn enhances osteogenesis. As we have previously documented, the initial shortening that closed tibial fractures experience does not increase with the physiological use of the extremity. The final shortening and angulation observed in most of the fractures should not be considered complications, simply inconsequential deviations from the normal. The same should apply to closed segmental fractures.


Possible role of prekallikrein in the mechanism of labor.
From the standpoint of labor mechanism, behavior of prekallikrein, a kinin-forming enzyme, during pregnancy and labor has been of great importance. Plasma prekallikrein determined by synthetic chromogenic tripeptide substrate was increased with advancing gestational ages, reaching approximately 200% of normal. When labor started, it decreased rapidly to 70%, then returned gradually to the normal level after delivery. Prekallikrein and kininogen are only two plasma proteins which change so markedly during labor among many plasma proteins. Role of prekallikrein in the mechanism of labor is presumptively as follows: (1) Prekallikrein is converted to kallikrein resulting in its consumption and decrease. (2) Kallikrein contributes to uterine contraction by liberating kinin from kininogen.


An analytical method for the simultaneous quantification of 30 bioactive compounds in spent coffee ground by HPLC-MS/MS.
Spent coffee ground (SCG) is the remaining residue produced after extraction of coffee, and it is considered a source of unextracted bioactive compounds. For this, in the latest years, the attention has been focused to innovative reuses that can exploit the potentiality of SCG. Unfortunately, the content of bioactive compounds has not been thoroughly studied yet, and the major of publication has investigated the caffeine and chlorogenic acids levels, total polyphenol contents, and total flavonoid content. Hence, these approaches have determined only an estimation of flavonoids and polyphenols content and lack on single polyphenols investigation. Therefore, the objective of the current work was to provide a deep characterization of bioactive compounds in SCG. For this purpose, a new analytical method for the quantification of 30 molecules, including caffeine, chlorogenic acids, phenolic acids, flavonoids, and secoiridoids, has been developed using high-performance liquid chromatography tandem mass spectrometry. Moreover, several extraction procedures, that is, liquid-solid extraction assisted and not by ultrasounds, testing diverse solvents, were evaluated. Liquid-solid extraction assisted by sonication, with water/ethanol (30/70, v/v), resulted the best in terms of total bioactive compounds, and, once validated, the new analytical method was applied to five different espresso SCG samples. Data showed that caffeine (means: 1193.886 ± 57.307 mg kg-1 ) and chlorogenic acids (means of total CQAs: 1705.656 ± 88.694 mg kg-1 ) were the most abundant compounds in all SCG samples followed by phenolic acids such as caffeic, ferulic, gallic, p-coumaric, syringic, trans-cinnamic, and vanillic acid. Moreover, some flavonoids, that is, rutin, cyanidin 3-glucoside, and quercetin, occurred in almost all samples. This work provided a deepened characterization of bioactive compounds in SCG and can contribute to develop new strategies of reuses.


IL-10 Polymorphisms and Haplotypes Predict Susceptibility to Hepatocellular Carcinoma Occurrence in Patients with Hepatitis C Virus Infection from Northeast India.
Chronic hepatitis C virus (HCV) infection leads to variable outcomes, ranging from prolonged slow hepatic damage leading to cirrhosis, and hepatocellular carcinoma (HCC). Polymorphism in cytokines IL-10 and IL-12 that impact the immune response to HCV infection may play a role in determining this outcome. This study was aimed to determine if polymorphisms in IL-10 and IL-12B contribute to HCV susceptibility and the risk of developing HCC in patients from Northeast India. IL-10 - 1082, -819, -592 polymorphisms and IL-12B -1188 polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism in a total of 266 HCV-infected patients and 100 age- and sex-matched controls. In the HCV-infected subjects, 110 patients had chronic hepatitis C (CHC), 96 with liver cirrhosis, and 60 with HCC. Serum levels of IL-10 were also measured and correlated with disease severity. Haplotype analysis for IL-10 polymorphisms was carried out. Statistical data were analyzed using SPSS ver. 22.0. The frequency of IL-10 - 592 AA genotype/A allele was significantly higher in HCC patients than in CHC patients. The intermediate IL-10-producing ACC haplotype was significantly more frequent in HCC and cirrhotic patients than in CHC patients. No significant association was found for IL-10 - 819, -592 and IL-12B -1188 polymorphisms with the susceptibility to HCV infection or occurrence of HCC in HCV-infected patients. IL-10 - 592 CA polymorphism and IL-10 ACC haplotype are significant biomarkers of HCC in HCV-infected patients from Northeast India. Higher serum levels of IL-10 were also linked to higher disease severity.


Trend of risk factors for cardiovascular diseases among young and middle-aged indians: Insights from a nationally representative survey.
India, as a nation is witnessing epidemiological transition, which is taking place across all the states at different level, over past couple of decades. Owing to the long natural history of non-communicable diseases (NCDs), early identification of these risk factors can aid in understanding the distribution and future development of cardiovascular diseases (CVDs). Also, studying the trend of these risk factors over time can help in prediction of burden of various CVDs in future. Thus, the present study aims at understanding the trend of various risk factors for CVDs across rural and urban India, and states. The present study was conducted using secondary data from the third, fourth and fifth round of the National Family Health Survey (NFHS) conducted in India. The surveys collected data for estimation of burden of the common modifiable risk factors of CVDs including tobacco and alcohol consumption overweight/obesity, raised blood pressure, and raised blood sugar. The analysis for the present study was done among interviewed males and females between 15 and 49 years. The weighted prevalence of these risk factors was computed and binary logistic regression was done to study the predictors for the same. A declining trend of tobacco (29.2% in NFHS 3; 8.1%in NFHS 5) and alcohol consumption (14.2% in NFHS 3; 3.2%in NFHS 5) was observed from 2005 -06 to 2019-21. A rising trend of overall raised blood pressure (11.4% in NFHS 4; 12.2%in NFHS 5), raised blood sugar (6.2% in NFHS 4; 8.5%in NFHS 5), and overweight and obesity (11.4% in NFHS 3; 23.6%in NFHS 5) was observed from the three rounds of the survey. The odds of all the studied risk factors were significantly higher among older age across all the rounds of the survey. Except overweight/obesity, the odds of rest all studied risk factors was found to be higher among males compared to females. Also, higher odds of alcohol consumption, overweight/obesity, raised blood pressure, and raised blood sugar were found among the participants living in urban areas compared to rural areas, across all the rounds of the survey. The present highlights the rising burden of CVD risk factors, including overweight and obesity, raised blood pressure and raised blood sugar, and a declining trend of tobacco and alcohol consumption across the country. The study also highlights the need for in-depth assessment of predictors of these risk factors using longitudinal study designs.


Escape dynamics of coupled particles in nonlinear, disordered lattices.
We consider the deterministic escape dynamics of a lattice chain of harmonically coupled particles from a metastable state over a one-dimensional potential barrier. While the case of periodic lattices has already been elaborated, the aim of the present work is to explore the extension to nonperiodic, i.e., disordered, lattices. Each particle evolves in an individual local potential, which is characterized by a harmonic term and a nonlinear term. Two kinds of parametric disorder are considered. "Disorder in nonlinearity" is only caused by different nonlinear terms--"disorder in harmonicity" only by different harmonic terms. We assure that the two kinds of disorder, with their individual potential barriers uniformly distributed around a globally equal mean barrier height, exhibit a comparable strength of disorder. Starting with an initial completely delocalized state, we observe localization of energy and formation of breathers ensues. It is shown that increasing disorder in nonlinearity decreases the mean escape time opposite to increasing mean escape times resulting from increased disorder in harmonicity. Comparison with the mean escape time obtained for a third kind of parametric disorder characterized by overall equal barrier heights leads to the conclusion that indeed inhomogeneous barriers facilitate the speedy escape.


"Bligh and Dyer" and Folch Methods for Solid-Liquid-Liquid Extraction of Lipids from Microorganisms. Comprehension of Solvatation Mechanisms and towards Substitution with Alternative Solvents.
Bligh and Dyer (B & D) or Folch procedures for the extraction and separation of lipids from microorganisms and biological tissues using chloroform/methanol/water have been used tens of thousands of times and are "gold standards" for the analysis of extracted lipids. Based on the Conductor-like Screening MOdel for realistic Solvatation (COSMO-RS), we select ethanol and ethyl acetate as being potentially suitable for the substitution of methanol and chloroform. We confirm this by performing solid-liquid extraction of yeast (Yarrowia lipolytica IFP29) and subsequent liquid-liquid partition-the two steps of routine extraction. For this purpose, we consider similar points in the ternary phase diagrams of water/methanol/chloroform and water/ethanol/ethyl acetate, both in the monophasic mixtures and in the liquid-liquid miscibility gap. Based on high performance thin-layer chromatography (HPTLC) to obtain the distribution of lipids classes, and gas chromatography coupled with a flame ionisation detector (GC/FID) to obtain fatty acid profiles, this greener solvents pair is found to be almost as effective as the classic methanol-chloroform couple in terms of efficiency and selectivity of lipids and non-lipid material. Moreover, using these bio-sourced solvents as an alternative system is shown to be as effective as the classical system in terms of the yield of lipids extracted from microorganism tissues, independently of their apparent hydrophilicity.


Blood pressure in primary school children in Uganda: a cross-sectional survey.
Non-communicable diseases are an emerging concern in sub-Saharan Africa, and risks for these conditions are often based on exposures in early life, with premonitory signs developing during childhood. The prevalence of hypertension has been reported to be high in African adults, but little is known about blood pressure in African children. We studied prevalence and risk factors for high blood pressure (HBP) among school children in central Uganda. Two urban and five rural schools were randomly selected from government schools in Wakiso district, Uganda. Questionnaires were administered and anthropometric measures taken. Blood pressure (BP) was measured three times in one sitting (on day 1) and the average compared to internationally-used normograms. Children with BP >95th percentile were re-tested at two additional sittings (day 2 and day 3) within one week, and at two further follow up visits over a period of six months. Those with sustained HBP were referred for further investigation. Of 552 students included, 539 completed the initial assessments (days 1-3) of whom 92 (17.1%) had HBP at the initial sitting. Age (adjusted odds ratio (aOR) 1.29 (95% confidence interval 1.14, 1.47), p< 0.001), body mass index (1.70 (1.25-2.31) p = 0.001) and soil-transmitted helminths (2.52 (1.04-6.11), 0.04) were associated with increased prevalence of HBP at the initial sitting. After further investigation, sustained HBP was seen in 14 children, yielding an estimated prevalence of 3.8% allowing for losses to follow up. Four children required treatment. It is feasible to measure blood pressure accurately in the school setting. A high HBP prevalence on initial readings gave cause for concern, but follow up suggested a true HBP prevalence commensurate with international normograms. Extended follow up is important for accurate assessment of blood pressure among African children.


Cytokine mRNA levels in Alopecia areata before and after treatment with the contact allergen diphenylcyclopropenone.
Although the nature of the noxious signal and the anatomical target in alopecia areata (AA) are still unknown, it has been assumed that CD4+ T lymphocytes surrounding and infiltrating the hair bulb might trigger the hair loss. As these T lymphocytes do not promote cytotoxic activity we hypothesize that AA is triggered by cytokines. Topical immunotherapy with diphenylcyclopropenone (DCP) is at present the most effective approach. If it is true that AA results from a distinct cytokine pattern, we can hypothesize that the beneficial effect of DCP should be mediated by locally secreted cytokines during the contact allergy. Using semiquantitative reverse transcription-polymerase chain reaction with RNA extracted from scalp biopsies from patients with AA before and after successful treatment with DCP, and from healthy controls we detected a T-cell response with increased steady state mRNA levels for interferon (IFN)-gamma, interleukin (IL)-1 beta, and IL-2 in untreated AA of the totalis type. After DCP treatment, the IFN-gamma expression was reduced but still above the constitutive level found in controls, whereas mRNA expression of IL-2, IL-8, IL-10, and tumor necrosis factor-alpha was increased. Our results point towards cytokines involved in the pathogenesis in AA. A TH1 type cytokine pattern is present in untreated AA, and this is modified by cytokines secreted during DCP treatment. IL-10 has recently been described as an immunomodulator of the TH1 response and, therefore, we hypothesize that basal keratinocytes or lesional T cells secrete bioactive IL-10 after DCP application, resulting in an inhibitory effect on lesional T lymphocytes. This hypothesis would explain the effectiveness of DCP and implies the theoretical possibility of a response to topical or intralesional application of recombinant IL-10.


Pregnancy and fetal characteristics after transfer of vitrified in vivo and cloned bovine embryos.
This study was conducted to examine pregnancy progression and fetal characteristics following transfer of vitrified bovine nuclear transfer versus in vivo-derived embryos. Nuclear transfer (NT) was conducted using cumulus cells collected from an elite Holstein-Friesian dairy cow. Expanding and hatching blastocysts on Day 7 were vitrified using liquid nitrogen surface vitrification. Day 7 in vivo embryos, produced using standard superovulation procedures applied to Holstein-Friesian heifers (n=6), were vitrified in the same way. Following warming, embryos were transferred to synchronized recipients (NT: n=65 recipients; Vivo: n=20 recipients). Pregnancies were monitored by ultrasound scanning on Days 25, 45 and 75 and a sample of animals were slaughtered at each time point to recover the fetus/placenta for further analyses. Significantly more animals remained pregnant after transfer of in vivo-derived embryos than NT embryos at all time points: Day 25 (95.0 versus 67.7%, P<0.05), Day 45 (92.8 versus 49.1%, P<0.01) and Day 75 (70.0 versus 20.8%, P<0.0). There was no significant difference (P=0.10) in the weight of the conceptus on Day 25 from NT transfers (1.14+/-0.23 g, n=8) versus in vivo transfers (0.75+/-0.19 g, n=8). On Day 45, there was no significant difference in the weight of either fetus (P=0.393) or membranes (P=0.167) between NT embryos (fetus: 2.76+/-0.40, n=12; membranes: 59.0+/-10.0, n=11) or in vivo-derived embryos (fetus: 2.60+/-0.15, n=6; membranes: 41.8+/-5.2, n=4). However, on Day 75 the weight of the fetus and several of the major organs were heavier from NT embryos. These data suggest that morphological abnormalities involving the fetus and the placenta of cloned pregnancies are manifested after Day 45.


Chloroplastic thioredoxin m functions as a major regulator of Calvin cycle enzymes during photosynthesis in vivo.
Thioredoxins (Trxs) regulate the activity of various chloroplastic proteins in a light-dependent manner. Five types of Trxs function in different physiological processes in the chloroplast of Arabidopsis thaliana. Previous in vitro experiments have suggested that the f-type Trx (Trx f) is the main redox regulator of chloroplast enzymes, including Calvin cycle enzymes. To investigate the in vivo contribution of each Trx isoform to the redox regulatory system, we first quantified the protein concentration of each Trx isoform in the chloroplast stroma. The m-type Trx (Trx m), which consists of four isoforms, was the most abundant type. Next, we analyzed several Arabidopsis Trx-m-deficient mutants to elucidate the physiological role of Trx m in vivo. Deficiency of Trx m impaired plant growth and decreased the CO2 assimilation rate. We also determined the redox state of Trx target enzymes to examine their photo-reduction, which is essential for enzyme activation. In the Trx-m-deficient mutants, the reduction level of fructose-1,6-bisphosphatase and sedoheptulose-1,7-bisphosphatase was lower than that in the wild type. Inconsistently with the historical view, our in vivo study suggested that Trx m plays a more important role than Trx f in the activation of Calvin cycle enzymes.


Metformin and temozolomide act synergistically to inhibit growth of glioma cells and glioma stem cells in vitro and in vivo.
Glioblastoma (GBM) is the most frequent and aggressive brain tumor in adults. In spite of advances in diagnosis and therapy, the prognosis of patients with GBM has remained dismal. The fast recurrence and multi-drug resistance are some of the key challenges in combating brain tumors. Glioma stem cells (GSCs) which are considered the source of relapse and chemoresistance, the need for more effective therapeutic options is overwhelming. In our present work, we found that combined treatment with temozolomide (TMZ) and metformin (MET) synergistically inhibited proliferation and induced apoptosis in both glioma cells and GSCs. Combination of TMZ and MET significantly reduced the secondary gliosphere formation and expansion of GSCs. We first demonstrated that MET effectively inhibited the AKT activation induced by TMZ, and a combination of both drugs led to enhanced reduction of mTOR, 4EBP1 and S6K phosphorylation. In addition, the combination of the two drugs was accompanied with a powerful AMP-activated protein kinase (AMPK) activation, while this pathway is not determinant. Xenografts performed in nude mice demonstrate in vivo demonstrated that combined treatment significantly reduced tumor growth rates and prolonged median survival of tumor-bearing mice. In conclusion, TMZ in combination with MET synergistically inhibits the GSCs proliferation through downregulation of AKT-mTOR signaling pathway. The combined treatment of two drugs inhibits GSCs self-renewal capability and partly eliminates GSCs in vitro and in vivo. This combined treatment could be a promising option for patients with advanced GBM.


Five-year outcome of catheter ablation of persistent atrial fibrillation using termination of atrial fibrillation as a procedural endpoint.
This study aimed to determine 5-year efficacy of catheter ablation for persistent atrial fibrillation (AF) using AF termination as a procedural end point. One hundred fifty patients (57±10 years) underwent persistent AF ablation using a stepwise ablation approach (pulmonary vein isolation, electrogram-guided, and linear ablation) with the desired procedural end point being AF termination. Repeat ablation was performed for recurrent AF or atrial tachycardia. AF was terminated by ablation in 120 patients (80%). Arrhythmia-free survival rates after a single procedure were 35.3%±3.9%, 28.0%±3.7%, and 16.8%±3.2% at 1, 2, and 5 years, respectively. Arrhythmia-free survival rates after the last procedure (mean 2.1±1.0 procedures) were 89.7%±2.5%, 79.8%±3.4%, and 62.9%±4.5%, at 1, 2, and 5 years, respectively. During a median follow-up of 58 (interquartile range, 43-73) months after the last ablation procedure, 97 of 150 (64.7%) patients remained in sinus rhythm without antiarrhythmic drugs. Another 14 (9.3%) patients maintained sinus rhythm after reinitiation of antiarrhythmic drugs, and an additional 15 (10.0%) patients regressed to paroxysmal recurrences only. Failure to terminate AF during the index procedure (hazard ratio 3.831; 95% confidence interval, 2.070-7.143; P<0.001), left atrial diameter≥50 mm (hazard ratio 2.083; 95% confidence interval, 1.078-4.016; P=0.03), continuous AF duration≥18 months (hazard ratio 1.984; 95% confidence interval, 1.024-3.846; P<0.04), and structural heart disease (hazard ratio 1.874; 95% confidence interval, 1.037-3.388; P=0.04) predicted arrhythmia recurrence. In patients with persistent AF, an ablation strategy aiming at AF termination is associated with freedom from arrhythmia recurrence in the majority of patients over a 5-year follow-up period. Procedural AF nontermination and specific baseline factors predict long-term outcome after ablation.


In ovo inoculation of duck embryos with different strains of Bacillus cereus to analyse their synergistic post-hatch anti-allergic potentialities.
Bacillus cereus is a Gram-positive, facultative anaerobic bacteria with few strains reported to be used as probiotics for animals and birds in recent times if the doses are formulated properly. To analyse the synergistic anti-allergic potentiality of different Bacillus cereus strains on experimental in ovo and in vitro duck model, as probiotic immune stimulant. Different strains of Bacillus cereus from 29 isolates were identified through 16S rRNA gene sequencing from the milk samples of buffalo breeds of South Asia. The probiotic properties were tested in aspects of gram staining, catalase test, coagulase, test, bile salt tolerance, pH tolerance and phenol tolerance test. MIC50 and MIC90 levels were profiled using nine different antibiotics, and antimicrobial activity against eight different enteric pathogens was assessed. Finally, the test strains of Bacillus cereus (Colony Forming Unit [CFU] 30X1011 ) were combined-infused at different concentrations in embryonated duck eggs to assess the post-hatch anti-allergic effects against histamine-induced allergic reaction and their immunoglobulin E (IgE) level was tested. Molecular identification confirmed the test strains as B. cereus HKS 1-1, B. cereus LOCK 1,002 and B. cereus BF2, which were all motile, spore-forming, catalase-positive and rod-shaped. All were 0.3% bile salt, 0.4% phenol and pH tolerant. Two-way ANOVA test P values revealed that B. cereus BF2 was statistically significant (p < .0014) in bile salt tolerance test. B. cereus HKS 1-1 was significant in phenol and pH tolerance at p < .0002 and p < .0489, respectively. Besides, the test strains showed antibiotic sensitivity and antimicrobial activity to different enteric pathogens. In vivo model referred the test strains as effective in partial allergy reduction at same CFU but at different concentrations with p < .0001 among the groups. The isolated and characterized strains of B. cereus showed partial immune-stimulating potentiality against experimentally induced allergic reaction.


Clinical Overview of Obesity and Diabetes Mellitus as Risk Factors for Atrial Fibrillation and Sudden Cardiac Death.
The epidemics of obesity and diabetes mellitus are associated with an increased incidence of both atrial fibrillation (AF), the most common sustained arrhythmia in adults, and sudden cardiac death (SCD). Obesity and DM are known to have adverse effects on cardiac structure and function. The pathologic mechanisms are thought to involve cardiac tissue remodeling, metabolic dysregulation, inflammation, and oxidative stress. Clinical data suggest that left atrial size, epicardial fat pad thickness, and other modifiable risk factors such as hypertension, glycemic control, and obstructive sleep apnea may mediate the association with AF. Data from human atrial tissue biopsies demonstrate alterations in atrial lipid content and evidence of mitochondrial dysfunction. With respect to ventricular arrhythmias, abnormalities such as long QT syndrome, frequent premature ventricular contractions, and left ventricular hypertrophy with diastolic dysfunction are commonly observed in obese and diabetic humans. The increased risk of SCD in this population may also be related to excessive cardiac lipid deposition and insulin resistance. While nutritional interventions have had limited success, perhaps due to poor long-term compliance, weight loss and improved cardiorespiratory fitness may reduce the frequency and severity of AF.


Metabolic changes in diabetic uremic patients on hemodialysis.
By studying the metabolic values of a nondiabetic and diabetic uremic population we demonstrated the following: 1. Insulin is higher in diabetic than nondiabetic uremic patients. A slight arteriovenous difference across the dialyzer membrane suggests that insulin is dialyzable in small amounts in man. 2. C-peptides are highest in nondiabetics, lower in maturity onset diabetics, and lowest in juvenile diabetics. 3. Growth hormone is higher in diabetics than nondiabetics, decreased in both groups during hemodialysis, and returns to pre-dialysis levels 2 hrs after the completion of dialysis treatment. 4. Plasma triglycerides are elevated in both popualtions during the fasting state anddrop during hemodialysis, rising slowly towards the end of hemodialysis. 5. The majority of diabetics on hemodialysis have low renin levels and do not respond to volume reduction. In the high renin diabetics and high and low renin nondiabetics the plasma renin levels rise in response to volume reduction during hemodialysis. Renin is not dialyzable in man. 6. Thyroid function tests show that diabetic and nondiabetic patients have measurements in the low normal range. Our results reveal significant information concerning metabolic changes which take place in diabetic and nondiabetic uremic patients on hemodialysis and helps to characterize these populations. This report may have implications in better understanding the nature of the problems encountered in these populations and in their management (Table III).


The biological effectiveness of solar electromagnetic radiation in space.
An attempt has been made to determine the solar ultraviolet action spectrum for dried coliphage T-1 exposed to space under various filters at sounding rocket altitudes between 80 to 150 km. The survival of these microorganisms was compared with the preliminary results of laboratory ultraviolet irradiation experiments using monochromatic light sources of wavelengths of 1633 angstroms, 2062 angstroms, 2537 angstroms and of 3064 angstroms to 3200 angstroms. The results indicate that ultraviolet light of wave-lengths between 2000 angstroms to 3000 angstroms was mainly responsible for the killing of the filter protected microorganisms. More studies of the biological action spectrum of the vacuum ultraviolet light including the Lyman alpha emission are needed to determine the cause of the more than 100 fold higher death rate of the microorganisms which were not protected during the space exposure by filters.


Hereditary neuropathy with liability to pressure palsy.
Hereditary neuropathy with liability to pressure palsy (HNPP) is an autosomal dominant disease with sensory and motor nerve palsies usually precipitated by trivial trauma or compression. In the majority of cases HNPP is caused by deletion of the peripheral myelin protein 22 gene (PMP22) on chromosome 17p11.2. The authors present a family case with genetically proven HNPP.


Seasonal levels of serum parathyroid hormone, calcitonin and alkaline phosphatase in relation to antler cycles in white-tailed deer.
Seasonal levels of serum parathyroid hormone (PTH), calcitonin (CT), and alkaline phosphatase (AP) were studied in relation to antler growth cycles in 8 male (2.5-6 years old) white-tailed deer. Feed consumption was recorded weekly, whereas body weight was recorded biweekly. Antler length was measured from the pedicle to the tip after velvet growth was initiated. Serum samples were obtained biweekly while animals were tranquilized with xylazine hydrochloride. Serum Ca was significantly (P less than 0.05) elevated during the summer. Serum P was significantly (P less than 0.05) elevated only during early fall. There was an increase in serum PTH during velvet initiation in April-May, but not thereafter. CT increased during the rapid antler growth period. Serum PTH levels were significantly (P less than 0.05) elevated (0.628 vs 0.884 ng/ml) during post-velvet shedding and decreased (0.602 vs 0.346 ng/ml, P less than 0.05) during post-antler casting. Serum AP activity was highest during rapid velvet antler growth. Feed intake was lowest in early winter, but a compensatory increase was found in late winter. Feed intake peaked in May, then gradually decreased. Body weight was maximum in November and minimum in March. It is concluded that increased PTH during velvet initiation is responsible for Ca absorption and/or mobilization. Increasing PTH levels are related to final mineralization of antlers post-velvet shedding. Higher levels of serum Ca in June-July inhibit continued increase in PTH. Increased CT during rapid antler growth may have prevented excessive bone resorption.


High prevalence of substance use and associated factors among high school adolescents in Woreta Town, Northwest Ethiopia: multi-domain factor analysis.
Substance use is a major public health concern in global settings, and is very common during adolescence period leading to physical and/or mental health complications. This study assessed the prevalence of substance use and associated factors among high school adolescents in Woreta Town, Northwest Ethiopia, 2012. A school based cross-sectional study was conducted from April 7 to April 15, 2012 amongst 684 9th to 12th grade high school students in the town of Woreta. Participants were selected by stratified sampling, and data were collected using an anonymous questionnaire adapted from the 2008 Community That Care Youth Survey. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with substance use. A total of 651 students participated in the study with a response rate of 95.2%. The current prevalence of substance use among Woreta high school students was 47.9% and life-time prevalence was 65.4%. The current and lifetime prevalence of alcohol use was 40.9% and 59% respectively. Siblings' use of substances (AOR [95% CI]: 2.72 [1.79, 4.14]), family history of alcohol and substance use (AOR [95% CI] 2.24 [1.39-3.59]) and friends' use of substances (AOR [95% CI] 2.14 [1.44-3.18]) were factors positively associated with substance use. On the other hand, religiosity and social skill were found to be 54% (AOR [95% CI] 0.46, [0.31-0.68]) and 39% (AOR [95% CI] 0.6 [0.40-0.91]) negatively associated with substance use. The prevalence of substance use amongst adolescents was high for the three substances namely alcohol, cigarette and khat with alcohol being the most common. Community norms favorable to substance use, family history of alcohol and substance use, siblings' substance use, poor academic performance, low perceived risk of substances and friends' use of substances had positive association with adolescent substance use while religiosity and social skills were found to have negative association with adolescent substance use. Initiate public awareness campaigns to inform adolescents and adults, particularly parents, of the risk of substance use. Developing culture friendly, gender based adolescent and family based programs and initiating public awareness are recommended to decrease substance use by adolescents.


(2E)-2-[2-(Cyclo-hexyl-carbamothio-yl)hydrazinylidene]-propanoic acid.
In the title thio-urea derivative, C(10)H(17)N(3)O(2)S, the carboxyl group and the least-squares plane through the cyclo-hexyl ring are twisted out of the plane through the central CN(3)S residue; the respective dihedral angles are 7.18 (8) and 62.29 (4)°. The conformation about the azomethine bond [1.275 (2) Å] is E. The NH groups are anti, with one forming an intra-molecular N-H⋯N hydrogen bond. The main feature of the crystal structure is the formation of linear supra-molecular chains along [110] mediated by alternating pairs of O-H⋯O and pairs of N-H⋯S hydrogen bonds.


[Social situation of persons with dermatoses as a phenomena of interpersonal perception (author's transl)].
Discussing the medical importance of the topic, the necessity of cooperation with social-scientific disciplines is demonstrated. Reflecting some relevant psychological theories, an experimental concept for analysing the interpersonal communication with persons suffering from skin-diseases is developed. It is a purpose of this investigation, not only to get the estimations of persons with and without skin-diseases but also the opinion which the other group is supposed to have. It was assumed that the state of health in persons with dermatoses is depending on these supposed estimations by the social environment. After describing the experimental setting, the results which were received from the answers of 465 persons (mean and women with and without dermatoses) are referred. Finally the findings are discussed from different points of view (methodical, cognition-theoretical, learning-psychological, psychoanalytical and last not least medical).


Experimental infection of five subspecies of Oncomelania snails with Angiostrongylus cantonensis.
Five subspecies of Oncomelania snails, Oncomelania hupensis nosophora, O.h. hupensis, O.h.chiui, O.h.formosana and O.h.quadrasi, were experimentally exposed to the first stage larvae of Angiostrongylus cantonesis. The presence of third stage larvae was observed in all of the five subspecies of Oncomelania snails 20 days after infection. Infection rates of the third stage larvae of the parasite in Oncomelania snails were 38.0-40.0%. There were no differences in preferences among Oncomelania snails. The third stage larvae in Oncomelania snails almost distributed in kidney and intestine region, and most of the larvae were active and free in tissues. The distribution pattern of the larvae in Oncomelania snails was quite different from that in Achatina fulica and Ampullarium sp. These third stage larvae were ingested by rats, and developed to adults. These data suggest that Oncomelania snails may play important role when A. cantonensis will spread, and indicate the possibility of human infection with A. cantonensis.


Anomalous multiphoton photoelectric effect in ultrashort time scales.
In a multiphoton photoelectric process, an electron needs to absorb a given number of photons to escape the surface of a metal. It is shown for the first time that this number is not a constant depending only on the characteristics of the metal and light, but varies with the interaction duration in ultrashort time scales. The phenomenon occurs when electromagnetic energy is transferred, via ultrafast excitation of electron collective modes, to conduction electrons in a duration less than the electron energy damping time. It manifests itself through a dramatic increase of electron production.


Cellular adenosine triphosphate production and consumption in the descending thin limb of Henle's loop in the rat.
To characterize the properties of cellular adenosine triphosphate (ATP) production and consumption in the descending thin limb of Henle's loop (DTL) in rats, we measured the cellular ATP content by applying the microchemiluminescence method. For ATP production, isolated DTL from the short- and long-loop nephron (SDL and LDL, respectively) was incubated with several substrates such as alanine, glucose, glutamine, beta-hydroxybutyrate (beta-HBA), lactate, and pyruvate; for ATP production from each substrate indicated that glucose and pyruvate were the preferred substrates to maintain cellular ATP in both SDL and LDL. ATP production from glutamine, beta-HBA, and lactate was substantial in LDL. In SDL, glutamine was the preferred substrate, and beta-HBA and lactate were minimal. The utilization of alanine was minimal in both LDL and SDL. The cellular ATP was significantly restored by ouabain at concentrations of 1.5 x 10(-5) and 1.5 x 10(-3) M in LDL, but in SDL only at 1.5 x 10(-3) M. In both segments, the cellular ATP level was significantly decreased by monensin above the concentrations of 1 micrograms/ml in LDL and 5 micrograms/ml in SDL. From these observations, we conclude that there exist clear differences between LDL and SDL in ATP-supplying substrate specificities and ATP-consuming properties.


[PAPILLARY THYROID CARCINOMA TREATMENT - IS THE PENDULUM SHIFTING?]
The incidence of papillary thyroid carcinoma has been on the rise in the past few decades while the disease specific mortality remains stable. During prophylactic central neck dissection (level 6), an average of 60% positive occult lymph nodes metastasis are found, hence the justification for performing a prophylactic central neck dissection. The opponents for performing neck dissection claim that the disease specific mortality is low regardless of the operation and that adding a neck dissection will, significantly, increase surgical morbidity. Guidelines regarding prophylactic central neck dissection differ between countries and cultures. The difficulty to determine unequivocal guidelines is due to the scarcity of randomized controlled trials to assess the effectiveness of prophylactic neck dissection. In this literature review we will explore data in favor and against prophylactic central neck dissection for patients with papillary thyroid carcinoma.


Socio-behavioral determinants of oral hygiene practices among USA ethnic and age groups.
In this study, socio-behavioral determinants of oral hygiene practices were examined across several dentate ethnic and age groups. Oral hygiene scale scores were constructed from toothbrushing and dental floss frequencies self-reported by population-based samples of middle-aged (35-44 years) and older (65-74 years) dentate adults representing Baltimore African-American and White, San Antonio Hispanic and non-Hispanic White, and Navajo and Lakota Native American persons participating in the WHO International Collaborative Study of Oral Health Outcomes (ICS-II) survey. Female gender, education, certain oral health beliefs, household income, and the presence of a usual source of care were revealed with multivariate analysis to show a significant positive relationship with higher oral hygiene scale scores (indicating better personal oral hygiene practices). Other socio-behavioral variables exhibited a more varied, ethnic-specific pattern of association with oral hygiene scale scores.


Cytomegalovirus infection in day nurseries.
One hundred and seventeen children and 41 teachers in day nurseries were screened for cytomegalovirus (CMV) viruria over a period of one year. Thirty two (27%) children and two (5%) teachers were found to be excreting virus on at least one occasion. Restriction endonuclease typing showed that virus strains isolated from the children were dissimilar, with the exception of those from sibling pairs and one unrelated pair. The virus isolate from one teacher matched those from two unrelated children, while the isolate from another teacher could not be distinguished from that from a sibling pair. The CMV serological state of the 41 teachers was not significantly different from 500 matched controls and no seroconversions occurred. It is concluded that although transmission of CMV among children and teachers may occur in day nurseries, the dissimilarity of most of the virus strains indicates that infection predominantly occurs outside. Furthermore, teachers in day nurseries showed no evidence of an increased risk of past CMV infection when compared with matched controls.


Midterm Clinical Outcomes After Arthroscopic Rotator Cuff Repair in Olympic Volleyball Players: Return to Sports and Return to Performance.
The decision-making process and predicting the time to return to sport (RTS) and return to performance (RTP) after arthroscopic rotator cuff repair (ARCR) in elite volleyball players are difficult issues to address, even among experienced shoulder surgeons. The purpose of the study was to evaluate the results in Olympic-level volleyball players treated with arthroscopic supraspinatus repair and to report the RTS and the RTP. It was hypothesized that these athletes had higher RTS and faster RTP. Case series; Level of evidence, 4. This study included 17 elite volleyball athletes (11 male, 6 female; mean age, 26.2 years) who underwent ARCR for partial- and full-thickness supraspinatus tears that did not improve despite nonoperative treatment. The clinical results were evaluated at 12 months postoperatively. The authors compared the athletes' preoperative, 6-month, and 12-month Kerlan-Jobe Orthopaedic Clinic (KJOC) scores and the visual analog scale (VAS) for pain after competition and conducted 6- and 12-month isometric strength analyses. The athletes' RTS and RTP times were recorded. All tears were on the dominant side (15 right, 2 left), and 82% were partial tears (14 partial thickness, 3 full thickness). The mean time from the onset of symptoms to surgery was 11.3 ± 6.7 months. While the mean Kerlan-Jobe Orthopaedic Clinic score was 31 preoperatively, it was 89 after 6 months (P < .001 vs preoperative) and 96 after 12 months (P = .003 vs 6 months). The mean VAS for pain was 7.9 preoperatively, 0.4 at 6 months (P < .001 vs preoperative), and 0.1 at 12 months (P = .02 vs 6 months). All athletes were able to reach their preinjury level, with RTS at a mean of 6.9 months and RTP at a mean of 12.4 months. ARCR appears to be an effective option for Olympic-level volleyball players who do not benefit from nonoperative treatment. All athletes returned to their preinjury level of sports. The surgeon and athlete can plan surgical decision-making and timing based on the mean RTS time of 6.9 months and mean RTP time of 12.4 months.


Surgical and short-term oncological safety of total neoadjuvant therapy in high-risk locally advanced rectal cancer.
Management for locally advanced rectal cancer (LARC) conventionally comprises long-course chemoradiotherapy (LCCRT), total mesorectal excision (TME), and adjuvant chemotherapy. However, the RAPIDO study published in 2021 showed that total neoadjuvant therapy (TNT) led to better oncological outcomes without increased toxicity. We review the surgical and short-term oncological outcomes of patients with high-risk LARC who underwent TNT or LCCRT before TME. Patients with high-risk LARC who underwent TNT or LCCRT before TME between 2021 and 2022 were reviewed. Thirty-five patients (66%) had TNT as per RAPIDO whilst 18 underwent LCCRT. Median follow-up was 16 months (range 5-25). Of the patients who had TNT, median age was 65 years old (range 44-79), 34 (97%) had clinical Stage 3 LARC and median height FAV was 5 cm (range 0.5-14). Nine (26%) required a dose delay/reduction due to treatment toxicity. Seven (50%) showed resolution of previously enlarged lateral nodes. Three (9%) had pathological complete response. Postoperative major morbidity was 23%, of which 4 patients required a reoperation. Six (17%) patients had disease-related treatment failure, with two having disease progression during TNT, two developed local recurrence, and two developed distal metastasis following surgery. Median duration to surgery following completion of chemotherapy was significantly shorter with TNT (36 days versus 74 days) (P < 0.001). There were no other significant differences in outcomes. TNT is clinically safe in high-risk LARC patients with no significant difference to surgical and short-term oncological outcomes compared to LCCRT, although a higher incidence of early surgical morbidity was observed.


[Combined endoscopic treatment with extracorporeal lithotripsy in chronic calcifying pancreatitis].
In the management of severe chronic pancreatitis, a variety of new endoscopic methods have been proposed as an alternative to traditional surgery. The main goal of these procedures is the remission of pain. They include pancreatic endoscopic sphincterotomy with subsequent endoscopic extraction, which can be associated to extracorporeal shock-wave lithotripsy for stone desintegration before removal of large calculi, and to the insertion of a pancreatic stent in case of a pancreatic duct stricture. We present two cases of severe chronic pancreatitis managed successfully with this endoscopic treatment.


Laryngotracheal reconstruction with a muscle-pedicle hyoid bone flap: a series of 23 patients.
We conducted a study to evaluate the effectiveness of muscle-pedicle hyoid bone flaps in the repair and reconstruction of the larynx and trachea in 23 patients who had undergone extended partial laryngectomy. Of this group, 17 patients had undergone surgery to correct laryngotracheal stenosis and 6 to remove laryngeal carcinoma. Intervention resulted in successful decannulation in 20 of the 23 patients (87.0%). Of the 3 patients who did not experience a successful outcome initially, 2 were successfully decannulated following a second intervention; the other patient required a total laryngectomy because of cancer recurrence. In light of our follow-up results, we conclude that hyoid bone appears to be an effective autograft in such cases.


Smell and taste symptom-based predictive model for COVID-19 diagnosis.
The presentation of coronavirus 2019 (COVID-19) overlaps with common influenza symptoms. There is limited data on whether a specific symptom or collection of symptoms may be useful to predict test positivity. An anonymous electronic survey was publicized through social media to query participants with COVID-19 testing. Respondents were questioned regarding 10 presenting symptoms, demographic information, comorbidities, and COVID-19 test results. Stepwise logistic regression was used to identify predictors for COVID-19 positivity. Selected classifiers were assessed for prediction performance using receiver operating characteristic (ROC) curve analysis. A total of 145 participants with positive COVID-19 testing and 157 with negative results were included. Participants had a mean age of 39 years, and 214 (72%) were female. Smell or taste change, fever, and body ache were associated with COVID-19 positivity, and shortness of breath and sore throat were associated with a negative test result (p < 0.05). A model using all 5 diagnostic symptoms had the highest accuracy with a predictive ability of 82% in discriminating between COVID-19 results. To maximize sensitivity and maintain fair diagnostic accuracy, a combination of 2 symptoms, change in sense of smell or taste and fever was found to have a sensitivity of 70% and overall discrimination accuracy of 75%. Smell or taste change is a strong predictor for a COVID-19-positive test result. Using the presence of smell or taste change with fever, this parsimonious classifier correctly predicts 75% of COVID-19 test results. A larger cohort of respondents will be necessary to refine classifier performance.


Assessment of regional atrial function in patients with hypertrophic cardiomyopathies using tissue Doppler imaging.
This study applied tissue Doppler imaging and color tissue Doppler imaging to study atrial function changes in patients with hypertrophic cardiomyopathy (HCM). The profile of the segmental atrial velocities and the strain rate were determined and compared with those of normal matched control subjects. This study investigated 20 patients with HCM and 20 age-matched healthy control subjects. In a four-chamber apical view, tissue Doppler imaging was used to measure the lateral left and right atrial (LA and RA) and interatrial septal (IAS) wall systolic, early, and late diastolic velocities. Similarly, the atrial strain rate during ventricular systole (SR(S)) and the early (SR(E)) and late (SR(A)) diastolic phases in patients and control subjects were measured. The interventricular septal tissue Doppler-derived isovolumic relaxation time was calculated. Only the IAS annular and middle segments showed a significant reduction in the early diastolic velocity (mean, 4.01 +/- 2.2 vs 8.7 +/- 1.1, p = 0.001; 3.23 +/- 2 vs 6.01 +/- 1.9, p = 0.001, respectively) for the patients with HCM in comparison with the control subjects. Generally, the atrial strain rate was clearly reduced. The systolic strain rate (SR(S)) was significantly reduced in the LA wall in the annular (p = 0.007) and middle (p = 0.001) segments and in the IAS middle segment (p = 0.007). Similarly, there was a reduction of the early diastolic strain rate (SR(E)) in the LA annular (p = 0.001) and middle (p = 0.01) segments and in the IAS annular (p = 0.05) and middle (p = 0.001) segments, as well as in the RA annular segment (p = 0.02). The RA middle segments showed insignificant changes. Atrial function may be affected by HCM due to impairment of myocardial diastolic function. Strain rate imaging is reproducible, yields readily obtained parameters that provide unique data about global and longitudinal segmental atrial contraction, and can quantify the atrial dysfunction in patients with HCM.


Low susceptibility of non-target Lepidopteran maize pests to the Bt protein Cry1Ab.
Transgenic Bt maize expressing the Cry1Ab toxin is poorly effective for suppressing populations of two non-target Lepidoptera, Mythimna unipuncta and Helicoverpa armigera. In order to determine the mechanisms that may be involved in this poor effectiveness, last instar larvae of the two Lepidoptera were fed with a diet containing lyophilized leaves with Bt vs non-Bt toxin for different periods; additionally, some larvae fed on Bt diet were transferred to non-Bt diet for an additional period. In the experimental larvae, we measured the growth (weight) gain from just before treatment to after the end of the treatment, and the Cry1Ab contents in the hemolymph, the peritrophic membrane and its contents and midgut epithelium. Effects of the treatments on the midgut epithelium were observed by light and transmission electron microscopy. It was seen that multiple mechanisms can be involved in the low susceptibility of the two Lepidoptera. The low content of the toxin within the peritrophic membrane 48 h after ingestion indicates a high rate of toxin elimination in this space. Moreover, M. unipuncta larvae fed on the Bt diet displayed a similar growth gain index to those fed on the non-Bt diet, and showed an increasing elimination rate during the experiment. Little toxin reached the midgut epithelium, indicating a low permeability of the peritrophic membrane or a low affinity at the binding sites. Larvae fed on the Bt toxin showed rapid recovery in weight gain and in the midgut epithelium, and also showed overcompensation mechanisms.


Everolimus in Combination with Octreotide Long-Acting Repeatable in a First-Line Setting for Patients with Neuroendocrine Tumors: A 5-Year Update.
We previously presented data of this multicentric, phase II study showing that everolimus plus octreotide long-acting repeatable (LAR) for advanced neuroendocrine neoplasms (NENs), in the first line setting, is an active and safe treatment. We now present updated data at 5 years. Patients with advanced well-differentiated, previously untreated neuroendocrine tumors of the gastroenteropancreatic tract and of the lung received octreotide LAR 30 mg plus everolimus 10 mg/day. The primary endpoint was the objective response rate (ORR). We performed an analysis of "long responder" patients and of time to progression (TTP) and overall survival (OS) at 5 years. Fifty patients were enrolled; the primary tumor site was: pancreas (14 patients), lung (11 patients), ileum (9 patients), jejunum/duodenum (2 patients), and unknown (14 patients). Seventeen (34%) of these patients have received treatment for more than 2 years. The median exposure to study drugs was 519.5 days (range 48-2,024). Currently 3 patients are still in treatment. The ORR (partial response + complete response) was 18% (95% confidence interval [CI] 7.4-28.6): complete response 1 patient (2%), partial response 8 patients (16%), stable disease 37 patients (74%). The median TTP was 33.6 months (95% CI 18.7-41.2) and the median OS was 61.0 months (95% CI 49.8-not reached). In this update of clinical outcome at 5-year follow-up, everolimus plus octreotide has been shown to be active in advanced NENs. The current analysis showed a further prolongation of TTP and a long exposure to the study drug without major side effects in the long term.


Reactivity of normal rat epiphyseal chondrocytes with monoclonal antibodies recognizing different leucocyte markers.
The aim of the study was to test whether normal rat epiphyseal chondrocytes react with monoclonal antibodies (MoAbs) detecting different markers of lymphoid cells. For this purpose, isolated chondrocyte and, for comparison, splenocyte cytosmears were exposed to a battery of different MoAbs followed by indirect immunoperoxidase staining. As we were able to show, all chondrocytes reacted with OX17 MoAb detecting Class II (Ia) antigen encoded by the RT1.D subregion of rat major histocompatibility complex (MHC). However, unlike splenocytes they did not react with OX6 MoAb detecting the RT1.B encoded Class II molecule. Moreover, all chondrocytes were stained with W3/25 MoAb specific for the rat equivalent of human CD4 (T4) antigen and with W3/13 MoAb specific for rat leucocyte sialoglycoprotein. A positive reaction was also obtained with the antibody against the S-100 protein. By contrast, chondrocytes did not react with antibodies specific for all T (OX19) or B (HIS14) cells, rat CD8 (T8) equivalent, monocytes/macrophages (ED1, ED2), factor VIII (M616), or glial fibrillary acidic protein (Z334).


Attribution of Mental States in Glossolalia: A Direct Comparison With Schizophrenia.
Glossolalia ("speaking in tongues") is a rhythmic utterance of pseudo-words without consistent semantic meaning and syntactic regularities. Although glossolalia is a culturally embedded religious activity, its connection with psychopathology (e.g., psychotic thought disorder and altered mental state attribution/mentalization) is still a matter of debate. To elucidate this issue, we investigated 32 glossolalists, 32 matched control participants, and 32 patients with schizophrenia using the Animated Triangle Test (ATT) and the Reading the Mind in the Eyes Test (RMET). The ATT can detect hypo- and hypermentalization using animations of two moving triangles. Healthy adults describe these as random movements (e.g., bouncing), willed actions (e.g., playing), or they mentalize (e.g., tricking). We found that glossolalists provided more mentalizing descriptions in the ATT random and intentional movement animations relative to the control participants. They also recognized more mental states in the RMET than the controls. None of them had a diagnosis of mental disorders. In contrast, patients with schizophrenia hypermentalized only in the ATT random movement condition, whereas they showed hypomentalization in the ATT intentional movement condition and in the RMET relative the control subjects. Hypermentalization in the ATT positively correlated with intrinsic religiosity in the glossolalia group. In conclusion, our results demonstrated a substantial difference in the mentalizing ability of glossolalists (generalized hypermentalization) and patients with schizophrenia (both hypo- and hypermentalization).


Adiponectin is related to carotid artery plaque and a predictor of cardiovascular outcome in a cohort of non-diabetic peritoneal dialysis patients.
Adiponectin is an adipocytokine with antiatherogenic and anti-inflammatory properties. We investigated associations between circulating adiponectin, inflammation and cardiovascular disease in peritoneal dialysis patients. A prospective study was performed in 59 non-diabetic patients. The concentrations of serum adiponectin, biochemical data and ultrasound of carotid artery were measured at enrollment. The patients were followed up to 39 months mainly for cardiovascular events. The serum adiponectin concentration was elevated and inversely related to C-reactive protein and interleukin-6 in the patients. The adiponectin level of patients with carotid plaques was significantly lower than in those without plaques (p < 0.01). Kaplan-Meier analysis showed that the cumulative survival without new cardiovascular events was better in patients with higher adiponectin levels than in those with lower adiponectin levels. Serum adiponectin levels are inversely related with markers of systemic inflammation and signs of atherosclerosis which may explain why hyperadiponectinemia in this study was associated with better cardiovascular outcome.


No indication of brain reorganization after unilateral ischemic lesions of the auditory cortex.
We used magnetoencephalography to study contralesional auditory reorganization in three men with chronic unilateral ischemic lesions of the auditory cortex. Although no response was found over the lesioned hemisphere, processing in the unaffected hemisphere was indistinguishable vs healthy controls. In contrast to sensorimotor and language systems, the auditory system seems to lack contralateral reorganization, presumably because patients are typically not aware of hearing deficits and thus do not perform training.


Isolation, Characterization of Zn Solubilizing Bacterium (Pseudomonas protegens RY2) and its Contribution in Growth of Chickpea (Cicer arietinum L) as Deciphered by Improved Growth Parameters and Zn Content.
Background: Zinc is an essential micronutrient required for optimum plant growth. Zinc-solubilizing bacteria convert applied inorganic zinc to available forms that could be used by plants. Research design: In present study, experiments were conducted to isolate, characterize, and evaluate Zn solubilization potential of different bacteria. Results: Among 10 isolated strains, Pseudomonas protegens (RY2, MF351762) was found to be the most promising strain having zinc-solubilizing potential on 4 different insoluble zinc sources. In quantitative assay, Zn solubilization by RY2 was significantly higher than other strains at different incubation time. P. protegens RY2 was selected (based on zinc solubilizing and plant growth promoting activities like P solubilization and ACC deaminase) for plant experiments. Meanwhile, available Zn release rate in soil was determined at day 10 of incubation. Chickpea seeds were inoculated with RY2 strain and ZnO is used as zinc source. Growth parameters and quantifying zinc content of shoot and root using atomic absorption spectrophotometer were determined. Enhanced shoot and root dry weights and lengths were observed in chickpea plants compared to control. Maximum increase of 44%, 67%, and 75% in T2 (Soil + RY2), T5 (Soil + ZnO + RY2), and T7 (Soil + manure + ZnO + RY2), respectively, was found in shoot length compared to control (T1). Conclusion: The study indicated that zinc-solubilizing RY2 strain possesses potential for enhanced Zn in soil so it would allow reduced inorganic Zn application.


Treatment of giant-cell arteritis: from broad spectrum immunosuppressive agents to targeted therapies.
For decades, the treatment of GCA has relied on glucocorticoids. Work over the past two decades has supported a modest efficacy of MTX but no clear benefit from anti-TNF-based therapies. More recently, the therapeutic armamentarium for GCA has expanded. The availability of agents targeting specific cytokines, cytokine receptors or signalling pathways, along with a better, although still limited, understanding of the immunopathology of GCA, are opening further therapeutic possibilities. Blocking IL-6 receptor with tocilizumab has been effective in maintaining remission and reducing glucocorticoid exposure and tocilizumab has been approved for the treatment of GCA. However, nearly half of the patients do not benefit from tocilizumab and additional options need to be investigated. This review focuses on standard therapeutic approaches and on targeted therapies that have been or are currently under investigation.


Probabilistic approach to nonlinear wave-particle resonant interaction.
In this paper we provide a theoretical model describing the evolution of the charged-particle distribution function in a system with nonlinear wave-particle interactions. Considering a system with strong electrostatic waves propagating in an inhomogeneous magnetic field, we demonstrate that individual particle motion can be characterized by the probability of trapping into the resonance with the wave and by the efficiency of scattering at resonance. These characteristics, being derived for a particular plasma system, can be used to construct a kinetic equation (or generalized Fokker-Planck equation) modeling the long-term evolution of the particle distribution. In this equation, effects of charged-particle trapping and transport in phase space are simulated with a nonlocal operator. We demonstrate that solutions of the derived kinetic equations agree with results of test-particle tracing. The applicability of the proposed approach for the description of space and laboratory plasma systems is also discussed.


Administration order of midazolam/fentanyl for moderate dental sedation.
The purpose of this study is to investigate the effects of administration order when a sedative drug (midazolam) and an opioid analgesic drug (fentanyl) is applied for moderate intravenous (IV) sedation in dentistry. A retrospective chart review was conducted in one dental clinic during its transition from a midazolam-first to a fentanyl-first protocol for dental procedures requiring moderate IV sedation. Physiological parameters, drug administration times, patient recovery times, drug dosages, and patient recall and satisfaction were investigated for differences. A total of 76 charts (40 midazolam-first and 36 fentanyl-first administrations), were used in the analysis. Administering midazolam first resulted in an average 4.38 min (52%) decrease in administration times (P < 0.001), and a decrease in procedural recollection immediately following the procedure (P = 0.03), and 24 to 48 hours later (P = 0.009). Administering fentanyl first required an average of 2.43 mg (29%) less midazolam (P < 0.001). No significant differences were found for change in vital signs, minimum oxygen saturation levels, recovery times, and patient satisfaction (P > 0.05). Oxygen saturation levels did not drop below 90% for either group; however, 5 cases in the fentanyl-first group fell to between 90% and 92%, compared with 0 cases in the midazolam-first group. The administration order of fentanyl and midazolam may have different effects on patients and the sedation procedure. Findings from this study should be used to facilitate discussion among dental practitioners and to guide additional research investigating this topic.


Gastrointestinal symptoms and diet of members of an irritable bowel self-help group.
A self-administered questionnaire was completed by 103 members of a self-help group for irritable bowel syndrome (IBS) and 130 controls, to compare the presence of IBS symptoms. Dietary fibre prescription, compliance and efficacy were documented in the IBS group. There were significant differences in the frequency of defaecation and number of symptoms present between the two groups. Most of the IBS subjects had been prescribed a high fibre diet but adherence to the diet and symptomatic improvement were poor. In contrast many IBS sufferers were following a range of diets not prescribed by their doctor. The seriousness of the IBS condition was highlighted by the fact that 8% of the IBS group had retired early due to their condition.


Update in tonometry. Phosphene and rebound tonometries, self-tonometry and technologies for the future.
The Proview phosphene (eye-pressure) tonometer and the Rebound tonometer ICare are relatively new devices basically different from the Goldmann applanation tonometry (GAT). Both technologies will be presented in this review with respect to their principle, their technique, their advantages and limits, as well as their accuracy, the IOP measurements agreement with GAT, and the influence of central corneal thickness on the reliability of these measurements. Because the current data base for the interpretation of glaucoma disease course and its management are still relatively small, the development of a continuous, accurate, reliable and harmless monitoring of IOP over 24 hours is strongly desirable in the future. Approaches for self-tonometry and devices such as smart contact lenses which can take the IOP from the corneal surface have been developed with this goal. The future will probably confirm whether telemetric IOP monitoring with an implantable active microsystem allows a reliable IOP monitoring or not. In any case, active implants will open new and important perspectives in the diagnosis and the treatment of glaucomatous optic neuropathy.


Core transcriptional regulatory circuitry in human embryonic stem cells.
The transcription factors OCT4, SOX2, and NANOG have essential roles in early development and are required for the propagation of undifferentiated embryonic stem (ES) cells in culture. To gain insights into transcriptional regulation of human ES cells, we have identified OCT4, SOX2, and NANOG target genes using genome-scale location analysis. We found, surprisingly, that OCT4, SOX2, and NANOG co-occupy a substantial portion of their target genes. These target genes frequently encode transcription factors, many of which are developmentally important homeodomain proteins. Our data also indicate that OCT4, SOX2, and NANOG collaborate to form regulatory circuitry consisting of autoregulatory and feedforward loops. These results provide new insights into the transcriptional regulation of stem cells and reveal how OCT4, SOX2, and NANOG contribute to pluripotency and self-renewal.


Braces for postoperative bandage after otoplasty.
Postoperative bandaging following otoplasty is commonly used. It is also frequently perceived as cumbersome and often lost by patients. Simple splinting potentially offers a less obtrusive postoperative ear fixation. Braces consisting of silicone-coated steel wire have been designed for simpler and lighter postoperative fixation. The braces replaced conventional bandaging. The initial favorable experience with the ear braces is described following the otoplasty of 17 ears. It is suggested that the use of splints may improve the immediate postoperative appearance, and subsequently compliance for patients. However, the long-term effect of postoperative bandaging remains unknown.


Burnout and Mental Health of COVID-19 Frontline Healthcare Workers: Results from an Online Survey.
Objective: The COVID-19 pandemic has been prolonged and healthcare workers have become exhausted. The purpose of this study was to investigate burnout and its relationship with mental health in COVID-19 frontline healthcare workers. Method : This cross-sectional study was carried out in all hospitals where patients with COVID-19 were admitted in Hamedan, Iran. With the census method and considering the inclusion criteria, 924 COVID-19 frontline healthcare workers participated in this study. Data were collected using a web-based survey consisting of demographic characteristics, GHQ-28, and Maslach Burnout Inventory. Statistical analysis was performed using Stata 14. Results: The results showed that the main cause of concern and stress in employees was that it was not clear how long this situation would continue. The results regarding burnout and mental health showed that 29.33% of participants were high in emotional exhaustion (EE), 10.93% were high in depersonalization (DP), 34.31% were low in personal accomplishment (PA), 50.4% had physical symptoms, 50.2% had anxiety and insomnia symptoms, 62.2% had social dysfunction and 17.5% had depression symptoms. The results of the multivariate logistic regression showed that EE had the greatest role in reducing mental health of employees with OR = 6.92 for moderate EE and OR = 39.42 for high EE (P < 0.001). Conclusion: COVID-19 frontline healthcare workers are at risk for burnout and poor mental health. Health policies should be implemented to help reduce burnout in healthcare workers. Also, person-directed and organizational-directed interventions to rejuvenate these employees seem necessary.