High-Strength, Freeze-Resistant, Recyclable, and Biodegradable Polyvinyl Alcohol/Glycol/Wheat Protein Complex Organohydrogel for Wearable Sensing Devices.
The application of flexible wearable sensing devices based on conductive hydrogels in human motion signal monitoring has been widely studied. However, conventional conductive hydrogels contain a large amount of water, resulting in poor mechanical properties and limiting their application in harsh environments. Here, a simple one-pot method for preparing conductive hydrogels is proposed, that is, polyvinyl alcohol (PVA), wheat protein (WP), and lithium chloride (LiCl) are dissolved in an ethylene glycol (EG)/water binary solvent. The obtained PVA/EG/WP (PEW) conductive organohydrogel has good mechanical properties, and its tensile strength and elongation at break reach 1.19 MPa and 531%, respectively, which can withstand a load of more than 6000 times its own weight without breaking. The binary solvent system composed of EG/water endows the hydrogel with good frost resistance and water retention. PEW organohydrogel as a wearable strain sensor also has good strain sensitivity (GF = 2.36), which can be used to detect the movement and physiological activity signals in different parts of the human body. In addition, PEW organohydrogels exhibit good degradability, reducing the environmental footprint of the flexible sensors after disposal. This research provides a new and viable way to prepare a new generation of environmentally friendly sensors.


Flip-flop is slow and rate limiting for the movement of long chain anthroyloxy fatty acids across lipid vesicles.
An issue that is central to understanding cellular fatty acid (FA) metabolism is whether physiologic transport of FA across cell membranes requires protein mediation or can be satisfied by the rate of spontaneous movement through the lipid phase. For this reason, considerable effort has been devoted to determining the rate-limiting steps for transport of FA across pure lipid bilayer membranes. Previously, we found that transbilayer flip-flop was the rate-limiting step for transport of long chain anthroyloxy FA (AOFA) across lipid bilayers and that the times for long chain AOFA flip-flop were > or = 100 s, yielding rate constants for flip-flop (k(ff)) that were < or = 0.01 s(-1) [Storch, J., & Kleinfeld, A. M. (1986) Biochemistry 25, 1717-1726; Kleinfeld, A. M., & Storch, J. (1993) Biochemistry 32, 2053-2061]. In those studies, k(ff) values were inferred from the time course of AOFA transfer between lipid vesicles. Recently, Kamp et al. [Kamp, F., Zakim, D., Zhang, F., Noy, N., & Hamilton, J. A. (1995) Biochemistry 34, 11928-11937], using pyranine trapped within lipid vesicles to detect flip-flop more directly, have reported that flip-flop rates of long chain AOFA are extremely rapid (k(ff) > 10 s(-1)) and are not rate limiting for transbilayer transport. Because no defect was apparent in our previous measurements, we have extended, for AOFA, the pyranine method of Kamp et al. (1995) by using stopped-flow fluorometry to resolve flip-flop rates of both short and long chain AOFA in vesicles. In addition, we have monitored the time course of transbilayer AOFA flip-flop using carboxyfluorescein (CF) trapped within the lipid vesicles as a resonance energy transfer (RET) acceptor of AO fluorescence. The differential quenching of AOFA fluorescence in the outer and inner leaflets of the bilayer allows flip-flop to be separated from the time course of AOFA binding to the vesicles. Results obtained from both the pyranine and CF methods indicate, in agreement with our previous results, that flip-flop of the long chain AOFA is slow relative to either the binding or the rate of dissociation from the vesicle. In particular, we find that the time constant (tau) for pyranine quenching by 2-AO-palmitate (2-AOPA) was > 40 s and that k(ff) obtained from RET in CF vesicles was about 0.003 s(-1). Also, in contrast to Kamp et al. (1995) who reported that k(ff) values were independent of FA chain length or structure for the C-12 to C-18 native and the C-18 AOFA within a factor of 2, we find that the rate of pyranine quenching for the shorter chain 11-AO-undecanoic acid is more than 50-fold faster than for the longer chain AOFA. We conclude, therefore, that transbilayer transport of the AOFA is limited by the rate of flip-flop and that this rate is a sensitive function of the AOFA structure.


Distribution analysis of vitamin D highlights differences in population subgroups: preliminary observations from a pilot study in UK adults.
There is no consensus between Authors on the definition of a replete or deficient vitamin D state. Our aim was to describe a suitable method that could be used to compare vitamin D data in subject groups with small or large numbers. Two hundred and forty indigenous asymptomatic, non-pregnant adult subjects recruited from a single-consultation outpatient attendance with normal biochemistry, represented a sample of our inner city district population. 25-hydroxyvitamin D (25,OHD3) levels were measured to illustrate the effects of season, sex and ethnic group on vitamin D levels and subjected to distribution analysis. This method quantifies as a percentage the distribution of 25,OHD3 concentrations (observed concentration, OC) in pooled group data. The data can be expressed as distribution frequency domains or cumulative frequency ogives (0-100%) or transformed into discrete linear probits, amenable to regression analysis. An estimate of the OC50 (mid-point) and upper (either OC75 or OC95) or lower (either OC25 or OC5) range or at any other frequency between subject groups can be compared. A marked difference in 25,OHD3 levels between Asian and non-Asian asymptomatic adult subjects was seen during both seasons. 25,OHD3 deficiency was defined as at or below the OC25 for the non-Asian group (for both sexes: winter < 13.36 ng/ml, summer <13.38 ng/ml). The majority of Asians of both sexes were 25,OHD3 deficient (winter 94%, summer 82%). The distribution analysis provides an easy technique to compare 25,OHD3 status of different subject groups, allowing the description of populations using either longitudinal or cross-sectional data. This method may offer a way of describing 25,OHD3 deficiency between observers worldwide.


A case of inclusion body myositis with systemic sclerosis.
Abstract We report a case of systemic sclerosis (SSc) associated with inclusion body myositis (IBM). A 58-year-old man was diagnosed as having SSc at the age of 35 years, and had been suffering from chronic progressive weakness and atrophy of the limb muscles. A diagnosis of IBM was established by muscle biopsy. Although most such patients show a poor response to corticosteroids and immunosupressants, glucocorticoid therapy was effective in the present case.


Utilization of L-threonine by a species of Arthrobacter. A novel catabolic role for "aminoacetone synthase".
1. A species of Arthrobacter (designated Arthrobacter 9759) was isolated from soil by its ability to grow aerobically on l-threonine as sole source of carbon atoms, nitrogen atoms and energy; the organism also grew well on other sources of carbon atoms including glycine, but no growth was obtainable on aminoacetone or dl-1-aminopropan-2-ol. 2. During growth on threonine, (14)C from l-[U-(14)C]threonine was rapidly incorporated into glycine and citrate, and thereafter into serine, alanine, aspartate and glutamate. 3. With extracts of threonine-grown cells supplied with l-[U-(14)C]threonine, evidence was obtained of the NAD and CoA-dependent catabolism of l-threonine to produce acetyl-CoA plus glycine. Short-term incorporation studies in which [2-(14)C]acetate and [2-(14)C]glycine were supplied (a) to cultures growing on threonine, and (b) to extracts of threonine-grown cells, showed that the acetyl-CoA was metabolized via the tricarboxylic acid cycle and glyoxylate cycle whereas the glycine was converted into pyruvate via the folate-dependent ;serine pathway'. 4. The threonine-grown organism contained ;biosynthetic' threonine dehydratase and a potent NAD-linked l-threonine dehydrogenase but possessed no l-threonine aldolase activity. 5. Evidence was obtained that the acetyl-CoA and glycine produced from l-threonine had their immediate origin in the alpha-amino-beta-oxobutyrate formed by the threonine dehydrogenase; the CoA-dependent cleavage of this compound was catalysed by an alpha-amino-beta-oxobutyrate CoA-ligase, which was identified with ;aminoacetone synthase'. A continuous spectrophotometric assay of this enzyme was developed, and it was found to be inducibly synthesized only during growth on threonine and not during growth on acetate plus glycine. 6. By using a reconstituted mixture of separately purified l-threonine dehydrogenase and alpha-amino-beta-oxobutyrate CoA-ligase (i.e. ;aminoacetone synthase'), l-[U-(14)C]threonine was broken down to [(14)C]glycine plus [(14)C]acetyl-CoA (trapped as [(14)C]citrate). 7. There was no evidence of aminoacetone metabolism by Arthrobacter 9759 even though a small amount of this amino ketone appeared in the culture medium during growth on threonine.


The reliability and validity of the World Health Organization Disability Assessment Schedule (WHODAS-II) in stroke.
Psychometric properties of the World Health Organization Disability Assessment Schedule (WHODAS-II) in stroke have received some attention recently, mostly using classical approaches, but there is still an absence of investigation from a modern psychometric perspective. This study aimed to test the reliability and validity of the WHODAS-II in stroke, using modern psychometric analysis. A total of 188 community-dwelling poststroke patients were recruited. Internal construct validity was assessed by Rasch analysis, reliability by internal consistency and person separation index (PSI), and external construct validity by associations with Functional Independence Measure (FIM(™)). Rasch analysis indicated that total score (based upon 32 items, omitting the work-related items) was satisfactory, after adjustment for local dependency. The proposed "activities" and "participation" components also satisfied Rasch model expectations. An existing short form was problematic due to inclusion of a work-related item, but an alternative 10-item version was acceptable. Cronbach's α for the WHODAS-II, its domains and components varied between 0.83 and 0.99 and PSI between 0.70 and 0.95. External construct validity was confirmed by expected correlations with FIM(™). WHODAS-II provides a reliable and valid instrument for measuring disability and components of "activities" and "participation" in stroke survivors. Various combinations of the item set may provide a range of scales to suit most research needs.


The mast cell and gut nematodes: damage and defence.
Gut nematode infection induces a dominant type 2 immune response, crypt hyperplasia and mucosal mastocytosis. Despite their strong association with nematode infection, the role of mast cells in the mechanism of worm expulsion is yet to be fully defined. Recent work suggests that they contribute to resistance, aiding the effector mechanisms which ultimately result in worm expulsion. Although it is widely accepted that both connective and mucosal mast cells arise from a common progenitor, it is clear that mucosal mastocytosis is dependent on the presence of type 2 cytokines such as interleukin 4 (IL-4), IL-9, IL-10 and IL-13. Importantly, it is now evident that mucosal mast cells can amplify this protective response, as well as contributing to intestinal pathology. Here we discuss current areas of interest in this field, including the potentially conflicting role that mast cells play in intestinal inflammation. We also highlight the significance of these responses to current ideas relating to parasite infection and allergy.


A ligamentum flavum-preserving approach to the lumbar spinal canal.
This is a retrospective study of a consecutive series of patients undergoing spinal decompression or disc enucleation with preservation of the ligamentum flavum. MacNab criteria and Prolo scoring was used to assess them pre- and after surgery. The aim of the study was to assess the incidence of perioperative complications and long-term clinical outcome of the procedure. One previous study has shown this technique to be effective in reducing the rate of perioperative complications and recurrences in patients undergoing microscopic disc enucleation. However, this study does not comment on the long-term clinical results or the use of the technique in a wider range of spinal procedures. Between 1991 and 1999, we operated on 214 patients for peripheral lumbar radiculopathy. MacNab criteria and Prolo scoring was used for their pre- and postoperative assessment. Postoperative assessment was with the help of a postal questionnaire. In addition, clinical notes were studied to look for any further procedures or operative complications. All 214 patients returned the postoperative questionnaires. There were 104 males and 110 females. The mean follow-up was 5.97 years. Thirty-eight patients had an associated fusion or Graf ligament stabilization. Two hundred ninety-six levels were operated in all. There were four instances of dural tear and one of nerve root injury. Five patients underwent revision. There was a statistically significant improvement in the MacNab criteria (P < 0.001) and Prolo score (P < 0.001) after surgery. We recommend a ligamentum flavum preserving approach because it decreases the rate of perioperative complications while giving comparable long-term results.


A Triple Primary Cell Culture Model of the Human Blood-Brain Barrier for Studying Ischemic Stroke In Vitro.
Ischemic stroke is a major cause of death and disability worldwide with limited therapeutic options. The neuropathology of ischemic stroke is characterized by an interruption in blood supply to the brain leading to cell death and cognitive dysfunction. During and after ischemic stroke, blood-brain barrier (BBB) dysfunction facilitates injury progression and contributes to poor patient recovery. Current BBB models primarily include endothelial monocultures and double co-cultures with either astrocytes or pericytes. Such models lack the ability to fully imitate a dynamic brain microenvironment, which is essential for cell-to-cell communication. Additionally, commonly used BBB models often contain immortalized human endothelial cells or animal-derived (rodent, porcine, or bovine) cell cultures that pose translational limitations. This paper describes a novel well-insert-based BBB model containing only primary human cells (brain microvascular endothelial cells, astrocytes, and brain vascular pericytes) enabling the investigation of ischemic brain injury in vitro. The effects of oxygen-glucose deprivation (OGD) on barrier integrity were assessed by passive permeability, transendothelial electrical resistance (TEER) measurements,and direct visualization of hypoxic cells. The presented protocol offers a distinct advantage inmimicking the intercellular environment of the BBB in vivo, serving as a more realistic in vitro BBB model for developing new therapeutic strategies in the setting of ischemic brain injury.


Publications by doctoral candidates at Charité University Hospital, Berlin, from 1998-2008.
One quality parameter of medical theses is the number of articles published by the doctoral candidates. Over the course of the past decade the Charité-Universitätsmedizin Berlin has taken steps to improve the quality of the theses completed by its doctoral students in medicine and increase their publication activity. This study was designed to verify the efficacy of these measures and to detect general trends. Medical theses completed in 1998, 2004 and 2008 (sample size >250 for each year) were retrospectively analyzed with regard to associated publications within a 7-year period (from 5 years before completion to 2 years thereafter). Quality and quantity were recorded. Publications found in the PubMed database were evaluated; the impact factor of the publishing journal was used as quality parameter. The sample sizes were 264 for 1998, 316 for 2004, and 316 for 2008. The number of publications per doctoral student increased from 0.78 to 1.39 over the course of the study period, and the average impact factor rose from 2.42 to 3.62. Analysis using the current impact factors of the publishing journals showed an increase from 3.13 to 3.85. The proportion of case reports fell from 12.7% to 8%. The proportion of first authorships remained about the same. The past decade has seen an increase in the number of publications by doctoral students at the Charité and a rise in the average impact factor of the journals concerned.


Impact of enzymatic digestion on bacterial community composition in CF airway samples.
Previous studies have demonstrated the importance of DNA extraction methods for molecular detection of Staphylococcus, an important bacterial group in cystic fibrosis (CF). We sought to evaluate the effect of enzymatic digestion (EnzD) prior to DNA extraction on bacterial communities identified in sputum and oropharyngeal swab (OP) samples from patients with CF. DNA from 81 samples (39 sputum and 42 OP) collected from 63 patients with CF was extracted in duplicate with and without EnzD. Bacterial communities were determined by rRNA gene sequencing, and measures of alpha and beta diversity were calculated. Principal Coordinate Analysis (PCoA) was used to assess differences at the community level and Wilcoxon Signed Rank tests were used to compare relative abundance (RA) of individual genera for paired samples with and without EnzD. Shannon Diversity Index (alpha-diversity) decreased in sputum and OP samples with the use of EnzD. Larger shifts in community composition were observed for OP samples (beta-diversity, measured by Morisita-Horn), whereas less change in communities was observed for sputum samples. The use of EnzD with OP swabs resulted in significant increase in RA for the genera Gemella (p < 0.01), Streptococcus (p < 0.01), and Rothia (p < 0.01). Staphylococcus (p < 0.01) was the only genus with a significant increase in RA from sputum, whereas the following genera decreased in RA with EnzD: Veillonella (p < 0.01), Granulicatella (p < 0.01), Prevotella (p < 0.01), and Gemella (p = 0.02). In OP samples, higher RA of Gram-positive taxa was associated with larger changes in microbial community composition. We show that the application of EnzD to CF airway samples, particularly OP swabs, results in differences in microbial communities detected by sequencing. Use of EnzD can result in large changes in bacterial community composition, and is particularly useful for detection of Staphylococcus in CF OP samples. The enhanced identification of Staphylococcus aureus is a strong indication to utilize EnzD in studies that use OP swabs to monitor CF airway communities.


[Malignant hyperthermia in ophthalmologic surgery].
Malignant hyperthermia is a potentially fatal complication of general anesthesia that may occur with greater frequency in ptosis and strabismus surgery. The case of a two-year-old girl who suffered a malignant hyperthermia crisis during strabismus surgery is reported. The pathophysiology, clinical features, treatment and pre-anesthetic diagnosis are reviewed in detail.


Smart home adoption factors: A systematic literature review and research agenda.
Smart homes represent the complement of various automation technologies that together make up a network of devices facilitating the daily tasks of residents. These technologies are being studied for their application from different sectors, including the projection of their use to improve energy consumption planning and health care management. However, technology adoption depends on social awareness within the scope of cognitive advantages and innovations compared to perceived risk because although there are multiple benefits, potential users express fears related to the loss of autonomy and security. This study carries out a systematic literature review based on PRISMA in order to analyze research trends and literary evolution in the technological adoption of smart homes, considering the main theories and variables applied by the community. In proposing a research agenda in accordance with the identified gaps and the growing and emerging themes of the object of study, it is worth highlighting the growing interest in the subject, both for the present and its development in the future. Until now, adoption factors have been attributed more to the technological acceptance model and the diffusion of innovation theory, adopting components of the Theory of Planned Behavior; therefore, in several cases, the attributes of different theories are merged to adapt to the needs of each researcher, promoting the creation of empirical and extended models.


Changes in intracranial pressure gradients between the cerebral hemispheres in patients with intracerebral hematomas in one cerebral hemisphere.
Intracranial-pressure (ICP) monitoring is useful for patients with increased ICP following hemorrhagic stroke. In this study, the changes in pressure gradients between the two cerebral hemispheres were investigated after hemorrhagic stroke of one side, and after a craniotomy. Twenty-four patients with acute cerebral hemorrhages and intracerebral hematomas who exhibited mass effect and midline shift to the contralateral side on computed tomography were selected for this study. After admission, both sides of the cranium were drilled, and optical fiber sensors were implanted to monitor the brain parenchyma pressure (BPP) in both cerebral hemispheres. All patients underwent surgical hematoma evacuations. The preoperative and postoperative BPP data from both cerebral hemispheres were collected at various time points and compared pairwise. There were statistically significant differences (P < 0.01) in the preoperative BPP values between the two hemispheres at three different time points. Differences in the BPP values between the two hemispheres at the time of surgery, and 24 and 48 h after surgery, were not statistically significant (P > 0.05). The posteroperative BPPs of both hemispheres were statistically significantly lower than preoperative recordings. BPP sensors should be applied to the injured cerebral hemisphere, because this becomes the source of increased ICP. Hematoma evacuation surgery effectively decreases ICP and eliminates pressure gradients between the two cerebral hemispheres, consequently enabling brain shift correction.


A commissioning rod assembly for the Jamaican SLOWPOKE-2 nuclear reactor.
Within the framework of the Material Management and Minimization Conversion Program of the U.S. Department of Energy's National Nuclear Security Administration, the Argonne National Laboratory approved the manufacturing of a Jamaica's SLOWPOKE-2 nuclear reactor (JM-1) mock-up, reactor removal tools, and commissioning rods by Polytechnique Montreal. This mock-up reactor was then used to practice dry runs of the JM-1 high enriched uranium core removal activities and fresh low enriched uranium core loading operations of the JM-1 reactor conversion. One of the most crucial elements in the commissioning of a new reactor core is the commissioning rod assembly. Hence, this paper presents the design, the fabrication, the calibration, and the dry runs performed at Polytechnique Montreal with commissioning rod assembly. The work was then resumed at Jamaica's International Centre for Environmental and Nuclear Sciences.


Anticonvulsant-induced changes in tissue manganese, zinc, copper, and iron concentrations in Wistar rats.
Human epileptics have been reported to have low blood manganese (Mn) concentrations in comparison to nonepileptics, an observation that is important because Mn deficiency can increase seizure susceptibility in experimental animals. Factors that have been suggested to contribute to the low blood Mn levels in epileptics include anticonvulsant use, seizure-induced tissue redistribution of Mn, and genetics; in the present study, the first of these possibilities was tested. Wistar rats were fed semipurified diets containing diphenylhydantoin ([DPH] 3 g/kg diet), phenobarbital ([PB] 2 g/kg diet), or primidone ([PRIM] 3 g/kg diet) for 7 weeks, at which time they were killed and tissues collected and analyzed for Mn, zinc (Zn), copper (Cu), and iron (Fe) concentrations. In comparison to pair-fed rats, DPH- and PRIM-fed rats had significantly elevated liver Mn concentrations, while Mn concentrations in blood, brain, heart, and kidney were unaffected by anticonvulsant exposure. Changes in the concentrations of Zn, Cu, and Fe in specific tissues were also found. Overall, these findings suggest that the anticonvulsants tested do not lead to significant derangements in the metabolism of Mn.


Comparison of the clinical application of reactive oxygen species and inflammatory markers in patients with endocarditis.
Infective endocarditis (IE) is still connected with high operative mortality. Inflammatory markers are commonly used in monitoring patient clinical condition. Respiratory burst and reactive oxygen species (ROS) are the main way of pathogen elimination. Specificity of this process in the aspect of bacterial infection is the key for correlation assessment between ROS and inflammatory markers in patients with IE. In the study, assessment of ROS as a clinical indicator in IE was conducted. During 2007/2008 in the Cardiosurgical Clinic of the Medical University in Lodz there were 20 patients operated on for IE. The examined population consisted of 13 men and 7 women, aged from 23 to 74 years. Inflammatory markers - leukocytosis (WBC), C-reactive protein (CRP), procalcitonin (PCT) and erythrocyte sedimentation rate (ESR) - were assessed preoperatively, on the 3(rd), 7(th), 12(th) and 21(st) day. Simultaneously, with the second venous blood sample chemiluminescence (luminal enhanced whole blood chemiluminescence) was carried out and used to assess ROS production. The results were analyzed statistically. Positive correlation between ESR, CRP and ROS in the preoperative period was confirmed. An increase in ROS and a statistically significant increase in inflammatory markers on the 3(rd) day were observed. The ROS normalized on the 12(th) day. Marked individual variability was specific for the inflammatory markers. Despite the significant decrease, not all of them achieved a normal level at the last control point. Assessment of ROS seems to be a universal parameter with possible application in patients with IE.


Chemistry of nitrosoureas. Decomposition of Deuterated 1,3-bis(2-chloroethyl)-1-nitrosourea.
BCNU-alpha-d4 [1,3-bis(2-chloro-1,1-dideuterioethyl)-1-nitrosourea] and BCNU-beta-d4 [1,3-bis(2-chloro-2,2-dideuterioethyl)-1-nitrosourea] were synthesized and decomposed in buffered (pH 7.4)water. The products were analyzed by GC-MS. The deuterium distribution in the products is inconsistent with vinylcarbonium ion or diazochloroethane intermediacy but is consistent with a 2-chloroethylcarbonium ion intermediate with some rearrangement to the 1-chloroethylcarbonium ion and the cyclic chloronium ion.


Bone Marrow Derived Extracellular Vesicles Activate Osteoclast Differentiation in Traumatic Brain Injury Induced Bone Loss.
Traumatic brain injury (TBI) is a major source of worldwide morbidity and mortality. Patients suffering from TBI exhibit a higher susceptibility to bone loss and an increased rate of bone fractures; however, the underlying mechanisms remain poorly defined. Herein, we observed significantly lower bone quality and elevated levels of inflammation in bone and bone marrow niche after controlled cortical impact-induced TBI in in vivo CD-1 mice. Further, we identified dysregulated NF-κB signaling, an established mediator of osteoclast differentiation and bone loss, within the bone marrow niche of TBI mice. Ex vivo studies revealed increased osteoclast differentiation in bone marrow-derived cells from TBI mice, as compared to sham injured mice. We also found bone marrow derived extracellular vesicles (EVs) from TBI mice enhanced the colony forming ability and osteoclast differentiation efficacy and activated NF-κB signaling genes in bone marrow-derived cells. Additionally, we showed that miRNA-1224 up-regulated in bone marrow-derived EVs cargo of TBI. Taken together, we provide evidence that TBI-induced inflammatory stress on bone and the bone marrow niche may activate NF-κB leading to accelerated bone loss. Targeted inhibition of these signaling pathways may reverse TBI-induced bone loss and reduce fracture rates.


Pilot-scale multi-stage reverse osmosis (DT-RO) for water recovery from landfill leachate.
Recovery of high quality water from municipal landfill leachate was studied by three-stage disc tube reverse osmosis optimized in pilot-scale. Following UF-membrane-assisted activated sludge plant, overall 46.5 tons of leachate were post-treated in real environment and analyzed for conventional contaminants and hazardous compounds (e.g. heavy metals, boron, selenium) throughout operation of membrane system. Operating pressure ranged from 21 to 76 bar, while permeate flux varied in the range 7.1-32.5 L m-2 h-1. Rejection factors of specific ions were related to the pressure and global removals were assessed for each stage (e.g. E%COD = 92.4-99.2%, E%NH4 = 46.2-95.8%, E%NOx = 84.8-97.9%; E%TDS = 88-95.5%). Boron removal was assessed in the range 34-48%, so as to require the third stage to reach standard for discharge or reuse. Two stages were sufficient to reach water recovery higher than 91%. Long-term operation and mathematical modeling demonstrated how the Δπ/ΔP ratio can support the decisions for membrane cleaning and predictive maintenance: permeability decline was associated to the ratio increase from 0.72 to 0.73 to 1.13-1.21.


Infections and demanding endocrine care contribute to increased mortality in patients with APECED.
Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) has variable clinical course. Overall mortality is increased but reasons for this remain largely unknown. Our objective was to assess the causes of death and factors contributing to increased mortality. A follow-up study of the Finnish APECED cohort in 1970-2019. In 33 deceased patients with APECED, causes of death and clinical course preceding the death were analyzed using national registry data, death certificates, autopsy reports, and patient records. Most common causes leading to death were infections (24%), oral and esophageal malignancies (15%; median age at death 36.7 years; median survival 1.5 years), and diseases of the circulatory system (18%). Adrenal crisis was an independent cause of death in two patients. In addition, in four patients, the adrenal crisis was a complicating factor during a fatal infection. Other APECED manifestations leading to death were hypoparathyroidism, diabetes, and hepatitis. Other causes of death included accidents (12%), alcohol-related causes, and amyotrophic lateral sclerosis. Challenges in overall, and especially in the endocrine, care contributed to deaths related to carcinomas and adrenal crisis. Age at death and year of death correlated (r = 0.345, P = 0.045), suggesting improved longevity. Infections, malignancies, and diseases of the circulatory system are the most common primary causes of death in patients with APECED. Adrenal crisis is an independent cause of death but more often a contributing factor in fatal infections. Despite the high overall mortality and the demanding care, our results suggest improved patient survival in recent years.


Independent association between obstructive sleep apnea severity and glycated hemoglobin in adults without diabetes.
We tested the hypothesis of an independent cross-sectional association between obstructive sleep apnea (OSA) severity and glycated hemoglobin (HbA(1c)) in adults without known diabetes. HbA(1c) was measured in whole-blood samples from 2,139 patients undergoing nocturnal recording for suspected OSA. Participants with self-reported diabetes, use of diabetes medication, or HbA(1c) value ≥6.5% were excluded from this study. Our final sample size comprised 1,599 patients. A dose-response relationship was observed between apnea-hypopnea index (AHI) and the percentage of patients with HbA(1c) >6.0%, ranging from 10.8% for AHI <5 to 34.2% for AHI ≥50. After adjustment for age, sex, smoking habits, BMI, waist circumference, cardiovascular morbidity, daytime sleepiness, depression, insomnia, sleep duration, and study site, odds ratios (95% CIs) for HbA(1c) >6.0% were 1 (reference), 1.40 (0.84-2.32), 1.80 (1.19-2.72), 2.02 (1.31-3.14), and 2.96 (1.58-5.54) for AHI values <5, 5 to <15, 15 to <30, 30 to <50, and ≥50, respectively. Increasing hypoxemia during sleep was also independently associated with the odds of HbA(1c) >6.0%. Among adults without known diabetes, increasing OSA severity is independently associated with impaired glucose metabolism, as assessed by higher HbA(1c) values, which may expose them to higher risks of diabetes and cardiovascular disease.


[Spinal cord injury due to penetrating missiles].
Gunshot wound of the spine is a major cause of spinal cord injury among US civilian population, members of the military armed conflict personnel, or civilians injured in terrorists attacks. The bullet fragments cause damage to the spinal cord even without penetrating the spinal canal. Concussive effects, heat, fractures or vascular injury may cause the neurological damage. Unfortunately, bullet or shrapnel removal or laminectomy do not change the prognosis. In this article we review the historical background, the Israeli experience, ballistic-forensic considerations, complications, treatment and prognosis.


Hypocalcaemia after subtotal thyroidectomy for thyrotoxicosis.
Eighty-one patients who underwent subtotal thyroidectomy for thyrotoxicosis had a 10 per cent incidence of symptomatic hypocalcaemia (corrected calcium less than 2.0 mmol/l) but only a 1.2 per cent incidence of prolonged hypocalcaemia. In the same patients only one had a transient right sided recurrent laryngeal nerve palsy. These results would seem to confirm the wisdom of lateral ligation of the inferior thyroid arteries to protect the recurrent laryngeal nerve. They lend no support to the suggestion that in order to protect parathyroid function this teaching be abandoned in favour of a policy of ligation of the arteries on the surface of the gland. Nevertheless, injury, devascularization or inadvertent removal of parathyroid tissue must still be the first practical consideration.


Isolation and Characterization of Vaccine Candidate Genes Including CSP and MSP1 in Plasmodium yoelii.
Malaria is an infectious disease affecting humans, which is transmitted by the bite of Anopheles mosquitoes harboring sporozoites of parasitic protozoans belonging to the genus Plasmodium. Despite past achievements to control the protozoan disease, malaria still remains a significant health threat up to now. In this study, we cloned and characterized the full-unit Plasmodium yoelii genes encoding merozoite surface protein 1 (MSP1), circumsporozoite protein (CSP), and Duffy-binding protein (DBP), each of which can be applied for investigations to obtain potent protective vaccines in the rodent malaria model, due to their specific expression patterns during the parasite life cycle. Recombinant fragments corresponding to the middle and C-terminal regions of PyMSP1 and PyCSP, respectively, displayed strong reactivity against P. yoelii-infected mice sera. Specific native antigens invoking strong humoral immune response during the primary and secondary infections of P. yoelii were also abundantly detected in experimental ICR mice. The low or negligible parasitemia observed in the secondary infected mice was likely to result from the neutralizing action of the protective antibodies. Identification of these antigenic proteins might provide the necessary information and means to characterize additional vaccine candidate antigens, selected solely on their ability to produce the protective antibodies.


Measurement of layer-like hemodynamic trends in scalp and cortex: implications for physiological baseline suppression in functional near-infrared spectroscopy.
A multidetector, continuous wave, near-infrared spectroscopy (NIRS) system is developed to examine whether the hemodynamics of the scalp and brain in adults contain significant layer-like hemodynamic trends. NIRS measurements are made using contrasting geometries, one with four detectors equidistant from a source 33 mm away, and one with detectors collinear with the source (5 to 33 mm away). When NIRS time series are acquired over the prefrontal cortex from resting adults using both geometries, variations among the time series are consistent with a substantially homogeneous two-layer model (p<0.001) and inconsistent with one dominated by heterogeneities. Additionally, when time series measured 5 mm from the source are subtracted from corresponding 33-mm signals via a least-squares algorithm, 60% of the hemoglobin changes are on average removed. These results suggest that hemodynamic trends present in the scalp can contribute significantly to NIRS measurements, and that attempts to reduce this noise by subtracting a simultaneous near-channel measurement using a two-layer model are justified. Such subtractions are then performed on NIRS measurements from two stimulus protocols. For systemic stimulations (Valsalva maneuver), the subtraction cancels the hemodynamic response, as desired. For localized stimulation of the occipital lobe (viewing a flickering pattern), the subtraction isolated a stimulus-correlated hemodynamic feature from background noise.


[Stunting, overweight and obesity during the nutrition transition in schoolchildren of Arandas, Jalisco, Mexico].
Nutrition transition provokes changes in the nutritional status of individuals subjected to the interaction of various environmental factors; therefore, the aim was to demonstrate that nutrition transition is associated with socioeconomic changes, eating habits and physical activity, potentially involved in stunting, overweight and obesity of schoolchildren. Case-control study. 102 participants from the Instituto Alteño para el Desarrollo de Jalisco (cases) and 194 from the elementary school system (controls), aged 5 to 12 years, were included. Dependent variables were these indexes weight/age (Z), height/age (Z), BMI (Z). Independent variables were the socioeconomic and demographic characteristics. Student's t test, chi square, odds ratio (OR) and 95% confidence intervals (95% CI) were estimated. Family income was low (p = 0.031) and unstable job was higher in cases: OR = 4.1, 95% CI = 2.8-6.0. The frequency of stunting was higher in cases (9.9% vs. 5.9%). The combination of overweight/obesity was higher in controls (27.3% vs. 16.8%), OR = 1.85, 95% CI = 1.0-3.4. The nutritional status of children of Arandas, Jalisco, has been modified by an accelerate nutrition transition, provoked by socioeconomic, educational and demographic factors that might have influence on the persistence of stunting and an increasing prevalence of overweight/obesity.


Effect of Dietary Supplementation of Biological Curcumin Nanoparticles on Growth and Carcass Traits, Antioxidant Status, Immunity and Caecal Microbiota of Japanese Quails.
This study was planned to evaluate the impact of different nano-curcumin levels on the growth rate, carcass, blood chemistry and caecal microbes of growing quail. A total of 270 Japanese quails at one-week-old were distributed to six equal groups; each group consisted of 45 unsexed birds with five replications (nine quails each). The 1st group was fed a basal diet, whereas the 2nd, 3rd, 4th, 5th and 6th groups were fed diets containing nano-curcumin (0.1, 0.2, 0.3, 0.4 and 0.5 g/kg diet, respectively). Nano-curcumin levels significantly increased (p ≤ 0.0001) body weight at 3 weeks and 5 weeks of age. Body weight gain during 1-3, 3-5 and 1-5 weeks of age was significantly increased (p < 0.0001) in groups treated with nano-curcumin levels (except at 0.3 g/kg; 1-3 weeks) compared to control. During 1 to 5 weeks, feed intake was decreased (p < 0.0001) in birds receiving nano-curcumin (0.1, 0.3 and 0.4 g/kg) diets. The best values of feed conversion ratio were recorded for the 0.4 g nano-curcumin-treated group. Carcass traits were not affected Nano-curcumin levels. The inclusion of nano-curcumin (0.2, 0.3 or 0.5 g/kg) significantly increased serum TP (p = 0.0004), albumin (p = 0.0078) and globulin (p < 0.0001). Quails fed with nano-curcumin (0.2 g/kg) exhibited the highest SOD and GSH activities, serum IgG and IgM concentrations and complement values compared to control. The addition of any level of nano-curcumin in the quail diet also significantly improved the lipid profile. In conclusion, supplemental nano-curcumin had beneficial impacts on growth, lipid profile, blood constituents, antioxidant indices, and immunity of growing quail, as well as increasing counts of lactic acid bacteria and reducing pathogenic bacteria.


Early experience of primary angioplasty at Waikato Hospital.
Acute angioplasty for myocardial infarction without prior thrombolytic therapy (primary angioplasty) has been advocated as the preferred treatment for high risk infarct patients, however data is primarily from highly experienced units. This report describes the first year's experience of primary angioplasty at Waikato Hospital which is a moderate sized institution performing 300 elective angioplasty procedures per year. Patients presenting with an acute infarction who were deemed to be either at high risk or who had a contraindication to streptokinase received primary angioplasty. The program operated 24 hours a day, 7 days a week with all procedural and clinical outcomes being prospectively recorded on a database. Fifty one patients underwent primary angioplasty in the first year. Vessel patency was achieved in 86%, with TIMI III flow present in 82%. Time from emergency room arrival to reperfusion averaged 95 minutes and median hospital length of stay was 5 days. Five (10%) patients died while in hospital: those in cardiogenic shock on presentation had a mortality of 33%, and the remainder 5%. These results suggest that primary angioplasty is logistically feasible in a moderate sized New Zealand hospital with clinical results similar to those reported by the large interventional centers in Europe and the USA.


A simple approach for assessing equilibrated Kt/V beta 2-M on a routine basis.
Large observational studies have shown a reduction in morbidity and mortality in patients on high-flux haemodialysis (HD) or convective techniques, compared with low-flux HD. An index to evaluate treatment efficiency in middle molecule (MM) removal would be recommended. Since beta-2-microglobulin (beta2-M) is a recognized MM marker, we evaluated an easy approach for Kt/V(beta2-M) assessment on a routine basis, avoiding other complex methods. An equation that estimates single-pool (sp) Kt/V(beta2-M) was derived from Leypoldt's formula, which calculates beta2-M dialyser clearance (K(beta2-M)) from the post/pre-dialysis beta2-M concentration (C(t)/C(0)) ratio and the weight loss/end-dialysis weight (Delta W/W) ratio. Our equation, spKt/V(beta2-M) = 6.12 Delta W/W [1 - ln(C(t)/C(0))/ln(1 + 6.12 Delta W/W)], was derived by assuming urea distribution volume (V(u)) as 49% of W and beta2-M volume (V(beta2-M)) as V(u)/3, in agreement with the average patient values in the HEMO Study. The spKt/V(beta2-M) values calculated with our equation (F) in 129 patients on 407 sessions of different high-flux treatments were compared with those calculated with the method applied in the HEMO Study (HM). Equilibrated beta2-M concentration (C(eq)) of the same sessions was also estimated with the equation for C(eq) by Tattersall, and equilibrated Kt/V (eKt/V(beta2-M)) was calculated by introducing Tattersall's equation into our simplified spKt/V(beta2-M) formula. Mean results of our spKt/V(beta2-M) equation (F) were very close to those of the HM method (1.48 +/- 0.38 vs 1.47 +/- 0.37). The difference was less than +/-0.1 in 95% of cases. A mean end-session beta2-M rebound of 44 +/- 14% was predicted, which caused a mean reduction in actual Kt/V(beta2-M) of ~27% (eKt/V(beta2-M) = 1.08 +/- 0.26). The method proposed to estimate spKt/V(beta2-M) and eKt/V(beta2-M) could become a simple tool to monitor the efficiency of high-flux HD and convective techniques and to evaluate the adequacy of treatments in terms of MM removal. Moreover, it might help to better understand the effects of different dialysis schedules. Validation on a larger dialysis population is required.


A unified view of the role of electrostatic interactions in modulating the gating of Cys loop receptors.
In the Cys loop superfamily of ligand-gated ion channels, a global conformational change, initiated by agonist binding, results in channel opening and the passage of ions across the cell membrane. The detailed mechanism of channel gating is a subject that has lent itself to both structural and electrophysiological studies. Here we defined a gating interface that incorporates elements from the ligand binding domain and transmembrane domain previously reported as integral to proper channel gating. An overall analysis of charged residues within the gating interface across the entire superfamily showed a conserved charging pattern, although no specific interacting ion pairs were conserved. We utilized a combination of conventional mutagenesis and the high precision methodology of unnatural amino acid incorporation to study extensively the gating interface of the mouse muscle nicotinic acetylcholine receptor. We found that charge reversal, charge neutralization, and charge introduction at the gating interface are often well tolerated. Furthermore, based on our data and a reexamination of previously reported data on gamma-aminobutyric acid, type A, and glycine receptors, we concluded that the overall charging pattern of the gating interface, and not any specific pairwise electrostatic interactions, controls the gating process in the Cys loop superfamily.


Lady with wings: a case report of giant neurofibromatosis type I.
Neurofibromatosis type I (NF-I) accounts for approximately 90% of neurofibromatosis. NF-I is an autosomal dominant genetic disease which results from the gene mutation of NF-I situated in chromosome 17q11.2. A 32-year-old lady presented with a giant wing like structure on her back which started growing from her childhood. A diagnosis of NF-I was confirmed as she presented with multiple cutaneous nodules, multiple café-au-lait macules of different sizes, scoliosis deformity, and positive family history of neurofibroma. Surgical excision of tumor and multiple Z plasty reconstruction of the back was carried out. The excised neurofibroma weighed 6.7 kg containing thickened nerves, nerve roots, and circuitous vessels. The histopathological report confirmed plexiform and diffuse type cutaneous neurofibroma without any malignant transformation. Surgical excision and reconstruction with regular follow-up is an excellent choice of treatment for such a giant neurofibroma as in this case. NF-I is a genetic disease which could present as a giant cutaneous neurofibroma. One of the treatment options for giant neurofibromas causing deformity and physical disability is by surgical excision and histopathological examination with regular follow-up for NF-I recurrence.


[Current knowledge on pathogenesis and pathologic anatomy of chronic obstructive pulmonary disease].
In smokers with chronic obstructive pulmonary disease (COPD), pathological changes can be found in the central airways, peripheral airways, lung parenchyma and pulmonary arteries. Interestingly, some of these changes can be already present in the lungs of smokers with normal lung function indicating that smoking itself is able to damage the lung even before airflow limitation occurs. The purpose of this paper is to describe the structural changes present in the lungs of smokers with normal lung function and those present in the lungs of smokers with COPD, in an attempt to underline the possible mechanisms contributing to airflow limitation in these patients. In addition we will review the few studies that described the structural changes that occur in severe COPD and those that occur during an exacerbation of the disease. Finally we will address the effect of smoking cessation or anti-inflammatory treatment in an attempt to investigate the potential reversibility of the pathologic lesions characteristic of COPD.


Nonvolatile magnetoelectric coupling in two-dimensional van der Waals sandwich heterostructure CuInP2S6/MnCl3/CuInP2S6.
Electrical control of magnetism is of great interest for low-energy-consumption spintronic applications. Due to the recent experimental breakthrough in two-dimensional materials, with the absence of hanging bonds on the surface and strong tolerance for lattice mismatch, heterogeneous integration of different two-dimensional materials provides a new opportunity for coupling between different physical properties. Here, we report the realization of nonvolatile magnetoelectric coupling in vdW sandwich heterostructure CuInP2S6/MnCl3/CuInP2S6. Using first-principles calculations, we reveal that when interfacing with ferroelectric CuInP2S6, the Dirac half-metallic state of monolayer MnCl3 will be destroyed. Moreover, depending on the electrically polarized direction of CuInP2S6, MnCl3 can be a half-metal or a ferromagnetic semiconductor. We unveil that the obtained ferromagnetic semiconductor in MnCl3 can be attributed to the different gain and loss of electrons on the two adjacent Mn atoms due to the sublattice symmetry broken by interlayer coupling. The effects of interfacial magnetoelectric coupling on magnetic anisotropy and ferromagnetic Curie temperature of MnCl3 are also investigated, and a multiferroic memory based on this model is designed. Our work not only provides a promising way to design nonvolatile electrical control of magnetism but also renders monolayer MnCl3 an appealing platform for developing low-dimensional memory devices.


Prediction of preterm delivery using plasma corticotrophin-releasing hormone and other biochemical variables.
Preterm delivery is responsible for the vast majority of neonatal mortality in developed countries and is also associated with substantial long-term morbidity. The incidence of preterm birth remains between 6-10% despite many advances in our understanding of the physiology of human parturition. Biochemical markers have been used in an attempt to identify more accurately those women, amongst high and low-risk groups who will deliver preterm, from their counterparts who will go on to deliver at term. Only by accurately identifying those women early, who will eventually deliver preterm, will specific interventions be able to be used in order to try and treat the cause or delay delivery until a safer time for the fetus. The clinical utility of these markers when used alone in an unselected population remains limited. As our understanding of the pathophysiology of preterm delivery improves, the challenge lies for researchers to combine these markers in the most effective way to unravel the complex biological system of parturition and improve the predictive capability of a biochemical test for prematurity.


[Osteosynthesis and radiotherapy of the proximal femur: report of 6 cases].
Post-radiation shaft fractures of long bones are uncommon. Late or partial healing increases the risk of stress fracture. Different fixation techniques have been proposed. Treatment of radiated bone is difficult. We report a series of 6 nonunions of the proximal femur after radiotherapy. Three patients had true fractures of irradiated bones several years after radiotherapy for bone or soft tissue tumors. Three other patients had pathological fractures or malignant osteolysis related to a myeloma and treated by osteosynthesis and post-operative radiotherapy. Treatment required a total of 19 surgical procedures. There were nine stress fractures of ostheosynthesis material involving locked nails, cervicodiaphyseal nails and plates. There were no vascularized grafts in this series. At last follow-up the pathological fracture had healed in three cases, was stable but not healed in two, and required prosthetic reconstruction in one. We emphasize the importance of rigorous patient selection for radiotherapy and the possible preventive effect of osteosynthesis in certain cases with a high risk of secondary fracture of an irradiated bone. Vascularized grafts may be useful for refractory nonunion and may be proposed as first line treatment for post-radiation fractures.


Elevated vacuum suspension preserves residual-limb skin health in people with lower-limb amputation: Randomized clinical trial.
A growing number of clinical trials and case reports support qualitative claims that use of an elevated vacuum suspension (EVS) prosthesis improves residual-limb health on the basis of self-reported questionnaires, clinical outcomes scales, and wound closure studies. Here, we report first efforts to quantitatively assess residual-limb circulation in response to EVS. Residual-limb skin health and perfusion of people with lower-limb amputation (N = 10) were assessed during a randomized crossover study comparing EVS with nonelevated vacuum suspension (control) over a 32 wk period using noninvasive probes (transepidermal water loss, laser speckle imaging, transcutaneous oxygen measurement) and functional hyperspectral imaging approaches. Regardless of the suspension system, prosthesis donning decreased perfusion in the residual limb under resting conditions. After 16 wk of use, EVS improved residual-limb oxygenation during treadmill walking. Likewise, prosthesis-induced reactive hyperemia was attenuated with EVS following 16 wk of use. Skin barrier function was preserved with EVS but disrupted after control socket use. Taken together, outcomes suggest chronic EVS use improves perfusion and preserves skin barrier function in people with lower-limb amputation. ClinicalTrials.gov; "Evaluation of limb health associated with a prosthetic vacuum socket system": NCT01839123; https://clinicaltrials.gov/ct2/show/NCT01839123?term=NCT01839123&rank=1.


Tri-amelia and phocomelia with multiple malformations resembling Roberts syndrome in a fetus: is it a variant or a new syndrome?
Roberts-SC phocomelia syndrome is a rare autosomal recessive disorder characterized by morphological anomalies such as limb defects and midfacial clefting, and by premature centromeric division in chromosomal study. Although it has been regarded as a single genetic entity and includes various morphologic defects, babies are being reported nowadays with severe facial defects, tetra-amelia, and pulmonary abnormality, yet with normal chromosomal findings. We have added a case resembling Roberts syndrome with various congenital anomalies. A gestation with a fetus was terminated at 24 weeks of gestational age because of multiple fetal anomalies. Postmortem examination revealed a severe mid-facial cleft, tri-amelia and phocomelia, multiple encephaloceles, protruding and hypoteloric eyes, low-set ears, atrial septal defect of ostium secundum type, patent ductus arteriosus, bilateral two-lobed lungs with incomplete lobation, multiple visceral anomalies, a penis without scrotum, abnormal dermoglyphics, and absence of nipples.


Let's stick together: Infection enhances preferences for social grouping in a songbird species.
Acute infections can alter foraging and movement behaviors relevant to sociality and pathogen spread. However, few studies have directly examined how acute infections caused by directly transmitted pathogens influence host social preferences. While infected hosts often express sickness behaviors (e.g., lethargy) that can reduce social associations with conspecifics, enhanced sociality during infection might be favored in some systems if social grouping improves host survival of infection. Directly assaying social preferences of infected hosts is needed to elucidate potential changes in social preferences that may act as a form of behavioral tolerance (defined as using behavior to minimize fitness costs of infection). We tested how infection alters sociality in juvenile house finches (Haemorhous mexicanus), which are both highly gregarious and particularly susceptible to infection by the bacterial pathogen Mycoplasma gallisepticum (MG). We inoculated 33 wild-caught but captive-held juvenile house finches with MG or media (sham control). At peak infection, birds were given a choice assay to assess preference for associating near a flock versus an empty cage. We then repeated this assay after all birds had recovered from infection. Infected birds were significantly more likely than controls to spend time associating with, and specifically foraging near, the flock. However, after infected birds had recovered from MG infection, there were no significant differences in the amount of time birds in each treatment spent with the flock. These results indicate augmented social preferences during active infection, potentially as a form of behavioral tolerance. Notably, infected birds showed strong social preferences regardless of variation in disease severity or pathogen loads, with 14/19 harboring high loads (5-6 log10 copies of MG) at the time of the assay. Overall, our results show that infection with a directly transmitted pathogen can augment social preferences, with important implications for MG spread in natural populations.


[Application Effect of Four Typical Submerged Macrophytes on Removing Cadmium from Polluted Sediment].
In this study, four typical submerged macrophytes, namely Hydrilla verticillata, Elodea canadensis, Potamogeton crispus, and Ceratophyllum demersum, were tested for their chlorophyll content and antioxidant enzyme activity, to analyze their cadmium tolerance. The biota-sediment accumulation factor (BSAF) and plant transport factor (TF) were utilized to understand the accumulation capacity of the plants. Finally, the distribution of cadmium in submerged macrophytes was revealed through phytohistochemical methods, to provide theoretical support for the practical application of submerged macrophytes. The results showed that three of the plants, excluding C. demersum, exhibited varying tolerances to cadmium pollution in sediments, among which the tolerance of H. verticillata and E. canadensis were the strongest. P. crispus had the strongest accumulation capacity (BSAF was 2.32) at relatively low pollution levels (≤20 mg·kg-1). In this study, because of its weak root system, the BSAF of C. demersum was less than 1.0, indicating that macrophyte roots play an important role in phytoremediation of Cd-contaminated sediments. Comparing the TF of different plants, it can be found that the roots of H. verticillata had the strongest above-ground cadmium transport capacity, while P. crispus mainly accumulated cadmium in its roots. At the same time, when the cadmium concentration was 50 mg·kg-1, cadmium was found to be evenly distributed in the stem organelles of P. crispus, in contrast to the other plants. Based on the cadmium tolerance and accumulation mechanism of the plants, and in consideration of real-world factors, H. verticillata and P. crispus were selected as ideal plants for repairing cadmium-containing sediments. Meanwhile, based on the different transport capabilities of plants, it is recommended that only the above-ground part of H. verticillate should be removed, while P. crispus should be uprooted regularly.


Disparities in the use of antineoplastic immunotherapy in pediatric malignant adrenal tumors.
Dinutuximab is a costly life-prolonging immunotherapy for high-risk neuroblastoma. We used a large pediatric inpatient database to analyze the use of antineoplastic immunotherapy in patients with malignant adrenal tumors 1 year after Food and Drug Administration approval of dinutuximab for high-risk neuroblastoma. On multivariate modeling, children of Black race (odds ratio [OR] 0.62, P = .04; referent non-Black) and the lowest ZIP code income quartile (OR 0.74, P = .03; referent wealthier 3 quartiles) were significantly less like to receive antineoplastic immunotherapy. These results suggest substantial disparities in the distribution of a vital therapy in children with advanced cancer.


TAK1 regulates reactive oxygen species and cell death in keratinocytes, which is essential for skin integrity.
Mice with a keratinocyte-specific deletion of Tak1 exhibit severe skin inflammation due to hypersensitivity to tumor necrosis factor (TNF) killing. Here we have examined the mechanisms underlying this hypersensitivity. We found that TAK1 deficiency up-regulates reactive oxygen species (ROS) resulting in cell death upon TNF or oxidative stress challenge. Because blockade of NF-kappaB did not increase ROS or did not sensitize cells to oxidative stress in keratinocytes TAK1 regulates ROS mainly through the mechanisms other than those mediated by NF-kappaB. We found that c-Jun was decreased in TAK1-deficient keratinocytes and that ectopic expression of c-Jun could partially inhibit TNF-induced increase of ROS and cell death. Finally, we show that, in an in vivo setting, the antioxidant treatment could reduce an inflammatory condition in keratinocyte-specific Tak1 deletion mice. Thus, TAK1 regulates ROS partially through c-Jun, which is important for preventing ROS-induced skin inflammation.


Merging Photoredox with Brønsted Acid Catalysis: The Cross-Dehydrogenative C-O Coupling for sp3 C-H Bond Peroxidation.
A photoredox and Brønsted acid synergistically catalyzed cross-dehydrogenative C-O coupling reaction is developed in which isochroman peroxyacetals are formed through sp3 C-H bond peroxidation. The reported method is characterized by its extremely mild reaction conditions, excellent yields, and broad substrate scope. An oxocarbenium ion p-chlorobenzenesulfonate was speculated to be the reactive intermediate. The role of hemiacetals and oxygenated dimers on the effective stabilization of the oxocarbenium ion was investigated; the presence of acid appeared to establish equilibrium between hemiacetals and oxygenated dimers with the oxocarbenium ion pairs. The broad applicability of the method highlights the potential of the protocol for molecule synthesis.


Effects of surgery and general anaesthesia on sleep-wake timing: CLOCKS observational study.
Surgery and general anaesthesia have the potential to disturb the body's circadian timing system, which may affect postoperative outcomes. Animal studies suggest that anaesthesia could induce diurnal phase shifts, but clinical research is scarce. We hypothesised that surgery and general anaesthesia would result in peri-operative changes in diurnal sleep-wake patterns in patients. In this single-centre prospective cohort study, we recruited patients aged ≥18 years scheduled for elective surgery receiving ≥30 min of general anaesthesia. The Munich Chronotype Questionnaire and Pittsburgh Sleep Quality Index were used to determine baseline chronotype, sleep characteristics and sleep quality. Peri-operative sleeping patterns were logged. Ninety-four patients with a mean (SD) age of 52 (17) years were included; 56 (60%) were female. The midpoint of sleep (SD) three nights before surgery was 03.33 (55 min) and showed a phase advance of 40 minutes to 02.53 (67 min) the night after surgery (p < 0.001). This correlated with the midpoint of sleep three nights before surgery and was not associated with age, sex, duration of general anaesthesia or intra-operative dexamethasone use. Peri-operatively, patients had lower subjective sleep quality and worse sleep efficiency. Disruption started from one night before surgery and did not normalise until 6 days after surgery. We conclude that there is a peri-operative phase advance in midpoint of sleep, confirming our hypothesis that surgery and general anaesthesia disturb the circadian timing system. Patients had decreased subjective sleep quality, worse sleep efficiency and increased daytime fatigue.


Effects of correcting in situ ruminal microbial colonization of feed particles on the relationship between ruminally undegraded and intestinally digested crude protein in concentrate feeds.
In situ estimates of ruminally undegraded protein (RUP) and intestinally digested protein (IDP) of ten concentrates, uncorrected or corrected for the ruminal microbial colonization, were used to examine the effects of this correction on the relationship between IDP and RUP values. Both variables were established for three rumen and duodenum cannulated wethers using 15 N labeling-techniques and considering measured rates of ruminal particle comminution (kc ) and outflow (kp ). A covariance analysis showed that the close relationship found between both variables (IDP = -0.0132 ± 0.00679 + 0.776 ± 0.0002 RUP; n = 60; P < 0.001; r = 0.960) is not affected by correcting for microbial colonization (P = 0.682). The IDP content in concentrates and industrial by-products can be predicted from RUP values, thus avoiding the laborious and complex procedure of determining intestinal digestibility; however, a larger sample of feeds is necessary to achieve more accurate predictions. The lack of influence of the correction for microbial contamination on the prediction observed in the present study increases the data available for this prediction. However, only the use of corrected values may provide an accurate evaluation. © 2017 Society of Chemical Industry.


Oxatomide in the treatment of pruritus senilis. A double-blind placebo-controlled trial.
The antiallergic drug oxatomide was evaluated in a double-blind placebo-controlled study in 35 patients with pruritus senilis. The trial was run in the wintertime, and the patients were orally given either 30 mg oxatomide b.i.d. (n = 19) or a placebo (n = 16) for 2 months. Complete suppression or marked improvement of the complaints was experienced by 79% of the patients given oxatomide and by 31% of the control patients. Oxatomide was superior to the placebo in reducing both the duration and the severity of itching. The need of additional topical medication was higher in the placebo group. Somnolence and cramps were each reported by 1 oxatomide-treated patient.


Exosomes derived from HBV-associated liver cancer promote chemoresistance by upregulating chaperone-mediated autophagy.
Liver cancer, which is the second leading cause of tumor-associated mortality, is of great concern worldwide due to its resistance to chemotherapeutic drugs. Transcatheter arterial chemoembolization (TACE) has previously been used as a treatment for unresectable liver tumors in China; however, the response to TACE treatment differs between patients. It has been reported that hepatitis B virus (HBV)-as sociated tumors are less sensitive to TACE treatment compared with non-HBV-associated liver cancer. Previous studies have demonstrated that exosomes serve a crucial role in hepatic carcinoma chemoresistance. We therefore hypothesized that HBV may modulate chemosensitivity via exosomes. The aim of the present study was to investigate how exosomes affect chemoresistance by assessing their role in chaperone-mediated autophagy (CMA)-dependent chemoresistance in HBV-associated liver cancer. Iconography data from HBV-positive and HBV-negative patients with hepatic carcinoma receiving TACE treatment were assessed, and it was revealed that the tumor volume was decreased in the patients with non-HBV-associated liver cancer compared with that in the patients with HBV-associated tumors following TACE therapy. Furthermore, it was revealed that exosomes from HBV-infected liver cancer cells were able to downregulate cell apoptosis when treated with oxaliplatin compared with exosomes from normal HepG2 cells. Furthermore, the results demonstrated that HBV-associated exosomes modulate cell death via activating the CMA pathway, and its key molecule, lysosome-associated membrane protein (Lamp2a), was also upregulated. Lamp2a-knockdown was also found to reverse anti-apoptotic effects in liver cancer. Taken together, the results of the present study suggest that chemoresistance in patients with HBV-associated hepatic tumors may be mediated by exosomes, and thus may provide a basis for the development of novel treatment strategies for chemoresistant liver cancer.


Development of real-time and lateral flow dipstick recombinase polymerase amplification assays for rapid detection of goatpox virus and sheeppox virus.
Goatpox virus (GTPV) and sheeppox virus (SPPV), which belong to the Capripoxvirus (CaPV), are economically important pathogens of small ruminants. Therefore, a sensitive, specific and rapid diagnostic assay for detection of GTPV and SPPV is necessary to accurately and promptly control these diseases. Recombinase polymerase amplification (RPA) assays combined with a real-time fluorescent detection (real-time RPA assay) and lateral flow dipstick (RPA LFD assay) were developed targeting the CaPV G-protein-coupled chemokine receptor (GPCR) gene, respectively. The sensitivity of both CaPV real-time RPA assay and CaPV RPA LFD assay were 3 × 102 copies per reaction within 20 min at 38 °C. Both assays were highly specific for CaPV, with no cross-reactions with peste des petits ruminants virus, foot-and-mouth disease virus and Orf virus. The evaluation of the performance of these two assays with clinical sample (n = 107) showed that the CaPV real-time RPA assay and CaPV RPA LFD assay were able to specially detect SPPV or GTPV present in samples of ovine in liver, lung, kidney, spleen, skin and blood. This study provided a highly time-efficient and simple alternative for rapid detection of GTPV and SPPV.


Altered Metabolism in Alzheimer Disease Brain: Role of Oxidative Stress.
Significance: Alzheimer disease (AD) is an all-too-common condition in the aging population. However, aging does not automatically equal neurodegeneration and memory decline. Recent Advances: This review article involves metabolic changes in the AD brain that are related to oxidative stress. Selected pathways are identified as potential targets for intervention in AD. Critical Issues: One of the main factors of AD is the oxidative imbalance within the central nervous system, causing a disruption in metabolic processes. Reactive oxygen species (ROS) are a natural consequence of many cellular processes, especially those associated with mitochondria, such as the electron transport chain. Some ROS, when kept under control and maintained at reasonable levels, often play roles in cell signaling. The cellular damage of ROS arises when oxidative imbalance occurs, in which case ROS are not controlled, leading to a myriad of alterations in cellular metabolic processes. These altered pathways include, among others, dysfunctional glycolysis, calcium regulation, lipid metabolism, mitochondrial processes, and mammalian target of rapamycin pathway dysregulation. Future Directions: Understanding how ROS can lead to these alterations can, ideally, elucidate therapeutic options for retarding AD progression in the aging population. Antioxid. Redox Signal. 36, 1289-1305.


Antithrombin deficiency: A pediatric disorder.
Hereditary antithrombin (AT) deficiency is an autosomal dominant thrombophilic disorder. Guidelines do not support routine testing of children based on personal or familial thrombosis. To investigate clinical, genetic and laboratory profiles of AT deficient children and their affected family members. Data were analyzed from a prospective cohort of pediatric patients with AT deficiency. The SERPINC1 gene was sequenced for all individuals with available DNA. AT, thromboelastography (TEG), calibrated automated thrombogram (CAT), D-dimer, thrombin-antithrombin complex (TAT) and factor VIII activity were performed on patient samples. Thirty-six individuals from 11 families had AT deficiency (activities 45-70 U/dL) with incident thrombosis in 13 children and 10 adults (64% overall). Three neonates presented with middle cerebral artery and/or aortic occlusions with inferior vena cava and cerebral or renal vein thromboses in 2 of the 3. Two pre-pubertal children were symptomatic, one with cerebral venous sinus thrombosis who suffered recurrent arterial and venous thrombi. Both Type I and Type II AT deficiencies conferred a high severity of thromboses. Heterozygous SERPINC1 mutations were identified in seven families; three were novel, resulting in missense, splice site and frameshift alterations. Thrombin generation (CAT) was increased in all asymptomatic affected patients including 9 children and 1 adult. Genetic AT deficiency often presents in infants and children, warranting laboratory evaluation based on personal and family history. Increased thrombin generation was detected in all asymptomatic children and adults, suggesting a possible role in detecting and monitoring individuals at risk for thrombosis.


In-line phase-contrast breast tomosynthesis: a phantom feasibility study at a synchrotron radiation facility.
The major objective is to adopt, apply and test developed in-house algorithms for volumetric breast reconstructions from projection images, obtained in in-line phase-contrast mode. Four angular sets, each consisting of 17 projection images obtained from four physical phantoms, were acquired at beamline ID17, European Synchroton Radiation Facility, Grenoble, France. The tomosynthesis arc was ±32°. The physical phantoms differed in complexity of texture and introduced features of interest. Three of the used phantoms were in-house developed, and made of epoxy resin, polymethyl-methacrylate and paraffin wax, while the fourth phantom was the CIRS BR3D. The projection images had a pixel size of 47 µm × 47 µm. Tomosynthesis images were reconstructed with standard shift-and-add (SAA) and filtered backprojection (FBP) algorithms. It was found that the edge enhancement observed in planar x-ray images is preserved in tomosynthesis images from both phantoms with homogeneous and highly heterogeneous backgrounds. In case of BR3D, it was found that features not visible in the planar case were well outlined in the tomosynthesis slices. In addition, the edge enhancement index calculated for features of interest was found to be much higher in tomosynthesis images reconstructed with FBP than in planar images and tomosynthesis images reconstructed with SAA. The comparison between images reconstructed by the two reconstruction algorithms shows an advantage for the FBP method in terms of better edge enhancement. Phase-contrast breast tomosynthesis realized in in-line mode benefits the detection of suspicious areas in mammography images by adding the edge enhancement effect to the reconstructed slices.


Nutritional properties of starch in buckwheat noodles.
Buckwheat noodles were studied to identify the possibility of reduced starch hydrolysis rate and glucose release after the ingestion of buckwheat meals, in comparison to the wheat-based meals. The rate of starch hydrolysis and the resistant starch (RS) formation in boiled buckwheat noodles (BWN), boiled wheat noodles (WN), boiled buckwheat groats (BWG), and white wheat bread (WB) were evaluated in vitro. The highest content of RS (total starch basis) was found in boiled BWG (6%), compared with the BWN (3.4%), WN (2.1%), and WB (0.8%). The rate of in vitro amylolysis was significantly reduced (p<0.05) in both studied buckwheat products in comparison to the reference WB. The calculated hydrolysis index (HI) was lower in BWN (61) in comparison to WN (71), but higher in comparison to boiled BWG (50). It is confirmed that BWN have some potential in diets designed in accordance with the dietary recommendations for diabetic patients and for healthy subjects.


Roles of pyruvate carboxylase in human diseases: from diabetes to cancers and infection.
Pyruvate carboxylase (PC), an anaplerotic enzyme, plays an essential role in various cellular metabolic pathways including gluconeogenesis, de novo fatty acid synthesis, amino acid synthesis, and glucose-induced insulin secretion. Deregulation of PC expression or activity has long been known to be associated with metabolic syndrome in several rodent models. Accumulating data in the past decade clearly showed that deregulation of PC expression is associated with type 2 diabetes in humans, while targeted inhibition of PC expression in a mouse model reduced adiposity and improved insulin sensitivity in diet-induced type 2 diabetes. More recent studies also show that PC is strongly involved in tumorigenesis in several cancers, including breast, non-small cell lung cancer, glioblastoma, renal carcinoma, and gall bladder. Systems metabolomics analysis of these cancers identified pyruvate carboxylation as an essential metabolic hub that feeds carbon skeletons of downstream metabolites of oxaloacetate into the biosynthesis of various cellular components including membrane lipids, nucleotides, amino acids, and the redox control. Inhibition or down-regulation of PC expression in several cancers markedly impairs their growth ex vivo and in vivo, drawing attention to PC as an anti-cancer target. PC has also exhibited a moonlight function by interacting with immune surveillance that can either promote or block viral infection. In certain pathogenic bacteria, PC is essential for infection, replication, and maintenance of their virulence phenotype.


Two New Tools for Glycopeptide Analysis Researchers: A Glycopeptide Decoy Generator and a Large Data Set of Assigned CID Spectra of Glycopeptides.
The glycopeptide analysis field is tightly constrained by a lack of effective tools that translate mass spectrometry data into meaningful chemical information, and perhaps the most challenging aspect of building effective glycopeptide analysis software is designing an accurate scoring algorithm for MS/MS data. We provide the glycoproteomics community with two tools to address this challenge. The first tool, a curated set of 100 expert-assigned CID spectra of glycopeptides, contains a diverse set of spectra from a variety of glycan types; the second tool, Glycopeptide Decoy Generator, is a new software application that generates glycopeptide decoys de novo. We developed these tools so that emerging methods of assigning glycopeptides' CID spectra could be rigorously tested. Software developers or those interested in developing skills in expert (manual) analysis can use these tools to facilitate their work. We demonstrate the tools' utility in assessing the quality of one particular glycopeptide software package, GlycoPep Grader, which assigns glycopeptides to CID spectra. We first acquired the set of 100 expert assigned CID spectra; then, we used the Decoy Generator (described herein) to generate 20 decoys per target glycopeptide. The assigned spectra and decoys were used to test the accuracy of GlycoPep Grader's scoring algorithm; new strengths and weaknesses were identified in the algorithm using this approach. Both newly developed tools are freely available. The software can be downloaded at http://glycopro.chem.ku.edu/GPJ.jar.


Efficacy of olopatadine ophthalmic solution 0.2% in reducing signs and symptoms of allergic conjunctivitis.
Olopatadine hydrochloride ophthalmic solution 0.2% (Pataday, Alcon) is a new formulation of olopatadine hydrochloride ophthalmic solution, the first topical ocular antiallergic agent indicated for once-daily dosing. The aim of this study was to evaluate the safety, efficacy, onset, and duration of action of olopatadine 0.2% in the treatment of allergic conjunctivitis. Using the conjunctival allergen challenge, this double-masked, randomized by eye, parallel-group study included four visits over a 5-week period. Subjects were screened for eligibility (visit 1) and their ocular allergic responses were confirmed at visit 2. The efficacy of olopatadine in reducing the signs and symptoms of allergic conjunctivitis was evaluated at onset of action (visit 4) and 16 hours (visit 3) after masked medication instillation. The primary efficacy parameter was ocular itching. Safety parameters were also evaluated. Ninety subjects were evaluated. Olopatadine 0.2% was significantly (p < 0.001) more effective than placebo in the treatment of ocular itching at all time points at both the onset of action and the 16-hour allergen challenges. Olopatadine 0.2% was significantly (p < 0.03) more effective than placebo in the reduction of conjunctival redness, chemosis, and eyelid swelling at all time points (with the exception of conjunctival redness, which was significantly reduced at five of six time points). There were no serious adverse events and no treatment-related adverse events. Once-daily dosing with olopatadine 0.2% reduced the signs and symptoms of allergic conjunctivitis with a rapid and prolonged duration of action. Safety analyses indicated that olopatadine 0.2% was safe and well tolerated in subjects with a history of allergic conjunctivitis.


Fractures of the neck of the fifth metacarpal bone, treated by percutaneous intramedullary nailing: surgical technique, radiological and clinical results study (28 cases).
This study report the results in 28 patients affected by closed fractures of the neck of the fifth metacarpal bone (boxer's fracture), treated with percutaneous elastic intramedullary nailing using a single wire, to verify the effectiveness of this surgical treatment. We reviewed the results of 28 patients treated with A single Kirschner wire (K-wire) pre-bent in a lazy-S fashion with a mild bend at approximately 5 millimeters, The K-wire is inserted blunt end first in an antegrade manner and the fracture reduced as the wire is passed across the fracture site The wire is usually removed with pliers post-operatively at four weeks in the fracture clinic. The follow-up period averaged of 20,75 months. The parameters evaluated included angulation, rotational alignment, postoperative metacarpophalangeal (MCP) range of motion, and time to union. We opted for this treatment in all cases, regardless volar angulation of the metacarpal head, malrotation of the fifth finger and associated or/no with a severe swelling of the hand. All the patients were reviewed clinically and radiologically at an average of 20,75 months after surgery. At the final follow-up, no patient reported residual pain and All fractures proceeded to bony union but we have one fracture had to be revised for failed fixation and three superficial wound infections needed antibiotic treatment. We recommend that this minimally invasive: percutaneous intramedullary nailing using a single k-wire in all metacarpal neck fracture (boxers' fractures), especially when severe swelling of the hand is present, with good functional results and low morbidity.


Layer-by-layer-assembled high-performance broadband antireflection coatings.
Nanoparticles are indispensable ingredients of solution-processed optical, dielectric, and catalytic thin films. Although solution-based methods are promising low-cost alternatives to vacuum methods, they can have significant limitations. Coating uniformity, thickness control, roughness control, mechanical durability, and incorporation of a diverse set of functional organic molecules into nanoparticle thin films are major challenges. We have used the electrostatic layer-by-layer assembly technique to make uniform, conformal multistack nanoparticle thin films for optical applications with precise thickness control over each stack. Two particularly sought-after optical applications are broadband antireflection and structural color. The effects of interstack and surface roughness on optical properties of these constructs (e.g., haze and spectral response) have been studied quantitatively using a combination of Fourier-transform methods and atomic force microscopy measurements. Deconvoluting root-mean-square roughness into its large-, intermediate-, and small-scale components enables enhanced optical simulations. A 4-stack broadband antireflection coating (<0.5% average reflectance in the visible range, and 0.2% haze) composed of alternating high-index (n approximately 1.96) and low-index (n approximately 1.28) stacks has been made on glass substrate. Films calcinated at 550 degrees C endure a one-hour-long cloth cleaning test under 100 kPa normal stress.


Model of reversible cerebral ischemia in a monkey model.
We have developed a model of reversible cerebral ischemia in a high-level nonhuman primate. By using endovascular techniques, the posterior cerebral artery is permanently occluded with coils, and the ipsilateral middle cerebral artery is temporarily occluded with a balloon. The balloon can be deflated and/or removed to reestablish flow at precise time intervals. Functional imaging of the brain can be performed during occlusion and reperfusion, since the balloon can be deflated or removed in a scanner.


Preoperative pharmacological management of phaeochromocytoma.
Phaeochromocytoma is a rare catecholamine-secreting neuroendocrine tumour with a high cardiovascular morbidity and mortality if left untreated. Surgical resection is the only curative therapy. During surgery there is a high risk of massive release of catecholamines, which can result in potentially fatal hypertensive crises and cardiac arrhythmias. Administration of vasoactive drugs such as (non)selective alpha- and beta-antagonists and calcium channel blocking agents have reduced the operation risk. Guidelines for the preoperative medical management of the patient with a phaeochromocytoma are mainly based on retrospective studies and case reports. We reviewed the relevant literature on this subject. In addition, we compared the several preoperative treatment protocols of the eight university medical centres in the Netherlands.


Disability syndrome: the effects of early vs delayed rehabilitation intervention.
1. Disability syndrome occurs when an individual with a work related injury or other disability chooses not to work when it has been medically determined that they are capable of doing so. 2. A possible contributor to the development of disability syndrome includes systems reinforcers or rules that discourage return to work. For example, many attorneys discourage early return to work or modified duty. 3. Early intervention by rehabilitation counselors at the time of injury can facilitate a positive attitude and empower the worker to resist the negative effect of systems reinforcers that discourage early return to work.


Core beliefs in dieters and eating disordered women.
The current study aimed to investigate the difference in the levels of core beliefs between eating disordered women and those who showed milder forms of symptomatology. Thirty-five eating disordered women, 16 symptomatic dieters, 39 normal dieters and 34 non-clinical comparison women completed questionnaires measuring eating symptomatology (Eating Disorders Inventory [EDI]), core beliefs (Young Schema Questionnaire [YSQ]), depression (The Beck Depression Inventory-II [BDI-II]) and self-esteem (Rosenberg Self-Esteem Inventory [RSE]). With the exception of Entitlement beliefs, there were significant differences in the levels of core beliefs across all four groups. In particular, symptomatic dieters and eating disordered women differed on 8 YSQ subscales despite showing very similar level of eating symptomatology. The current findings lend support to the discontinuity model that suggests that there are fundamental differences between women with a clinical eating disorder and those with milder eating psychopathology. The clinical and research implications of the present results were discussed.


Treatment of pediatric obesity using a parent-only approach: a case example.
There is a great need for solution-oriented studies and descriptions of interventions for pediatric obesity in real-world settings. This report describes a group-based behavioral parent-only intervention to promote healthier lifestyle habits and reduce weight status in an obese 12-year-old female participant. The behavioral parent-only intervention program described was part of a randomized controlled trial that evaluated the impact of 2 behavioral interventions that addressed dietary intake, physical activity, and weight status in overweight and obese youth living in rural settings. Both the child and parent were targeted for behavior change. The intervention included 12 group sessions over 4 months. Behavioral strategies, including self-monitoring, goal setting, performance feedback, reinforcement, stimulus control, and instruction in behavioral parenting strategies were flexibly applied to meet the needs of the family. Assessments were completed at baseline, month-4 posttreatment, and month-10 follow-up. The parent attended 10 of 12 treatment sessions. At follow-up the child had lost 17 pounds and grew 1.7 in. in height. The child also experienced improved quality of dietary intake and a drop in the number of self-reported unhealthy weight control behaviors. The parent experienced no notable decrease or increase in BMI. The report describes the successful application of a behavioral intervention to address pediatric obesity that uses a parent-only approach. It is hoped that this presentation will facilitate discussion and help encourage further presentations of how the flexible application of evidenced-based interventions can be applied in real-world settings.


Investigating a multigene prognostic assay based on significant pathways for Luminal A breast cancer through gene expression profile analysis.
The present study aimed to investigate potential recurrence-risk biomarkers based on significant pathways for Luminal A breast cancer through gene expression profile analysis. Initially, the gene expression profiles of Luminal A breast cancer patients were downloaded from The Cancer Genome Atlas database. The differentially expressed genes (DEGs) were identified using a Limma package and the hierarchical clustering analysis was conducted for the DEGs. In addition, the functional pathways were screened using Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses and rank ratio calculation. The multigene prognostic assay was exploited based on the statistically significant pathways and its prognostic function was tested using train set and verified using the gene expression data and survival data of Luminal A breast cancer patients downloaded from the Gene Expression Omnibus. A total of 300 DEGs were identified between good and poor outcome groups, including 176 upregulated genes and 124 downregulated genes. The DEGs may be used to effectively distinguish Luminal A samples with different prognoses verified by hierarchical clustering analysis. There were 9 pathways screened as significant pathways and a total of 18 DEGs involved in these 9 pathways were identified as prognostic biomarkers. According to the survival analysis and receiver operating characteristic curve, the obtained 18-gene prognostic assay exhibited good prognostic function with high sensitivity and specificity to both the train and test samples. In conclusion the 18-gene prognostic assay including the key genes, transcription factor 7-like 2, anterior parietal cortex and lymphocyte enhancer factor-1 may provide a new method for predicting outcomes and may be conducive to the promotion of precision medicine for Luminal A breast cancer.


Risk Factors for Gastric Tumorigenesis in Underlying Gastric Mucosal Atrophy.
Atrophic gastritis is considered a premalignant lesion. We aimed to evaluate the risk factors for gastric tumorigenesis in underlying mucosal atrophy. A total of 10,185 subjects who underwent upper gastrointestinal endoscopy between 2003 and 2004 were enrolled in this retrospective cohort study. Follow-up endoscopy was performed between 2005 and 2014. Atrophic gastritis and intestinal metaplasia were assessed by endoscopy using the Kimura-Takemoto classification. Helicobacter pylori infection was evaluated based on serum immunoglobulin G antibody levels, the rapid urease test, or the urea breath test. Atrophic gastritis was confirmed in 3,714 patients at baseline; 2,144 patients were followed up for 6.9 years, and 1,138 exhibited increased atrophy. A total of 69 subjects were diagnosed with gastric neoplasm during follow-up (35 adenoma and 34 carcinoma). Age ≥55 years (hazard ratio [HR], 1.234), alcohol consumption (HR, 1.001), and H. pylori infection (HR, 1.580) were associated with increased mucosal atrophy. The risk factors for gastric neoplasm in underlying mucosal atrophy were age ≥55 years (HR, 2.582), alcohol consumption (HR, 1.003), extent of mucosal atrophy (HR, 2.285 in C3-O1; HR, 4.187 in O2-O3), and intestinal metaplasia (HR, 2.655). Extent of atrophy, intestinal metaplasia, and alcohol consumption are significant risk factors for gastric neoplasm in underlying mucosal atrophy.


Follicle-stimulating hormone receptors in oocytes?
The regulatory mechanisms of oocyte maturation remain poorly understood. Although gonadotropins play a major role in these processes, they have generally been considered to act on somatic supportive cells, but not directly on germ cells. We have raised high affinity monoclonal antibodies against LH and FSH receptors. When using the latter to study receptor distribution in human and pig ovaries we have observed the presence of FSH (but not LH) receptors in the oocytes. FSH receptors appeared in the oocytes of primary follicles during follicular development and persisted up to the preovulatory stage. In denuded human preovulatory oocytes, FSH receptor mRNA was detected at a concentration per cell exceeding by about 20-fold that present in granulosa cells. Saturable binding of [(125)I]FSH to the membrane of oocytes was demonstrated by autoradiography. When incubated with FSH, denuded oocytes responded by a mobilization of Ca(2+). These observations concur to demonstrate the presence of functional FSH receptors in oocytes and raise the possibility of direct control of oocyte development by FSH.


HIF1α-associated circDENND4C Promotes Proliferation of Breast Cancer Cells in Hypoxic Environment.
Accumulating evidence has shown that hypoxia plays a key role in regulating proliferation of breast cancer cells. However, the mechanism of how hypoxia regulates breast cancer remains unclear. We sought to investigate if hypoxia regulated proliferation through circular RNA. Western blot was used to detect hypoxia-inducible factor 1 alpha (HIF1α) levels in breast cancer cells under hypoxic conditions. Candidate circular RNAs (circRNAs) were selected and quantified by quantitative real-time polymerase chain reaction (qRT-PCR) after hypoxia induction. CCK8 assay was used to investigate the changes of proliferation after interfering circDENND4C and HIF1a. In breast cancer cells, circDENND4C was increased under hypoxic conditions and decreased after knocking-down HIF1α. In addition, knocking-down circDENND4C inhibited proliferation of breast cancer cells in a hypoxic environment. Finally, tumors with a large size had higher circDENND4C expression levels than those of small size. CircDENND4C is a HIF1α-associated circRNA promoting the proliferation of breast cancer cells under hypoxia.


Analysis of the Management Effect of Cancer Patients after Oral Chemotherapy Based on Nursing Process Reengineering.
With the pollution of the environment and the acceleration of the social rhythm, the prevalence of tumors has increased year by year, and tumors have brought huge pain and inconvenience to patients. However, traditional nursing work consumes a lot of manpower and material resources, but it is difficult to improve the happiness of cancer patients, and it also brings a lot of troubles to many nursing workers. Based on the above reasons, we reengineered the traditional nursing process based on the BPR theory and applied the new process to the analysis of the management effect of cancer patients after oral chemotherapy drugs. The data shows that there are 23 patients with no pressure ulcer risk (score greater than 19) before care, 27 patients with low risk (15-19 points), 32 patients with moderate risk (13-14 points), and 18 people at high risk (less than 12 points). After nursing, there were 82 patients with no pressure ulcer risk, 10 patients with low risk, 7 patients with moderate risk, and 1 patient with high risk. This shows that the risk of pressure ulcers in patients with cancer after the use of chemotherapy drugs is significantly reduced compared with those without nursing. Nursing intervention can improve the psychological state of cancer patients during the recovery period, and nursing intervention can promote the compliance of cancer patients in various aspects of rehabilitation.


Odontomas: review of the literature and case reports.
Odontomas are one of the most common Odontogenic Tumors of the jaw. The exact etiology of odontomas is unknown. Histologically they are composed of various formations of dental tissue (enamel, dentin, cementum and sometimes pulp). In the WHO classification, they are divided into complex odontoma and compound odontoma. Clinically, odontomas are generally asymptomatic and only in rare cases cause swelling, pain, suppuration or bony expansion. Radiologically, the tumor is initially lucent, but with time, it develops small calcifications, which eventually coalesce to form a radiodense lesion with a lucent rim. Surgical resection is the treatment of choice and there is no recurrence. The aim of this paper is to define the principal characteristics and the treatment of these lesions, based on literature and personal experience.