Recanalization of peripheral chronic total occlusions: 'no fancy devices, just a crossing catheter'.
Chronic total occlusions (CTOs) are challenging to treat endovascularly. Classic subintimal approach is offering only moderate success rates mainly due of the lack of dedicated crossing catheters. Purpose of this study is to assess the acute procedural success of the use of a novel hydrophilic crossing catheter in the recanalization of peripheral CTOs. This is a retrospective, single-centre study of patients with femoropopliteal CTOs. Revascularization was performed with the use of the NaviCross®- crossing catheter (Terumo Europe). Technical, procedural success and complications were assessed. Thirty-two patients were included in the study. Mean age was 65.9 (46-85) years; Critical limb ischemia was the indication for the procedure in 26 (81%). Target vessels included 12 superficial femoral arteries, 9 popliteal, and 11 femoropopliteal segment lesions. Mean length was 85 (50-350) mm; 21(65.6%) lesions were heavily calcified. In all cases a sub-intimal approach was used; in 21 cases the procedure was performed as a day case. Technical success was achieved in 31 (96.8%) cases. Recanalization was achieved with a guidewire in 22 (71%) lesions and with the catheter alone in 9 (29%) cases. Procedural success was achieved in all lesions. No major adverse events occurred. The use of the NaviCross®- crossing catheter showed high rate of technical and procedural success in challenging femoropopliteal CTOs without significant complications. The use of this catheter needs to be considered as the first approach for CTOs prior to the use of any other more complex re-entry device.


The maternal thiol/disulfide homeostasis does not change in pregnancies complicated by preterm prelabor rupture of membranes.
To evaluate the maternal thiol/disulfide homeostasis in pregnant women complicated by preterm prelabor rupture of membranes (PPROM) and to compare the results with healthy pregnancies. This cohort study consisted of thirty-nine pregnancies complicated by PPROM and 44 gestational age-matched healthy pregnancies in the third trimester of gestation. Maternal serum samples were obtained at the day of diagnosis, and thiol/disulfide profiles were measured by using an automated assay method. The patients were followed till delivery, and perinatal outcomes were noted. The maternal native thiol (319.9 ± 30.5 μmol/L versus 305.1 ± 49.2 μmol/L, p: .100), total thiol (379.2 ± 38.8 μmol/L versus 363.6 ± 56.4 μmol/L, p: .142) and disulfide (29.7 ± 11.7 μmol/L versus 29.3 ± 10.1 μmol/L, p: .864) levels were similar between the groups. Maternal disulfide/native thiol, disulfide/total thiol and native thiol/total thiol ratios were similar between the groups (p: .610, p: .565 and .562, respectively). The maternal serum thiol/disulfide profiles were not significantly correlated with maternal serum C-reactive protein, white blood cell count values and ongoing pregnancy outcomes (p > .05). The current study demonstrated that there was not any disturbance in maternal thiol/disulfide homeostasis in pregnancies complicated by PPROM at the time of initial diagnosis. Follow-up studies with larger sample size are needed to confirm our results.


Starvation induces differential small bowel luminal amino acid transport.
The importance of small intestinal mucosa functions has been emphasized in recent years because gut metabolism becomes better defined. One of the major activities of the enterocyte is amino acid transport, which is important not only for the organism but also for the integrity of the mucosa. Bowel rest during the postoperative period is marked by decreased calorie and protein intake with atrophy of the brush border mucosa. We sought to determine whether active amino acid transport is altered during 72 hours of fasting. New Zealand white rabbits were fed (control) or fasted for 72 hours. Brush border membrane vesicles were prepared from scraped jejunal mucosa, and their purity was assessed by marker enzyme enrichment (17- to 25-fold). Transport of tritiated glutamine, arginine, alanine, methylamino-isobutyric acid (MeAIB), and leucine into brush border membrane vesicles was measured by rapid mixing filtration. Fasted animals lost on average 138 +/- 51 gm of body weight. Glutamine and arginine transport were decreased in rabbits fasted for 72 hours compared with controls; alanine, MeAIB, and leucine transport were maintained. The decrease in Glutamine transport was due to a decrease in Vmax (545 +/- 22 versus 836 +/- 93 pmol/mg protein/10 sec; p < 0.05), consistent with a decrease in the number of functional transporter proteins. Km values were similar in both groups (644 +/- 25 versus 624 +/- 18 mumol/L), indicating no change in carrier affinity. Differential changes occur in brush border amino acid transport during a 3-day period of bowel rest. The apparent gut nutritive transporters for Glutamine and arginine are decreased, although the gluconeogenic transporters for alanine, MeAIB, and leucine are maintained. These adaptive changes may help explain the difficulties seen in postoperative and critically ill patients on prolonged bowel rest.


Acupuncture for Low-Back Pain.
Low-back pain affects 84% of the world's population. At present, no method of treatment can be considered as the method of choice. Acupuncture is effective, scientific, cost-effective, and free from major side-effects. Three illustrative cases, showing the beneficial effects of acupuncture are presented. Attention is drawn to the possible presence of underlying sacroiliac-joint dysfunction, which could masquerade as sciatica, hip pain, and/or groin pain.


Panic disorder: the potential role of serotonin reuptake inhibitors.
The authors review the role of the serotonergic system in panic disorder and the potential for use of the new serotonin (5-HT) reuptake inhibitors in treating panic disorder. Data currently available are only preliminary but suggest a future potential for this class of drug in the treatment of panic/anxiety disorders. The authors present a succinct and comprehensive overview of the data available, which aims to assist in the planning of future research in this area.


Care Provided to Women Victims of Intimate Partner Violence From the Perspective of Health Professionals.
Intimate Partner Violence (IPV) is a recurring phenomenon in society and can have important repercussions for the lives and health of women worldwide. Even in this alarming global scenario, many health workers still have difficulties approaching IPV with women and providing care for the victims of this type of violence. Given this context, this qualitative study aims at understanding how primary health care professionals provide care for women victims of violence by intimate partners. In view of the methodology design proposed in the Grounded Theory, data collection took place through theoretical sampling. Data collection was carried out in 22 institutions offering primary health care, with 31 female workers from different professional categories being interviewed individually and in depth, including physicians, nurses, dentists, psychologists, and social workers. The results show that, in order to overcome the difficulties encountered in caring for victims of IPV, primary health care workers have been developing strategies for the care of these women. These strategies include identification of such cases through questions about the woman's intimate relationship, by establishing a bond with the victim so that she feels welcomed, and through articulation with other team professionals to propose expanded health care. The interventions carried out by these professionals include meeting the demands of women in the health institution where they work, referral to other services in the network, if necessary, and notification of IPV cases to epidemiological surveillance. Based on this understanding of the care offered by the professionals to women who are victims of IPV in primary health care, the research aims at contributing to the sensitization of professionals working in health institutions regarding the identification of signs that raise suspicion of IPV, as well as at addressing such cases in a way to fully meet these women's needs.


Pharmacokinetics of a new human monoclonal antibody against cytomegalovirus. First communication: plasma concentration, distribution, metabolism and excretion of the new monoclonal antibody, regavirumab after intravenous administration in rats and rabbits.
TI-23 consists of lyophilized regavirumab (monoclonal antibody C23, MCA C23), a new human monoclonal antibody against cytomegalovirus (CMV), human serum albumin (HSA) and amino acetic acid. The pharmacokinetics of MCA C23 was investigated in rats and rabbits. Plasma concentrations of radioactivity were shown to increase dose-dependently after 2, 10 or 50 mg/kg of 125I-labeled TI-23 was administered intravenously to rats. Their elimination of half-lives from plasma were 11-13 days. The radioactivity in plasma corresponded with the idiotype activity (antigenicity against idiotype antibody) of the monoclonal antibody. No significant difference was detected in plasma concentration and half-lives between male and female rats. Quantitative and qualitative distribution studies demonstrated that high radioactivity was distributed predominantly to the blood and blood-rich organs. The idiotype activity which remained in those tissues was attributable to the blood in the tissues. The radioactivity was mainly excreted in the urine as free iodine, and about 40% of the dose remained in the body. After the rabbits received 2 mg/kg of 125I-TI-23, the initial radioactivity in plasma was higher than in rats, and a larger distribution volume and shorter elimination half-lives of radioactivity in plasma were observed.


Distribution of tetrodotoxin in pufferfish collected from coastal waters of Sihanouk Ville, Cambodia.
In Cambodia, fatal food poisonings associated with the consumption of pufferfish have occurred for decades, but the causative species or toxins have never been documented. Herein, we investigated the toxicity of three pufferfish species of the genus Lagocephalus collected from the coastal waters of Sihanouk Ville, one of the main regions where poisonings have occurred. L. wheeleri and L. spadiceus were non-toxic, whereas L. lunaris was toxic and all of its body tissues exhibited toxicity levels exceeding the safety limit for human consumption (10 mouse units/g). Tetrodotoxin (TTX) was identified as the main toxin in this species; no paralytic shellfish poison(s) were detected. Consequently, we can confirm pufferfish to be a hazardous reservoir of TTX in Sihanouk Ville. It is likely that L. lunaris is one of the causative species of past pufferfish poisonings that have occurred in Cambodia.


Different Complexation Behavior of P-Functionalized Ferrocene Derivatives Towards SnCl2 , SnCl4 and SnPh2 Cl2 : Auto-ionization and Redox-Type Reactions.
The novel phosphonyl-substituted ferrocene derivatives [Fe(η(5) -Cp)(η(5) -C5 H3 {P(O)(O-iPr)2 }2 -1,2)] (Fc(1,2) ) and [Fe{η(5) -C5 H4 P(O)(O-iPr)2 }2 ] (Fc(1,1') ) react with SnCl2 , SnCl4 , and SnPh2 Cl2 , giving the corresponding complexes [(Fc(1,2) )2 SnCl][SnCl3 ] (1), [{(Fc(1,1') )SnCl2 }n ] (2), [(Fc(1,1') )SnCl4 ] (3), [{(Fc(1,1') )SnPh2 Cl2 }n ] (4), and [(Fc(1,2) )SnCl4 ] (5), respectively. The compounds are characterized by elemental analyses, (1) H, (13) C, (31) P, (119) Sn NMR and IR spectroscopy, (31) P and (119) Sn CP-MAS NMR spectroscopy, cyclovoltammetry, electrospray ionization mass spectrometry, and single-crystal as well as powder X-ray diffraction analyses. The experimental work is accompanied by DFT calculations, which help to shed light on the origin for the different reaction behavior of Fc(1,1') and Fc(1,2) towards tin(II) chloride.


[Surgery in esophageal carcinoma: risks and results].
Surgical treatment of esophageal cancer is largely palliative. To clarify the indication it is necessary to assess the effectiveness of the palliation in relief of dysphagia and the operative risks. In a retrospective study we analyzed the perioperative morbidity and follow-up in 25 patients with carcinoma of the esophagus treated between 1984 and 1988 (5 years). With combined anesthesia, early extubation and intensive pulmonary therapy, no perioperative respiratory insufficiency was observed. Perioperative mortality was 0%. An anastomotic leak in 2 patients with a cervical anastomosis was healed in both cases by conservative management. On hospital discharge all patients were able to eat normally. 13 patients died after 1 year on average (4 months to 3 years). 12 patients are alive 6 months to 4 years after operation, 10 of them without symptoms. Our results show that with optimal perioperative management of esophageal carcinoma low morbidity is possible and good palliation of dysphagia is feasible.


Hierarchical 3D Percolation Network of Ag-Au Core-Shell Nanowire-Hydrogel Composite for Efficient Biohybride Electrodes.
Metal nanomaterials are highly valued for their enhanced surface area and electrochemical properties, which are crucial for energy devices and bioelectronics. However, their practical applications are often limited by challenges, such as scalability and dimensional constraints. In this study, we developed a synthesis method for highly porous Ag-Au core-shell nanowire foam (AACNF) using a one-pot process based on a simultaneous nanowelding synthesis method. The unique characteristics of AACNF as metal-based electrodes show the lowest density among metal-based electrodes while demonstrating high electrical conductivity (99.33-753.04 S/m) and mechanical stability. The AACNF's excellent mass transport properties enable multiscale hierarchical incorporation with functional materials including polymeric precursors and living cells. The enhanced mechanical stability at the nanowelded junctions allows AACNF-hydrogel composites to exhibit large stretching (∼700%) and 10,000 times higher electrical conductivity than hydrogel-nanowire composites without the junction. Large particles in the 1-10 μm scale, including fibroblast cells and exoelectrogenic microbes, are also successfully incorporated with AACNF. AACNF-based microbial fuel cells show high power density (∼330.1 W/m3) within the optimal density range. AACNF's distinctive ability to form a hierarchical structure with substances in various scales showcases its potential for advanced energy devices and biohybrid electrodes in the future.


A Case of Subacute Combined Degeneration of the Spinal Cord with Infective Endocarditis.
Background. Subacute combined degeneration (SCD) is a rare cause of demyelination of the dorsal and lateral columns of spinal cord and is a neurogenic complication due to cobalamin deficiency. Anemia of chronic disease (ACD) occurs in patients with acute or chronic immune activation, including infective endocarditis. It remains to be elucidated whether ACD patients are more sensitive to suffer from SCD. Little cases about SCD patients accompanied with ACD have been reported till now. Here we reported a 36-year-old man with SCD with a medical history of mitral inadequacy over 20 years, who was admitted and transported from another hospital to our hospital due to an 8-month history of gait disturbance, lower limb weakness and paresthesia, and loss of proprioception. Significant laboratory results and echocardiography suggest iron deficiency anemia and infective endocarditis (IE). The SCD diagnosis was confirmed by MRI, which showed selective demyelination in the dorsal and lateral columns of spinal cord. In conclusion, the ACD patients may suffer from SCD, which can be diagnosed by 3 Tesla magnetic resonance imaging.


Georges Brohee Prize. Oestrogen-progesterone, a new therapy of bleeding gastrointestinal vascular malformations.
Gastrointestinal vascular malformations can cause haemorrhage requiring multiple transfusions. Surgical or endoscopic therapy are ineffective when the vascular malformations are spread diffusely over the gastrointestinal tract, when lesions escape identification or are not accessible for treatment. Several reports suggest that oestrogen-progesterone therapy is effective in the treatment of epistaxis in hereditary haemorrhagic telangiectasia. The aim of our studies is to test the hypothesis that oestrogen-progesterone is an effective treatment for bleeding gastrointestinal vascular malformations in patients with a very high transfusion need and in whom surgical or endoscopic treatment failed or could not be performed. The mean transfusion requirement prior to entering the studies amounted to 35.4 units packed per patient. In an uncontrolled trial oestrogen-progesterone therapy diminished significantly transfusion requirements from 3.4 units packed cells per patient per month to 0.1 units packed cells (p = 0.02). Haemorrhage ceased totally in 3 of 7 patients. A double-blind randomized placebo-controlled, cross-over trial shows that therapy with 0.050 mg ethinyloestradiol and 1 mg norethisterone is very effective in reducing transfusion requirements: 2.8 versus 11.2 units packed cells over a 6 month treatment period (p = 0.002). Only 3 of 13 patients treated with ethinyloestradiol and norethisterone required transfusions for persistent bleeding, while 12 of 13 patients in the placebo group had transfusion requirements (p = 0.001). After stopping hormonal therapy, no transfusions were needed for a mean of 10 months. This indicates a long-lasting effect of ethinyloestradiol and norethisterone on bleeding and transfusion requirements.(ABSTRACT TRUNCATED AT 250 WORDS)


Age-related changes in tactile spatial resolution from 6 to 16 years old.
The aim of this study was to determine age-related changes in tactile spatial resolution from 6 to 16 years old. Two hundred and twenty-two healthy children (105 boys and 117 girls) were assessed. The tactile spatial resolution threshold was determined using a classic set of JVP domes with a procedure adapted for children. Preadolescence appears to be an important step in tactile spatial resolution since children aged between 6 and 9 years old had a worse tactile spatial resolution than older children. Both peripheral and central explanations for this improvement of tactile spatial resolution with age are considered. The authors suggest that cortical maturational processes are likely to explain the better results of older children.


Spinal dysraphism illustrated; Embroyology revisited.
Spinal cord development occurs through three consecutive periods of gastrulation, primary nerulation and secondary neurulation. Aberration in these stages causes abnormalities of the spine and spinal cord, collectively referred as spinal dysraphism. They can be broadly classified as anomalies of gastrulation (disorders of notochord formation and of integration); anomalies of primary neurulation (premature dysjunction and nondysjunction); combined anomalies of gastrulation and primary neurulation and anomalies of secondary neurulation. Correlation with clinical and embryological data and common imaging findings provides an organized approach in their diagnosis.


Nighttime Trauma Fellow Care Is Associated with Improved Outcomes after Injury.
Time of admission and surgeon experience may explain variations in trauma outcomes. We hypothesized that earlier admission time by a more experienced trauma surgeon leads to improved outcomes after injury. We conducted a retrospective cohort study using trauma registry and performance improvement data at our Level 1 trauma center. Consecutive patients presenting at night from 2013 to 2014 were dichotomized into early (6:00 pm-12:00 am) and late (12:01 am-7:00 am) cohorts. Second year trauma fellows acting as attendings and staff trauma surgeons were categorized as less and more experienced, respectively. The primary study outcome was any complication tracked by our state registry, missed injury, delay in diagnosis, or death. The influence of admission time and trauma surgeon experience on this endpoint was examined using multivariable logistic regression. A total of 2078 patients presented either during early (n = 1189) or late (n = 889) night. The cohorts were not different with respect to Deyo-Charlson index, systolic blood pressure, Glasgow Coma Scale, Injury Severity Core, admitting trauma surgeon age, experience, or unadjusted primary study outcome (early 14 vs late 16%; P = 0.206). Trauma surgeon experience was independently predictive of outcomes. Trauma patients admitted at night by fellows were 29 per cent less likely to sustain complications or death than those admitted by staff (adjusted odds ratio 0.71; 95% confidence interval: 0.54-0.92, P = 0.010). This protective effect of fellow care was found only in patients admitted after midnight (P = 0.03). In conclusion, nighttime initial trauma care by fellows was associated with improved outcomes. Possible explanations include more oversight of nighttime fellow care, variations in daytime responsibilities between fellows and staff, and differential effects of sleep loss by age.


Polyamine oxidase mediates intra-erythrocytic death of Plasmodium falciparum.
Using a number of established culture strains of Plasmodium falciparum, the effects of the addition of polyamine oxidase and spermine on the intra-erythrocytic forms were studied. Cultures to which polyamine oxidase and polyamines were added contained only degenerate parasites but if one or other were added alone the cultures were similar to the controls. The effects were confirmed by 35S-methionine incorporation.


Postnatal induction of transforming growth factor beta signaling in fibroblasts of mice recapitulates clinical, histologic, and biochemical features of scleroderma.
Increased signaling by transforming growth factor beta (TGFbeta) has been implicated in systemic sclerosis (SSc; scleroderma), a complex disorder of connective tissues characterized by excessive accumulation of collagen and other extracellular matrix components in systemic organs. To directly assess the effect of sustained TGFbeta signaling in SSc, we established a novel mouse model in which the TGFbeta signaling pathway is activated in fibroblasts postnatally. The mice we used (termed TBR1(CA); Cre-ER mice) harbor both the DNA for an inducible constitutively active TGFbeta receptor I (TGFbetaRI) mutation, which has been targeted to the ROSA locus, and a Cre-ER transgene that is driven by a fibroblast-specific promoter. Administration of 4-hydroxytamoxifen 2 weeks after birth activates the expression of constitutively active TGFbetaRI. These mice recapitulated clinical, histologic, and biochemical features of human SSc, showing pronounced and generalized fibrosis of the dermis, thinner epidermis, loss of hair follicles, and fibrotic thickening of small blood vessel walls in the lung and kidney. Primary skin fibroblasts from these mice showed elevated expression of downstream TGFbeta targets, reproducing the hallmark biochemical phenotype of explanted SSc dermal fibroblasts. The mouse fibroblasts also showed elevated basal expression of the TGFbeta-regulated promoters plasminogen activator inhibitor 1 and 3TP, increased Smad2/3 phosphorylation, and enhanced myofibroblast differentiation. Constitutive activation of TGFbeta signaling in fibroblastic cells of mice after birth caused a marked fibrotic phenotype characteristic of SSc. These mice should be excellent models with which to test therapies aimed at correcting excessive TGFbeta signaling in human scleroderma.


Rate of movement and composition of rapidly transported proteins in regenerating olfactory nerve.
In a previous study, three successive groups of regenerative fibers, growing initially at 5.8, 2.1, and 0.8 mm/day, were observed in the regenerating garfish olfactory nerve. In the present study, fast axonal transport in the most rapidly regenerating axons (phase I and II) has been examined. Rapid transport in phase I fibers occurs at a velocity of 208 +/- 9 mm/day at 23 degrees, a rate identical to that measured in intact nerves. This first phase of regenerating fibers represents only 3 to 5% of the original axonal population, but each fiber appears to contain 6 to 16 times more transported radioactivity than an axon in an intact nerve. Subcellular distribution of rapidly moving material in phase I and II fibers was closely related to the distribution obtained in intact nerves. Small but significant differences indicate a shift of the transported radioactivity from a heavier to a light axonal membranous fraction. This shift might be characteristic of the immature membrane of a growing axon. The polypeptide distribution of transported radioactivity was also very similar to that of a normal nerve, with most of the radioactivity associated with high-molecular-weight polypeptides.


Hydrothermal routes to prepare nanocrystalline mesoporous SnO2 having high thermal stability.
We report simple hydrothermal routes to prepare thermally stable SnO2 particles having high specific surface areas and mesoporosity. The preparation method includes a new combination of synthetic processes: hydrolysis of tin(IV) chloride at 95 degrees C in the absence of alkaline solutions (aqueous NH3 or NaOH), formation of nanocrystalline SnO2, and subsequent hydrothermal treatments at temperatures between 100 and 200 degrees C. After annealing treatments of the hydrothermally treated SnO2 particles at 400 or 500 degrees C, their crystallite sizes remained smaller than 7.7 nm and their specific surface areas were still higher than 110 m2/g, indicative of the high thermal stability against particle growth and sintering. Furthermore, mesoporosity evolved with a relatively narrow pore size distribution typically in the range of 3.0-4.3 nm. The effects of the hydrothermal treatment were explained by uniformization of the particle size that was beneficial to the suppression of particle growth.


Effects of spontaneous breathing during airway pressure release ventilation on respiratory work and muscle blood flow in experimental lung injury.
To evaluate the effects of spontaneous breathing at ambient airway pressure (Paw) and during airway pressure release ventilation (APRV) on respiratory work and respiratory muscle blood flow (RMBF) in experimental lung injury. Prospective experimental study. Research laboratory of a university hospital. Twelve hemodynamically stable, analgosedated, and tracheotomized domestic pigs. Respiratory work was estimated by the inspiratory pressure time product (PTPinsp) of esophageal pressure, and RMBF was measured with colored microspheres. Lung injury was induced with IV boli of oleic acid. The first set of measurements was performed before induction of lung injury while pigs were breathing spontaneously at ambient Paw, the second after induction of lung injury while breathing spontaneously at ambient Paw, and the third with lung injury and spontaneous breathing with APRV. After induction of lung injury PTPinsp increased from 138 +/- 14 to 214 +/- 32 cm H2O s/min when pigs breathed spontaneously at ambient Paw (p < 0.05) and returned to 128 +/- 27 cm H2O s/min during APRV. While systemic hemodynamics and blood flow to the psoatic and intercostal muscles did not change, diaphragmatic blood flow increased from 0.34 +/- 0.05 before to 0.54 +/- 0.08 mL/g/min after induction of lung injury and spontaneous breathing at ambient Paw (p < 0.05) and returned to 0.32 +/- 0.05 mL/g/min during APRV (p < 0.05 vs spontaneous breathing at ambient Paw [lung injury]). Respiratory work and RMBF are increased in acute lung injury when subjects breathe spontaneously at ambient Paw. Supporting spontaneous breathing with APRV decreases respiratory work and RMBF to physiologic values.


Structural, electronic, magnetic and optical properties of icosahedral silver-nickel nanoclusters.
We present a systematic study of the structural, electronic, magnetic and optical properties of icosahedral bimetallic Ag((13-p))Ni(p) (p < or = 6) clusters in the gas phase investigated in the framework of density functional theory (DFT and TDDFT). In the most-stable structures, the central position is found to be occupied by a nickel atom. The evolution of spin-multiplicities and local atomic spin densities with Ag/Ni composition are discussed. The evolution of the optical properties with the Ag/Ni composition and the spatial positions of Ni atoms are analysed. An interpretation of spectroscopic patterns in terms of contribution from s- and d-type excitations is also given. In particular the d-electrons of nickel atoms are found to play a crucial role in the optical transitions of Ni-rich systems. Finally, our theoretical spectra are compared to the experimental ones for large Ni-core/Ag-shell clusters (about 2-5 nm in size).


Recent progress in magnetic iron oxide-semiconductor composite nanomaterials as promising photocatalysts.
Photocatalytic degradation of toxic organic pollutants is a challenging tasks in ecological and environmental protection. Recent research shows that the magnetic iron oxide-semiconductor composite photocatalytic system can effectively break through the bottleneck of single-component semiconductor oxides with low activity under visible light and the challenging recycling of the photocatalyst from the final products. With high reactivity in visible light, magnetic iron oxide-semiconductors can be exploited as an important magnetic recovery photocatalyst (MRP) with a bright future. On this regard, various composite structures, the charge-transfer mechanism and outstanding properties of magnetic iron oxide-semiconductor composite nanomaterials are sketched. The latest synthesis methods and recent progress in the photocatalytic applications of magnetic iron oxide-semiconductor composite nanomaterials are reviewed. The problems and challenges still need to be resolved and development strategies are discussed.


Quality Assessment of Gentiana rigescens from Different Geographical Origins Using FT-IR Spectroscopy Combined with HPLC.
Gentiana rigescens is a precious herbal medicine in China because of its liver-protective and choleretic effects. A method for the qualitative identification and quantitative evaluation of G. rigescens from Yunnan Province, China, has been developed employing Fourier transform infrared (FT-IR) spectroscopy and high performance liquid chromatography (HPLC) with the aid of chemometrics such as partial least squares discriminant analysis (PLS-DA) and support vector machines (SVM) regression. Our results indicated that PLS-DA model could efficiently discriminate G. rigescens from different geographical origins. It was found that the samples which could not be determined accurately were in the margin or outside of the 95% confidence ellipses. Moreover, the result implied that geographical origins variation of root samples were more obvious than that of stems and leaves. The quantitative analysis was based on gentiopicroside content which was the main active constituent in G. rigescens. For the prediction of gentiopicroside, the performances of model based on the parameters selected through grid search algorithm (GS) with seven-fold cross validation were better than those based on genetic algorithm (GA) and particle swarm optimization algorithm (PSO). For the SVM-GS model, the result was satisfactory. FT-IR spectroscopy coupled with PLS-DA and SVM-GS can be an alternative strategy for qualitative identification and quantitative evaluation of G. rigescens.


MiR-185-5p suppresses HBV gene expression by targeting ELK1 in hepatoma carcinoma cells.
To investigate the role and underlying mechanism of miR-185-5p in hepatitis B virus (HBV) expression and replication. The relative levels of hepatitis B surface antigen and hepatitis B e antigen were detected by enzyme-linked immunosorbent assay (ELISA). The HBV DNA copies in the cultures medium were measured by RT-qPCR. The HBV large surface antigen promoter (S1p) activity was analyzed by luciferase reporter assay. The target relationship between miR-185-5p and ELK1 was identified by bioinformatics analysis and EGFP fluorescent reporter assay. The ELK1 expression was determined by RT-qPCR and Western blot. miR-185-5p significantly decreased HBV large surface antigen promoter activity and subsequently the production of HBV proteins and HBV DNA copies in vitro. Further, we identified the ETS transcription factor ELK1 is a target of miR-185-5p. Overexpression and knockdown experiments showed overexpression of ELK1 stimulated HBV large surface antigen promoter activity and promoted the production of HBV proteins and HBV DNA copies, whereas knockdown of ELK1 has the opposite effects. Moreover, the rescue of ELK1 expression reversed the suppression of miR-185-5p on HBV replication and gene expression. Further mechanistic study showed that the ETS binding sites within the HBV large surface antigen promoter are required for the repression effect of miR-185-5p on HBV. There are few reports about the interaction between miRNAs and the transcription from HBV S1p, we found that miR-185-5p decreases HBV S1p activity by targeting ELK1, which may provide a promising therapeutic strategy for HBV infection.


Oral fibrolipoma: a rare histological variant.
Lipomas are benign soft tissue mesenchymal neoplasms. Fibrolipoma is a histological variant of lipoma that mostly affects the buccal mucosa and causes functional and cosmetic disabilities. The diagnosis and differentiation of fibrolipoma with clinically similar lesions such as fibroma and pleomorphic adenoma is very essential for a correct treatment plan and complete follow-up. This article presents a case of a 35-year-old female with a fibrolipoma on the lingual marginal gingiva of the mandibular left third molar.


Immune Reconstitution Inflammatory Syndrome Associated Thrombocytopenia in a Patient with Human Immunodeficiency Virus Infection: A Rare Hematological Manifestation.
Human immunodeficiency virus (HIV) associated thrombocytopenia was commonly encountered in the era prior to the advent of antiretroviral therapy (ART). With the widespread use of ART, its incidence has significantly declined. Immune reconstitution inflammatory syndrome (IRIS) is an immune dysregulation phenomenon that reveals itself clinically as paradoxical deterioration after the commencement of ART in HIV infected patients. It has a wide variety of clinical manifestations. However, hematologic involvement is rare. Here, we present a very rare case of IRIS associated thrombocytopenia. With this case we intend to create mindfulness of the possibility of IRIS being one of the explanations for thrombocytopenia.


[Etiology composition and prognosis of pediatric chronic critical illness in a pediatric intensive care unit].
To explore the etiology composition and outcomes of pediatric chronic critical illness (PCCI) in the pediatric intensive care unit (PICU). The children who were hospitalized in the PICU of Dongguan Children's Hospital Affiliated to Guangdong Medical University and met the diagnostic criteria for PCCI from January 2017 to December 2022 were included in the study. The etiology of the children was classified based on their medical records and discharge diagnoses. Relevant clinical data during hospitalization were collected and analyzed. Among the 3 955 hospitalized children in the PICU from January 2017 to December 2022, 321 cases (8.12%) met the diagnostic criteria for PCCI. Among the 321 cases, the most common etiology was infection (71.3%, 229 cases), followed by unintentional injury (12.8%, 41 cases), postoperation (5.9%, 19 cases), tumors/immune system diseases (5.0%, 16 cases), and genetic and chromosomal diseases (5.0%, 16 cases). Among the 321 cases, 249 cases (77.6%) were discharged after improvement, 37 cases (11.5%) were discharged at the request of the family, and 35 cases (10.9%) died in the hospital. Among the deaths, infection accounted for 74% (26/35), unintentional injury accounted for 17% (6/35), tumors/immune system diseases accounted for 6% (2/35), and genetic and chromosomal diseases accounted for 3% (1/35). From 2017 to 2022, the proportion of PCCI in PICU diseases showed an increasing trend year by year (P<0.05). Among the 321 children with PCCI, there were 148 infants and young children (46.1%), 57 preschool children (17.8%), 54 school-aged children (16.8%), and 62 adolescents (19.3%), with the highest proportion in the infant and young children group (P<0.05). The in-hospital mortality rates of the four age groups were 14.9% (22/148), 8.8% (5/57), 5.6% (3/54), and 8.1% (5/62), respectively. The infant and young children group had the highest mortality rate, but there was no statistically significant difference among the four groups (P>0.05). The proportion of PCCI in PICU diseases is increasing, and the main causes are infection and unintentional injury. The most common cause of death in children with PCCI is infection. The PCCI patient population is mainly infants and young children, and the in-hospital mortality rate of infant and young children with PCCI is relatively high.


Direct Processing and Storage of Cell-Free Plasma Using Dried Plasma Spot Cards.
Plasma separation cards represent a viable approach for expanding testing capabilities away from clinical settings by generating cell-free plasma with minimal user intervention. These devices typically comprise a basic structure of the plasma separation membrane, unconstrained porous collection pad, and utilize either (i) lateral or (ii) vertical fluidic pathways for separating plasma. Unfortunately, these configurations are highly susceptible to (i) inconsistent sampling volume due to differences in the patient hematocrit or (ii) severe contamination due to leakage of red blood cells or release of hemoglobin (i.e., hemolysis). Herein, we combine the enhanced sampling of our previously reported patterned dried blood spot cards with an assembly of porous separation materials to produce a patterned dried plasma spot card for direct processing and storage of cell-free plasma. Linking both vertical separation and lateral distribution of plasma yields discrete plasma collection zones that are spatially protected from potential contamination due to hemolysis and an inlet zone enriched with blood cells for additional testing. We evaluate the versatility of this card by quantitation of three classes of analytes and techniques including (i) the soluble transferrin receptor by enzyme-linked immunosorbent assay, (ii) potassium by inductively coupled plasma atomic emission spectroscopy, and (iii) 18S rRNA by reverse transcriptase quantitative polymerase chain reaction. We achieve quantitative recovery of each class of analyte with no statistically significant difference between dried and liquid reference samples. We anticipate that this sampling approach can be applied broadly to improve access to critical blood testing in resource-limited settings or at the point-of-care.


Chronology of the Acheulean to Middle Stone Age transition in eastern Africa.
The origin of the Middle Stone Age (MSA) marks the transition from a highly persistent mode of stone toolmaking, the Acheulean, to a period of increasing technological innovation and cultural indicators associated with the evolution of Homo sapiens We used argon-40/argon-39 and uranium-series dating to calibrate the chronology of Acheulean and early MSA artifact-rich sedimentary deposits in the Olorgesailie basin, southern Kenya rift. We determined the age of late Acheulean tool assemblages from 615,000 to 499,000 years ago, after which a large technological and faunal transition occurred, with a definitive MSA lacking Acheulean elements beginning most likely by ~320,000 years ago, but at least by 305,000 years ago. These results establish the oldest repository of MSA artifacts in eastern Africa.


MAAP: malarial adhesins and adhesin-like proteins predictor.
Malaria caused by protozoan parasites belonging to the genus Plasmodium is a dreaded disease, second only to tuberculosis. The emergence of parasites resistant to commonly used drugs and the lack of availability of vaccines aggravates the problem. One of the preventive approaches targets adhesion of parasites to host cells and tissues. Adhesion of parasites is mediated by proteins called adhesins. Abrogation of adhesion by either immunizing the host with adhesins or inhibiting the interaction using structural analogs of host cell receptors holds the potential to develop novel preventive strategies. The availability of complete genome sequence offers new opportunities for identifying adhesin and adhesin-like proteins. Development of computational algorithms can simplify this task and accelerate experimental characterization of the predicted adhesins from complete genomes. A curated positive dataset of experimentally known adhesins from Plasmodium species was prepared by careful examination of literature reports. "Controversial" or "hypothetical" adhesins were excluded. The negative dataset consisted of proteins representing various intracellular functions including information processing, metabolism, and interface (transporters). We did not include proteins likely to be on the surface with unknown adhesin properties or which are linked even indirectly to the adhesion process in either of the training sets. A nonhomology-based approach using 420 compositional properties of amino acid dipeptide and multiplet frequencies was used to develop MAAP Web server with Support Vector Machine (SVM) model classifier as its engine for the prediction of malarial adhesins and adhesin-like proteins. The MAAP engine has six SVM classifier models identified through an exhaustive search from 728 kernel parameters set. These models displayed an efficiency (Mathews correlation coefficient) of 0.860-0.967. The final prediction P(maap) score is the maximum score attained by a given sequence in any of the six models. The results of MAAP runs on complete proteomes of Plasmodium species revealed that in Plasmodium falciparum at P(maap) scores above 0.0, we observed a sensitivity of 100% with two false positives. In P. vivax and P. yoelii an optimal threshold P(maap) score of 0.7 was optimal with very few false positives (upto 5). Several new predictions were obtained. This list includes hypothetical protein PF14_0040, interspersed repeat antigen, STEVOR, liver stage antigen, SURFIN, RIFIN, stevor (3D7-stevorT3-2), mature parasite-infected erythrocyte surface antigen or P. falciparum erythrocyte membrane protein 2, merozoite surface protein 6 in P. falciparum, circumsporozoite proteins, microneme protein-1, Vir18, Vir12-like, Vir12, Vir18-like, Vir18-related and Vir4 in P. vivax, circumsporozoite protein/thrombospondin related anonymous proteins, 28 kDa ookinete surface protein, yir1, and yir4 of P. yoelii. Among these, a few proteins identified by MAAP were matched with those identified by other groups using different experimental and theoretical strategies. Most other interspersed repeat proteins in Plasmodium species had lower P(maap) scores. These new predictions could serve as new leads for further experimental characterization (MAAP webserver: http://maap.igib.res.in).


The impact of link quality management on healthcare quality: a comparative study at The Fourth Hospital of Harbin Medical University.
To explore the impact of link quality management on healthcare quality. In 2021, The Fourth Hospital of Harbin Medical University followed various regulations and systems to manage the quality of hospital links. In 2022, the hospital upgraded and strengthened the quality management of hospital links. We collected and compared data from 2021 and 2022 on several observation indicators, including error rates in medical records, outpatient and inpatient numbers, surgical volumes, adverse event reporting, dispute complaints, inpatient medical records and outpatient prescriptions grading, timely filing rate of medical records, inpatient satisfaction rate, average length of hospital stay, rate of level 3-4 surgeries, admission rate of critically ill patients, workload index, work efficiency index, diagnostic quality index, treatment quality index, antimicrobial drug use rate, staff satisfaction rate, patient satisfaction rate, composite index, and Case Mix Index (CMI). In 2021, the error rate of the first page of the general surgery medical records in The Fourth Hospital of Harbin Medical University was 27.91%, while in 2022 it significantly improved to 9.60% (P<0.05). The error rates of the main diagnosis, major surgical operations, other diagnoses, and other surgical operations on the medical records were all significantly different between 2021 and 2022 (all P<0.05). In 2022, the outpatient volume, inpatient volume, surgical volume, and adverse event reporting increased significantly compared to those in 2021, while the number of dispute complaints decreased significantly. The first-grade rate of inpatient medical records, first-grade rate of outpatient prescriptions, timely filing rate of medical records, inpatient satisfaction rate, average length of hospital stay, rate of level 3-4 surgeries, and admission rate of critically ill patients in 2022 were all significantly higher than those in 2021 (all P<0.05). The workload index, work efficiency index, diagnostic quality index, and treatment quality index in 2022 were all significantly higher than those in 2021 (all P<0.05). The outpatient antimicrobial drug use rate, emergency department antimicrobial drug use rate, and inpatient antimicrobial drug use rate in 2022 were significantly lower than those in 2021 (all P<0.05). In 2022, the satisfaction rate of medical staff was 93.57%, which was significantly higher than 81.16% in 2021 (P<0.05). In 2022, the patient satisfaction rate was 91.53%, which was significantly higher than 82.17% in 2021 (P<0.05). In 2022, the composite index and CMI values increased, while the error rate decreased significantly, as compared to those in 2021 (P<0.05). After upgrading and strengthening the link quality management, The Fourth Hospital of Harbin Medical University has achieved significant improvements in management level, medical quality, technical level, and staff satisfaction.


HIV+/AIDS related bioethical issues in Japan.
Annual and cumulative incidences of HIV+ and AIDS in patients reported by the AIDS Surveillance Committee of the Ministry of Health and Welfare are cited to illustrate some characteristics in Japan: nearly 59% of either HIV+ or AIDS patients were infected through injection of blood products or by blood transfusion. A number of plaintiffs have sued the Japanese government and pharmaceutical companies since 1989, but no judicial decisions have yet been made. The incidence of HIV decreases for each of the following routes of infection: the second highest route of transmission being heterosexual, followed by bisexual and unconfirmed or unknown cases, and less frequently homosexual, drug use and lastly via vertical transmission. The most serious bioethical problems with HIV+ and AIDS patients in Japan is the social segregation of these patients. There are many emotional fears among the general public and medical personnel about AIDS because of their inadequate scientific knowledge of this disease. The Japan Hospital Association is doing The Stop AIDS Campaign and made several surveys. Japan has become increasingly aware of the importance of AIDS education and a great deal of effort is being made to enhance bioethical consideration.


Reflections on the value of electron microscopy in the study of heterogeneous catalysts.
Electron microscopy (EM) is arguably the single most powerful method of characterizing heterogeneous catalysts. Irrespective of whether they are bulk and multiphasic, or monophasic and monocrystalline, or nanocluster and even single-atom and on a support, their structures in atomic detail can be visualized in two or three dimensions, thanks to high-resolution instruments, with sub-Ångstrom spatial resolutions. Their topography, tomography, phase-purity, composition, as well as the bonding, and valence-states of their constituent atoms and ions and, in favourable circumstances, the short-range and long-range atomic order and dynamics of the catalytically active sites, can all be retrieved by the panoply of variants of modern EM. The latter embrace electron crystallography, rotation and precession electron diffraction, X-ray emission and high-resolution electron energy-loss spectra (EELS). Aberration-corrected (AC) transmission (TEM) and scanning transmission electron microscopy (STEM) have led to a revolution in structure determination. Environmental EM is already playing an increasing role in catalyst characterization, and new advances, involving special cells for the study of solid catalysts in contact with liquid reactants, have recently been deployed.


The search for disease-modifying treatment for Alzheimer's disease.
As a result of advances in the understanding of neurodegenerative mechanism in Alzheimer's disease, several strategies for the development of disease-modifying treatment are being investigated. Nerve growth factor and other neurotrophins may improve neuronal survival, although targeted delivery remains an obstacle. Modulation of protein processing has the potential to decrease the formation of plaques and tangles. Pharmacologic reduction of oxidative stress and destructive inflammation may slow the rate of neurodegeneration. Continued research into basic mechanisms, along with therapeutic trials of promising drugs, are improving the likelihood that it will soon be possible to slow the progression of this disease.


Using LMS tables to determine waist circumference and waist-to-height ratios in Colombian children and adolescents: the FUPRECOL study.
Waist circumference (WC) and waist-to-height ratio (WHtR) are often used as indices predictive of central obesity. The aims of this study were: 1) to obtain smoothed centile charts and LMS tables for WC and WHtR among Colombian children and adolescents; 2) to evaluate the utility of these parameters as predictors of overweight and obesity. A cross-sectional study was conducted of a sample population of 7954 healthy Colombian schoolchildren [3460 boys and 4494 girls, mean age 12.8 (±2.3) years]. Weight, height, body mass index (BMI), WC and WHtR were measured, and percentiles were calculated using the LMS method (Box-Cox, median and coefficient of variation). Appropriate cut-off points of WC and WHtR for overweight and obesity, according to International Obesity Task Force definitions, were selected using receiver operating characteristic (ROC) analysis. The discriminating power of WC and WHtR is expressed as area under the curve (AUC). Reference values for WC and WHtR are presented. Mean WC increased and WHtR decreased with age for both genders. A moderate positive correlation was observed between WC and BMI (r = 0.756, P < 0.01) and between WHtR and BMI (r = 0.604, P < 0.01). ROC analysis revealed strong discrimination power in the identification of overweight and obesity for both measures in our sample population. Overall, WHtR was a slightly better predictor of overweight/obesity (AUC 95% CI 0.868-0.916) than WC (AUC 95% CI 0.862-0.904). This paper presents the first sex and age-specific WC and WHtR percentiles for Colombian children and adolescents aged 9.0-17.9 years. The LMS tables obtained, based on Colombian reference data, can be used as quantitative tools for the study of obesity and its comorbidities.


Fluorine MR Imaging of Inflammation in Atherosclerotic Plaque in Vivo.
To preliminarily test the hypothesis that fluorine 19 ((19)F) magnetic resonance (MR) imaging enables the noninvasive in vivo identification of plaque inflammation in a mouse model of atherosclerosis, with histologic findings as the reference standard. The animal studies were approved by the local animal ethics committee. Perfluorocarbon (PFC) emulsions were injected intravenously in a mouse model of atherosclerosis (n = 13), after which (19)F and anatomic MR imaging were performed at the level of the thoracic aorta and its branches at 9.4 T. Four of these animals were imaged repeatedly (at 2-14 days) to determine the optimal detection time. Repeated-measures analysis of variance with a Tukey test was applied to determine if there was a significant change in (19)F signal-to-noise ratio (SNR) of the plaques and liver between the time points. Six animals were injected with a PFC emulsion that also contained a fluorophore. As a control against false-positive results, wild-type mice (n = 3) were injected with a PFC emulsion, and atherosclerotic mice were injected with a saline solution (n = 2). The animals were sacrificed after the last MR imaging examination, after which high-spatial-resolution ex vivo MR imaging and bright-field and immunofluorescent histologic examination were performed. (19)F MR signal was detected in vivo in plaques in the aortic arch and its branches. The SNR was found to significantly increase up to day 6 (P < .001), and the SNR of all mice at this time point was 13.4 ± 3.3. The presence of PFC and plaque in the excised vessels was then confirmed both through ex vivo (19)F MR imaging and histologic examination, while no signal was detected in the control animals. Immunofluorescent histologic findings confirmed the presence of PFC in plaque macrophages. (19)F MR imaging allows the noninvasive in vivo detection of inflammation in atherosclerotic plaques in a mouse model of atherosclerosis and opens up new avenues for both the early detection of vulnerable atherosclerosis and the elucidation of inflammation mechanisms in atherosclerosis.


Impact of Single Nucleotide Polymorphisms on Plasma Concentrations of Efavirenz and Lopinavir/Ritonavir in Chinese Children Infected with the Human Immunodeficiency Virus.
Single nucleotide polymorphisms (SNPs) in the genes that encode the cytochrome P450 (CYP) drug metabolizing enzymes and drug transporters have been reported to influence antiretroviral drug pharmacokinetics. Although primarily metabolized by CYP2B6 and -3A, efavirenz (EFV) and lopinavir/ritonavir (LPV/r) are substrates of P-glycoprotein and the solute carrier organic (SLCO) anion transporter, respectively. We investigated the association between SNPs and efavirenz (EFV) or lopinavir/ritonavir (LPV/r) concentrations in Chinese children infected with the human immunodeficiency virus (HIV). Genotyping was performed on CYP2B6 516G→T, -1459C→T, and -983T→C, ABCB1 3435C→T, and SLCO1B1 521T→C in 229 HIV-infected Chinese pediatric patients (age range 4.0 to 17.5 yrs). Plasma concentrations of EFV and LPV/r were measured using validated high-performance liquid chromatography coupled with the mass spectrum method among 39 and 69 children who received EFV- and LPV/r-containing regimens, respectively. The frequencies of CYP2B6 516G→T in the study participants were 71%, 25%, and 4% for the G/G, G/T, and T/T genotypes, respectively. Among the children under therapeutic drug monitoring, 21% and 39% experienced EFV and LPV concentrations, respectively, above the upper threshold of the therapeutic window. CYP2B6 516G→T was significantly associated with EFV concentrations (p<0.001). Older children (older than 10 yrs) were more likely to have significantly higher EFV concentrations than the younger ones (p=0.0314). CYP2B6 genotyping and EFV concentration monitoring may help optimize antiretroviral therapy in pediatric patients who initiate an EFV-based regimen.


Comparative Variable Temperature Studies of Polyamide II with a Benchtop Fourier Transform and a Miniature Handheld Near-Infrared Spectrometer Using 2D-COS and PCMW-2D Analysis.
The main objective of this communication is to compare the performance of a miniaturized handheld near-infrared (NIR) spectrometer with a benchtop Fourier transform near-infrared (FT-NIR) spectrometer. Generally, NIR spectroscopy is an extremely powerful analytical tool to study hydrogen-bonding changes of amide functionalities in solid and liquid materials and therefore variable temperature NIR measurements of polyamide II (PAII) have been selected as a case study. The information content of the measurement data has been further enhanced by exploiting the potential of two-dimensional correlation spectroscopy (2D-COS) and the perturbation correlation moving window two-dimensional (PCMW2D) evaluation technique. The data provide valuable insights not only into the changes of the hydrogen-bonding structure and the recrystallization of the hydrocarbon segments of the investigated PAII but also in their sequential order. Furthermore, it has been demonstrated that the 2D-COS and PCMW2D results derived from the spectra measured with the miniaturized NIR instrument are equivalent to the information extracted from the data obtained with the high-performance FT-NIR instrument.


Safety assessment and global regulatory requirements for genetic toxicity evaluations of medical devices.
Medical devices have the potential to leach substances which, depending on the contact category of the device, can directly contact the human body. Hence, appropriate evaluation for genetic toxicity as part of the biocompatibility risk assessment is critical. The biocompatibility risk assessment of medical devices is guided by the ISO 10993 series of standards. The recently revised ISO 10993-3 (2014) provides guidance on evaluating the genotoxicity, carcinogenicity and reproductive toxicity potential of medical devices. The revised standard includes the use of risk assessments and chemical characterization in addition to traditional genetic toxicity tests. The ISO 10993-3 standard provides guidance on the selection and preparation of test samples, and the selection of tests to evaluate genetic toxicity. Although conformance to ISO 10993-3 is required by various national regulatory agencies for specific medical device categories, there are still differences in the interpretation of the requirements within the standard which may require additional testing. Environ. Mol. Mutagen. 58:375-379, 2017. © 2017 Wiley Periodicals, Inc.


[INTRAHEPATIC CHOLESTASIS OF PREGNANCY: STATE-OF-THE-ART].
Intrahepatic cholestasis of pregnancy (ICP) is a relatively benign cholestatic pathology of the liver developing in II or III trimester of pregnancy and characterized by itchy skin and enhanced serum bile acid levels. The cause of ICP is unknown; it may have a multifactor nature involving genetic (ABCB4, EXR, ABCC2 genes), hormonal (estrogens, progesterone), and environmental factors. As a rule, ICP first manifests itself on weeks 28-30 of pregnancy in the form of pruritus especially pronounced at night time. Almost half of the patients develop jaundice, usually within 1-4 weeks after appearance of pruritus. The enhanced serum bile acid level is sometimes the first or the sole laboratory sign of the disease. Ursodeoxycholic acid is currently the drug of choice for the treatment of ICP due to its confirmed effectiveness and safety.


Equivalence in Freud's Primary Process.
Freud's concept of the primary process, when confined to the selection of objects for the formation of dreams or symptoms, depends strongly on the concept of association, which in turn depends strongly on the logic of pars pro toto. An examination of how Freud saw the primary process selecting objects leads to the identification of an equivalence relationship as governing his model. This results in a logical understanding of how the primary process works in forming associations and choosing candidate objects for dreams and symptoms. The relationship of this result to the work of Matte Blanco is also discussed, and the insights of this paper are applied to defining Freud's concept of a complex.


[Serotonergic genes in the development of anxiety/depression-like state and pathology of aggressive behavior in male mice: RNA-seq data].
In course of daily agonistic interactions, mice tend to stratify into those with chronic social defeats and those that repeatedly display aggression, which lead to the development of mixed anxiety/depression-like state and the pathology of aggressive behavior, respectively. Using the data of whole transcriptome analysis (RNA-seq), the changes in the expression of serotonergic genes involved in the synthesis, inactivation, and reception of serotonin, as well as of the Creb1 (transcription factor) gene and the Bdnf (brain-derived neurotrophic factor) gene were detected in the striatum (STR), ventral tegmental area (VTA), midbrain raphe nuclei (MRN), hypothalamus (HYP), and hippocampus (HIP) of defeated and aggressive male mice. In mice of both groups, the Tph2, Ddc, Slc6a4, Htr2a, Htr3a, Htr5b, Slc18a2, and Bdnf genes were downregulated in the MRN and the Tph2, Ddc, and Slc6a4 genes were upregulated in the VTA. These changes were more significant in defeated mice. The Htr5b gene has first been shown to be involved in mechanisms of depression and pathology of aggressive behavior. In the defeated mice, the expression levels of the Htr4 and Aldh1b1 genes were increased in the MRN, and expression levels of the Maob, Htr4, Htr1a, and Slc18a2 genes were increased in the VTA, while the expression level of the Htr3a gene was decreased. In the HYP of aggressive mice the Maoa, Htr2a, Htr2c, and Creb1 genes were downregulated and the Htr6 gene was upregulated. In the defeated mice, the Maoa and Creb1 genes were downregulated and the Htr6 and Aldh1b1 genes were upregulated in the HYP. In the STR, the Htr1a gene was downregulated and the Htr7 and Bdnf genes were upregulated. The Htr1b gene was upregulated in the HIP. The coexpression of dopaminergic and serotonergic genes in the MRN and VTA in the control of pathological behaviors is discussed. Thus, the complex pattern of differential expression of serotonergic genes in brain regions developing under repeated agonistic interactions in mice in dependence on behavioral pathology have been observed.


Mechanopathology of biofilm-like Mycobacterium tuberculosis cords.
Mycobacterium tuberculosis (Mtb) cultured axenically without detergent forms biofilm-like cords, a clinical identifier of virulence. In lung-on-chip (LoC) and mouse models, cords in alveolar cells contribute to suppression of innate immune signaling via nuclear compression. Thereafter, extracellular cords cause contact-dependent phagocyte death but grow intercellularly between epithelial cells. The absence of these mechanopathological mechanisms explains the greater proportion of alveolar lesions with increased immune infiltration and dissemination defects in cording-deficient Mtb infections. Compression of Mtb lipid monolayers induces a phase transition that enables mechanical energy storage. Agent-based simulations demonstrate that the increased energy storage capacity is sufficient for the formation of cords that maintain structural integrity despite mechanical perturbation. Bacteria in cords remain translationally active despite antibiotic exposure and regrow rapidly upon cessation of treatment. This study provides a conceptual framework for the biophysics and function in tuberculosis infection and therapy of cord architectures independent of mechanisms ascribed to single bacteria.


A large solitary fibrous tumour of the pleura: a case report and review of the literature.
We report a clinical case of a solitary fibrous tumour of the pleura (SFTP) in a 67-year-old female patient complaining of chest pain for 2 months. A localized large mass was found in the left inferior hemithorax by computed tomography scan. The patient underwent a thoracotomy at the left side with endotracheal anaesthesia. During surgical resection, the tumour was located in the left inferior hemithorax and was attached to the inferior lobe of the left lung and diaphragmatic pleura by a fibrous pedicle. A wedge resection of the left lower lobe was undertaken to completely remove the tumour. Diagnosis of the SFTP was confirmed by the surgical findings and subsequent histological and immunohistochemical examinations. At the 6-month follow-up, no signs of local tumour recurrence or metastasis were documented. After a 3-year follow-up, this patient remains in good health.


Zinc deficiency is an independent risk factor for prehypertension in healthy subjects.
Objective: To assess whether zinc deficiency is associated with prehypertension (preHTN) in apparently healthy subjects. Design: Apparently healthy women and men, aged 20 to 60 years were enrolled into a case-control study. Individuals with and without preHTN were allocated into the case and control groups, respectively. Hypertension, liver disease, renal disease, smoking, pregnancy, diabetes, malignancy, hypernatremia, hypomagnesemia, medical treatment, and use of supplements containing zinc were exclusion criteria. PreHTN was defined by systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) of 120-139 mmHg and/or of 80-89 mmHg, respectively, and the zinc deficiency by serum zinc levels < 74 μg/dL in men and < 70 μg/dL in women. Results: In total, 142 subjects (90 women and 52 men) were enrolled and allocated in the case (n = 71) and control (n = 71) groups. In the overall population, the frequency of zinc deficiency was 11.1%; individuals in the case group showed significant higher frequency of zinc deficiency as compared with the control group (16.9% vs 5.5%, p = 0.04). The logistic regression analysis showed a significant association between zinc deficiency and preHTN (OR = 4.61; 95% CI: 1.24-17.12, p = 0.02). Conclusion: Our results suggest that zinc deficiency is associated with the presence of preHTN in apparently healthy subjects.


Physicochemical interactions at the dentin/adhesive interface using FTIR chemical imaging.
To date, much of our understanding of dentin bonding has been based on investigations performed on sound, healthy dentin. This is not the substrate generally encountered in clinical practice, rather dentists must frequently bond to caries-affected dentin. Because of the extreme complexity and variability of the caries-affected dentin substrate, conventional characterization techniques do not provide adequate information for defining those factors that impact bond formation. Using Fourier-transform infrared imaging, we characterized the inhomogeneities and compositional differences across the length and breadth of the caries-affected dentin/adhesive interface. Differences in mineral/matrix ratio, crystallinity, and collagen organization were noted in the comparison of caries-affected and healthy dentin. As compared to healthy dentin, there were striking differences in depth of demineralization, adhesive infiltration, and degree of conversion at the interface with caries-affected dentin.


Gastric mucosal injury and repair: effect of aging.
Although the gastric mucosa of healthy adult animals possesses the inherent capacity to promptly repair (often within 24 h) after a minor to moderate injury, aging appears to diminish its reparative capacity. At least two different repair mechanisms are thought to participate in full repair of the damaged gastric mucosa: the initial rapid process of mucosal restitution begins by migration of viable epithelial cells from gastric pits and glands; the subsequent slower process is replacement of lost cells by cell division. Intracellular events that regulate these processes are poorly understood, nor do we know how they may be affected by aging. However, evidence is accumulating which suggests that a number of gastrointestinal hormones/growth factors, most notably EGF and TGF-alpha may play a critical role in regulating gastric mucosal reparative processes. Since EGF and TGF-alpha exert their physiological actions by activating the intrinsic tyrosine kinase (Tyr-k) activity of their common receptor, the EGF-R, studies have been performed to assess the role of EGF-R Tyr-k in regulating mucosal reparative processes during aging. Recent data suggest that the age-related decline in mucosal repair after acute injury could in part be due to decreased activation of EGF-R Tyr-k. In addition, polyamines and prostaglandins are also thought to be involved in gastric mucosal reparative processes. Although the involvement of polyamines in gastric mucosal reparative processes during aging has not yet been studied, decreased mucosal prostaglandin levels in the aged are thought to be a causative factor for the increased susceptibility of the mucosa to injury. These and other relevant matters are discussed in the current review.


Inhibitory effect of decidua on fibrinolysis induced by urokinase and by the fibrinolytic activity of the rat ovum.
With the use of a technique, which permits the study of fibrinolytic enzymes and inhibitors in organ culture, human decidua was found to produce inhibitors capable of inhibiting plasminogen activation induced by urokinase as well as activators released from kidney explants. Also the medium in which rat and human decidua had been cultured was found to inhibit fibrinolytic activity of the rat ovum. The inhibitors emanating from the decidua are presumably of importance for facilatating the implantation of ova.


Virulence assessment of Listeria monocytogenes grown in different foods using a Galleria mellonella model.
Various produce including cantaloupe, caramel-coated apples, and packaged salads, have been recognized in recent years as vehicles for listeriosis, a human foodborne disease caused by intracellular pathogen Listeria monocytogenes. Our knowledge regarding the role of these foods in L. monocytogenes virulence, however, is limited. Understanding their role in modulating L. monocytogenes virulence can be useful in risk assessments and for developing control measures. In this study, we employed the Galleria mellonella larvae model to evaluate virulence potential of fifteen clinical, environmental and food isolates of L. monocytogenes, related to three major outbreaks, after growth on different foods. The non-human pathogen Listeria innocua was also included in the panel. Strains were inoculated in parallel in 5ml of brain heart infusion (BHI) broth, and on the surfaces of cantaloupe and apple fragments (5g each) at about 105 colony forming units (CFU)/ml/fragment. One set of inoculated broth and food fragments was incubated at 10°C for 5 days while the second set was kept at 25°C for 3 days. L. monocytogenes cells were recovered from the fruits and BHI, washed twice, re-suspended in saline, and used to inoculate G. mellonella larvae at final concentrations of 106 and 105 CFU/larva. The larvae were incubated at 37°C and monitored for mortality (LT50-time taken to kill 50% of the larvae) and phenotypic changes over seven days. L. monocytogenes grown on cantaloupe and apple flesh surfaces resulted in higher virulence than when grown in BHI. L. monocytogenes infection at 106 CFU/larvae resulted in an average LT50 of ≤ 30, 36 and 47 hours on cantaloupe, apples and BHI, respectively. These results represent a 2.5-4-fold increased mortality compared with an LT50 ≥120 hours in larvae infected with the same doses of L. innocua grown in corresponding matrices. Similar trends were also recorded with doses of about 105 CFU /larvae.


Concurrent Pneumocystis jirovecii and pulmonary histoplasmosis in an undiagnosed HIV patient.
Concurrent Pneumocystis jirovecii (PJ) and pulmonary histoplasmosis (PHP) are rare in a single HIV individual. We present a challenging case of concomitant PJ and PHP in a young HIV individual. A 44-year-old man presented to the emergency department with progressive pulmonary symptoms. He was hypoxic with bilateral pulmonary opacities on chest radiograph. CT of the chest showed a geographical pattern of ground-glass attenuation. He started receiving intravenous antibiotics in addition to oral Bactrim for suspected PJ. He also began receiving itraconazole, given suspected PHP with recent bat-droppings exposure. HIV test was positive, though history was negative; the CD4 count was 5 cells/mm3 Later, he developed respiratory failure without clinical improvement. First bronchoalveolar lavage (BAL) failed to confirm opportunistic pathogens. Repeat BAL revealed PJ but no Histoplasma. Histoplasma antigens were positive, confirming histoplasmosis. The patient died despite aggressive treatment with intravenous Bactrim and amphotericin B.


Role of CD8+ T cells in control of West Nile virus infection.
Infection with West Nile virus (WNV) causes fatal encephalitis more frequently in immunocompromised humans than in those with a healthy immune system. Although a complete understanding of this increased risk remains unclear, experiments with mice have begun to define how different components of the adaptive and innate immune response function to limit infection. Previously, we demonstrated that components of humoral immunity, particularly immunoglobulin M (IgM) and IgG, have critical roles in preventing dissemination of WNV infection to the central nervous system. In this study, we addressed the function of CD8(+) T cells in controlling WNV infection. Mice that lacked CD8(+) T cells or classical class Ia major histocompatibility complex (MHC) antigens had higher central nervous system viral burdens and increased mortality rates after infection with a low-passage-number WNV isolate. In contrast, an absence of CD8(+) T cells had no effect on the qualitative or quantitative antibody response and did not alter the kinetics or magnitude of viremia. In the subset of CD8(+)-T-cell-deficient mice that survived initial WNV challenge, infectious virus was recovered from central nervous system compartments for several weeks. Primary or memory CD8(+) T cells that were generated in vivo efficiently killed target cells that displayed WNV antigens in a class I MHC-restricted manner. Collectively, our experiments suggest that, while specific antibody is responsible for terminating viremia, CD8(+) T cells have an important function in clearing infection from tissues and preventing viral persistence.


Ubiquitin carboxyl-terminal hydrolase isozyme L5 inhibits human glioma cell migration and invasion via downregulating SNRPF.
Ubiquitin C-terminal Hydrolase-L5 (UCH-L5/UCH37), a member of the deubiquitinases (DUBs), suppresses protein degeneration via removing ubiquitin from the distal subunit of the polyubiquitin chain. The activity of UCH-L5 is enhanced when UCH-L5 combines with proteasome 19S regulatory subunit by Rpn13/Admr1 receptor and inhibited when UCH-L5 interacts with NFRKB. But the role of UCH-L5 in gliomas remains unknown. In this study, analysis of 19 frozen and 51 paraffin-embedded clinic pathological cases showed that UCH-L5 expression in glioma tissues was lower than normal brain tissues. In vitro, we found that UCH-L5 could inhibit migration and invasion of U87MG and U251 cells. It has been reported that the expression of SNRPN, SNRPF, and CKLF was abnormal in gliomas or other tumors. We also found that SNRPF-siRNA, SNRPN-siRNA and CKLF-siRNA could inhibit migration and invasion of U87MG cells. And knockdown of UCH-L5 expression improved both mRNA expression and protein level of SNRPF. The relationship between UCH-L5 and SNRPF was further confirmed in 293T cells. Our study showed that UCH-L5 could inhibit migration and invasion of glioma cells via down regulating expression of SNRPF. And the above findings suggest that UCH-L5 may inhibit occurrence and metastasis of gliomas.


Tumor-targeting delivery of herb-based drugs with cell-penetrating/tumor-targeting peptide-modified nanocarriers.
Cancer has become one of the leading causes of mortality globally. The major challenges of conventional cancer therapy are the failure of most chemotherapeutic agents to accumulate selectively in tumor cells and their severe systemic side effects. In the past three decades, a number of drug delivery approaches have been discovered to overwhelm the obstacles. Among these, nanocarriers have gained much attention for their excellent and efficient drug delivery systems to improve specific tissue/organ/cell targeting. In order to enhance targeting efficiency further and reduce limitations of nanocarriers, nanoparticle surfaces are functionalized with different ligands. Several kinds of ligand-modified nanomedicines have been reported. Cell-penetrating peptides (CPPs) are promising ligands, attracting the attention of researchers due to their efficiency to transport bioactive molecules intracellularly. However, their lack of specificity and in vivo degradation led to the development of newer types of CPP. Currently, activable CPP and tumor-targeting peptide (TTP)-modified nanocarriers have shown dramatically superior cellular specific uptake, cytotoxicity, and tumor growth inhibition. In this review, we discuss recent advances in tumor-targeting strategies using CPPs and their limitations in tumor delivery systems. Special emphasis is given to activable CPPs and TTPs. Finally, we address the application of CPPs and/or TTPs in the delivery of plant-derived chemotherapeutic agents.


Lapses and psychosocial factors related to physical activity in early postmenopause.
After menopause, leisure physical activity (PA) levels seem to decline for reasons that are not completely understood. This study examines the associations between PA, lapses in PA, and psychosocial factors in early postmenopausal women. This cross-sectional analysis included 497 women from the Women on the Move through Activity and Nutrition study. PA was assessed with a past-year, interviewer-administered Modifiable Activity Questionnaire. Measures of activity lapses of >or= 2 wk in the past 6 months, exercise decision making, processes of change, and self-efficacy were collected along with Beck Depression Inventory, State-Trait Anxiety Inventory, Cohen Perceived Stress Scale, and Short Form-36. Mean age of participants was 56.9 yr. Compared with less active women, women with significantly higher activity levels reported greater exercise self-efficacy (r = 0.31), more frequent use of behavioral exercise processes of change (r = 0.31), greater perceived benefits for PA (r = 0.22), and better physical quality of life (r = 0.16) (all P < 0.001). Women reporting no activity lapses had higher reported activity levels than regularly active women with lapses or occasionally active women with lapses (P < 0.0001 for trend). Of the women who reported lapses, 24% reported low self-confidence, 43% reported difficulty controlling their weight, and 55% reported difficulty maintaining their diet when they lapsed from PA. Thirty-nine percent of women reporting lapses did not resume PA (i.e., relapsed to inactivity). Higher anxiety and depressive symptoms, and less frequent use of behavioral exercise processes of change, were associated with relapse to inactivity. Future interventions for early postmenopausal women should consider psychosocial factors when attempting to encourage and maintain higher levels of PA. Addressing and preventing PA lapses may help to achieve PA goals in this population.


[Immunostimulative therapy of herpes zoster (three years' experience with inosiplex) (author's transl)].
The authors report on their three years' experience in treating 69 patients with herpes zoster of different localization by Inosiplex. The clinical study was carried out in two dermatological centres. Comparison of the results with those of the usual symptomatic treatment leads to the conclusion that the results achieved in the group treated with Inosiplex are significantly better.


Search for localized dysbiosis in Crohn's disease ulcerations by temporal temperature gradient gel electrophoresis of 16S rRNA.
The mucosa-associated microbiota lining the gut epithelium might play a central role in the activation and/or perpetuation of mucosal inflammation in Crohn's disease (CD). We sought for localized dysbiosis by comparing the biodiversity and composition of the microbiotas in ulcerated and nonulcerated mucosal samples from patients with CD. Biopsy samples (n = 75) of ulcerated and adjacent nonulcerated mucosa were collected during colonoscopy from 15 patients, from the ileum, right colon, left colon, and rectum. Temporal temperature gradient gel electrophoresis (TTGE) of bacterial 16S rRNAs was used to evaluate the dominant bacterial species. TTGE profiles were compared using software that calculates similarity percentages. For a given patient, average similarity indexes between ulcerated and nonulcerated mucosal TTGE profiles ranged from 95.2% +/- 4.2% to 97.9% +/- 1.7% (means +/- standard deviations) for the different segments. The mean values did not differ significantly. Average interindividual similarity indexes for a given segment among the different patients ranged from 33.6% +/- 15.5% to 42.0% +/- 25.6%. In CD, the dominant microbiotas do not differ qualitatively between ulcerated and nonulcerated mucosae. Biodiversity remains high in ulcerated mucosa. This argues against a pathogenic role of localized qualitative dysbiosis in CD-associated ulceration.


Cooperative state-federal turkey ornithosis task force, Texas, 1974.
Ornithosis was suggested by a routine analysis of tissue specimens from Texas turkey flocks submitted to the Texas A&M University Poultry Disease Laboratory at Gonzales on April 30, 1974, and of subsequent specimens from four additional flocks. Subsequently, illness in humans at turkey processing plants in Texas, Nebraska, and Missouri, implicating turkeys from Texas, was confirmed as ornithosis in July 1974; and, associated with this outbreak, ornithosis was suspected as the cause of the death of one human. Action was taken by state and federal poultry disease control and inspection officials, public health agencies, and the turkey industry in Texas.


Temperature and salt dependence of the gel migration anomaly of curved DNA fragments.
A series of oligonucleotides of different sequences have been cloned to study DNA curvature. Several DNA fragments containing these oligonucleotides in various numbers of repeats were analyzed in 10% polyacrylamide gels. A strong gel migration anomaly was found for dA4 sequences; a comparably very small but clearly detectable anomaly was observed for dA3 (both in a repeat length of 10 base-pairs). The temperature and salt (NaCl, MgCl2) dependence of the gel migration anomaly of these DNA fragments was measured. While a similar behaviour of all sequences is observed for the addition of NaCl, the temperature and MgCl2 dependence of the anomaly varies with the oligonucleotide sequence. These data are interpreted in terms of local DNA structure changes induced by changes in the temperature and the MgCl2 concentration which affect the planarity of the curved DNA fragments.


Modeling of Modulated Exosome Release From Differentiated Induced Neural Stem Cells for Targeted Drug Delivery.
A novel implantable and externally controllable stem-cell-based platform for the treatment of Glioblastoma brain cancer has been proposed to bring hope to patients who suffer from this devastating cancer type. Induced Neural Stem Cells (iNSCs), known to have potent therapeutic effects through exosomes-based molecular communication, play a pivotal role in this platform. Transplanted iNSCs demonstrate long-term survival and differentiation into neurons and glia which then fully functionally integrate with the existing neural network. Recent studies have shown that specific types of calcium channels in differentiated neurons and astrocytes are inhibited or activated upon cell depolarization leading to the increased intracellular calcium concentration levels which, in turn, interact with mobilization of multivesicular bodies and exosomal release. In order to provide a platform towards treating brain cancer with the optimum therapy dosage, we propose mathematical models to compute the therapeutic exosomal release rate that is modulated by cell stimulation patterns applied from the external wearable device. This study serves as an initial and required step in the evaluation of controlled exosomal secretion and release via induced stimulation with electromagnetic, optical and/or ultrasonic waves.


Phylogenetic similarity of the canine parvovirus wild-type isolates on the basis of VP1/VP2 gene fragment sequence analysis.
Biological material was taken from dogs with diarrhoea. Faecal samples were taken from within live animals and intestinal tract fragments (i.e. small intestine, and stomach) were taken from dead animals. In total, 18 specimens were investigated from dogs housed alone or in large groups. To test for the presence of the virus, latex (On Site Biotech, Uppsala, Sweden) and direct immunofluorescence tests were performed. At the same time, polymerase chain reaction (PCR) with primers complementary to a conservative region of VP1/VP2 was carried out. The products of amplification were analysed on 2% agarose gel. The purified products were cloned with the Template Generation System (Finnzymes, Espoo, Finland) using a transposition reaction and positive clones were searched using the 'colony screening by PCR' method. The sequencing gave 12 sequences of VP1/VP2 gene fragments that were of high similarity. Among the 12 analysed sequences, six exhibited 88% similarity, four exhibited 100% similarity and two exhibited 71% similarity.


Optimization for fast-scanning irradiation in particle therapy.
In three-dimensional irradiation with pencil beam scanning, an extra dose is inevitably delivered to the irradiated site due to the finite reaction times of the beam delivery system, and it causes a severe distortion of the dose distribution in the target region. Since the amount of the extra dose is proportional to the beam intensity, the dose uniformity deteriorates as the beam intensity is increased in order to shorten the treatment time. In order to overcome this problem and shorten the treatment time, we have developed an optimization method in which the extra dose is integrated into the optimization process of the best weighting matrix. The effectiveness and applicability of the optimization method for spot and raster scanning irradiation were confirmed with computer simulations and also confirmed using irradiation experiments for spot scanning irradiation. The treatment time could be shortened to about one sixth of the time needed without taking the extra dose into account while obtaining the same degree of dose homogeneity in the target volume. A typical treatment time with the proposed method is about 15 s for the irradiation of a spherical target with an 80 mm diameter at 3 GyE.


SGLT2 inhibition: a novel prospective strategy in treatment of diabetes mellitus.
The role of the kidney in glucose homeostasis and the potential of the kidney as a therapeutic target in type 2 diabetes is little appreciated. Hyperglycemia is an important pathogenic component in the development of microvascular and macrovascular complications in type 2 diabetes mellitus. Inhibition of renal tubular glucose re-absorption that leads to glycosuria has been proposed as a new mechanism to attain normoglycemia and thus prevent and diminish these complications, thus representing an innovative therapeutic strategy for the treatment of hyperglycemia and/or obesity in patients with type 1 or type 2 diabetes by enhancing glucose and energy loss through the urine. Sodium glucose co-transporter 2 (SGLT2) has a key role in re-absorption of glucose in kidney. Competitive inhibitors of SGLT2 have been discovered and a few of them have also been advanced in clinical trials for the treatment of diabetes.


Evaluation of elastography combined with serological indexes for hepatic fibrosis in patients with chronic hepatitis B.
To investigate the value of ultrasound elastography combined with serological indexes in diagnosing liver fibrosis and assessing its severity. A total of 338 chronic hepatitis B (CHB) patients were divided into a disease group (patients with hepatic fibrosis) and control group (subjects without hepatic fibrosis). The disease group was further divided into S1-S4 according to the degree of fibrosis. Independent risk factors for hepatic fibrosis were analyzed using multivariate logistic regression. The diagnostic values of hepatic fibrosis from different indicators were compared using receiver operating characteristic (ROC) curves. The combination of elastography and serological indexes was explored to assess the severity of hepatic fibrosis. The multivariate logistic regression analysis results revealed that shear wave velocity (SWV), hyaluronic acid (HA), type IV collagen (CIV) and aspartate aminotransferase-to-platelet ratio index (APRI) significantly affected the occurrence of hepatic fibrosis. The ROC curve revealed that the accuracy of the diagnosis of hepatic fibrosis for SWV and HA were 87.3% and 84.8%, respectively. The accuracy of SWV combined with HA was 88.9%. The multiple linear regression analysis revealed that SWV, aspartate aminotransferase (AST)/alanine aminotransferase (ALT), HA, CIV, APRI and fibrosis index based on the 4 factor (FIB-4) were screened as statistically significant independent factors. The established regression equation was: Fibrosis level = -4.046 + 1.024 × SWV + 1.170 × AST/ALT + 0.011 × HA + 0.020 × CIV + 0.719 × APRI + 0.379 × FIB-4. SWV combined with serological indexes can improve the accuracy of diagnosis for CHB hepatic fibrosis. Serum indexes can help diagnose the degree of hepatic fibrosis.


Anesthetic Management of Inguinal Hernia Surgery Using a Second-Generation Supraglottic Airway in a Patient With Trisomy 18: A Case Report.
Children with trisomy 18 have abnormal airway anatomy, making their airway management challenging. Only a few papers have comprehensively described and discussed the use of supraglottic airway devices in patients with trisomy 18. We present a case of a 20-month-old boy with trisomy 18 who was scheduled for open repair of the right inguinal hernia. He had micrognathia, a short neck, and an atrial septal defect but was in a clinically stable condition. A supraglottic airway device was inserted under general anesthesia. The patient's respiration was maintained by pressure support ventilation with spontaneous breathing. A right ilioinguinal-iliohypogastric nerve block was performed for perioperative analgesia. The surgery ended without complications. After removing the supraglottic airway device and ensuring proper respiratory parameters, the patient was transferred to the post-anesthesia care unit. In our case, supraglottic airway devices could be effectively used as a primary airway for inguinal hernia repair. The concomitant ilioinguinal-iliohypogastric nerve block was helpful for anesthetic management with spontaneous breathing maintained using pressure support ventilation. A supraglottic airway device may be a potential alternative as a primary airway for superficial surgery in pediatric patients with trisomy 18. For pediatric patients with difficult airways, a second-generation supraglottic airway device with the insertion of a gastric tube to prevent gastric insufflation combining pressure support ventilation and positive end-expiratory pressure may be a beneficial choice for the maintenance of spontaneous breathing.


Ferroptosis-Like Death in Microorganisms: A Novel Programmed Cell Death Following Lipid Peroxidation.
Ferroptosis is a new kind of programmed cell death of which occurrence in microorganisms is not clearly verified. The elevated level of reactive oxygen species (ROS) influences cellular metabolisms through highly reactive hydroxyl radical formation under the iron-dependent Fenton reaction. Iron contributes to ROS production and acts as a cofactor for lipoxygenase to catalyze poly unsaturated fatty acid (PUFA) oxidation, exerting oxidative damage in cells. While ferroptosis is known to take place only in mammalian cells, recent studies discovered the possible ferroptosis-like death in few specific microorganisms. Capacity of integrating PUFA into intracellular membrane phospholipid has been considered as a key factor in bacterial or fungal ferroptosis-like death. Vibrio species in bacteria and Saccharomyces cerevisiae in fungi exhibited certain characteristics. Therefore, this review focus on introducing the occurrence of ferroptosis-like death in microorganisms and investigating the mode of action underlying the cells based on contribution of lipid peroxidation and iron-dependent reaction.


Chiral Hypervalent Iodine Catalysis Enables an Unusual Regiodivergent Intermolecular Olefin Aminooxygenation.
A novel iodide-catalyzed intermolecular aminooxygenation strategy is described here. Amide is used as the O- and N- source to probe for regiocontrol strategies. Notably, simple additives can be selectively introduced to achieve regiodivergent oxyamination processes for electronically activated alkenes while being regio-complementary for unactivated alkenes. Our preliminary data demonstrates that this regiocontrol strategy based on nucleophile can also be applied in asymmetric processes using chiral hypervalent iodine catalysis.


Fitness of indirectly transmitted pathogens: restraint and constraint.
Many pathogens of medical and veterinary importance have obligatory multihost life cycles. Yet, theoretical models aiming to predict patterns of pathogen reproductive success and the limited empirical data available with which to evaluate them, focus on directly transmitted microparasites. Patterns of host exploitation and the relative fitness of individual pathogen genotypes throughout the different host stages of multihost life cycles have thus remained ignored. We examined correlated responses to artificial selection of Schistosoma mansoni lines selected for high or low infection intensity in the intermediate host. Pathogen fitness in the intermediate host was strongly inversely correlated with pathogen fitness in the definitive host. Moreover, high pathogen infection intensity was associated with decreased, rather than increased, virulence to its intermediate host. These results raise important implications regarding the impact of genetic constraints on the maintenance of genetic and phenotypic polymorphisms in natural populations, the evolution and coevolution of parasite virulence and host specialization, as well as the success of host-directed control programs.


Social marketing in gynecological cancers prevention after the COVID-19 pandemic.
Assessment of the development and description of the characteristics of social marketing in Poland and the United States with regard to the prevention of gynecological cancers and achievements of these countries. Collective case study based on an analysis of five social campaigns in Poland and five social campaigns in the United States that were focused the gynecological cancers prevention. In the United States, there are more materials available on social campaigns dedicated to the prevention of gynecological cancers, and there are more public organizations that are involved in health promotion activities than in Poland. As opposed to American campaigns, Polish social campaigns did not cover all types of gynecological cancer. The study revealed that Facebook is the most commonly used social media platform by the social campaign organizers. Social marketing tools still have not been fully implemented in the prevention of gynecological cancers either in Poland or in the United States. However, social marketing in the US seems to be more effective in gynecological cancers prevention than Poland.


Children's emotion regulation: Self-report and physiological response to peer provocation.
The authors examined the notion that children's emotion regulation (ER) is a uniform skill by (a) investigating the concordance between self-report of ER and physiological measures and by (b) examining ER in a specific context (e.g., peer provocation) and context-free manner (e.g., during a semistructured interview of ER abilities). Seventy-two children in middle childhood (average age = 9 years) participated. Time-locked measures of heart rate reactivity and recovery were obtained in response to provoking comments, and vagal regulation was measured throughout the provocation session. Children who reported greater dysregulation showed increased heart rate reactivity to provocative comments (i.e., steeper heart rate slope) but no difference in heart rate recovery. The context-free but not the context-specific self-report measure was associated with a failure to suppress vagal tone. Implications for ER measurement and children's peer relations are discussed.


[Quality of life after surgical correction of penile deviation with the Schroeder-Essed plication].
For the correction of congenital and acquired penile deviations, there are two established operative methods: the Nesbit procedure and the Schroeder-Essed technique. However, which operative method is optimal with respect to the specific underlying pathology, is still controversial. The aim of the study was to evaluate patient satisfaction retrospectively after modified Essed-Schroeder plication using quality of life questionnaires. Between June 1997 and June 2000, 59 patients underwent Essed-Schroeder at our institution for correction of a penile deviation. Mean patient age was 40 years (18 - 71) and mean follow-up 30 months (19 - 36). A standardised questionnaire was sent to all patients. Of these, the questionnaires completed by 50 patients could be assessed as valid. Of these 50 patients, 22 suffered from a congenital penis deviation, 28 from Peyronie's disease. The percentage of patients who were able to perform sexual intercourse pre- and postoperatively was 62 % and 90 %, respectively. The proportion of patients who felt hampered during intercourse was reduced from 68 % to 48 %. Frequency of pain occurring during intercourse was diminished by half. Sixty percent of the patients would choose to have the same operation again, while 22 % were dissatisfied with the results. None of the patients showed complete erectile dysfunction after the operation. Seventy-four percent of the patients observed a decrease in penile length. In patients with Peyronie's disease, the Schroeder-Essed technique with tunica plicature leds to significant improvement in relatively few cases. Alternative methods, such as the Nesbit corporoplasty, appear to be superior in these patients. In cases of congenital penile deviation, however, where the aim is cosmetic correction under maximum protection of erectile function, the Schroeder-Essed tunica plicature has shown good results with regard to penile function and quality of life.