Features, management, and long-term outcome in dogs with pancreatitis and bile duct obstruction treated medically and surgically: 41 dogs (2015-2021).
Pancreatitis resulting in extrahepatic biliary obstruction (EHBO) can cause substantial morbidity and mortality. Endoscopic retrograde cholangiopancreatography is utilized for diagnostic and therapeutic purposes in humans; however, this is not available in veterinary medicine. Treatment options include medical management and biliary drainage procedures. The aim of this study was to describe the management of EHBO secondary to pancreatitis in dogs, treated medically and surgically and to determine whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) differ between the treatment groups. 41 dogs treated for EHBO secondary to pancreatitis during the period of May 2015 to November 2021. Records from 41 dogs diagnosed with EHBO secondary to pancreatitis were reviewed, and information extracted included clinical signs, ultrasound findings, NLR, PLR, histopathology, treatment, and outcomes. 18 of 19 (95%) surgical patients survived, while 12 of 21 (57%) medical patients survived. There was no difference in the length of hospitalization or time to return to adequate function between the groups; however, there was a significant difference in the 2- and 12-month survival between those treated surgically and medically. There was no difference in the NLR or PLR between surgically versus medically treated dogs or between survivors and nonsurvivors. The mortality rate of surgery for EHBO secondary to pancreatitis may be lower than previously described, and in this cohort of dogs, those treated surgically had improved survival at 2 and 12 months compared to those treated medically.


Engineering Saccharomyces cerevisiae for improvement in ethanol tolerance by accumulation of trehalose.
A genetic recombinant Saccharomyces cerevisiae starter with high ethanol tolerance capacities was constructed. In this study, the gene of trehalose-6-phosphate synthase (encoded by tps1), which catalyzes the first step in trehalose synthesis, was cloned and overexpressed in S. cerevisiae. Moreover, the gene of neutral trehalase (encoded by nth1, trehalose degrading enzyme) was deleted by using a disruption cassette, which contained long flanking homology regions of nth1 gene (the upstream 0.26 kb and downstream 0.4 kb). The engineered strain increased its tolerance against ethanol and glucose stress. The growth of the wild strain was inhibited when the medium contained 6 % or more ethanol, whereas growth of the engineered strain was affected when the medium contained 10 % or more ethanol. There was no significant difference in the ethanol yield between the wild strain and the engineered strain when the fermentation broth contained 10 % glucose (p > 0.05). The engineered strain showed greater ethanol yield than the wild type strain when the medium contained more than 15 % glucose (p < 0.05). Higher intracellular trehalose accumulation by overexpression of tps1 and deletion of nth1 might provide the ability for yeast to protect against environmental stress.


In vitro selection for different mutational patterns in the HIV-1 reverse transcriptase using high and low selective pressure of the nonnucleoside reverse transcriptase inhibitor HBY 097.
In vitro resistance of HIV-1 against high levels of HBY 097 ((S)-4-isopropoxycarbonyl-6-methoxy-3-(methylthiomethyl)-3, 4-dihydro-quinoxaline-2(1H)-thione) and other quinoxaline nonnucleoside reverse transcriptase inhibitors (NNRTIs) is characterized by a specific amino acid substitution in the reverse transcriptase (RT), Gly 190Glu. This change results in decreased RT polymerase activity and in reduced growth properties of the corresponding viral variant. Here we show that the appearance of the crippling mutation at codon 190 can be prevented by lowering the selective pressure exerted by HBY 097. Under low selective pressure an accumulation of other NNRTI-specific mutations is observed. Up to five NNRTI-specific substitutions were detected in some of these virus lineages. In addition, we report novel RT amino acid changes which were not observed previously, including Val106lle, Val106Leu, and Gly190Thr. HBY 097 selects for different mutational patterns under high and low selective pressure conditions, respectively. Thus, the type of mutations which appear in HIV-infected patients undergoing therapy may be determined by the levels of the selecting drug.


Acquisition and loss of best walking skills in children and young people with bilateral cerebral palsy.
To explore factors predicting acquisition and loss of best walking ability in young people with bilateral cerebral palsy (CP). In our population cohort (Study of Hips And Physical Experience) of 338 children (201 males, 137 females) with bilateral CP, age at achieving walking was recorded and walking ability predicted from early motor milestones. Walking was assessed at 5 to 8 years (mean 7y) and in 228 of 278 survivors at 13 to 19 years (mean 16y). Parent carers reported their view of any loss of best achieved walking. Factors potentially associated with loss of best achieved walking were explored: severity and type of motor disorder; intellect and communication; manipulative skill; general health and comorbidity; pain; orthopaedic surgery; musculoskeletal spine and lower limb deformity; weight; fatigue; mood; and presence of regular exercise regime. The ability to walk independently was reliably predicted by the motor milestone 'getting to sit and maintain sitting' by the age of 36 months (without aids) and 55 months (with aids). Forty-five per cent of the cohort never walked 10 steps independently. Not all who achieved walking without aids were still doing so by a mean age of 16 years, which was associated with later age at achieving walking and the degree of musculoskeletal deformity, as was the parent carers' report of loss of best walking. In this study, development of musculoskeletal deformity was a significant factor in not maintaining best achieved walking by mean age 16 years, which is most likely to occur in young people whose walking ability is with aids over short distances or in therapy only. Prediction of future walking ability in a child with bilateral CP can be made from early motor milestones.


System-on-chip solutions for portable medical devices.
A dedicated system-on-chip (SoC) integrates as much functionality as possible in a single chip and thereby allows miniaturisation of portable medical systems, while optimising performance and power consumption. Today's feature-rich semiconductor process technology platforms Smean that SoC based solutions also optimise the cost and reliability of the overall system by reducing the number of components that are employed.


Molecular epidemiology of live, attenuated varicella virus vaccine in children with leukemia and in normal adults.
Restriction endonuclease analysis of varicella-zoster virus (VZV) DNA has been used in unraveling the complex epidemiology of VZV infections in individuals immunized with a live, attenuated varicella virus vaccine. Early rashes appearing within the first six weeks after vaccination are invariably due to vaccine virus. True breakthrough infections with wild-type VZV also occur in vaccinees. Five cases of zoster have been seen in leukemic children vaccinated while in remission. One case appeared 22 months after vaccination in the same general area as the inoculation. The virus isolated was vaccine derived. A second case of zoster appeared in a dermatome unrelated to the sites of vaccination approximately 19 months after apparently natural varicella. This virus was wild type. Vaccine virus can therefore establish latency and can later reactivate as herpes zoster.


Post-Whipple imaging in patients with pancreatic ductal adenocarcinoma: association with overall survival: a multivariate analysis.
To compare the survival outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) who had regular imaging surveillance with those who had clinical follow-up after Whipple. We identified 229 patients, who underwent Whipple for resection of PDAC from 2005 to 2011, and had regular postoperative clinical follow-up at our hospital. Patients were retrospectively selected for two follow-up groups: imaging surveillance (IS) defined as routine imaging at scheduled intervals, vs. clinical (C) defined as imaging triggered by either change in clinical status or change in CA19-9. Follow-up was obtained through the hospital and Cancer Data Registry records. Survival was calculated from the date of surgery to death or last follow-up, with data censored as of March 13, 2013. Kaplan-Meier survival curves were compared using the log-rank test, and Cox regression models were used for multivariate analysis. Patients were followed for a mean period of 24.35 ± 2.56 months. IS-group underwent significantly more imaging (4.41 vs. 2.08 scans/year). The most frequent imaging was CT of chest and abdomen at 3-4 month interval. Univariate associations with overall survival were detected with post-Whipple ECOG status, T-stage, N-stage, tumor grade, surgical margin, recurrence, and IS. In multivariate analysis, grade, ECOG status, and recurrence were independent predictors of survival. Also, our predictor of interest, IS, was highly associated with longer survival in multivariate modeling (median overall survival, 30.4±3.85 (IS-group) vs. 17.1 ± 2.42 (C-groups) month, log-rank p = 0.002). Routine imaging surveillance was associated with prolonged overall survival post-Whipple in a multivariate model. This is a hypothesis-generating finding that should be studied prospectively and could ultimately impact surveillance guidelines.


[function of the patients' male partners].
To investigate the sexual behavior and sexual function of the male partners of breast cancer patients and their potential relationship with socio-demographic and clinical variables. In this cross-sectional study, we conducted an investigation among 196 male partners (aged 23-59 years) of breast cancer patients between May 2020 and October 2020. We completed the Male Sexual Function Questionnaire (BSFI) by online and telephone interview with the subjects and collected relevant socio-demographic and clinical variables. The average age of the interviewees was (46.13 ± 7.75) years old, and the mean duration of the patients' breast cancer was (1.58 ± 0.48) years at the time of the investigation. The incidence rate of sexual dysfunction in the male partners of the patients was dramatically higher after the onset of breast cancer than before it (49.76% vs 9.68%, P < 0.01). Low libido was found to be the main type of sexual dysfunction (38.3%) among the male subjects, with an even high incidence rate among those whose wives received mastectomy (OR = 5.533, P = 0.017, 95% CI: 1.366-22.412) and radiotherapy (OR = 3.439, P < 0.044, 95% CI: 1.058-11.171) and significantly correlated with age (OR = 1.134, P = 0.001, 95% CI: 1.053-1.222). Breast cancer and its treatment methods may affect the sexual function of the male partners of the patients. It is necessary for doctors to pay attention to the factors affecting the sexual function of the patients and their partners so as to take appropriate intervention measures.


Frequency of carrier screening and preventive orientation among first degree relatives of Thalassaemia patients.
To get preliminary data regarding the prevention of thalassaemia major in future generations. This Knowledge Attitude Practices study was conducted at Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from January to June 2016, using non-probability purposive sampling. Parents of children undergoing transfusion were interviewed. Questionnaires were used to collect demographics and data about awareness, attitude and frequency of screening among the first degree relatives of a thalassaemia major patient. SPSS 20 was used for data analysis. Of the 270 respondents 240(88.9%) had utilised screening services for their asymptomatic children and had a positive attitude towards prevention, but 30(11.1%) families did not screen asymptomatic children for thalassaemia minor. Besides, 49(18.1%) families had more than one thalassaemia major child in their nuclear family, while, 3(1.1%) were unwilling to let their children undergo tests. Nine (3.3%) respondents said they will not ask a prospective daughter/son-in-law to get tested for thalassaemia minor, while 194(71.9%) respondents had had cousin marriages. There were significant gaps in awareness among affected families.


Relationship between analgesia and respiratory depression for mu opioid receptor agonists in mice.
The relationship between analgesic activity, measured as the hot plate reaction time, and respiratory depression, measured as ventilatory frequency, was investigated in mice for a variety of mu opioid receptor agonists with differing selectivities for mu receptors compared with delta receptors. There was a weak correlation between analgesia and respiratory depression for opioids with the greatest selectivity for mu opioid receptors compared with delta receptors, such as alfentanil. The strength of the correlation increased for opioids which had greater delta receptor activity, such as morphine and fentanyl. Etorphine, which has almost equal affinity for mu, delta and, incidentally, kappa receptors, showed a strong correlation between analgesia and respiratory depression. We conclude that the predictability of the degree of respiratory depression produced by a given analgesic dose of an opioid appears to decrease with its selectivity for mu opioid receptors, at least in the mouse.


Biomechanical comparison of a modified Weaver-Dunn and a free-tissue graft reconstruction of the acromioclavicular joint complex.
Most surgical reconstructions of the separated acromioclavicular joint do not address the injured ligaments and capsule of the acromioclavicular joint. This study was undertaken to compare the biomechanical characteristics of a modified Weaver-Dunn reconstruction and an intramedullary acromioclavicular joint reconstruction that uses a free-tissue graft for reconstruction of both the coracoclavicular and acromioclavicular ligaments. Controlled laboratory study. Each pair of 6 matched pairs of cadaveric shoulders was randomly selected for a modified Weaver-Dunn reconstruction on 1 side and the contralateral side was used for free-tissue graft reconstruction of the coracoclavicular and acromioclavicular ligamentous complexes. Anterior-posterior and superior-inferior acromioclavicular joint translation (in millimeters) was measured with acromioclavicular joint compressions of 10, 20, and 30 N, and with translational loads of 10 and 15 N both before and after acromioclavicular joint reconstruction. Load-to-failure testing was then performed for each construct. Repeated-measures analysis of variance (translational testing) and Wilcoxon signed rank test (load-to-failure testing), both with P = .05, were used for statistical analysis. Mean anterior-posterior and superior-inferior translation of the intramedullary acromioclavicular joint reconstruction was significantly less than that of the modified Weaver-Dunn under all loading conditions (P < .001 and P = .001, respectively), but was not significantly different from that of the intact state (P = .656 and P = .173, respectively). Although the mean ultimate and yield loads and linear stiffness for the intramedullary acromioclavicular reconstruction were greater than that of the modified Weaver-Dunn reconstruction, this did not reach statistical significance (P = .625, P = .625, and P = .625, respectively). Acromioclavicular joint reconstruction with free-tissue graft for both the coracoclavicular and acromioclavicular ligamentous complexes demonstrates initial stability significantly better than a modified Weaver-Dunn and similar to that of intact specimens. This acromioclavicular joint reconstruction provides the surgeon with a relatively nondestructive option.


A departmental outcome assessment to evaluate educational achievement.
Defining and addressing outcome objectives is a crucial process in medical science and education. One outcome objective of the Physiology/ Pharmacology Department at Des Moines University is to prepare students to successfully complete Part I of the national licensure examination. This study assesses the effectiveness of the departmental curriculum in helping the students achieve success on Part I of the licensure examination. Standardized discipline examinations were used as the comprehensive final examination for the physiology and pharmacology courses for the classes of 1997, 1998, and 2002 through 2005. The results were assessed by class year and specific topic area as determined by an item keyword description. Student performance on Part I of the National Podiatric Board examination was assessed for each class. Podiatric medical students' performance tended to be similar to or slightly lower than that of the national cohort on the discipline examinations. Topic analysis revealed areas of weakness, which were then addressed in the second-year courses. Student performance on Part I was generally acceptable yet showed marked improvement with the curricular interventions and changes. External assessments provide us with an unbiased means to evaluate the strengths and weaknesses of the curriculum through student performance and to make appropriate adjustments to enhance students' success.


Development and application of a one-dimensional blood flow model for microvascular networks.
Although there are many studies available in the literature on time domain modelling of one-dimensional network blood flow, the rheological properties of blood in this modelling framework have often been disregarded through the inviscid assumption. While such a simplification may be suitable for studying the larger vessels of the circulatory system, this approach cannot be taken when modelling flow in the vessels of microcirculation in which viscous effects are much more significant. In this study, a one-dimensional network blood flow model was extended to incorporate experimentally characterized properties of the non-Newtonian blood rheology, namely the reduction in the effective viscosity in thin vessels (the Fahraeus-Lindqvist effect) and the non-proportional splitting of red blood cells at junctions (phase separation). The numerical implementation was based on the high-order finite element technique with implicit time integration, necessitated by the decreasing length of vessels on this scale. Investigations in small networks indicated that the diameter dependence of viscosity has a major impact on the overall flow and should be included in small vessel networks. However, since phase separation effects are significant only in small arterioles of diameter less than 40 microm and require significant additional complexities in computation, they may be neglected for networks that do not contain these vessels without causing a large error. The proposed technique was applied to a coronary vascular subnetwork extracted from micro computed tomography scans of a rat heart consisting of approximately 2500 segments and proved to be computationally efficient, thus providing a potential foundation for applying this model to future physiological investigations.


A case of 46,XY complete gonadal dysgenesis with a novel missense variant in SRY.
Disorders of sex development (DSD) with mild external genital abnormalities may be diagnosed after puberty. Here, we report a case of 46,XY complete gonadal dysgenesis with a novel missense variant in sex-determining region Y (SRY), diagnosed after primary amenorrhea. A 15-yr-old patient presented to our gynecology department with a chief complaint of amenorrhea. The patient was diagnosed with a 46,XY karyotype, and SRY gene positivity. Gonadotropin levels were high, whereas testosterone levels were low. A pelvic magnetic resonance imaging (MRI) revealed a hypoplastic uterus; however, no gonads could be identified. Laparoscopy revealed bilateral streak gonads, fallopian tube-like structures, and the uterus. The gonads were removed based on the risk of gonadal malignancy. Comprehensive genetic analysis of DSD revealed a previously unreported SRY variant, c.271A>T, p.Ser91Cys, and in silico analysis predicted the variant to be pathogenic. The patient was diagnosed with 46,XY complete gonadal dysgenesis with a novel missense variant in SRY. The patient continued female hormone replacement therapy and experienced breast enlargement and cyclic menstruation. Determining the etiology of DSD can be difficult, causing anxiety in patients and their families. In addition to surgical scrutiny, genetic analysis is important to aid in diagnosis and reassure patients and their families.


Hybrid layers deposited by an atmospheric pressure plasma process for corrosion protection of galvanized steel.
Finding alternative treatments to reproduce anticorrosion properties of chromated coatings is challenging since both physical barrier and self-healing effects are needed. Siloxane based treatments are known to be a promising way to achieve physical barrier coatings, mainly plasma polymerized hexamethyldisiloxane (ppHMDSO). In addition, it is known that cerium-based coatings can also provide corrosion protection of metals by means of self-healing effect. In this frame, innovative nanoAlCeO3/ppHMDSO layers have thus been deposited and studied. These combinations allow to afford a good physical barrier effect and active properties. Liquid siloxane and cerium-based particles mixture is atomized and introduced as precursors into a carrier gas. Gas mixture is then injected into an atmospheric pressure dielectric barrier discharge (DBD) where plasma polymerization of the siloxane precursor occurs. The influence of cerium concentration on the coating properties is investigated: coating structure and topography have been studied by scanning electron microscopy (SEM) and interferometry, and corrosion resistance of these different coatings is compared by electrochemistry techniques: polarization curves and electrochemical impedance spectroscopy (EIS). Potential self-healing property afforded by cerium in the layer was studied by associating EIS measurements and nanoscratch controlled damaging. Among the different combinations investigated, mixing of plasma polymerized HMDSO and AICeO3 nanoparticles seems to give promising results with a good physical barrier and interesting electroactive properties. Indeed, corrosion currents measured on such coatings are almost as low as those measured with the chromated film. Combination of nanoscratch damaging of layers with EIS experiments to investigate self-healing also allow to measure the active protection property of such layers.


Prostate cancer with an unusual metastatic affinity for the appendix, inducing acute appendicitis.
Acute appendicitis induced by metastatic disease is uncommon. We present the case of an 82-year-old man with known bony metastases secondary to prostatic cancer who presents with a short history of acute abdominal pain. A CT scan was indicative of acute appendicitis and the patient underwent a laparoscopic appendicectomy; a phlegmonous mass seen intraoperatively was suspicious for malignancy, and histopathology confirmed acute appendicitis as well as metastases of prostate cancer. Metastatic disease should be considered as an important differential in all patients with a known history of malignancy, as this may in turn complicate their presenting surgical complaint.


Mast cells positive for cluster of differentiation 117 protein: are they players or conductor in the orchestra of cholesteatoma?
The pathogenesis of cholesteatoma remains unclear, despite several theories. Alterations in the density of mast cells positive for cluster of differentiation 117 protein (also known as CD117) can be critical to cholesteatoma formation, due to the effect on keratinocyte growth factor production. This study aimed to investigate the potential role of these mast cells in cholesteatoma pathogenesis. The number and density of mast cells positive for cluster of differentiation 117 protein were immunohistochemically analysed in 52 patients: 22 with chronic otitis media alone (group one), 25 with chronic otitis media with cholesteatoma (group two) and five controls. The number of these mast cells was much higher in group two (in cholesteatoma matrix tissue) than in group one (in chronic otitis media granulation tissue) or the controls (in normal post-auricular skin). The density of these mast cells was significantly greater in group two than in group one or the controls (p < 0.05). The number and density of these mast cells was much greater in group one than in controls (p < 0.01). Mast cells positive for cluster of differentiation 117 protein could play a role in cholesteatoma formation. Further investigation of the role of these mast cells in cholesteatoma may suggest new ways of addressing this disorder, and may enable the development of targeted treatments.


Adjunctive pharmacologic agents and mechanical devices in primary percutaneous coronary intervention.
Primary percutaneous coronary intervention (PPCI) has been shown to be superior to thrombolysis in patients presenting with ST-segment elevation acute myocardial infarction (STEMI) in reducing death, stroke and re-infarction. However, bleeding and thrombotic complications can occur despite successful PPCI and slow fl ow/no-reflow or poor microvascular reperfusion can occur in a significant minority despite a technically successful procedure. Bleeding or need for peri-procedural transfusion has been shown to increase short- and long-term mortality. Newer anticoagulants appear to reduce the bleeding risk and improve overall clinical outcomes. A novel combination of antiplatelet agents also appears to further improve the outcomes after PPCI. Although PPCI can achieve high rates of epicardial artery patency, some patients experience suboptimal microvascular perfusion, which affects long-term prognosis. Several pharmacologic agents have been shown to improve microvascular perfusion and left ventricular function, although none impacts on clinical outcomes. Of the mechanical devices available to reduce distal embolisation, the simple aspiration catheter holds the most promise in reducing clinical adverse events. Additional research and well designed studies are needed to further enhance the outcomes after PPCI.


Monitored anesthesia care in and outside the operating room.
Monitored anesthesia care (MAC) is an anesthesia technique combining local anesthesia with parenteral drugs for sedation and analgesia. The use of MAC is increasing for a variety of diagnostic and therapeutic procedures in and outside of the operating room due to the rapid postoperative recovery with the use of relatively small amounts of sedatives and analgesics compared to general anesthesia. The purposes of MAC are providing patients with safe sedation, comfort, pain control and satisfaction. Preoperative evaluation for patients with MAC is similar to those of general or regional anesthesia in that patients should be comprehensively assessed. Additionally, patient cooperation with comprehension of the procedure is an essential component during MAC. In addition to local anesthesia by operators or anesthesiologists, systemic sedatives and analgesics are administered to provide patients with comfort during procedures performed with MAC. The discretion and judgment of an experienced anesthesiologist are required for the safety and efficacy profiles because the airway of the patients is not secured. The infusion of sedatives and analgesics should be individualized during MAC. Many procedures in and outside of the operating room, including eye surgery, otolaryngologic surgery, cardiovascular procedures, pain procedures, and endoscopy are performed with MAC to increase patient and operator satisfaction.


Changes in serum creatine phosphokinase MM isoenzyme after lumbar spine surgery.
Serum concentrations of creatine phosphokinase and its isoenzyme were measured serially in 47 patients who underwent lumbar surgery. To analyze the significance of postoperative creatine phosphokinase MM levels as indicators of muscle trauma after lumbar surgery. The authors of the present study previously have reported on iatrogenic back muscle injury in an animal model and in man. However, the relationship between the change of the creatine phosphokinase MM isoenzyme level and muscle injury after surgery has not been clarified. Peripheral venous blood samples were collected serially before surgery, just after surgery, and at 1, 3, 7, 14, and 21 days after surgery. The serum concentration of total creatine phosphokinase and its isoenzymes was measured by agarose gel electrophoresis. The serial postoperative change of the creatine phosphokinase MM isoenzyme concentration was evaluated with respect to age, gender, body weight, types and levels of surgery, and surgery time. Creatine phosphokinase MM activity increased after surgery and reached a maximum value 1 day after surgery, followed by recovery to the normal value 1 week after surgery. The maximum concentration of creatine phosphokinase MM isoenzyme in posterior lumbar surgery was significantly higher than that in anterior surgery (P = 0.04). It was significantly higher in men than in women (P = 0.02). Serum concentration of creatine phosphokinase MM isoenzyme showed no significant correlation to the extent of muscle exposure and surgery time. The time course of postoperative serum creatine phosphokinase MM isoenzyme activity is correlated with the histologic changes of the back muscles after surgery. The concentration of creatine phosphokinase MM isoenzyme in posterior lumbar surgery was significantly higher than that in anterior surgery. It was also significantly higher in men than in women.


Association of the interleukin-22 genetic polymorphisms with ulcerative colitis.
Interleukin-22 (IL-22) is a member of the IL-10 family of anti-inflammatory cytokines that mediates epithelial immunity. IL-22 expression was found to be increased in patients with ulcerative colitis (UC). Whether genetic polymorphisms of IL-22 also influence UC risk is still unknown. The purpose of this study was to investigate the association between the IL-22 gene polymorphisms (-429 C/T, +1046 T/A and +1995 A/C) and the risk of UC in Chinese Han patients. This hospital-based case-control study comprised 180 patients with UC and 180 age- and gender-matched controls. Genotypes of 3 common polymorphisms of the IL-22 gene were determined by fluorogenic 5' exonuclease assays (TaqMan). Patients with UC had a significantly higher frequency of IL-22 -429 TT genotype [odds ratio (OR) =2.43, 95% confidence interval (CI) =1.35, 4.37; P=0.003] and -429 T allele (OR =1.54, 95% CI=1.14, 2.07; P=0.004) than controls. The findings are still emphatic by the Bonferroni correction. The IL-22+1046 T/A and IL-22+1995 A/C gene polymorphisms were not associated with a risk of UC. When stratifying by clinical type, location and disease severity of UC, no significant differences were found in any groups. This is the first study to provide evidence for an association of IL-22 -429 C/T gene polymorphisms with UC risk. Additional well-designed large studies were required for the validation of our results. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_183.


Sexual Offender Views About Treatment: A Client Survey.
Sexual offender clients are often regarded as passive recipients of treatment whose views are of limited relevance to treatment outcome. This contrasts with other mental health client groups whose views are regarded as central to the therapeutic process. A group of clients receiving treatment for sexual offending were surveyed for their views regarding their treatment. Their responses indicate that, as a group, their views about treatment are similar to other client groups, suggesting that service users in offender programs may have an important role in the development of effective treatments.


Issues in imaging malignant neoplasms of the female reproductive system.
Radiological evaluation of malignant neoplasms of the female reproductive system is invaluable in the initial diagnosis, staging, treatment planning, and follow-up management. Radiologists serving as consultants for the general primary care internist, gynecologists, and specialists in gynecologic oncology should be familiar with the strengths and limitations of various modalities used to evaluate gynecologic cancer patients. This article discusses the most common female reproductive tract neoplasms (ie, cervical, endometrial, and ovarian cancers) and the role of ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography in their diagnosis and management. Imaging features that impact on clinical diagnostic or treatment algorithms are highlighted and illustrated. Finally, recent technical advances that demonstrate promise are described.


Nonsynonymous coding single-nucleotide polymorphisms spanning the genome in relation to glioblastoma survival and age at diagnosis.
Our aim was to discover possible inherited factors associated with glioblastoma age at diagnosis and survival. Although new genotyping technologies allow greatly expanded exploration of such factors, they pose many challenges. In this pilot study, we (a) genotyped 112 newly diagnosed glioblastoma patients ascertained through a population-based study (group 1) with the ParAllele assay panel of approximately 10,000 nonsynonymous coding single-nucleotide polymorphisms (SNP), (b) used several statistical and bioinformatic techniques to identify 17 SNPs potentially related to either glioblastoma age at diagnosis or survival, and (c) genotyped 16 of these SNPs using conventional PCR methods in an independent group of 195 glioblastoma patients (group 2). In group 2, only one of the 16 SNPs, rs8057643 (located on 16p13.2), was significantly associated with glioblastoma age at diagnosis (nominal P = 0.0017; Bonferroni corrected P = 0.054). Median ages at diagnosis for those with 0, 1, or 2 T alleles were 66, 57, and 59 years in group 1 and 64, 57, and 55 years in group 2 (combined P = 0.001). Furthermore, Cox regression analyses of time to death with number of T alleles adjusted for gender and patient group yielded a hazard ratio of 0.82 (95% confidence interval, 0.68-0.98; P = 0.03). Although limited by a relatively small sample size, this pilot study, using well-characterized, unambiguous disease characteristics, illustrates the necessity of independent replication owing to the likelihood of false positives. Several other challenges are discussed, including attempts to incorporate information on the potential functional importance of SNPs in genome-disease association studies.


Hepatic manifestations in typhoid fever.
Thirty one children with typhoid fever aged 2 months to 12 years and blood culture positive for multidrug resistant S. typhi were prospectively studied for their hepatic functions at the time of hospitalization and 2-3 weeks after completion of antibiotic therapy. Hepatic manifestations included hepatomegaly (51.6%); jaundice (16.1%); raised levels of serum glutamic oxaloacetic transaminase (SGOT) (61.3%), serum glutamic pyruvic transaminase (SGPT) (48.4%), alkaline phosphatase (AP) (22.6%) and serum bilirubin (SB) (6.1%); reduced levels of serum albumin (SA) (41.9%); prolonged prothrombin time (PT) (9.7%) and abnormal ultrasound abdomen (19.3%). Hepatic dysfunction was a notable feature even in those cases without hepatomegaly, with raised levels of SGOT (60%), SGPT (40%), AP (20%), SB (6.7%), decreased SA (53.3%) and prolonged PT (6.7%). There was no correlation between the degree of hepatic enlargement or hyperbilirubinemia with abnormalities in liver functions. Hepatic dysfunction was noticed to be transient, as all these parameters returned to normal within 2-3 weeks after successful antibiotic therapy.


Characterization of extracellular menadion-catalyzed H2O2 production by NIH/3T3 cells.
The extracellular menadione-catalyzed H2O2 production by NIH/3T3 cells was expected to depend on plasma membrane-bound NAD(P)H:quinone oxidoreductase. This enzyme was estimated to be a flavoprotein with the molecular mass of 70 KDa. Km values of plasma membrane-bound NAD(P)H:quinone oxidoreductase producing H2O2 were 60 microM for NADH and 150 microM for NADPH. Ca2+ ionophore A23187 controlled menadione-catalyzed H2O2 production by the cells in time- and concentration-dependent manner.


Formation of the metal-thiolate clusters of rat liver metallothionein.
The isoforms of rat liver apo-metallothionein (MT) were reconstituted in vitro with Cd and Zn ions to study the order of binding of the seven metal sites. Reconstitution with seven Cd ions resulted in a metalloprotein similar to induced Cd,Zn-MT by the criteria of electrophoretic mobility, insensitivity to proteolysis by subtilisin and the pH-dependent release of Cd. Proteolytic digestion of MT reconstituted with sub-optimal quantities of Cd followed by separation of Cd-containing polypeptide fragments by electrophoresis and chromatography revealed metal ion binding initially occurs in cluster A. Upon saturation of the four sites in cluster A, binding occurs in the three metal center, cluster B. Samples reconstituted with one to four Cd or Zn ions per protein molecule, followed by digestion with subtilisin, yielded increasing amounts of a proteolytically stable polypeptide fragment identical with the alpha fragment domain encompassing the four metal center. Samples renatured with five to seven Cd ions per MT molecule showed decreasing quantities of alpha fragment and increasing amounts of nativelike MT. The binding process in each domain is cooperative. Reconstitution of apo-MT with two Cd ions followed by proteolysis yields a 50% recovery of saturated Cd4-alpha cluster. Likewise, when Cd5-renatured MT was digested with subtilisin, 30% of the molecules were identified as Cd7-MT with the remainder as Cd4-alpha fragment.


Fibroblast growth factor (FGF)-23 in patients with primary hyperparathyroidism.
We aimed to determine the serum level of fibroblast growth factor-23 (FGF-23) in patients with primary hyperparathyroidism (pHPT) to understand its physiological role in the disorder. Ninety-eight patients with pHPT who underwent parathyroidectomy formed the study group. We also measured serum FGF-23 in 11 of these patients on postoperative day 6. Serum FGF-23 levels was significantly higher in pHPT patients than in healthy controls (35.6+/-17.8 ng/l vs 28.9+/-11.2 ng/l (mean+/-s.d.); P<0.001 (Pearson's correlation coefficient)), but there was no significant difference in the serum FGF-23 level between pHPT patients with normal renal function (creatinine clearance (Ccr) of >or=70 ml/min) and healthy controls. Serum FGF-23 correlated positively with serum calcium (P<0.0001) and intact parathyroid hormone (PTH) (P<0.01), and negatively with Ccr (P<0.001), serum phosphate (P<0.05), and serum 1,25-dihydroxyvitamin D (1,25(OH)(2)D) (P<0.05). Multiple linear regression analysis of factors potentially determining serum FGF-23 levels in pHPT patients showed serum calcium (P<0.01) and Ccr (P<0.001) to be significant predictors. The serum levels of FGF-23 did not change after parathyroidectomy despite the normalization of serum calcium values. Multiple linear regression analysis revealed that serum FGF-23 was not a significant predictor of serum phosphate or 1,25(OH)(2)D in pHPT patients. FGF-23 may not play a significant role in regulating phosphate or 1,25(OH)(2)D in pHPT patients, especially in those with normal renal function. Further studies are warranted to determine the role of FGF-23 in renal insufficiency or failure.


How conserved are the conserved 16S-rRNA regions?
The 16S rRNA gene has been used as master key for studying prokaryotic diversity in almost every environment. Despite the claim of several researchers to have the best universal primers, the reality is that no primer has been demonstrated to be truly universal. This suggests that conserved regions of the gene may not be as conserved as expected. The aim of this study was to evaluate the conservation degree of the so-called conserved regions flanking the hypervariable regions of the 16S rRNA gene. Data contained in SILVA database (release 123) were used for the study. Primers reported as matches of each conserved region were assembled to form contigs; sequences sizing 12 nucleotides (12-mers) were extracted from these contigs and searched into the entire set of SILVA sequences. Frequency analysis shown that extreme regions, 1 and 10, registered the lowest frequencies. 12-mer frequencies revealed segments of contigs that were not as conserved as expected (≤90%). Fragments corresponding to the primer contigs 3, 4, 5b and 6a were recovered from all sequences in SILVA database. Nucleotide frequency analysis in each consensus demonstrated that only a small fraction of these so-called conserved regions is truly conserved in non-redundant sequences. It could be concluded that conserved regions of the 16S rRNA gene exhibit considerable variation that has to be considered when using this gene as biomarker.


SARS-CoV-2 immunogenicity in individuals infected before and after COVID-19 vaccination: Israel, January-March 2021.
Between December 2020 and March 2021, we measured anti-SARS-CoV-2 IgG titres among 725 Israeli hospital workers vaccinated against COVID-19. Infection post-dose 1 vaccination did not increase IgG titres, and individuals infected post-dose 1 had IgG levels comparable to never-infected individuals who received a single dose, lower than fully vaccinated, never-infected individuals. This suggests dose 2, currently not offered to those infected post-dose 1, may be required in these individuals. Larger studies should confirm whether individuals infected post-dose 1 need the second.


Triclosan: a critical review of the experimental data and development of margins of safety for consumer products.
Triclosan (2,4,4'-trichloro-2'-hydroxy-diphenyl ether) is an antibacterial compound that has been used in consumer products for about 40 years. The tolerability and safety of triclosan has been evaluated in human volunteers with little indication of toxicity or sensitization. Although information in humans from chronic usage of personal care products is not available, triclosan has been extensively studied in laboratory animals. When evaluated in chronic oncogenicity studies in mice, rats, and hamsters, treatment-related tumors were found only in the liver of male and female mice. Application of the Human Relevance Framework suggested that these tumors arose by way of peroxisome proliferator-activated receptor alpha (PPARalpha) activation, a mode of action not considered to be relevant to humans. Consequently, a Benchmark Dose (BMDL(10)) of 47 mg/kg/day was developed based on kidney toxicity in the hamster. Estimates of the amount of intake from in the use of representative personal care products for men, women, and children were derived in two ways: (1) using known or assumed triclosan levels in various consumer products and assumed usage patterns (product-based estimates); and (2) using upper bound measured urinary triclosan levels from human volunteers (biomonitoring-based estimates) using data from the Centers for Disease Control and Prevention. For the product-based estimates, the margin of safety (MOS) for the combined exposure estimates of intake from the use of all triclosan-containing products considered were approximately 1000, 730, and 630 for men, women, and children, respectively. The MOS calculated from the biomonitoring-based estimated intakes were 5200, 6700, and 11,750 for men, women, and children, respectively. Based on these results, exposure to triclosan in consumer products is not expected to cause adverse health effects in children or adults who use these products as intended.


CR8, a novel inhibitor of CDK, limits microglial activation, astrocytosis, neuronal loss, and neurologic dysfunction after experimental traumatic brain injury.
Central nervous system injury causes a marked increase in the expression of cell cycle-related proteins. In this study, we show that cell cycle activation (CCA) is detected in mature neurons at 24 hours after rat lateral fluid percussion (LFP)-induced traumatic brain injury (TBI), as reflected by increased expression of cyclin G1, phosphorylated retinoblastoma (phospho-Rb), E2F1 and proliferating cell nuclear antigen (PCNA). These changes were associated with progressive cortical, hippocampal, and thalamic neuronal loss and microglial and astrocyte activation. Notably, we detected 5-bromo-2'-deoxyuridine (BrdU)-positive neurons, microglia, and astrocytes at 7 days, but not at 24 hours, suggesting that cell cycle reaches the S phase in these cell types at the latter time point. A delayed systemic post-LFP administration at 3 hours of CR8--a potent second-generation cyclin-dependent kinase (CDK) inhibitor--reduced CCA; cortical, hippocampal, and thalamic neuronal loss; and cortical microglial and astrocyte activation. Furthermore, CR8 treatment attenuated sensorimotor and cognitive deficits, alleviated depressive-like symptoms, and decreased lesion volume. These findings underscore the contribution of CCA to progressive neurodegeneration and chronic neuroinflammation following TBI, and demonstrate the neuroprotective potential of cell cycle inhibition in a clinically relevant experimental TBI model.


One-year outcomes after successful chronic total occlusion percutaneous coronary intervention: The impact of dissection re-entry techniques.
We aimed to determine clinical outcomes 1 year after successful chronic total occlusion (CTO) PCI and, in particular, whether use of dissection and re-entry strategies affects clinical outcomes. Hybrid approaches have increased the procedural success of CTO percutaneous coronary intervention (PCI) but longer-term outcomes are unknown, particularly in relation to dissection and re-entry techniques. Data were collected for consecutive CTO PCIs performed by hybrid-trained operators from 7 United Kingdom (UK) centres between 2012 and 2014. The primary endpoint (death, myocardial infarction, unplanned target vessel revascularization) was measured at 12 months along with angina status. One-year follow up data were available for 96% of successful cases (n = 805). In total, 85% of patients had a CCS angina class of 2-4 prior to CTO PCI. Final successful procedural strategy was antegrade wire escalation 48%; antegrade dissection and re-entry (ADR) 21%; retrograde wire escalation 5%; retrograde dissection and re-entry (RDR) 26%. Overall, 47% of CTOs were recanalized using dissection and re-entry strategies. During a mean follow up of 11.5 ± 3.8 months, the primary endpoint occurred in 8.6% (n = 69) of patients (10.3% (n = 39/375) in DART group and 7.0% (n = 30/430) in wire-based cases). The majority of patients (88%) had no or minimal angina (CCS class 0 or 1). ADR and RDR were used more frequently in more complex cases with greater disease burden, however, the only independent predictor of the primary endpoint was lesion length. CTO PCI in complex lesions using the hybrid approach is safe, effective and has a low one-year adverse event rate. The method used to recanalize arteries was not associated with adverse outcomes. © 2017 Wiley Periodicals, Inc.


Proprioceptive measurements of perceived hand position using pointing and verbal localisation tasks.
Previous studies revealed that healthy individuals consistently misjudge the size and shape of their hidden hand during a localisation task. Specifically, they overestimate the width of their hand and underestimate the length of their fingers. This would also imply that the same individuals misjudge the actual location of at least some parts of their hand during the task. Therefore, the primary aim of the current study was to determine whether healthy individuals could accurately locate the actual position of their hand when hidden from view, and whether accuracy depends on the type of localisation task used, the orientation of the hidden hand, and whether the left or right hand is tested. Sixteen healthy right-handed participants performed a hand localisation task that involved both pointing to and verbally indicating the perceived position of landmarks on their hidden hand. Hand position was consistently misjudged as closer to the wrist (proximal bias) and, to a lesser extent, away from the thumb (ulnar bias). The magnitude of these biases depended on the localisation task (pointing vs. verbal), the orientation of the hand (straight vs. rotated), and the hand tested (left vs. right). Furthermore, the proximal location bias increased in size as the duration of the experiment increased, while the magnitude of ulnar bias remained stable through the experiment. Finally, the resultant maps of perceived hand location appear to replicate the previously reported overestimation of hand width and underestimation of finger length. Once again, the magnitude of these distortions is dependent on the task, orientation, and hand tested. These findings underscore the need to control and standardise each component of the hand localisation task in future studies.


Synthesis and properties of two cationic narrow band gap conjugated polyelectrolytes.
We report the design, synthesis, and optical and electronic properties of two novel narrow band gap conjugated polyelectrolytes (NBGCPEs) based on a poly[2,6-(4,4-bis-alkyl-4H-cyclopenta[2,1-b;3,4-b']dithiophene)-alt-4,7-(2,1,3-benzothiadiazole)] donor/acceptor backbone. Comparison with the properties of the neutral precursor material shows that the ionic component in these cationic NBGCPEs leads to a red-shift in the absorption spectra and to a modification of the polymer electronic energy levels. Both the HOMO and the LUMO are lowered in energy, with the net effect being dependent on the choice of counterion, i.e. bromide vs tetrakis(1-imidazolyl)borate. Moreover, we unexpectedly find n-type transport in thin-film transistors, as opposed to the widely studied p-type transport in neutral systems with isoelectronic backbones. From these observations we conclude that introduction of ionic functionalities adjacent to semiconducting polymers that exhibit charge-transfer excitations offers unique opportunities for materials design.


Corneal curvature and central corneal thickness in eyes with pseudoexfoliation syndrome.
Previous studies have reported different central corneal thickness (CCT) values in eyes with pseudoexfoliation syndrome (PXS). There has been no report about corneal curvature (CC) in PXS eyes. The aim of this study was to investigate the CCT together with the CC in PXS eyes with and without glaucoma. The CC (simulated keratometry 1 [SimK1], SimK2, and mean K) and CCT were prospectively studied by rotating a Scheimpflug camera in 72 PXS eyes and comparing them with 65 normal eyes. In all PXS eyes, the mean K was significantly steeper than in control eyes (44.1 [SD 1.5] diopters (D) vs. 43.2 [SD 2.0] D, p = 0.04). When PXS eyes were subcategorized, the mean K was significantly steeper in both normotensive PXS eyes (44.6 [SD 1.6] D) and pseudoexfoliation glaucoma (PEXG) eyes (44.0 [SD 1.2] D) than normal eyes (43.2 [SD 2.0] D) (p = 0.001 and 0.02, respectively). In all PXS eyes, the mean CCT (546.4 [SD 39.6] microm) was not significantly different than the control eyes (542.9 [SD 32.2] microm) (p = 0.56). When PXS eyes were subcategorized, however, the CCT was significantly thinner in normotensive PXS eyes and significantly thicker in PEXG eyes. It appears that PEXG eyes have a significantly steeper CC and higher CCT than normal eyes. This could be of clinical significance because overestimation of true intraocular pressure may then occur in these eyes.


Cyclophanes of perylene tetracarboxylic diimide with different substituents at bay positions.
Cyclophanes of perylene tetracarboxylic diimides (PDIs) with different substituents at the bay positions, namely four phenoxy groups at the 1,7-positions (1), four piperidinyl groups at the 1,7-positions (2), and eight phenoxy groups at the 1,6,7,12-positions (3) of the two PDI rings, have been synthesized by the condensation of perylene dianhydride with amine in a dilute solution. These novel cyclophanes were characterized by (1)H NMR spectroscopy, MALDI-TOF mass spectrometry, electronic absorption spectroscopy, and elemental analysis. The conformational isomers of cyclophanes substituted with four piperidinyl groups at the 1,7-positions (2 a and 2 b) were successfully separated by preparative TLC. The main absorption band of the cyclophanes shifts significantly to the higher energy side in comparison with their monomeric counterparts, which indicates significant pi-pi interaction between the PDI units in the cyclophanes. Nevertheless, both the electronic absorption and fluorescence spectra of the cyclophanes were found to change along with the number and nature of the side groups at the bay positions of the PDI ring. Time-dependent DFT calculations on the conformational isomers 2 a and 2 b reproduce well their experimental electronic absorption spectra. Electrochemical studies reveal that the first oxidation and reduction potentials of the PDI ring in the cyclophanes increase significantly compared with those of the corresponding monomeric counterparts, in line with the change in the energy of the HOMO and LUMO according to the theoretical calculations.


Carbon dioxide clearance and deadspace during high frequency jet ventilation. Investigations in the dog.
The effects of frequency, tidal volume and added deadspace on carbon dioxide clearance were measured during high frequency jet ventilation at 1, 3 and 5 Hz in dogs. With a short, small volume deadspace, carbon dioxide clearance increased with minute volume at each frequency, but for a given minute volume the clearance decreased with increase in frequency. At 5 Hz, carbon dioxide clearance was less than carbon dioxide production. At 1 Hz, an increase in the volume of added deadspace decreased carbon dioxide clearance, but changes in the length of the deadspace, without change in volume, had no effect. At 5 Hz, an increased volume of added deadspace had little effect on carbon dioxide clearance, but increased length, without change in volume, decreased clearance. Carbon dioxide clearance was increased by placing the jet at the lung end of the tracheostomy tube. It is concluded that at 1 Hz, carbon dioxide elimination is governed by bulk flow, but at 5 Hz other mechanisms are important.


Effect of muscular contraction on magnetization transfer detected at 1.5 T.
The effect of rigor (formation of actomyosin complexes) on magnetization transfer was observed with a 1.5 T clinical magnetic resonance (MR) imaging system. The magnetization transfer ratio of chemically skinned (calcium-sensitive) muscle fiber preparations increased much more in a rigor state than in a relaxed state, while that of calcium-insensitive fiber preparations and solutions showed no difference. These results suggest that the formation of actomyosin complexes increased the magnetization transfer ratio. A clinical MR system is not only effective for medical imaging, but also has the potential to demonstrate physiological characteristics.


Effect of temperature on hepatic and renal uptake of components from University of Wisconsin solution.
In rat liver and kidney preservation, hepatic and renal uptake of 3H-adenosine, 3H-glutathione, and 3H-raffinose from University of Wisconsin solution and diffusion to the interstitial space were measured. At 4 degrees C only 0.38+/-0.47% and 2+/-0.92% of the total 3H-adenosine remained in the kidney and in the liver, respectively, but at 37 degrees C the amount remaining was 1+/-1% and 12+/-3% (P<0.001). Hepatic and renal uptake of the impermeant 3H-raffinose was unaffected by temperature. During flush out, interstitial accumulation of adenosine was significantly higher in livers than in kidneys and decreased during 24-h cold storage. Glutathione accumulation in the interstitial space was two orders of magnitude lower than 3H-adenosine accumulation and comparable to the impermeant raffinose. In summary, the bioavailability of components of preservation solutions at 4 degrees C is lower than at physiological temperatures, so that the application of cytoprotectants at 37 degrees C to organ donors, rather than simple addition to the cold storage solution, might improve cold storage preservation of livers and kidneys.


Red nuclear and cerebellar but no olivary activation associated with essential tremor: a positron emission tomographic study.
There has been debate as to whether essential tremor has a central origin and over the possible role of the inferior olivary nucleus in its genesis. We used positron emission tomography with radioactive water (H2(15)O) to detect abnormal patterns of cerebral activity associated with this condition, at rest, without tremor, and on posture when the tremor was present. At rest, cerebellar blood flow was significantly increased bilaterally in the group with essential tremor (30-40%) but no increased olivary activity was evident. Essential tremor during arm extension was associated with further abnormal increases in bilateral cerebellar and abnormal red nuclear activation. Again, no olivary overactivity was evident. Voluntary wrist oscillation in control subjects caused only ipsilateral cerebellar activation. We conclude that essential tremor is associated with abnormal bilateral overactivity of cerebellar and red nuclear connections but found no evidence of intrinsic overactivity of the inferior olivary nucleus, as evidenced by raised blood flow.


Radiation force on a bubble located near an interface.
The presence of a boundary produces marked changes in the oscillation amplitudes and types of bubble distortion modes excited by an external acoustic field. In the majority of cases, the radiation force can be determined based on the linearized equations of motion. Bispherical coordinates are used to obtain an analytical description of linearized bubble dynamics at distances from the interface comparable to those of the bubble size. In the limit of weak dissipation, explicit formulas have been derived that describe the dependence of the radiation force on the separation distance between the bubble and the interface, the material parameters of the contacting media, and the angle of incidence of the incoming wave. The component of the radiation force directed to the interface has been shown to exhibit qualitative changes when the direction of the incoming field passes through the angle of the total internal reflection.


[The relationship between corneal astigmatism with a vector-based method and whole eye second order wavefront aberrations].
To investigate the relationship between corneal astigmatism and second order wavefront aberration in myopic eyes. The corneal astigmatism and the whole eye wavefront aberrations of both eyes of 246 subjects were measured using the Humphrey corneal topography and the WASCA wavefront analyzer. According to axial of the corneal astigmatism, the subjects were divided into five groups (WR(0), WR(180), AR, OA(45) and OA(135)). The corneal astigmatism was decomposed into J(45) and J(0) with a Vector-based method, and correlated with the 2nd order Zernike aberrations (C(3) and C(5)). The mean corneal astigmatisms for the five groups were -1.34 D x 6.87 degrees, -1.03 D x 23.15 degrees, -0.48 D x 89.55 degrees, -0.91 D x 156.87 degrees and -1.02 D x 176.74 degrees respectively. Most of the corneal J(45) and J(0) components were correlated significantly with the C(3) and the C(5) aberrations in the whole eye. While the correlation coefficients (R(2)) between the J(45) and the C(3) were 0.138, 0.119, 0.090, 0.526 and 0.501, the R(2) between the J(0) and the C(5) were 0.711, 0.736, 0.864, 0.866 and 0.785 for the five groups respectively. The corneal astigmatism plays an important role in determining the 2nd order wavefront aberration in the whole eye, and the combination processes between the corneal and internal astigmatism (compensation and/or addition) change with the axial of the corneal astigmatism.


Integrated Coproduction of Power and Syngas from Natural Gas to Abate Greenhouse Gas Emissions without Economic Penalties.
Natural gas (NG)-fired power plants are significant greenhouse gas (GHG) emitters because of their substantial CO2 release. To avoid these emissions, precombustion and postcombustion CO2 capture alongside oxy-fuel combustion were considered in the literature. However, because of additional energy requirements, these options generally induce an approximately 7-10% decrease in net heat-to-power efficiencies regarding regular NG-air-fired stations without CO2 capture. To compensate for this declination, in this study, a simultaneous generation of power and syngas (CO and H2) was proposed in an integrated NG-oxygen-fired gas turbine unit (GTU). Hence, the combustion chamber in the NG-oxygen-fired gas turbine cycle was replaced by an NG partial oxidation reactor, which converts it into syngas. The syngas was separated from the working fluid of the cycle by the condensation of water vapor (steam), and a part of it was withdrawn from the GTU to be utilized as a chemical feedstock. A benchmark thermodynamic analysis at the same input-output conditions and requirements for carbon capture was conducted to compare the proposed unit with NG-air and NG-oxygen-fired power plants. The integration effect was shown by increasing the heat-to-power efficiency from 48 to 54%. With carbon monoxide (CO) as an intermediate, the author proposed capturing carbon in NG (methane) in liquid formic acid, which is a good commodity for transportation to a place where it can be reconverted into CO or H2 to manufacture various industrial chemicals. Simple economic considerations show that because of a substantially higher cost of formic acid than an equivalent power, CO conversion into formic acid substantiates the integrated approach as economically attractive.


Hyperbaric oxygen therapy reduces COX-2 expression in a dimethylhydrazine-induced rat model of colorectal carcinogenesis.
A better understanding of oncogenesis mechanisms should result in more effective approaches to colorectal cancer (CRC) treatment and prevention. Hyperbaric oxygen (HBO2) therapy is indicated as adjuvant treatment for infectious diseases as well as hypoxic and inflammatory lesions. The anti-inflammatory effect of HBO2 could reduce colorectal carcinogenesis. 48 Wistar rats were randomly divided into the following groups: * G1 - control; * G2 - HBO2 treatment; * G3 - 1,2-dimethylhydrazine (DMH) injection only; * G4 - DMH injection and HBO2 treatment. These groups were further randomly divided into two subgroups: a. euthanasia at six weeks; and. b. euthanasia at 12 weeks. Animals belonging to G2 and G4 were subjected to 15 HBO2 sessions, performed every 24 hours at 2.0 atm absolute pressure, 90 minutes each. Cancer was induced via intraperitoneal injection of DMH in G3 and G4. The aberrant crypt foci index (ACFi), the cell nuclear antigen index (PCNA) and the cyclooxygenase-2 index (iCOX-2) were determined. After DMH administration, ACFi increased and was higher in subgroups euthanized at six weeks than in those sacrificed at 12 weeks (p < 0.001). HBO2 alone (G2) did not affect ACFi (p > or = 0.05). Larger increases of PCNA were detected in G2 versus G3 (p < 0.05). Comparison between G4 and control group mice revealed no differences in PCNA (p > 0.05). COX-2 was overexpressed in G3 (p < 0.0001) compared to G4. COX-2 expression was "induced" by DMH and reverted to a "wild"-type level of expression upon exposure to HBO2.


The Use of Once-monthly Injectable Buprenorphine for the Treatment of Opioid Use Disorder in Postpartum Women: A Case Series.
For women with opioid use disorder (OUD), the postpartum period is an especially vulnerable period. Buprenorphine (BUP) improves OUD outcomes during this timeframe. Once-monthly injectable BUP (XRI-BUP) is a newer formulation for which evidence of use in postpartum women is extremely limited. We present a case series of 9 women who transitioned from sublingual (SL-BUP) to XRI-BUP in their first year postpartum. We conducted a retrospective chart review of our institution's medical record for patients who received at least one administration of XRI-BUP in their first year postpartum (January 2017-March 2020). Data were collected from baseline through mean follow-up of 281.4 days (range 235-417) for participant outcomes. The most common indications for initiating XRI-BUP were participant preference (n = 9) followed by challenges taking SL-BUP (n = 6). Four of the 9 participants transitioned back from XRI- to SL-BUP during the study timeframe, for reasons including incarceration and undesired side effects. Preliminary treatment outcomes demonstrated that participants remained on SL- (n = 4) or XRI-BUP (n = 5) through follow-up. The 5 participants who remained on XRI-BUP had consistent negative urine drug tests for nonprescribed opioids during the study period. To our knowledge, this is the first study that reviews the feasibility of using XRI-BUP in postpartum women. Our results suggest that XRI-BUP is a viable treatment option, which should be further investigated in future studies of postpartum women with OUD.


Metformin accelerates wound healing by Akt phosphorylation of gingival fibroblasts in insulin-resistant prediabetes mice.
This study aimed to investigate the effects of metformin on gingival wound healing in insulin-resistant prediabetes. C57BL/6J mice were fed normal diet (ND) or high-fat diet (HFD) for 10 weeks; half of the HFD mice were treated with metformin (HFD+ Met) for the last 2 weeks. Insulin and glucose tolerance tests were performed. The palatal gingiva (2.0 × 0.5 mm) was surgically removed adjacent to the maxillary molars. Post-surgical wound closure was histomorphometrically evaluated for 1 week. The mRNA expression of vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOS) in the tissue were quantified by real-time polymerase chain reaction. In vitro, the proliferation and migration of human gingival fibroblasts (HGFs) cultured under high-glucose or control conditions with/without metformin were analyzed. Akt phosphorylation and VEGF expression following the insulin stimulation were evaluated with/without metformin in high-glucose or control media. HFD mice showed significantly higher plasma glucose levels and insulin resistance than ND mice. Gingival wound healing was delayed in HFD group compared with ND group but significantly improved in HFD + MET group. The decreased expression of VEGF and eNOS in HFD group was significantly elevated in the HFD + MET group. The proliferation and migration of HGFs were significantly impaired in high-glucose conditions compared with control; metformin treatment partially attenuated these effects. Metformin treatment significantly recovered the downregulated Akt phosphorylation and VEGF expression in high-glucose conditions. Metformin improved delayed gingival wound healing in insulin-resistant prediabetes by accelerating HGFs proliferation and migration via Akt phosphorylation in insulin signaling pathway.


Individual and partner's level of occupation and the association with HbA1c levels in people with Type 2 diabetes mellitus: the Dutch Diabetes Pearl cohort.
Individual indicators of socio-economic status have been associated with glycaemic control in people with Type 2 diabetes, but little is known about the association between partner's socio-economic status and HbA1c levels. We therefore examined the cross-sectional association between individual and partner's level of occupation on HbA1c levels in people with Type 2 diabetes in the Netherlands. We included people with Type 2 diabetes with a partner who were treated in primary, secondary and tertiary care in the Diabetes Pearl cohort. Occupational level was classified according to International Standard Classification of Occupations (ISCO)-08 skill levels. Linear regression analyses were performed stratified for sex, and corrected for age, recruitment centre and diabetes medication. In total, 3257 participants (59.8% men, mean 62.2±9.4 years) were included. For men, having a partner with an intermediate level of occupation was associated with lower HbA1c levels [e.g. ISCO level 3: -2 mmol/mol (95% CI -4;-1) or -0.2% (95% CI -0.4;-0.1)], compared with having a partner of the highest occupational level (ISCO level 4). In women, having an unemployed partner was associated with higher HbA1c levels [14 mmol/mol (95% CI 6; 22) or 1.3% (95% CI 0.6; 2.0)], compared with having a partner of the highest occupational level. Partner's occupational status provided additional information on the association between socio-economic status and HbA1c levels in people with Type 2 diabetes. Women seemed to benefit from a partner with a higher occupational status, while men seemed to benefit from a partner with a lower status. Because of the cross-sectional nature of the present study, more research is necessary to explore this association.


Loss of polarity and de novo expression of the beta 1 family of integrins in thyroid tumors.
The expression and cell-membrane distribution of the beta 1 family of integrins (very-late-activation antigens, VLA) were investigated in benign and malignant human thyroid tumors. We compared tissue samples of normal glands, nodular goiters, adenomas and carcinomas. We also examined 3 thyroid-carcinoma cell lines cultured in vitro. The expression of subunits of the beta 1 family of integrins was assessed by flow cytometry and specific antibodies in dispersed single-cell suspensions and by immunofluorescence on frozen tissue sections. In contrast to the heterogeneity of the expression of beta 1 integrins observed in other tumors, thyroid neoplastic lesions showed a remarkably constant VLA profile. In all tumors, benign as well as malignant, and in carcinoma cell lines, all sub-units of beta 1 integrins were expressed at high levels. While sub-units alpha 1, alpha 3, alpha 5, alpha 6 and occasionally alpha 2 were also present in a cell sub-set of normal glands and nodular goiters, expression of alpha 4 was restricted to neoplastic lesions; this integrin can be therefore considered an antigen associated with thyroid tumors. It has been reported that in normal glands and in nodular goiters, the expression of beta 1 integrins is restricted to the basal-cell membrane. Immunofluorescence on tissue sections showed instead that, in adenomas and carcinomas, the polarized distribution of these integrins on the cell membrane is lost.


Resolution of an acute aortic syndrome with aortic valve insufficiency post-PCI.
Acute aortic syndrome is the modern term that includes aortic dissection, intramural hematoma, and symptomatic aortic ulcer. Iatrogenic coronary artery dissection extending to the aorta during percutaneous coronary intervention is a very rare but life-threatening complication. Despite some reports of spontaneous recovery, most of these patients are treated surgically as a spontaneous aortic dissection, especially if there is a complication of the aortic lesion. A 52-year-old white female was submitted to an angioplasty in the right coronary without success and the procedure was complicated by a dissection in aortic root with progressive extension to the ascending aorta. This lesion deformed the aortic valve, leaving it with an acute moderate regurgitation. Because of current use of clopidogrel and clinical stability of the patient, the local Heart Team decided to withdrawn this antiplatelet for 5 days before surgery despite the risk related to the aortic syndrome. A new echocardiogram 3 days later showed that the hematoma was reabsorbed with improvement of the aortic insufficiency. An angiotomography confirmed the reabsorption of the hematoma. The surgery was canceled and the patient was maintained in a conservative treatment and discharged. Seventeen months later, she was re-evaluated and was still asymptomatic without aortic regurgitation in the echocardiogram and showing progressive regression of the aortic hematoma in the tomography. Despite the conservative treatment, this case of iatrogenic aortic dissection complicated by an acute aortic regurgitation had a good evolution in a follow-up of 17 months.


Edwardsiella tarda MliC, a lysozyme inhibitor that participates in pathogenesis in a manner that parallels Ivy.
Edwardsiella tarda, a bacterial pathogen to farmed fish as well as humans, possesses the genes of two lysozyme inhibitors, ivy and mliC (ivy(Et) and mliC(Et)). We recently studied IvyEt and found it to be implicated in E. tarda virulence. In the present study, we characterized MliC(Et) in comparison with Ivy(Et) in a turbot model. MliC(Et) contains the FWSKG motif and two cysteines (C33 and C98) that are highly conserved in subgroup 1 MliCs but are of unknown functional importance. To examine the essentialness of these conserved structural features, recombinant MliC(Et) (rMliC) and its mutants bearing C33S and W79A (of the FWSKG motif) substitutions were prepared. Subsequent analysis showed that rMliC (i) inhibited lysozyme-induced lysis of a Gram-positive bacterium, (ii) reduced serum-facilitated lysozyme killing of E. tarda, and (iii) when introduced into turbot, promoted bacterial dissemination in fish tissues. The C33S mutation had no influence on the activity of rMliC, while the W79A mutation slightly but significantly enhanced the activity of rMliC. Knockout strains of either mliC(Et) or ivy(Et) were severely attenuated for the ability of tissue invasion, host lethality, serum survival, and intracellular replication. The lost virulence of the mliC transformant (TXΔmliC) was restored by complementation with an introduced mliC(Et) gene. Compared to the Δivy(Et) or ΔmliC(Et) single-knockout strains, the ΔmliC(Et) Δivy(Et) double-knockout strain was significantly impaired in most of the virulence features. Together, these results provide the first evidence that the conserved cysteine is functionally dispensable to a subgroup 1 MliC and that as a virulence factor, MliC(Et) most likely works in a concerted and parallel manner with Ivy.


Prevalence of depression and its correlation with anxiety, headache and sleep disorders among medical staff in the Hainan Province of China.
This cross-sectional survey aimed to investigate the prevalence of depression among medical staff and its risk factors as well as the association between depression, anxiety, headache, and sleep disorders. Stratified random cluster sampling was used to select medical staff from various departments of four hospitals in Sanya City. The Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) were used to quantitatively assess depression, anxiety, and sleep disorders. Correlation and regression analyses were performed to determine factors affecting the depression occurrence and scores. Among 645 medical staff members, 548 (85%) responded. The 1-year prevalence of depression was 42.7% and the prevalence of depression combined with anxiety, headache, and sleep disorders was 23, 27, and 34.5%, respectively. The prevalence of depression in women, nurses, the unmarried or single group, and the rotating-shift population was significantly higher than that in men (48.3% vs. 27.1%, odds ratio OR = 2.512), doctors (55.2% vs. 26.7%, OR = 3.388), the married group (50.5% vs. 35.8%, OR = 1.900), and the day-shift population (35.2% vs. 7.5%, OR = 1.719). The occurrence of depression was correlated with anxiety, sleep disorders, headache, and migraines, with anxiety having the highest correlation (Spearman's Rho = 0.531). The SDS was significantly correlated with the SAS and PSQI (Spearman's Rho = 0.801, 0.503) and was also related to the presence of headache and migraine (Spearman Rho = 0.228, 0.159). Multiple logistic regression indicated that nurse occupation and anxiety were risk factors for depression, while grades of anxiety, sleep disorders and nurse occupation were risk factors for the degree of depression in multiple linear regression. The prevalence of depression among medical staff was higher than that in the general population, especially among women, nurses, unmarried people, and rotating-shift workers. Depression is associated with anxiety, sleep disorders, headache, and migraines. Anxiety and nursing occupation are risk factors for depression. This study provides a reference for the promotion of occupational health among medical professionals.


Carboxypeptidase M as a marker of macrophage maturation.
During terminal maturation of blood monocytes (MO) into macrophages (MAC), a multitude of phenotypic and functional changes occur: cells increase in size and enhance their capacity for phagocytosis and tumor cytotoxicity, but decrease their ability for T-lymphocyte stimulation. The pattern of secreted cytokines is shifted as is the profile of surface antigens. The identity of the MAC maturation-associated antigen MAX.I/MAX.II with carboxypeptidase M (CPM), a phosphoinositol-linked endopeptidase, was recently described. CPM is able to process a multitude of different substrates, among them immunologically important peptides such as bradykinin, anaphylatoxins and enkephalins. It was previously shown to be expressed in placenta, lung and kidney. CPM as detected by MAX.I/II shows a strong expression on MO-derived MAC in vitro and on MAC in vivo accompanying T-lymphocyte activation such as during allogeneic transplant rejection or allergic alveolitis. In contrast, its expression is suppressed on MAC by some types of tumor cells. A synchronous expression of CPM together with MAC cytotoxic function makes a functional relationship very well possible. However, the biological importance of CPM expression on MAC in vivo is difficult to predict, since a wide range of biologically active peptides are substrates for CPM, and the relevance for most of those peptides to be processed by CPM during an immune reaction is only poorly understood at present.


Mucinous appendiceal neoplasms: pathologic classification, clinical implications, imaging spectrum and mimics.
Mucinous appendiceal neoplasms are uncommon, but important to recognize with imaging due to malignant potential. Peritoneal seeding and pseudomyxoma peritonei can occur with both frankly malignant as well as low-grade appendiceal neoplasms. Prospective imaging identification of potential appendiceal neoplasm is paramount to clinical/surgical management. When a mucinous appendiceal neoplasm is suspected, a right hemicolectomy with lymph node dissection is the preferred surgical management. Unfortunately, accurate preoperative diagnosis can be challenging due to a wide range of clinical presentations and overlapping imaging appearances of appendiceal neoplasms with benign entities. Using the 2010 World Health Organization (WHO) pathologic classification as a framework, we provide a comprehensive multi-modality pictorial essay detailing the broad array of imaging findings of mucinous appendiceal neoplasms and common imaging mimics.


TP10-Dopamine Conjugate as a Potential Therapeutic Agent in the Treatment of Parkinson's Disease.
Parkinson's disease (PD) is a common progressive neurodegenerative disorder for which the current treatment is not fully satisfactory. One of the major drawbacks of current PD therapy is poor penetration of drugs across the blood-brain barrier (BBB). In recent years, cell-penetrating peptides (CPPs) such as Tat, SynB, or TP10 have gained great interest due to their ability to penetrate cell membranes and to deliver different cargos to their targets including the central nervous system (CNS). However, there is no data with respect to the use of CPPs as drug carriers to the brain for the treatment of PD. In the presented research, the covalent TP10-dopamine conjugate was synthesized and its pharmacological properties were characterized in terms of its ability to penetrate the BBB and anti-parkinsonian activity. The results showed that dopamine (DA) in the form of a conjugate with TP10 evidently gained access to the brain tissue, exhibited low susceptibility to O-methylation reaction by catechol- O-methyltransferase (lower than that of DA), possessed a relatively high affinity to both dopamine D1 and D2 receptors (in the case of D1, a much higher than that of DA), and showed anti-parkinsonian activity (higher than that of l-DOPA) in the MPTP-induced preclinical animal model of PD. The presented results prove that the conjugation of TP10 with DA may be a good starting point for the development of a new strategy for the treatment of PD.


Integrative analysis of in vivo recording with single-cell RNA-seq data reveals molecular properties of light-sensitive neurons in mouse V1.
Vision formation is classically based on projections from retinal ganglion cells (RGC) to the lateral geniculate nucleus (LGN) and the primary visual cortex (V1). Neurons in the mouse V1 are tuned to light stimuli. Although the cellular information of the retina and the LGN has been widely studied, the transcriptome profiles of single light-stimulated neuron in V1 remain unknown. In our study, in vivo calcium imaging and whole-cell electrophysiological patch-clamp recording were utilized to identify 53 individual cells from layer 2/3 of V1 as light-sensitive (LS) or non-light-sensitive (NS) by single-cell light-evoked calcium evaluation and action potential spiking. The contents of each cell after functional tests were aspirated in vivo through a patch-clamp pipette for mRNA sequencing. Moreover, the three-dimensional (3-D) morphological characterizations of the neurons were reconstructed in a live mouse after the whole-cell recordings. Our sequencing results indicated that V1 neurons with a high expression of genes related to transmission regulation, such as Rtn4r and Rgs7, and genes involved in membrane transport, such as Na+/K+ ATPase and NMDA-type glutamatergic receptors, preferentially responded to light stimulation. Furthermore, an antagonist that blocks Rtn4r signals could inactivate the neuronal responses to light stimulation in live mice. In conclusion, our findings of the vivo-seq analysis indicate the key role of the strength of synaptic transmission possesses neurons in V1 of light sensory.


Lacosamide as a first-line treatment option in focal epilepsy: a cost-utility analysis for the Greek healthcare system.
Epilepsy is the most common serious neurological disorder worldwide. Approximately 40% of patients with focal epileptic seizures remain uncontrolled with antiepileptic drug (AED) monotherapy or polytherapy. Lacosamide has been recently approved by the European Medicines Agency as monotherapy for the treatment of focal seizures. The aim of this study was to estimate the cost-effectiveness of lacosamide compared with zonisamide as first-line treatment of focal epilepsy in patients with epilepsy aged ≥ 16 years to inform clinical decision-making in Greece. A discrete event simulation model was adapted to reflect treatment pathways and resource use within the Greek national healthcare system, as specified by clinical experts. The model captures time-varying events and patient characteristics. Clinical inputs were sourced from pivotal trials and a network meta-analysis comparing lacosamide with other AEDs. The model predicts disease progression and seizures, relevant and most common adverse events, withdrawal due to lack of efficacy or adverse events, and epilepsy-specific and all-cause mortality over a 2-year time horizon. Unit costs were retrieved from published Greek sources. Health outcomes were measured as quality-adjusted life years (QALYs); secondary outcome was the cost per seizure avoided. Robustness of the results was tested with univariate and probabilistic sensitivity analyses. The lacosamide treatment pathway was associated with higher costs (i.e. €1,064) and an additional 0.119 QALYs when compared with zonisamide, resulting in an incremental cost-effectiveness ratio of €8,938 per QALY gained. The sensitivity analyses demonstrated that the results are most sensitive to the efficacy and utility estimates. There are a number of limitations which stem from the process of model adaptation and lack of local real-world evidence. Lacosamide is a cost-effective option at a willingness-to-pay threshold of €30,000 per QALY, representing a valuable monotherapy treatment option for patients with focal epileptic seizures in the Greek setting.


[The GRADE system: a change in the way of assessing the quality of evidence and the strength of recommendations].
Individual clinicians and organizations making health care decisions should not only consider the magnitude of the benefits and harms of different courses of action (interventions), but also the confidence we can have in those estimates. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach offers a systematic and transparent way to summarize the evidence, to rate the confidence we can have in the effects of the interventions and to move from evidence to recommendations. The GRADE approach has been adopted by several organizations worldwide, including the World Health Organization and the Cochrane Collaboration. In Chile, this approach has already been used by guidelines produced by the Chilean Ministry of Health. In this paper we describe the core concepts of the GRADE approach to rate the quality of the evidence and to grade the strength of recommendations. As clinicians, being familiar with such concepts may be helpful to make decisions informed by the best available evidence.


Profiling of differentially expressed genes in LRRC4 overexpressed glioblastoma cells by cDNA array.
Our previous study has shown that LRRC4 is a novel member of the leucine-rich repeat (LRR) superfamily and has the potential to suppress brain tumor growth. In order to further analyze the functions of LRRC4 on the maintenance of normal function and suppression of tumorigenesis in the central nervous system, we investigated alterations in gene expression related to neurobiology by the Atlas array in two inducible dual-stable LRRC4-overexpressing cell lines. Seventeen of 588 genes spotted on the Atlas membrane showed altered expression levels in LRRC4 transfected U251MG Tet-on cells, which are involved in cell proliferation and cell cycle progression, tumor invasion and metastasis, and neurotransmitter synthesis and release. In addition, cell invasion assay results showed that LRRC4 can inhibit the U251MG cell migration. These studies represent the first cDNA array analysis of the effects of LRRC4 on the involvement of different neurobiological genes in U251MG glioblastoma cells and provide new insights into the function of LRRC4 in glioma.


Intravesical foreign body as a result of self catheterization: case report.
Foreign bodies inside urinary tract are a relatively rare condition in our practice. There are several reports published and in most cases the reason for self insertion of an object was autoerotic stimulation or psychiatric illness. Self treatment by homemade instruments is a rarely seen scenario. A 62-year-old man presented to our department complaining of lower urinary tract symptoms. On examination, a foreign body was detected inside the urinary bladder. Urethral stricture was also detected for which the patient had been previously treated on several occasions. The patient stated that he had attempted self catheterization using a homemade catheter. He had succeeded in emptying his bladder; however, the catheter entered the bladder completely and was irretrievable to him. Sachse urethrotomy was performed following retrieval of the foreign body. No psychiatric illness was detected in our patient. The patient's postoperative course was uneventful.


12-month-old infants allocate increased neural resources to stimuli associated with negative adult emotion.
Young infants use caregivers' emotional expressions to guide their behavior in novel, ambiguous situations. This skill, known as social referencing, likely involves at least 3 separate abilities: (a) looking at an adult in an unfamiliar situation, (b) associating that adult's emotion with the novel situation, and (c) regulating their own emotions in response to the adult's emotional display. The authors measured each of these elements individually as well as how they related to each other. The results revealed that 12-month-olds allocated more attention, as indicated by event-related potential measures, to stimuli associated with negative adult emotion than to those associated with positive or neutral emotion. Infants' interaction with their caregiver was affected by adult emotional displays. In addition, how quickly infants referenced an adult predicted both their brain activity in response to pictures of stimuli associated with negative emotion as well as some aspects of their behavior regulation. The results are discussed with respect to their significance for understanding why infants reference and regulate their behavior in response to adult emotion. Suggestions for further research are provided.


[Not Available].
The emergence of a 'norm of normalcy' in 19th century laboratories and hospitals was in no way simply a byproduct of the scientific search for knowledge. It was instead closely associated with expectations of social egalitarianism which merged with the moral economy of a new scientific objectivity. The establishment of normal people as a valid measure for a population socially divided and segregated in estates was thus an essential element of the processes of social formulation which created our modern society.


Tailoring the pore architecture in 3-D alginate scaffolds by controlling the freezing regime during fabrication.
The pore architecture in 3-D polymeric scaffoldings plays a critical role in tissue engineering as it provides the framework for the seeded cells to organize into a functioning tissue. In the present paper, we investigate the effect of freezing regime on the pore microstructure in 3-D alginate scaffolds, fabricated by the freeze-dry method. The scaffolds have shown isotropic pore structure, when the calcium crosslinked alginate solutions were slowly frozen at -20 degrees C, in a nearly homogenous cold atmosphere; the pores were spherical and interconnected. In contrast, when the cooling process was performed in liquid nitrogen or oil bath, where a temperature gradient was formed along the freezing solution, two main regions of pore structure were noted; at the interface with the cooling medium, small spherical pores were seen and above them a region with elongated pores. The different pore shape affected the compressibility of the scaffolds, while it had no effect on albumin diffusion. Rat hepatocytes seeded within the scaffolds were arranged according to the their pore shape. In scaffolds with elongated pores, the cells were lining along the pores, thus forming lines of interacting cells. In the scaffolds with the isotropic spherical pores, the hepatocytes clustered into spheroid-like aggregates. Thus, it appears that pore shape can modulate hepatocyte morphogenesis.


Intravaginal slingplasty.
After referring the causes of failing of many operative methods to cure female urinary incontience the technique of an intravaginal sling plasty is described in detail inclusively the pre- and postoperative care of the patient.


Lower and reduced expression of EphA4 is associated with advanced TNM stage, lymph node metastasis, and poor survival in breast carcinoma.
The expression of EphA4 has been well documented in the development of nerve and in certain types of human cancer. Few studies of EphA4, however, have focused on breast carcinoma. In this study, a set of breast carcinomas was subjected to immunohistochemical staining. In normal luminal cells, EphA4 was weakly detected in 11 (14.3 %), moderately detected in 15 (19.5 %) and highly detected in 51 out of 77 (66.2 %) samples, while in breast carcinoma cells, EphA4 was weakly detected in 42 (54.5 %), moderately detected in 19 (24.7 %) and highly detected in 16 out of 77 (20.8 %) samples (P < 0.001). The expression of EphA4 protein was significantly reduced in 68.8 % of breast carcinoma samples comparing with normal cells. The expression of EphA4 was significantly associated with tumor grade (P = 0.003), TNM stage (P = 0.034), lymph node metastasis (P = 0.034) and Ki-67 (P < 0.001). No significant relationship was found between the expression of EphA4 and age, molecular subtypes, and HER2 status. Survival analysis showed that significant association of low expression of EphA4 in tumor cells with short overall survival (P = 0.048) and disease-free survival (P = 0.051). Our data show that EphA4 was reduced in breast carcinoma, which is associated with high grade, advanced TNM stage, lymph node metastasis, and poor outcome of patients.


Circulating mediators and organ function in patients undergoing planned relaparotomy vs conventional surgical therapy in severe secondary peritonitis.
Planned relaparotomy (PRL) has been suggested to have detrimental effects on the systemic activation of inflammation mediators, thereby enhancing organ dysfunctions as assessed by clinical scores in secondary peritonitis. Prospective, nonrandomized control trial. Intensive care units of an urban and a university teaching hospital. Twenty-nine patients with secondary peritonitis. Of the 29 patients with comparable initial peritonitis conditions, 11 underwent PRL and 18 obtained primary abdominal closure. Blood samples were obtained preoperatively and at 2, 6, 8, 12, 18, 24, 30, 36, 42, and 48 hours after the primary operation, then every 12th hour until day 5 and once daily until day 8. Quantification of circulating inflammation parameters (coagulation, acute-phase proteins, cytokine system, cell adhesion, opsonization) in correlation with Acute Physiology and Chronic Health Evaluation II, multiple organ failure, and Sepsis-Related Organ Failure Assessment scores. Preoperatively, the patient groups did not differ in mean age, cause of peritonitis, or clinical scores. On average, 5.1 (SEM, +/- 0.7; range, 3-11) lavage treatments were performed in the PRL group, with 90% of the procedures executed during the first 6 days. The PRL treatment resulted in a significantly higher need of blood components and an increased inflammation mediator response, especially concerning coagulation factors, proinflammatory cytokines, adhesion molecules, and opsonic parameters. During PRL, clinical score systems showed higher values and a delayed decline compared with primary abdominal closure treatment. Incidence of multiorgan failure, mortality, and the mean intensive care unit hospitalization period were clearly more pronounced in the PRL group. In our pilot study, additional lavage treatment of secondary peritonitis resulted in an enhancement of systemic inflammatory mediator response (in particular interleukin 8), which may contribute to a further impairment of organ function.


Warming enhances dominance of vascular plants over cryptogams across northern wetlands.
Climate warming causes profound effects on structure and function of wetland ecosystem, thus affecting regional and global hydrological cycles and carbon budgets. However, how wetland plants respond to warming is still poorly understood. Here, we synthesized observations from 273 independent sites to explore responses of northern wetland plants to warming. Our results show that warming enhances biomass accumulation for vascular plants including shrubs and graminoids, whereas it reduces biomass accumulation for cryptogams including moss and lichen. This divergent response of vascular plants and cryptogams is particularly pronounced in the high latitudes where permafrost prevails. As warming continues, this divergent response is amplified, however, the reduction in cryptogams is more drastic. Warming leads to declined surface soil moisture and lowered water table, thereby shifting wetlands from a wet system dominated by cryptogams to a drier system with increased cover of vascular plants. Under a high-emission scenario of Shared Socioeconomic Pathways (SSP5), a 4.7-5.1°C mean global temperature rise will cause more than fivefold loss of cryptogams compared with current climate. As cryptogams are largely concentrated at northern high latitudes, where warming will likely be greater than the projected global mean, modification in wetland plant composition and major reduction in cryptogams are expected to occur even much earlier than 2100.


CDX2 expression can predict response to neoadjuvant therapy in gastric carcinoma.
Caudal-related homeobox transcription factor 2 (CDX2) has recently been proposed as a prognostic factor for gastric carcinoma. However and to the best of our knowledge, no previous report has analyzed CDX2 expression in patients with gastric adenocarcinoma receiving neoadjuvant therapy (NAT). This is a retrospective cohort study to analyze the potential role of CDX2 expression to predict response to NAT and prognosis. This study has enrolled 57 patients receiving chemotherapy for locally advanced gastric carcinoma. 59.6% of the patients were men; mean age was 64.96 years. Only 8% of the patients showed a complete response to therapy, 10% had grade 1, 28% grade 2, and 54% grade 3 regression, respectively, according to modified Ryan's criteria. On follow-up, 38.6% of the patients showed recurrence of disease (50% distant metastasis) and 28.1% eventually died of it. Twenty-three (40.4%) patients showed intense CDX2 expression. We found a statistically significant association between CDX2 expression and poor regression with NAT, but we found no association with outcome. Our study indicates that CDX2 expression can predict lack of response to NAT. Our results have not confirmed the association with prognosis shown in previous reports. Despite these preliminary results, furthermore studies are necessary to define the potential use of CDX2 in gastric carcinoma.