Development and Validation of the US Diabetes, Obesity, Cardiovascular Disease Microsimulation (DOC-M) Model: Health Disparity and Economic Impact Model.
Few simulation models have incorporated the interplay of diabetes, obesity, and cardiovascular disease (CVD); their upstream lifestyle and biological risk factors; and their downstream effects on health disparities and economic consequences. We developed and validated a US Diabetes, Obesity, Cardiovascular Disease Microsimulation (DOC-M) model that incorporates demographic, clinical, and lifestyle risk factors to jointly predict overall and racial-ethnic groups-specific obesity, diabetes, CVD, and cause-specific mortality for the US adult population aged 40 to 79 y at baseline. An individualized health care cost prediction model was further developed and integrated. This model incorporates nationally representative data on baseline demographics, lifestyle, health, and cause-specific mortality; dynamic changes in modifiable risk factors over time; and parameter uncertainty using probabilistic distributions. Validation analyses included assessment of 1) population-level risk calibration and 2) individual-level risk discrimination. To illustrate the application of the DOC-M model, we evaluated the long-term cost-effectiveness of a national produce prescription program. Comparing the 15-y model-predicted population risk of primary outcomes among the 2001-2002 National Health and Nutrition Examination Survey (NHANES) cohort with the observed prevalence from age-matched cross-sectional 2003-2016 NHANES cohorts, calibration performance was strong based on observed-to-expected ratio and calibration plot analysis. In most cases, Brier scores fell below 0.0004, indicating a low overall prediction error. Using the Multi-Ethnic Study of Atherosclerosis cohorts, the c-statistics for assessing individual-level risk discrimination were 0.85 to 0.88 for diabetes, 0.93 to 0.95 for obesity, 0.74 to 0.76 for CVD history, and 0.78 to 0.81 for all-cause mortality, both overall and in three racial-ethnic groups. Open-source code for the model was posted at https://github.com/food-price/DOC-M-Model-Development-and-Validation. The validated DOC-M model can be used to examine health, equity, and the economic impact of health policies and interventions on behavioral and clinical risk factors for obesity, diabetes, and CVD. We developed a novel microsimula'tion model for obesity, diabetes, and CVD, which intersect together and - critically for prevention and treatment interventions - share common lifestyle, biologic, and demographic risk factors.Validation analyses, including assessment of (1) population-level risk calibration and (2) individual-level risk discrimination, showed strong performance across the overall population and three major racial-ethnic groups for 6 outcomes (obesity, diabetes, CVD, and all-cause mortality, CVD- and DM-cause mortality)This paper provides a thorough explanation and documentation of the development and validation process of a novel microsimulation model, along with the open-source code (https://github.com/food-price/ DOCM_validation) for public use, to serve as a guide for future simulation model assessments, validation, and implementation.


Distinct and redundant functions of three homologs of RNase III in the cyanobacterium Synechococcus sp. strain PCC 7002.
RNase III is a ribonuclease that recognizes and cleaves double-stranded RNA. Across bacteria, RNase III is involved in rRNA maturation, CRISPR RNA maturation, controlling gene expression, and turnover of messenger RNAs. Many organisms have only one RNase III while others have both a full-length RNase III and another version that lacks a double-stranded RNA binding domain (mini-III). The genome of the cyanobacterium Synechococcus sp. strain PCC 7002 (PCC 7002) encodes three homologs of RNase III, two full-length and one mini-III, that are not essential even when deleted in combination. To discern if each enzyme had distinct responsibilities, we collected and sequenced global RNA samples from the wild type strain, the single, double, and triple RNase III mutants. Approximately 20% of genes were differentially expressed in various mutants with some operons and regulons showing complex changes in expression levels between mutants. Two RNase III's had a role in 23S rRNA maturation and the third was involved in copy number regulation one of six native plasmids. In vitro, purified RNase III enzymes were capable of cleaving some of the known Escherichia coli RNase III target sequences, highlighting the remarkably conserved substrate specificity between organisms yet complex regulation of gene expression.


[Expression of Toll-like receptor 7 in gastric cancer cell lines and effects of TLR7 agonist on proliferation and apoptosis of SGC-7901 cells in vitro].
To investigate the expression of Toll-like receptor 7 (TLR7) in gastric cancer cell lines and the effect of imiquimod, a TLR7 agonist, on the proliferation and apoptosis of SGC-7901 cells. The protein expression levels of TLR7 were detected with Western blotting in 3 human gastric cancer cell lines (SGC-7901, HGC-27 and MKN-28). The cell line expressing the highest TLR7 level was exposed to different doses of imiquimod for 12-72 h and the cell viability was assessed with MTT assay. The cell apoptosis rate after 100 µg/ml imiquimod treatment for 12 or 24 h was quantified by flow cytometry, and the ultrastructual changes of the cells were observed under electron microscope. The expression of apoptosis-related genes Bcl-2 and Bax were analyzed with real-time PCR. All the 3 cell lines expressed TLR7, among which SGC-7901 cells showed the highest expression level. TLR7 agonist imiquimod dose- and time-dependently reduced the viability of SGC-7901 cells. Exposure to 100 µg/ml imiquimod for 24 h resulted in SGC-7901 cell apoptosis as shown by an increased ratio of early apoptotic cells and significant ultrastructural changes of the cells. Real-time PCR demonstrated that imiquimod treatment for 24 h caused a dose-dependent reduction of Bcl-2 mRNA expression and increment of Bax mRNA expression. TLR7 protein is expressed in all the 3 gastric cancer lines and its agonist imiquimod can inhibit cell proliferation and induce apoptosis in SGC-7901 cells.


Determinants of Poor Sleep Quality During the COVID-19 Pandemic Among Women Attending Antenatal Care Services at the Health Facilities of Debre Berhan Town, Ethiopia: An Institutional-Based Cross-Sectional Study.
Women's ability to get sleep can be affected by pregnancy-related hormonal changes or other external stressful situations like the coronavirus disease 2019 (COVID-19). The objective of this study was to assess the proportion of poor sleep quality during the COVID-19 pandemic and its determinants among pregnant women attending antenatal care (ANC) services. An institutional-based cross-sectional study was conducted among 423 women attending ANC services at the health facilities in Debre Berhan Town, Ethiopia, from May to June 2020. A systematic random sampling technique was used to select the required samples. The tool consisted of questions that assessed (1) socio-demographic characteristics, obstetric and health care service-related characteristics; and media exposure to get information regarding COVID-19 infection; (2) To assess sleep quality; the Pittsburgh Sleep Quality Index (PSQI) was applied. And a global score of >5 indicates poor sleep quality, and a global score of ≤5 indicates good sleep quality. The overall prevalence of poor sleep quality was 62.8%, and was associated with pregnant women aged ≥46 years (AOR = 4.27), being in the third trimester (AOR = 2.51), being multigravida (AOR = 2.72), and having co-morbidity (AOR = 3.57). The prevalence of poor sleep quality among pregnant women during the pandemic was found to be high. Advanced maternal age, third trimester pregnancy, being multigravida, and having comorbidity were determinants of poor sleep quality among pregnant women during the COVID-19 pandemic.


Renal Dietitians' Perceptions of the Value of Subjective Global Assessment: A Mixed Methods Study.
The objective of this study is to assess how renal registered dietitians (RDs) in Canada perceive the value of Subjective Global Assessment (SGA) to assess protein-energy wasting for clients with chronic kidney disease. A sequential exploratory mixed method approach included 2 focus groups (n = 6 and 8) and a national survey (n = 54). Two online focus groups were conducted 1 month apart followed by an online survey. Participants included renal RDs working with Stage 5 chronic kidney disease (dialysis and non-dialysis) patients. Five main themes (consistency, organizational/environment, confidence, interpretation, and education) emerged. Renal RDs support using a tool to provide a standardized process for nutrition assessment and feel SGA is an effective educational tool; however, barriers such as time, privacy, confidence in the tool, as well as ability to perform physical assessment, interpretation, and subjectivity limit the use of SGA. Renal RDs feel that it is important to examine nutrition interventions in conjunction with SGA results. The main results of the study describing the limitations to the clinical use of the SGA tool revolve around RDs' time, confidence, ability to interpret the SGA tool, and how SGA is used by administration. The results support the need for educators and administrators to communicate the use of SGA results and provide education opportunities focusing on the use of validated, reliable, responsive tools to assess nutrition status as well as hands-on physical assessment. In some situations, an alternative validated version of SGA or screening tool may be appropriate.


Gain of BDNF Function in Engrafted Neural Stem Cells Promotes the Therapeutic Potential for Alzheimer's Disease.
Stem cell-based therapy is a potential treatment for neurodegenerative diseases, but its application to Alzheimer's disease (AD) remains limited. Brain-derived neurotrophic factor (BDNF) is critical in the pathogenesis and treatment of AD. Here, we present a novel therapeutic approach for AD treatment using BDNF-overexpressing neural stem cells (BDNF-NSCs). In vitro, BDNF overexpression was neuroprotective to beta-amyloid-treated NSCs. In vivo, engrafted BDNF-NSCs-derived neurons not only displayed the Ca(2+)-response fluctuations, exhibited electrophysiological properties of mature neurons and integrated into local brain circuits, but recovered the cognitive deficits. Furthermore, BDNF overexpression improved the engrafted cells' viability, neuronal fate, neurite complexity, maturation of electrical property and the synaptic density. In contrast, knockdown of the BDNF in BDNF-NSCs diminished stem cell-based therapeutic efficacy. Together, our findings indicate BDNF overexpression improves the therapeutic potential of engrafted NSCs for AD via neurogenic effects and neuronal replacement, and further support the feasibility of NSC-based ex vivo gene therapy for AD.


Semiconductor nanowires: from self-organization to patterned growth.
The synthesis of semiconductor nanowires has been studied intensively worldwide for a wide spectrum of materials. Such low-dimensional nanostructures are not only interesting for fundamental research due to their unique structural and physical properties relative to their bulk counterparts, but also offer fascinating potential for future technological applications. Deeper understanding and sufficient control of the growth of nanowires are central to the current research interest. This Review discusses the various growth processes, with a focus on the vapor-liquid-solid process, which offers an opportunity for the control of spatial positioning of nanowires. Strategies for position-controlled and nanopatterned growth of nanowire arrays are reviewed and demonstrated by selected examples as well as discussed in terms of larger-scale realization and future prospects. Issues on building up nanowire-based electronic and photonic devices are addressed at the end of the Review, accompanied by a brief survey of recent progress demonstrated so far on the laboratory level.


Dyed particle capture immunoassay for detection of incipient brown-rot decay.
An immunological method for detecting incipient fungal decay in wood is described. Monoclonal antibody to extracellular beta-1,4-xylanase of the brown-rot fungus Postia placenta was immobilized in a defined capture zone to a strip of hydrophobic polyester cloth. Polyclonal-labeled latex particles were applied near one end of the polyester assay substrate. The resulting test strip was dipped into extracts from wood blocks inoculated with various wood decay fungi. Extracts flowed laterally through the antibody-labeled latex particles and the capture zone. When antigen was present in the extract, the antigen was complexed by the monoclonal and labeled-polyclonal antibodies to form an observable particle complex in the zone of capture. Wood samples were tested at various stages of decay and correlated with wood weight loss. Incipient brown-rot decay was detected with the particle capture immunoassay at less than 2 percent wood weight loss.


Enantioselective synthesis of the C10-C20 fragment of fusicoccin A.
A synthesis of the fully protected C-ring fragment of the tricyclic diterpene fusicoccin A is reported. The desired cyclopentenyl halides 5a,b are obtained in a total of nine steps. Key transformations of the synthesis sequence are a nonconventional Cr-catalyzed allylic oxidation of a protected intermediate cylcopentenone, a diastereoselective addition of a propenyl Grignard/CeCl(3) reagent to the unmasked cyclopentenone, and an asymmetric hydroboration of the isopropenyl substituent. The protected and suitably functionalized C-ring fragment paves the way to explore further the total synthesis of fusicoccin A.


[The effect of complex use of nicotinic acid electrophoresis and air bubble baths on microcirculation in patients with diabetic polyneuropathy].
To study of the effect of the combined impact of nicotinic acid electrophoresis and air bubble baths on the state of microcirculation (MC) in patients with diabetic polyneuropathy (DPN). 60 patients with DPN and type 2 diabetes mellitus with a disease duration of 6 to 25 years were examined and treated. All patients were divided into 2 groups: 30 patients of the 1st group received the combined impact of nicotinic acid electrophoresis and air-bubble baths; 30 patients of the 2nd group - only electrophoresis of nicotinic acid according to Vermel. The dynamics of the MC state was evaluated according to laser Doppler flowmetry (LDF). Before treatment, in most patients with DPN (98%), according to LDF, a spastic type of MC was established. After a course of treatment, it was found that the combined use of nicotinic acid electrophoresis and air bubble baths in patients with DPN has a more pronounced corrective effect on the condition of the MC than the use of Vermel's electrophoresis of nicotinic acid only. Complex therapy, including electrophoresis of nicotinic acid and air bubble baths, has a pronounced effect on the condition of the MC in patients with DPN and is pathogenetically justified for the treatment of this category of patients.


Docking Studies of Adenosine Analogues with NS5 Methyltransferase of Yellow Fever Virus.
Yellow fever virus (YFV) is caused by single stranded positive RNA virus called Flavivirus. Till now no specific antiviral agents are available for the treatment of YFV, and despite a commercial YFV vaccine, there are still approximately 30,000 deaths worldwide each year and cases have been increasing in the last 20 years. Here, the effects of adenosine analogues and commercially available adenosine derivative drugs on NS5 methyltransferase of YFV have been performed by the comparative docking study. Based on the docking score, the glide energy and the number of interactions of the adenosine analogues with the Pubchem ID 13792 and 1077 showed the better scoring function than the best ranked commercially available adenosine analogue derived antiviral drug Cc3ado. From the docking result it reveals that these adenosine analogues can bind to the active site of NS5 methyltransferase protein and inhibit the viral replication.


Co-existence of thrombocytopenia and hyperleukocytosis ('critical period') as a risk factor of haemorrhage into the central nervous system in patients with acute leukaemias.
The aim of this work was to examine whether the risk of death i.a. due to haemorrhage into the central nervous system (CNS) is higher during some phases of acute myeloblastic leukaemia (AML), lymphoblastic leukaemia (ALL), and the blastic phase of chronic myelogenous leukaemia (BP) when two important risk factors that worsen the prognosis are simultaneously present: low thrombocytopenia and hyperleukocytosis. Clinical and post-mortem neuropathological examination was performed in 143 patients, aged 17-76 years, who died from AML (80 cases), BP (38), and ALL (25). Periods with co-existence of thrombocytopenia below 25 x 10(9) per l and hyperleukocytosis above 100 x 10(9) per l were identified after plotting the results and were termed the 'critical period' (CP). The study showed that the risk of death was disproportionately high during the CP. This finding was obtained in all patient groups, although it involved mainly patients with AML and BP, i.e. leukaemias with the highest frequency of hyperleukocytosis in peripheral blood. It is suggested that the risk of death during the CP is so high because leukaemic cells are a potent synergistic factor to thrombocytopenia in causing CNS haemorrhage. When a CP is detected, hyperleukocytosis and thrombocytopenia should be controlled and treated aggressively: leukapheresis and platelet concentrates should be administered. Patients with CP should not be given packed red blood cells, in order to avoid a further increase in blood viscosity, which is already high due to hyperleukocytosis. In fact, anaemia during the CP should be regarded as a potentially life-saving factor.


Selective Shunting Based on Dual Monitoring with Electroencephalography and Stump Pressure for Carotid Endarterectomy.
The aim of this study is to analyze postoperative outcomes for carotid endarterectomy (CEA) in addition to the preoperative clinical characteristics related to selective shunting based on dual monitoring with stump pressure (SP) and electroencephalography (EEG). We retrospectively reviewed medical records of 70 patients who underwent CEA from March 2010 to December 2017. CEA was performed under general anesthesia and selective shunting was done if the SP was lower than 35 mmHg regardless of EEG or if intraoperative EEG showed any changes different from preoperative one regardless of SP. There was no postoperative 30-day adjusted mortality or adverse cardiac events. Three patients (4.3%) had postoperative minor stroke finally reaching pre-operative neurologic status at the time of discharge. Twenty-six patients (37.1%) used shunting and severe contralateral internal carotid stenosis or occlusion was related to shunting (P<0.010). There were larger number of symptomatic patients in shunt group in spite of no statistical significance (P=0.116). Perioperative stroke rate was 4.3% for CEA under general anesthesia based on dual intraoperative monitoring with SP and EEG. There was no 30-day adjusted mortality and adverse cardiac event. Severe stenosis or occlusion of contralateral internal carotid artery is related to shunting (P<0.010).


[Hepatitis B virus genotypes in chronic carriers on the island of Gran Canaria. Clinical and epidemiological characteristics].
To investigate the prevalence of hepatitis B virus (HBV) genotypes in Spanish hepatitis B carriers, and to study the differences in epidemiological characteristics, e antigen (HBeAg) seroconversion, serum DNA viral levels (VL) and liver function alterations. This study included 108 patients. Genotyping was carried out in 84 with the INNO-LiPA HBV genotyping assay (Innogenetics). There were 41 women and 67 men, with a mean age of 44.1 years. The source of transmission was family contact in 26 patients (24.1%); transfusions in 10 (9.3%); sexual promiscuity in 9 (8.3%), intravenous drug use in 3 (2.8%), health care accident in 2 (1.8%); and unknown causes in 58 (53.7%). Forty patients had chronic hepatitis and 68 (63%) were healthy carriers. The time of evolution of the infection was known in only in 45 patients, and was over 10 years in 42 of them. One hundred patients (92.6%) were HbeAg-negative and 90 (83.3%) had detectable viral DNA. Genotype A was present in 46 (54.8%), D in 20 (23.8%), F in 2 (2,4%), C in 1 (1.2%), A-G coinfection in 7 (8.3%), A-D in 4 (4.8%), D-G in 2 (2,4%), A-C in 1 (1.2%), and A-D-G in 1 (1.2%). There were no significant differences between genotypes. A trend towards an association was found between VL <or= 10(5) copies/mL and the presence of chronic hepatitis in genotype A (28.9%) as opposed to genotype D (7.7%) (p non significant). HBV genotypes A and D, and coinfections with G are predominant in our area. Genotype A showed a tendency to produce greater inflammatory activity when VL was <or= 10(5) copies/mL.


Adolescents with adequate birth weight newborns diminish energy expenditure and cease growth.
Maternal energy requirements increase during pregnancy but the magnitude of this increment is unknown among adolescents. We determined the effects of maternal age and weight status on adjustments in gestational weight gain, resting energy expenditure (REE), and growth among adolescents. Weight, and growth rates of pregnant adolescents (PA) < or =17 y during late pregnancy were compared with changes in nonpregnant adolescents (NPA) over a 5-mo period. REE was also measured monthly in the PA group. Paired t-tests and general linear models for repeated measures were used for the analysis; height was included as a confounding variable. Weight, height, and BMI of the PA and NPA women did not differ at baseline. During the follow-up period, NPA grew 0.94 +/- 30 cm; growth rate was greater in adolescents < or =14 y of age (P < 0.001) than in the older subjects. No growth occurred in the PA group. REE tended to increase linearly between 20 and 36 wk of gestation (P = 0.164); the net change in women >14 y (25%) tended (P = 0.164) to be greater than that of younger adolescents (7%). The mean increment of REE from wk 20 to wk 36 was 230 +/- 30 kcal/d (962 +/- 126 kJ/d) and the smallest increase occurred in women with BMI <20 (P = 0.010). Women with BMI <20 had a decrease in REE/kg that was greater than that of normal weight (BMI 20-25) or overweight (BMI > or =25) women (within subject, P = 0.010; between subject, P = 0.001). In conclusion, PA appear to adjust their resting energy needs by ceasing growth.


Associations of polymorphisms in the cytokine genes IL1β (rs16944), IL6 (rs1800795), IL12b (rs3212227) and growth factor VEGFA (rs2010963) with anthracosilicosis in coal miners in Russia and related genotoxic effects.
Anthracosilicosis (AS), a prevalent form of pneumoconiosis among coal miners, results from the accumulation of carbon and silica in the lungs from inhaled coal dust. This study investigated genotoxic effects and certain cytokine genes polymorphic variants in Russian coal miners with АS. Peripheral leukocytes were sampled from 129 patients with AS confirmed by X-ray and tissue biopsy and from 164 asymptomatic coal miners. Four single-nucleotide polymorphisms were genotyped in the extracted DNA samples: IL1β T-511C (rs16944), IL6 C-174G (rs1800795), IL12b A1188C (rs3212227) and VEGFA C634G (rs2010963). Genotoxic effects were assessed by the analysis of chromosome aberrations in cultured peripheral lymphocytes. The mean frequency of chromatid-type aberrations and chromosome-type aberrations, namely, chromatid-type breaks and dicentric chromosomes, was found to be higher in AS patients [3.70 (95% confidence interval {CI}, 3.29-4.10) and 0.28 (95% CI, 0.17-0.38)] compared to the control group [2.41 (95% CI, 2.00-2.82) and 0.09 (95% CI, 0.03-0.15)], respectively. IL1β gene T/T genotype (rs16944) was associated with AS [17.83% in AS patients against 4.35% in healthy donors, odds ratio = 4.77 (1.88-12.15), P < 0.01]. A significant increase in the level of certain chromosome interchanges among AS donors is of interest because such effects are typical for radiation damage and caused by acute oxidative stress. IL1β T allele probably may be considered as an AS susceptibility factor among coal miners.


Predictors of Short-Term Prognosis While in Pediatric Headache Care: An Observational Study.
To characterize the short-term prognosis of a clinical population of pediatric and young adult patients with migraine and explore predictors of clinical worsening while in care. This was a retrospective study of all migraine patients seen at the Cincinnati Children's Hospital Headache Center from 09/01/2006 to 12/31/2017, who had at least 1 follow-up visit within 1-3 months of the index visit analyzed. Included data were: age, sex, race, primary ICHD diagnosis, chronic migraine, medication overuse, history of status migrainosus, BMI percentile, headache frequency, headache severity, PedMIDAS score, allodynia, preventive treatment type, lifestyle habits, disease duration, depressive and anxiety symptoms. Clinical worsening was defined as an increase in 4 or more headache days per month between the index visit and the follow-up visit. Data for 13,160 visit pairs (index and follow-up), from 5316 patients, were analyzed. Clinical worsening occurred in only 14.5% (1908/13,160), whereas a reduction in headache frequency was observed in 56.8% of visit intervals (7475/13,160), with 34.8% of the intervals (4580/13,160) showing a reduction of 50% or greater. The change in headache frequency was minimal (increase in 0-3 headaches/month) in 28.7% of intervals (3737/13,160). In the multivariable model, the odds of worsening were significantly higher with increasing age, female sex, chronic migraine, status migrainosus, depressive symptoms, higher PedMIDAS scores, and use of nutraceuticals, whereas the odds of worsening were lower for summer visits, caffeine drinkers, higher headache frequencies, and use of pharmaceuticals. The majority of pediatric patients who receive multimodal interdisciplinary care for migraine improve over time. Our findings highlight a set of clinical features that may help in identifying specific factors that may contribute to an unfavorable short-term prognosis.


Religion and medical neglect.
This is a literature review of religion-associated medical neglect of children. It attempts to document the most common denominations involved in religion-associated medical neglect. There is a discussion of the history of religious exemptions to medical care and health risks to children as a result of religious exemption. Suggestions are made for the clinician regarding recognition and management of religion-associated medical neglect in children.


Water for all: Towards an integrated approach to wetland conservation and flood risk reduction in a lowland catchment in Scotland.
Strategies for sustainable water resources management require integration of hydrological, ecological and socio-economic concerns. The "Water for all" project has sought to develop a multi-disciplinary science case for innovative management of water levels and flows in a lowland catchment in Scotland. Water demands of arable agriculture, protection from flood risk and conservation needs of lowland mesotrophic wetlands needed to be considered. Water management strategy focused on the outlet zone of Balgavies lake in Eastern Scotland, where the Lunan Water discharges into a partially confined common channel (lade). Water releases to a mill, to the downstream river, and to floodplain wetlands (Chapel Mires) are partially controlled by an existing weir. Based on observations of management of this weir, we postulated that upgrading hydraulic management in this zone could reduce upstream flood risk, help protect mesotrophic wetlands and facilitate downstream water supply at low flows. We considered potential for: (a) installing a remotely operated tilting weir, for improved management of release and routing of flows from the common lade; (b) dredging of the common lade in combination or instead of the tilting weir. Rapid ecological assessment and mixing analysis of the Lunan Water with waters in Chapel Mires showed a gradient of trophic status across the wetlands linked to impact of river-borne nutrients. Stage-discharge relationships, derived from steady-state approximations of the in-channel hydraulics, showed that the proposed tilting weir had potential to divert seasonal nutrient rich water from the upstream Lake away from Chapel Mires. Significant impact of the proposed weir on upstream flood risk was not demonstrated, but carrying out dredging of the channel reduced the current observed probability of upstream flooding. The proposed weir could help to maintain these dredging benefits. Survey and interviews with catchment stakeholders and residents showed constructive interest in the scheme, with half of the respondents willing to pay to support its implementation. The survey also revealed concerns about the proposed project, especially its long-term governance. The lessons learned have wider relevance to development of an integrated approach to water ecosystem services provision, especially where benefits are uncertain and thinly spread across a range of users.


Escitalopram for perimenopausal depression: an open-label pilot study.
Women have a relatively high risk of experiencing depressive episodes during the perimenopause. Indications for and acceptance of hormone replacement therapy (HRT) are increasingly controversial, and serotonin reuptake inhibitor antidepressants are an attractive potential treatment option for both the mood and somatic symptoms of perimenopause. This study is an open-label, 8-week trial of escitalopram for perimenopausal depression and somatic symptoms associated with perimenopause. Twenty women received escitalopram and were serially assessed with the Hamilton Rating Scale for Depression (HAMD, 30-item), the Greene Climacteric Scale (GCS), and the Clinical Global Impression (CGI). There were significant differences between pretest and posttest scores for each measure, as demonstrated in an intent-to-treat analysis: GCS (p < 0.0001), HAM-D30 (p < 0.0001), and CGI (p < 0.0001). Two subjects dropped out prior to the second visit because of drug side effects. In this study, benefits of treatment were observed in several domains of perimenopausal symptoms, including those representative of psychological, vasomotor, and somatic symptoms. The limitations of this study are small sample size and lack of placebo control. Larger, long-term, controlled trials of antidepressants are warranted for the treatment of perimenopausal depression and associated somatic symptoms.


Disordered eating attitudes and behaviors in ballet students: examination of environmental and individual risk factors.
The current study compared the prevalence of disordered eating attitudes and behaviors among adolescent ballet dancers at national, regional, and local schools. Female ballet students (N = 239; mean age = 15.0 +/- 1.5 years) from five geographically disparate summer programs completed the Eating Dis-order Inventory (EDI) and answered questions regarding eating disorder symptoms. Students from both national and local schools reported significantly higher EDI total, Drive for Thinness, and Perfectionism scores compared with regional students. In contrast, national students reported significantly greater dieting scores and lifetime histories of self-induced vomiting compared with regional and local students. Eating pathology among adolescent ballet dancers may be a function of both genetic and environmental risk. Dancers who exhibit high levels of perfectionism and, perhaps consequently, place themselves in highly competitive environments, may exhibit a significantly increased risk for disordered eating in comparison to dancers who are less perfectionistic and/or place themselves in less competitive environments.


[Possibility of early diagnosis of hepatic fibrosis in chronic alcoholics determining the N-terminal peptide of type-III procollagen].
The authors examined the behaviour of sP-III-P and other parameters in 40 patients affected by alcoholic liver disease (20 of whom with steatosis, 10 with steatofibrosis, 10 with liver cirrhosis) and at the same time in a group of non drinking controls. The levels of sP-III-P appeared significantly increased in the patients with steato-fibrosis and even more so in those with liver cirrhosis, while in those with steatosis the increase was insignificant. The gamma-globulins showed similar behaviour while serum albumin appeared proportionally reduced in the cases in which sP-III-P and gamma-globulins showed a greater increase. The authors believe that the study of sP-III-P is valuable in the follow-up of patients with alcoholic liver disease and in particular in chronic alcoholism to reveal the presence of an increased fibrogenesis.


Low level technology tool (LLTT) in screening for blindness: test qualities in the outpatients department of a tertiary eye unit using the Snellen chart.
To validate the use of finger counting (low level technology tool) in screening for blindness in the outpatients department of a tertiary eye unit with the view of employing the test for screening illiterate people in hard to reach parts of the country where the conventional visual acuity charts are not available. Aperformance evaluation of counting fingers (LLTT) in screening for blindness against the standard test (Snellen chart). Sekuru Kaguvi Eye Unit, Parirenyatwa Hospital, Zimbabwe. Patients presenting to the Eye Outpatient Department at Sekuru Kaguvi Eye Unit with various eye problems. Sensitivity of low level technology tool (LLTT) in identifying blind people. Sensitivity and specificity of LLTT in detecting blindness in all age groups combined was 100% and 88.5% respectively. Although sensitivity was not affected by patient age, specificity decreased with increasing age. The overall positive predictive value for the test was 53.3% and the prevalence of blindness among outpatient attendees was 11.6%. Finger counting is an effective tool that can be employed in screening for blindness in communities which are hard to reach, have low literacy rate and when conventional methods of testing visual acuity are not available.


Microfluidic gas-flow profiling using remote-detection NMR.
We have used nuclear magnetic resonance (NMR) to obtain spatially and temporally resolved profiles of gas flow in microfluidic devices. Remote detection of the NMR signal both overcomes the sensitivity limitation of NMR and enables time-of-flight measurement in addition to spatially resolved imaging. Thus, detailed insight is gained into the effects of flow, diffusion, and mixing in specific geometries. The ability for noninvasive measurement of microfluidic flow, without the introduction of foreign tracer particles, is unique to this approach and is important for the design and operation of microfluidic devices. Although here we demonstrate an application to gas flow, extension to liquids, which have higher density, is implicit.


Formation and Stability of Bulk Nanobubbles Generated by Ethanol-Water Exchange.
Bulk nanobubbles have unique properties and find potential applications in many important processes. However, their stability or long lifetime still needs to be understood and has attracted much attention from researchers. Bulk nanobubbles are generated based on ethanol-water exchange, a method that is generally used in the study of surface nanobubbles. Their formation and stability is further studied by using a new type of dynamic light scattering known as NanoSight. The results show that the concentration of the bulk nanobubbles produced by this method is about five times greater than that in the degassed group, which indicates the existence of bulk gas nanobubbles. The effects of ethanol/water ratios and temperature on the stability of the bulk nanobubbles have also been studied and their numbers reach a maximum at a ratio of about 1:10 (v/v).


Optical coherence tomography and histopathology of macular uveitis.
Spectral-domain optical coherence tomography (SD-OCT) is a noninvasive technique that can provide high-resolution images of macular morphology. The purpose of this study was to examine the pathological mechanism of uveitis and compare the changes in the macula of uveitis patients and the histopathological features of experimentally induced uveitis in mice. Macular OCT was performed on 78 eyes of 51 patients of the Eye Hospital of Shandong University of Traditional Chinese Medicine, China, with apparent uveitis changes. C57BL/6 mice were injected with interphotoreceptor retinoid-binding protein (IRBP)-specific T cells from naïve mice immunized with complete Freund adjuvant IRBP(1-20) to induce uveitis. The disease was monitored by indirect fundoscopy. The eyes of the mice with experimental autoimmune uveitis (EAU) were enucleated 18 days after injection and classified according to pathological characteristics. The characteristics of uveitis were classified into six categories. Macular edema was detected in 48 eyes (61.5%); macular epiretinal membrane in 22 eyes (28.2%); choroidal neovascularization and macular lamellar holes in 4 eyes (5.1%), respectively; macular atrophy in 10 eyes (12.8%); and serous neuroepithelium detachment in 22 eyes (28.2%). As in human patients, pathological examinations of mouse EAU showed inflammation, folds, and atrophy of the outer part of the neuroretina, choroidal neovascularization with hemorrhagic retinal detachment, serous neuroepithelium detachment, and epiretinal membrane formation. Macular OCT of uveitis patients can display different morphological characteristics. Mouse EAU can simulate human uveitis. The comparative analysis of macular OCT in human uveitis and transfer EAU histopathology changes could provide important information on the pathogenesis of human uveitis.


Adiponectin (ADIPOQ) gene variants and haplotypes in Saudi Arabian women with polycystic ovary syndrome (PCOS): a case-control study.
The aim of this study is to assess the association of nine SNPs on ADIPOQ on the PCOS risk among Saudi Arabian Women. A case-control study, including 162 cases and 162 controls in Saudi Arabia, was enrolled. Genotyping was carried out by the allelic discrimination method. Estimated haplotype frequencies were assessed using the maximum likelihood method. Results showed that ADIPOQ SNPs were not associated with PCOS for allelic and genotypic frequencies (p > .05). In haplotype estimation analysis, a significant positive association was detected between 21211 haplotype (rs2241766/rs1501299/rs2241767/rs3774261/rs17366743) in additive model with increased risk of PCOS (p = .009, OR = 2.16 [1.22-3.82] CI 95%). None of the nine SNPs illustrated significant association with the quantitative traits after multiple test corrections. These results support a significant association of 21211 haplotype (rs2241766/rs1501299/rs2241767/rs3774261/rs17366743) of ADIPOQ gene in Saudi women with polycystic ovary syndrome.


PDZRN4 acts as a suppressor of cell proliferation in human liver cancer cell lines.
Recently, some reports show that Ligand of Numb Protein-X 1 (LNX1) could be a suppressor gene in gliomas, while our current research has firstly shown that PDZ domain containing ring finger 4 (PDZRN4), another member of LNX family, could also be a potential suppressor in hepatocellular carcinoma (HCC). PDZRN4, also named LNX4 (Ligand of Numb Protein-X 4), is a member of the LNX family. We recently found that PDZRN4, but not LNX1, was down-regulated in HCC samples, and the role of PDZRN4 in the progression of HCC had not been studied before. To address this question, firstly, we evaluated the expression of PDZRN4 in HCC samples and adjacent non-cancerous tissues. Semi-quantitative polymerase chain reaction showed that PDZRN4 was down-regulated in 24/36 (66.7%) HCC samples separately. In addition, our research shows that PDZRN4 is silenced in all of the 12 HCC cell lines tested. Subsequently, cell-based functional assay exhibited that ectopic expression of PDZRN4 inhibits the proliferation, plate colony formation and anchorage-independent colony formation of HCC cells. Collectively, our results showed that PDZRN4 might be a potential tumour suppressor gene and had anti-proliferative effect on HCC cell proliferation, which would be of great significance to the researches on HCC.


A Multilevel Model Approach for Investigating Individual Accident Characteristics and Neighborhood Environment Characteristics Affecting Pedestrian-Vehicle Crashes.
Walking is the most basic movement of humans and the most fundamental mode of transportation. To promote walking, it is necessary to create a safe environment for pedestrians. However, pedestrian-vehicle crashes still remain relatively high in South Korea. This study employs a multilevel model to examine the differences between the lower-level individual characteristics of pedestrian crashes and the upper-level neighborhood environmental characteristics in Seoul, South Korea. The main results of this study are as follows. The individual characteristics of pedestrian-vehicle crashes are better at explaining pedestrian injury severity than built environment characteristics at the neighborhood level. Older pedestrians and drivers suffer more severe pedestrian injuries. Larger vehicles such as trucks and vans are more likely to result in a high severity of pedestrian injuries. Pedestrian injuries increase during inclement weather and at night. The severity of pedestrian injuries is lower at intersections and crosswalks without traffic signals than at crosswalks and intersections with traffic signals. Finally, school zones and silver zones, which are representative policies for pedestrian safety in South Korea, fail to play a significant role in reducing the severity of pedestrian injuries. The results of this study can guide policymakers and planners when making decisions on how to build neighborhoods that are safer for pedestrians.


Antibiotic-resistant gram-negative bacilli in the sewage of the City of Concepcion, Chile.
Counts of total and of antibiotic-resistant heterotrophic Gram-negative bacteria were performed in samples collected from the main sewage effluent of the city of Concepcion, Chile, during an eleven month period in 1991-1992. Antibiotic resistance patterns (ARP) were determined and antibiotic resistance indexes (ARI) were calculated for some fermenting and nonfermenting strains of resistant bacteria. Ampicillin-resistant strains were the most frequent among fermenting bacteria, whereas those cephalothin-resistant were the most frequent among nonfermenting bacilli. These results correlate with the frequency of clinical use of both antibiotics in the community of Concepción. Higher values of ARI for nonfermenting bacilli are probably due to the natural intrinsic resistance of these microorganisms to several beta-lactam compounds. Since plasmid-coded resistance is frequent among enteric bacilli, the large number of resistant bacilli in sewage may be important in the natural dis-


Frequent D-loop polymorphism in mtDNA enables genotyping of 1400-year-old human remains from Merowingian graves.
Improvements of DNA extraction and amplification techniques presently enable DNA analysis of ancient DNA (aDNA) from samples which range from several hundred years of age up to possibly 5000 years. Taking advantage of the abundance of mitochondrial DNA and its polymorphic D-loop sequence, ten individuals from multiple burial sites of the Merowingian culture (South Germany), estimated to be about 1400 years old, were genotyped to determine possible kinship. Moreover, gonosomal DNA markers from the X- and Y-chromosome were applied for sex determination of the remains. In all individuals investigated, deviations from the Anderson mtDNA consensus sequence were observed, all representing substitutions (7 transitions and 3 transversions). Although such mutations have been reported from recent populations, our study constitutes the first description of these mtDNA mutations from numerous aDNA samples recovered from multiple burial sites. The results obtained by molecular anthropology can aid in describing kinship relations and burial customs of ancient remains.


TRPC1/4/5 channels contribute to morphine-induced analgesic tolerance and hyperalgesia by enhancing spinal synaptic potentiation and structural plasticity.
Opioid analgesics remain the mainstay for managing intractable chronic pain, but their use is limited by detrimental side effects such as analgesic tolerance and hyperalgesia. Calcium-dependent synaptic plasticity is a key determinant in opiates tolerance and hyperalgesia. However, the exact substrates for this calcium-dependent synaptic plasticity in mediating these maladaptive processes are largely unknown. Canonical transient receptor potential 1, 4, and 5 (TRPC1, 4, 5) proteins assemble into heteromultimeric nonselective cation channels with high Ca2+ permeability and influence various neuronal functions. However, whether and how TRPC1/4/5 channels contribute to the development of opiates tolerance and hyperalgesia remains elusive. Here, we show that TRPC1/4/5 channels contribute to the generation of morphine tolerance and hyperalgesia. Chronic morphine exposure leads to upregulation of TRPC1/4/5 channels in the spinal cord. Spinally expressed TRPC1, TPRC4, and TRPC5 are required for chronic morphine-induced synaptic long-term potentiation (LTP) as well as remodeling of synaptic spines in the dorsal horn, thereby orchestrating functional and structural plasticity during the course of morphine-induced hyperalgesia and tolerance. These effects are attributed to TRPC1/4/5-mediated Ca2+ elevation in the spinal dorsal horn induced by chronic morphine treatment. This study identifies TRPC1/4/5 channels as a promising novel target to prevent the unwanted morphine tolerance and hyperalgesia.


Thermal Emission Control via Bandgap Engineering in Aperiodically Designed Nanophotonic Devices.
Aperiodic photonic crystals can open up novel routes for more efficient photon management due to increased degrees of freedom in their design along with the unique properties brought about by the long-range aperiodic order as compared to their periodic counterparts. In this work we first describe the fundamental notions underlying the idea of thermal emission/absorption control on the basis of the systematic use of aperiodic multilayer designs in photonic quasicrystals. Then, we illustrate the potential applications of this approach in order to enhance the performance of daytime radiative coolers and solar thermoelectric energy generators.


FACTORS RELATING TO ACADEMIC PERFORMANCE OF MEDICAL STUDENTS AT THE UNIVERSITY OF BRITISH COLUMBIA.
The performance of medical students enrolled at the University of British Columbia from 1952 to 1961 is reviewed and related to certain descriptive factors available to the screening committee at the time of application. Almost 40% of enrolled students had academic difficulty in medical school; 16.4% failed a complete year. Since 91% of students who failed out, did so after freshman medicine examinations, these grades were examined for significant association with certain intellectual and non-intellectural factors. Sex and year of registration were not significantly associated with freshman performance, but permanent home address was: students from other Commonwealth countries did not perform as well as Canadians. Significant correlations were observed between both pre-medical grades and Medical College Admission Test scores and first-year medicine marks. By multiple regression analysis four factors were found to be predictive: age, number of pre-medical years completed at the time of application, overall pre-medical grade average and "Science" M.C.A.T. score. From the resulting equation, 77.4% of the grades of medical students who completed their freshman year in 1962 were predicted within one standard error. Students on the whole were noted to perform consistently in pre-medicine and medicine.


Mid-Term Outcomes Following Percutaneous Pulmonary Valve Implantation Using the "Folded Melody Valve" Technique.
The folded valve is a manual shortening of the Melody device, which has been validated as a valuable therapeutic option for the management of dysfunctional right ventricular outflow tracts needing a short valved stent. In this article, we aimed to evaluate, in a multicenter cohort, the mid-term outcomes of patients in whom a percutaneous pulmonary valve implantation was performed using the folded valve technique. A 2012 to 2018 retrospective multicenter study was performed in 7 European institutions. All patients who benefit from percutaneous pulmonary valve implantation with a folded Melody valve were included. A total of 49 patients (median age, 19 years [range 4–56], 63% male) were included. The primary percutaneous pulmonary valve implantation indication was right ventricular outflow tract stenosis (n=19; 39%), patched native right ventricular outflow tracts were the most common substrate (n=15; 31%). The folded technique was mostly used in short right ventricular outflow tracts (n=28; 57%). Procedural success was 100%. After a median follow-up of 28 months (range, 4–80), folded Melody valve function was comparable to the immediate postimplantation period (mean transvalvular peak velocity=2.6±0.6 versus 2.4±0.6 m/s, P>0.1; only 2 patients had mild pulmonary regurgitation). Incidence rate of valve-related reinterventions was 2.1% per person per year (95% CI, 0.1%–3.9%). The probability of survival without valve-related reinterventions at 36 months was 90% (95% CI, 76%–100%). The folded Melody valve is a safe technique with favorable mid-term outcomes up to 6.5 years after implantation, comparable with the usual Melody valve implantation procedure. Complications and reinterventions rates were low, making this technique relevant in selected patients.


Interleukin-1 family cytokines and mast cells: activation and inhibition.
Activated mast cells (MCs) secrete a number of compounds including pro-inflammatory and anti-inflammatory cytokines. MCs are a potential source of cytokines and chemokines which participate in allergic reactions and inflammation. MCs can be activated by IgE through its receptor FceRI, but also by Toll-like receptors and/or interleukin (IL)-1. MCs can be a target for both pro-inflammatory and anti-inflammatory cytokines. IL-1 activates MCs to release inflammatory chemical mediators, and cytokines/chemokines, an effect which can be potentially inhibited by IL-37. In addition, IL-36 is also a powerful cytokine with a pro-inflammatory activity. IL-38 binds IL-36R and inhibits the pro-inflammatory activity of IL-36, thus performing a therapeutic action. In this article we review the role of MCs in relation to pro-inflammatory and anti-inflammatory IL-1 family member cytokines and a possible therapeutic effect in inflammatory disorders.


Evidence for extrusion of unfolded extracellular enzyme polypeptide chains through membranes of Bacillus amyloliquefaciens.
The production of extracellular alpha-amylase and protease by protoplasts of Bacillus amyloliquefaciens has been achieved. The production of enzymically active protease was totally dependent on a high concentration of either Mg2+, Ca2+, or spermidine, but production of active alpha-amylase was not. This cation dependence of protease production was seen immediately upon addition of lysozyme to intact cells. The cations could prevent the inactivation of protease and alter the cytoplasmic membrane configuration of protoplasts. Production of active alpha-amylase and protease by protoplasts was totally inhibited by proteolytic enzymes such as trypsin, alpha-chymotrypsin, or the organism's purified extracellular protease. The evidence suggests that these degradative enzymes act specifically on the emerging polypeptide of the extracellular enzyme and that the polypeptide emerges in a conformation different from that of the native molecule.


Decision making and experience level influence frontal plane knee joint biomechanics during a cutting maneuver.
The purpose of this study was to examine the combined impact of experience and decision making on frontal plane knee joint biomechanics during a cutting maneuver. Kinematic and kinetic data were collected from 12 recreationally active and 18 NCAA Division I female athletes during execution of anticipated and unanticipated single-leg land-and-cut maneuvers. Knee joint abduction angles and external knee joint abduction torques were calculated and discrete peak stance-phase variables were extracted. Angle and torque time-series data were also submitted to separate functional data analyses. Variables derived from the functional data analyses indicated that decision making influenced knee abduction angle and torque time series in the recreational group only. Specifically, these variables pointed to greater knee abduction at the end of stance as well as a greater, albeit delayed peak in knee abduction torque at the beginning of landing in the recreational athletes during the unanticipated condition. In addition, the recreational athletes displayed greater discrete peak knee abduction angles than the Division I athletes regardless of condition. Discrete peak knee abduction torque did not differ between groups or conditions.


Cloning and sequencing of the gene for the lactose carrier of Citrobacter freundii.
The gene coding for the lactose carrier of Citrobacter freundii was cloned into the plasmid pBR322. The gene was sequenced and the amino acid sequence was found to be 70% identical to the lactose carrier of E. coli. All of the charged residues in the membrane spanning region were conserved. The sugar specificity is somewhat different from that of E. coli. The C. freundii carrier has less activity for lactose and more activity for o-nitrophenyl-galactose (ONPG) than the carrier of E. coli.


[Partial surgery in cancer of the upper respiratory and digestive tracts].
Partial or functional surgery for cancers of the upper aerodigestive tract essentially concerns the larynx and the pharyngolaryngeal area. The aim of this surgery is to preserve voice and deglutition. Therefore fundamental anatomical structures such as the cricoid cartilage or at least one arytenoid cartilage must be spared, pointing the limitations of the techniques. Based on these principles, many authors have divided partial surgical procedures ranging from the simplest (cordectomy) to reconstruction on near-total laryngectomy. Cancers of the hypopharynx can benefit from similar techniques always founded on reconstruction by muscle and aponeurosis or by a free flap. Carcinologic results after partial surgery for cancer of upper aerodigestive tract are better than those obtained after total laryngectomy. This fact could be explained by the nature of these cancers that are limited. The carcinologic and functional success of this surgery needs a precise clinical indication and a perfect approach of the various surgical techniques.


Computer-aided antibody design.
Recent clinical trials using antibodies with low toxicity and high efficiency have raised expectations for the development of next-generation protein therapeutics. However, the process of obtaining therapeutic antibodies remains time consuming and empirical. This review summarizes recent progresses in the field of computer-aided antibody development mainly focusing on antibody modeling, which is divided essentially into two parts: (i) modeling the antigen-binding site, also called the complementarity determining regions (CDRs), and (ii) predicting the relative orientations of the variable heavy (V(H)) and light (V(L)) chains. Among the six CDR loops, the greatest challenge is predicting the conformation of CDR-H3, which is the most important in antigen recognition. Further computational methods could be used in drug development based on crystal structures or homology models, including antibody-antigen dockings and energy calculations with approximate potential functions. These methods should guide experimental studies to improve the affinities and physicochemical properties of antibodies. Finally, several successful examples of in silico structure-based antibody designs are reviewed. We also briefly review structure-based antigen or immunogen design, with application to rational vaccine development.


The first sideways-bonded peroxo complex for a tetraaminecobalt(III) species.
Cobalt(II) salts react with H2O2 in the presence of 2 equiv of tetramethylethylenediamine (tmen) to produce a stable sideways bonded mononuclear peroxo complex [Co(tmen)2O2]ClO4 which has been characterized chemically and by a single crystal X-ray determination. This is the first such tetraaminecobalt(III) complex, indeed, the first for any tetraaminemetal ion complex. The mononuclear peroxo complex can also be synthesized by O2 2- anation of cis-[Co(tmen)2(OH2)2]3+. This reaction is reversed in acid, and this offers the potential to develop Co(III) catalyzed oxidation reactions.


[Immunohistological coexpression of keratin and vimentin in the epithelial neoplastic cells].
Filed formalin-fixed paraffin blocks of 128 cases of epithelial neoplasms were selected for immunohistochemical study of keratin and vimentin expression. The results showed that 35.1% (45/128) of different carcinomas expressed vimentin. The immuno-positivity of vimentin in thyroid carcinomas, ovarian carcinomas, prostatic adenocarcinomas, pulmonary carcinomas and malignant mesotheliomas were 81.8%, 42.8%, 66.7%, 30.5% and 53.4%, respectively. Carcinomas of breast, kidneys, salivary glands, adrenal glands and nasopharyngeal carcinomas also showed various degrees of positive reaction. The results suggest that an immunohistochemical positive vimentin reaction does not exclude histopathological diagnosis of carcinomas. The significance and noticeable aspects of immunohistochemical methods in histopathological diagnosis are also discussed.


Substrate specificity of Xenopus matrix metalloproteinase stromelysin-3.
The matrix metalloproteinase stromelysin-3 (ST3 or MMP11) was initially identified as a breast carcinoma associated protease and has since been shown to be highly expressed in diverse carcinomas and in developmental processes that involve extensive cell death (apoptosis) and tissue remodeling. Unlike other MMPs, purified ST3 has little activity toward known extracellular matrix (ECM) proteins in vitro but cleaves strongly a few non-ECM, extracellular proteins, including human alpha1-proteinase inhibitor (alpha1-PI). To investigate the possibility of alpha1-PI as a conserved physiological substrate for ST3 during vertebrate development, we analyzed the ability of Xenopus laevis ST3 catalytic domain to cleave frog alpha1-PI. Surprisingly, we found the ST3 failed to recognize the site in alpha1-PI equivalent to the major cleavage site in human alpha1-PI by mammalian ST3. Sequence and mutagenic analysis revealed that multiple substitutions at P2-P3' positions between human and Xenopus alpha1-PI contributed to the inability of Xenopus alpha1-PI to be cleaved by ST3. Our studies showed that (A)(G/A)(A)(M)(F/A)(L) (P3-P3') as a preferred cleavage site for ST3. We further demonstrated that mutations in the cleavage sites affected cleavage by ST3 differently from several other MMPs. These findings, together with earlier reports on ST3, showed that ST3 has distinct substrate specificities compared to other MMPs. Our results further suggest that alpha1-PI is unlikely to be a physiological substrate for ST3, at least with regard to evolutionarily conserved developmental processes.


The influence of contralateral breast augmentation on the development of complications in direct-to-implant breast reconstruction.
Simultaneous contralateral augmentation in direct-to-implant (DTI) breast reconstruction may increase the risk of skin flap necrosis on the reconstruction side due to increased tension on the skin flap when implants are larger than the original breast size. The purpose of this study was to evaluate whether the contralateral augmentation procedure affects complications in unilateral DTI breast reconstruction. Patients who underwent immediate unilateral DTI breast reconstruction from January 2013 to July 2017 were included in this study. Data were collected through retrospective review of individual medical records. The primary outcome variable was the development of perioperative complications including skin flap necrosis. Univariable and multivariable logistic regression analyses were performed to identify risk factors for complications. A total of 121 patients who underwent unilateral immediate DTI breast reconstruction were included in this study. Twenty-one patients (17.4%) underwent simultaneous contralateral augmentation mammoplasty and 100 patients (82.6%) underwent DTI without contralateral augmentation. Overall complications were not different between the contralateral augmentation and no-augmentation groups (23.8% vs. 31%, respectively, p = 0.512). The frequency of skin flap necrosis in the augmentation group (14.3%) was not significantly different from that in the no-augmentation group (18.0%, p > 0.999). In multivariable analysis, mastectomy weight was the only predictor for complications (p = 0.053) and contralateral augmentation was not associated with development of complications. Contralateral breast augmentation in DTI breast reconstruction is not a risk factor for complications and can be safely performed in selected patients.


Intramuscular temperature responses in the human leg to two forms of cryotherapy: ice massage and ice bag.
Cryotherapy is often used to affect the muscle underlying skin and subcutaneous tissues. However, the relationship between the penetrative ability of various cryotherapy methods and treatment time is not thoroughly understood. The purpose of this study was to measure muscle temperature responses during two frequently used cryotherapy techniques. A 23-gauge hypodermic needle microprobe was inserted to one-half skin-fold thickness plus 1 cm into the medial aspect of the gastrocnemius muscle of 14 subjects. Two groups of seven subjects each were measured for temperature changes during ice bag or ice massage treatment. Each treatment consisted of a 15-minute application of the selected method. A significant difference between the two methods was observed (t = -2,157, p < or = 0.05). Ice massage achieved its lowest temperature in an average of 17.9 +/- 2.4 minutes, while ice bag reached its lowest temperature in 28.2 +/- 12.5 minutes. Ice massage appears to cool muscle more rapidly than ice bag.


Control of Phase Separation in Polystyrene/Ionic Liquid-Blended Films by Polymer Brush-Grafted Particles.
Immiscible composite materials with controlled phase-separated structures are important in areas ranging from catalysis to battery. We succeeded in controlling the phase-separated structures of immiscible blends of polystyrene (PS) and two ionic liquids (ILs), namely, N, N-diethyl- N-(2-methoxyethyl)- N-methylammonium bis(trifluoromethylsulfonyl)imide (DEME-TFSI) and 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide, by adding precisely designed concentrated polymer brush-grafted (CPB-grafted) silica nanoparticles (CPB-SiPs) prepared by surface-initiated atom-transfer radical polymerization. We discuss relationships between chemical species and molecular weights of the CPB and phase-separated structures. When the CPB was composed of a PS homopolymer of an appropriate molecular weight, the IL phase formed a continuous structure and a quasi-solid-blended film was successfully fabricated because the CPB-SiPs were adsorbed at the PS/IL interface and prevented macroscopic phase separation. We propose that CPB-SiP adsorption and the fabrication of quasi-solid films are governed by the degree of penetration of the matrix PS chains into the CPB and deformability of the CPB-SiPs. We found that the DEME-TFSI domain size can be controlled by the CPB-SiP content and that only 1 wt % of the CPB-SiPs was needed to fabricate a quasi-solid film. In addition, we investigated the ionic properties of the quasi-solid PS/DEME-TFSI-blended film. Owing to continuous ion channels composed only of DEME-TFSI, the film exhibited an ionic conductivity of 0.1 mS/cm, which is relatively high compared to previously reported quasi-solid electrolytes. Finally, we demonstrated that an electric double-layer capacitor fabricated using this film as the electrolyte exhibited high charge/discharge cycling stability and reversibility.


Effectiveness and safety of a newly designed partially covered tracheal metallic Y-shaped stent for the treatment of high cervical gastro-tracheal or tracheo-esophageal fistula: A retrospective observational study.
The aim of this study was to evaluate the effectiveness and safety of a partially covered metallic tracheal Y-shaped stent for the treatment of high cervical gastro-tracheal fistula (GTF) and tracheo-esophageal fistula (TEF). From January 2017 to January 2019, 16 patients with high cervical GTF and TEF received partially covered metallic Y-shaped stent placement under fluoroscopic guidance. The technical and clinical success rates, incidence of major complications, and survival outcomes were analyzed. Eastern Cooperative Oncology Group (ECOG) score and quality of life (SF-36 questionnaire) were compared pre and post stent placement. Technical and clinical success rates were 100% and 81.3%, respectively. Major complications (severe tumor ingrowth, mucostasis, hyperplastic granulation tissue) occurred in 7/16 (43.8%) patients. ECOG score and 5 of the 8 domains of the SF-36 (physical function, role physical, general health, vitality, social function) were significantly improved at 1 month after treatment (P < .01). During the median follow-up period of 8.3 months, 9 patients were alive. Median overall survival was 10.3 months (95% CI, 8.0-12.6). The newly designed partially covered tracheal Y-shaped stent appears to be effective and safe for treatment of high cervical GTF and TEF.


Cytological evaluation of endometrial hyperplasia in relation to histological pictures.
The Authors analyse possible parameters of cytological evaluation which can be used for the grading of endometrial hyperplasias and the diagnostic differentiation between atypical hyperplasia and adenocarcinoma. They consider 77 women who underwent endometrial cytology by aspiration just before diagnostic examination of the uterine cavity. Results show that in atrophic endometrium desquamation in clusters of less than 100 cells prevails whereas proliferative and secretory endometrium presents mainly clusters of 100-500 regularly stratified cells. Hyperplasia show progressive increase in isolated cells; "branched" glands appear rarely in hyperplasia with minimal atypia while prevailing in hyperplasia with severe atypia and adenocarcinoma. Simple layers prevail in atrophic endometrium, stratified regular layers prevail in proliferative and secretory endometrium; three-dimensional clusters appear in hyperplasia with minimal atypia and become significant with severe atypia. Adenocarcinoma is characterized by haematic and necrotic background, high percentage of isolated cells and prevalence of clusters of less than 100 cells, mainly three-dimensional. In addition it shows a significant incidence of papillary and rosette-like arrangements and abnormal cytoplasmic vacuolization.


A "real-life" study on height in prepubertal asthmatic children receiving inhaled steroids.
Asthma is the most common chronic respiratory disease in children and inhaled corticosteroids (ICS) constitute the first line of treatment for these patients. However, the potential growth-inhibiting effect of ICS has often been a cause of concern for both caregivers as well as physicians, and there still remains conflict regarding their safety profile. To assess whether the administration of ICS in low or medium doses is associated with height reduction in prepubertal children. We performed a retrospective study to examine the association between ICS treatment and growth deceleration in children with mild persistent asthma. The comparison of height measurements every 6 months from 3 to 8 years of age was conducted among three groups of patients: patients not receiving ICS, patients being treated with low dose of ICS and patients being treated with medium dose of ICS (GINA Guidelines 2015). This study included 284 patients (198 male, 86 female) aged 3-8 years; 75 patients were not receiving ICS, 63 patients were on low-dose ICS and 146 patients were on medium-dose ICS. The measured height every 6 months did not differ significantly (p > 0.05) among the three groups while the difference remained stable (p > 0.05), even when we evaluated males and females separately. In this "real-life" study we found that long-term treatment with ICS in low or medium doses is not associated with height reduction in prepubertal children with asthma.


Total abdominal colectomy vs. restorative total proctocolectomy as the initial approach to medically refractory ulcerative colitis.
There is scant data assessing the consequences of staging restorative proctocolectomy for ulcerative colitis. The aim of the study is to compare outcomes of initial vs. staged restorative proctocolectomy. Patients completing restorative proctocolectomy, including ileostomy reversal, during 2006-2012 were identified from an IRB-approved database. Demographics, treatment variables, and perioperative outcomes were assessed. Out of 521 patients, 322 (62%) underwent initial total abdominal colectomy before restorative proctectomy. This group was associated with more common preoperative anemia, leukocytosis, hypoalbuminemia, severe colitis, steroids and biologics use, decreased proximal ileostomy rate at the time of completion restorative proctectomy (92.5 vs 97.5%, p = 0.023), shorter hospital stay (6.6 vs 7.8, p < 0.001), and marginally decreased pelvic sepsis rate (6.2 vs 11.1%, p = 0.05) compared with patients having initial restorative proctocolectomy. However, they also required longer combined postoperative hospital stays (17 vs 12 days, p < 0.001) and treatment span (10.4 vs 5.7 months, p < 0.001) to complete all surgical stages and they were associated with increased overall postoperative surgical site infection, hemorrhage, and small bowel obstruction rates. Pouch function and QOL were comparable between the groups, except for increased nightly bowel movements in the initial abdominal colectomy group (2.5 ± 2.2 vs 2.1 ± 1.8, p = 0.012). Patients undergoing initial total abdominal colectomy require longer treatment time and experience increased overall morbidity, but ultimately experience comparable ileal pouch outcomes when compared to patients undergoing initial restorative proctocolectomy.


Asymptotic theory of a large fiber-laser array passive phase locking.
Coherent laser beam combining is a potentially attractive way to increase the combined beam brightness beyond the technological limits to single-mode fiber lasers. Passive phase locking (PPL) does not need external management and leads to strong simplification of the system. A specific feature of fiber amplifiers and lasers is that they possess optical path differences of the magnitude of many wavelengths. The involved problem in the PPL approach is to specify an ultimate limit to the phase-locked laser-array size. Earlier studies confirm the stabilizing role of gain saturation on beam-combining efficiency. The purpose of our study is to decipher the desired effect of nonlinearity on the combining efficiency in two architectures of a globally coupled fiber-laser array: (I) an array of amplifiers in ring resonator configuration with spatially filtered feedback; (II) an array of lasers also with external feedback. The external-cavity feedback in both systems results in global coupling, i.e., each element is coherently coupled to all the others. A semi-analytical approach based on the probability theory is developed to calculate the probability density for the efficiency as a function of system parameters in both ensembles. Comparison between (I) and (II) arrays indicates that the II-type arrays demonstrate better characteristics while scaling the array size.


Distribution and Drug Resistance of Bacterial Pathogens Associated with Lower Respiratory Tract Infection in Children and the Effect of COVID-19 on the Distribution of Pathogens.
By studying the distribution and drug resistance of bacterial pathogens associated with lower respiratory tract infection (LRTI) in children in Chengdu and the effect of the COVID-19 on the distribution of pathogens and by analyzing the epidemic trend and drug resistance changes of the main pathogens of LRTI, this research is supposed to provide a useful basis for the prevention of LRTI in children and the rational use of drugs in clinical practice. Hospitalized children clinically diagnosed with LRTI in Chengdu Women and Children's Central Hospital from 2011 to 2020 were selected as the study subjects. The pathogens of LRTI in children and the distribution of pathogens in different ages, genders, seasons, years, and departments and before and after the pandemic situation of COVID-19 were counted. The drug resistance distribution of the top six pathogens with the highest infection rate in the past three years and the trend of drug resistance in the past decade were analyzed. A total of 26,469 pathogens were isolated. Among them, 6240 strains (23.6%) were Gram-positive bacteria, 20152 strains (76.1%) were Gram-negative bacteria, and 73 strains (0.3%) were fungi. Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, and Staphylococcus aureus were highly isolated in the group of infants aged 0-1 (P < 0.01), Moraxella catarrhalis and Streptococcus pneumoniae were highly isolated in children aged 1-6 (P < 0.01), and Haemophilus influenzae was highly isolated in children over 1 (P < 0.01). The isolation rates of Enterobacteriaceae, Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Staphylococcus aureus, and Candida albicans in the lower respiratory tract of 0-1 year-old male infants were higher than those of female infants (p < 0.05). Haemophilus influenzae was highly isolated in spring and summer, and Moraxella catarrhalis was highly isolated in autumn and winter, while the infection of Streptococcus pneumoniae was mainly concentrated in winter. This difference was statistically significant (P < 0.01). Affected by the COVID-19 pandemic, the isolation rates of Haemophilus influenzae and Streptococcus pneumoniae were significantly lower than those before the pandemic, and the isolation rate of Moraxella catarrhalis was significantly higher. The difference was statistically significant (P < 0.01). The proportion of isolated negative bacteria in NICU and PICU was higher than that in positive bacteria, and the infection rates of Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, and Acinetobacter baumannii were higher than those in other departments. The differences were statistically significant (P < 0.01). The results of drug sensitivity test showed that the drug resistance of Haemophilus influenzae and Moraxella catarrhalis was mainly concentrated in Ampicillin, First- and Second-generation cephalosporins, and Cotrimoxazole, with stable sensitivity to Third-generation cephalosporins, while the drug resistance of Streptococcus pneumoniae was concentrated in Macrolides, Sulfonamides, and Tetracyclines, with stable sensitivity to Penicillin. Staphylococcus aureus is highly resistant to penicillins and macrolides and susceptible to vancomycin. Enterobacteriaceae resistance is concentrated in cephalosporins, with a low rate of carbapenem resistance. From 2018 to 2020, 1557 strains of Staphylococcus aureus were isolated, of which 416 strains were MRSA, accounting for 27% of the isolates; 1064 strains of Escherichia coli were isolated, of which 423 strains were ESBL and 23 strains were CRE, accounting for 40% and 2% of the isolates, respectively; and 1400 strains of Klebsiella pneumoniae were isolated, of which 385 strains were ESBL and 402 strains were CRE, accounting for 28% and 29% of the isolates, respectively. Since 2011, the resistance of Escherichia coli and Klebsiella pneumoniae to Third-generation cephalosporins has increased, peaking in 2017, and has decreased after 2018, years after which carbapenem resistance has increased significantly, corresponding to an increase in the detection rate of Carbapenem-resistant Enterobacteriaceae CRE. Findings from this study revealed that there are significant differences in community-associated infectious pathogens before and after the COVID-19 pandemic, and there are significant age differences, seasonal epidemic trends, and high departmental correlation of pathogens related to lower respiratory tract disease infection in children. There was a significant gender difference in the isolation rate of pathogens associated with LRTI in infants under one year. Vaccination, implementation of isolation measures and social distance, strengthening of personal protective measures, aseptic operation of invasive medical treatment, hand hygiene, and environmental disinfection are beneficial to reducing community-associated pathogen infection, opportunistic pathogen infection, and an increase in resistant bacteria. The strengthening of bacterial culture of lower respiratory tract samples by pediatricians is conducive to the diagnosis of respiratory tract infections caused by different pathogens, contributing to the selection of effective drugs for treatment according to drug susceptibility results, which is important for the rational use of antibiotics and curbing bacterial resistance.


Exercise-induced bronchospasm: a pilot survey in Nairobi school children.
Exercise-induced bronchospasm (EIB), a common feature of asthma in children, has been used as the outcome measure in community-based surveys of childhood asthma to circumvent difficulties arising from relative lack of objectivity in the use of questionnaires in communities with different cultural and language orientations. We report here the results of the first community-based study of childhood asthma in Kenya using EIB as the outcome measurement. The data was collected in a pilot study to develop methodology for a larger subsequent study. The survey targeted grade four children in five Nairobi City Council school each representing a neighbourhood social economic status (SES). Out of 597 eligible, 408 children took part in the study (68% participation rate). EIB defined as decline in FEV1 of 15% or more, post-exercise was found in 10.5% (95% CI; 10.3, 10.7) of the children studied, the highest rate reported so far in Africa. While boys were more likely to exhibit EIB compared to girls, the prevalence of EIB tended to decrease with age, especially among children residing in low SES neighbourhoods where the EIB prevalence rates tended to be lower compared to those among children from higher SES neighbourhoods. However, none of these differences was statistically significant. This study confirms the feasibility of undertaking exercise challenge tests in the African context and we recommend that additional studies of similar nature be carried out in other populations of Africa to explore the potential of using an exercise test as a marker of asthma in epidemiologic studies.


Microcystin Prevalence throughout Lentic Waterbodies in Coastal Southern California.
Toxin producing cyanobacterial blooms have increased globally in recent decades in both frequency and intensity. Despite the recognition of this growing risk, the extent and magnitude of cyanobacterial blooms and cyanotoxin prevalence is poorly characterized in the heavily populated region of southern California. Recent assessments of lentic waterbodies (depressional wetlands, lakes, reservoirs and coastal lagoons) determined the prevalence of microcystins and, in some cases, additional cyanotoxins. Microcystins were present in all waterbody types surveyed although toxin concentrations were generally low across most habitats, as only a small number of sites exceeded California's recreational health thresholds for acute toxicity. Results from passive samplers (Solid Phase Adsorption Toxin Tracking (SPATT)) indicated microcystins were prevalent throughout lentic waterbodies and that traditional discrete samples underestimated the presence of microcystins. Multiple cyanotoxins were detected simultaneously in some systems, indicating multiple stressors, the risk of which is uncertain since health thresholds are based on exposures to single toxins. Anatoxin-a was detected for the first time from lakes in southern California. The persistence of detectable microcystins across years and seasons indicates a low-level, chronic risk through both direct and indirect exposure. The influence of toxic cyanobacterial blooms is a more complex stressor than presently recognized and should be included in water quality monitoring programs.


Effect of lymphokine-containing sera on adenocarcinoma BW10232 and melanoma B16 in C57BL/6 mice.
Lymphokine-containing sera (LKS) inhibited the growth of adenocarcinoma BW10232 and melanoma B16 in C57BL/L mice. Resistance to tumor growth was conferred by daily injections into the challenge site. The injection of LKS did not provide long-term resistance, inasmuch as termination of treatment permitted resumption of tumor growth at the primary tumor site. Whether LKS exerted a direct or indirect effect on the tumor cells to retard their was not certain.


[Test strip evaluation of albuminuria for the early detection of chronic kidney disease in persons with different risks (the experience of the Health Centers of the Moscow Region)].
To evaluate albuminuria (AU) in the Moscow Region's dwellers visiting the health centers and to clarify its association with the proven and discussed risk factors (RF) of chronic kidney disease (CKD). A total of 1623 patients (390 (24%) men and 1233 (76%) women; mean age 46 +/- 16 years) were examined. Urinalysis using test strips was performed in all the examinees. AU was estimated by the following scale: normal AU (NAU) (< 10 mg/l), an initial increase (11-30 mg/l), a pronounced increase (31-300 mg/ml), very high AU (> 300 mg/ml). A questionnaire covering gender, age, patients' anthropometric data, comorbidities, healthy lifestyle adherence, and smoking was designed to assess possible RFs for CKD. Body mass index (BMI) was calculated. Medical history examination showed metabolic disturbances and cardiovascular diseases. The detection rate of NAU was 18%; the initial and pronounced increases were found in 40 and 41% of the examinees, respectively; the very high AU was in 1%. The first questionnaire items associated with AU > 30 mg/ml were complaints of edema, sternal pain, poor appetite, meat aversion, and constant thirst. The detection rate of AU > 30 mg/l in hypertensive persons was 51%. If the patients had diabetes mellitus or a history of increased blood glucose episodes, the detection rate of AU > 30 mg/l amounted to as much as 65.5%. Estimation of overweight and obesity indicated that AU of > 30 mg/l was found in 44 and 49% of cases, respectively (p < 0.001). Analgesic abusers, long-term smokers, and sedentary people were statistically significantly more frequently found to have AU of > 30 mg/l. The pronounced and very high AU was noted in more than 40% of those who had visited the health centers. A questionnaire survey makes it possible to reveal a variety of AU increase-associated factors that primarily reflect metabolic disturbances and cardiovascular diseases and to identify a risk group in order to study AU first. Particular emphasis should be placed on the examinees' lifestyle. Healthy lifestyle non-adherence is closely correlated with increased AU and may be regarded as a RF for CKD.


Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases.
The cutaneous manifestations of COVID-19 disease are poorly characterized. To describe the cutaneous manifestations of COVID-19 disease and to relate them to other clinical findings. We carried out a nationwide case collection survey of images and clinical data. Using a consensus we described five clinical patterns. We later described the association of these patterns with patient demographics, the timing in relation to symptoms of the disease, the severity and the prognosis. The lesions may be classified as acral areas of erythema with vesicles or pustules (pseudo-chilblain) (19%), other vesicular eruptions (9%), urticarial lesions (19%), maculopapular eruptions (47%) and livedo or necrosis (6%). Vesicular eruptions appear early in the course of the disease (15% before other symptoms). The pseudo-chilblain pattern frequently appears late in the evolution of the COVID-19 disease (59% after other symptoms), while the rest tend to appear with other symptoms of COVID-19. The severity of COVID-19 shows a gradient from less severe disease in acral lesions to more severe in the latter groups. The results are similar for confirmed and suspected cases, in terms of both clinical and epidemiological findings. Alternative diagnoses are discussed but seem unlikely for the most specific patterns (pseudo-chilblain and vesicular). We provide a description of the cutaneous manifestations associated with COVID-19 infection. These may help clinicians approach patients with the disease and recognize cases presenting with few symptoms. What is already known about this topic? Previous descriptions of cutaneous manifestations of COVID-19 were case reports and mostly lacked illustrations. What does this study add? We describe a large, representative sample of patients with unexplained skin manifestations and a diagnosis of COVID-19, using a consensus method to define morphological patterns associated with COVID-19. We describe five clinical patterns associated with different patient demographics, timing and prognosis, and provide illustrations of these patterns to allow for easy recognition.


Monoallelic Loss-of-Function IFT140 Pathogenic Variants Cause Autosomal Dominant Polycystic Kidney Disease: A Confirmatory Study With Suspicion of an Additional Cardiac Phenotype.
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease. While biallelic variants affecting IFT140 are responsible for Mainzer-Saldino syndrome (characterized by severe ciliopathy causing skeletal abnormalities, kidney disease, and cysts), monoallelic loss-of-function (LoF) variants have been recently reported as an important cause of ADPKD beyond PKD1/2 genes. Herein, we report 6 non-family-related cases of monoallelic IFT140 LoF variants, identified from 1,340 exomes sequenced for nephrological indications in our local database. Every patient presented with polycystic kidney disease. Furthermore, the mother of a boy diagnosed with Mainzer-Saldino syndrome with a biallelic variant affecting IFT140 presented with several bilateral cysts, revealed after kidney imaging, and was found to carry a pathologic frameshift IFT140 variation. As well as this particular Mainzer-Saldino case, our 6 additional patients confirm that heterozygous IFT140 frameshift variants are responsible for the cystic phenotype and kidney failure. Interestingly, of the 6 patients, 2 also exhibited dilated cardiomyopathy, which was of unknown origin, as no genetic cause was found after exome sequencing analysis, suggesting a potential connection between IFT140 and heart disease.


A compact high-resolution spectrometer based on a segmented conical crystal analyzer.
In this work, the design, fabrication, and evaluation of a compact, one-shot spectrometer based on a segmented conically bent crystal analyzer are described. The system is a "one-shot" wavelength dispersive spectrometer, which has a crystal analyzer with an innovative geometry. It reaches an energy resolution of around 8 eV for Mn Kα1 line, which is at least an order of magnitude better than the commonly used energy dispersive spectrometers for fluorescence, and is comparable to current wavelength dispersive spectrometers. The prototype spectrometer fabricated in this work avoids angle scans that most wavelength dispersive spectrometers require, has the advantage of a sample-detector distance of only 146 mm, and allows for the simultaneous measurement of approximately a 2 keV window. This system is suitable to be used at synchrotron radiation facilities and free electron lasers, and it can even be adapted to an x-ray tube in any conventional x-ray laboratory.


[Laparoscopy: incisional hernias].
Post-laparoscopics incisionals hernias are among the serious complications of laparoscopy, however they are probably under-reported. We undertook a literature review to discuss their main characteristics. We emphasized on the need of controlled studies regarding their prevention measures.


Intestinal anisakiasis can cause intussusception in adults: an extremely rare condition.
We report an extremely rare case of adult intussusception caused by anisakiasis. A 41-year-old man was admitted into our hospital for right lower abdominal colicky pain. Ultrasonography and computed tomography revealed the presence of intussusception. As pneumo-dynamic resolution by colonoscopy failed, surgery was performed. The anisakis body was found in the submucosal layer of the resection specimen. The patient was discharged 9 d after the operation. Anisakiasis may cause intussusception in any country where sushi or sashimi now exists as a popular food. If suspicious, detailed clinical interview as to food intake prior to symptom development is crucial.


Serum digoxin concentration: increase after rest in different body positions.
If outpatients are allowed to rest in the supine position before their blood is sampled, serum digoxin increases. In a recent study, the serum digoxin concentration after 2-h standardized supine rest correlated better with the clinical status of patients than the value before rest. In the present study, 21 outpatients were studied on 2 consecutive days, approximately 24 h after the latest dose of digoxin. Blood samples for the assay of serum digoxin were taken on arrival at the department and after 1.5- and 2-h rest either supine or sitting (random order). The increases after 1.5-h rest were 12% (0-25%; p less than 0.001) and 12% (-3-47%; p less than 0.001), supine and sitting, respectively. The respective increases after 2-h rest were 14% (-11-32%; p less than 0.001) and 16% (0-74%; p less than 0.001). There were no statistically significant differences between the increases in serum digoxin concentration after supine and sitting rest. These results make it possible to recommend standardized rest in the sitting position (1.5-2 h) for outpatients before blood samples are collected when reliable serum digoxin analyses are of importance.


The effect of tree shade on ambient conditions and heat stress indicator traits of new-born South African Mutton Merino and Dormer lambs: Preliminary results.
This preliminary study investigated the provision of shade on heat stress indicators of South African Mutton Merino (SAMM) and Dormer lambs shortly after birth, during the autumn 2017 and 2018 lambing seasons. Newborn lambs were assessed to determine whether welfare, as assessed by respiratory response and rectal temperature as heat stress indicators, survival and early growth benefitted from the provision of shade. Groups consisting of 4-17 pregnant SAMM and Dormer ewes were randomly allocated to 5-10 paddocks with natural shade from trees and 5-9 paddocks that were directly in the sun with no shade available. The lambs were recorded within 24 h of birth at noon. Climate data were obtained from a nearby weather station. The lambs were also weighed at 12 (SD = 2) days of age at tail-docking. Tree shade had a moderating effect on temperature, resulting in lower maximum daytime and higher minimum night-time temperatures. There was an interaction between a temperature-humidity index (THI) and the treatments (access to shade or no access to shade) for respiration and rectal temperature (P < 0.01). Both traits were relatively unaffected by the THI at values below 77. Unshaded lambs exhibited a pronounced upwards trend following a THI-threshold of 77-78. Tailing weight tended to be higher while lamb survival of live-born lambs to tail-docking was lower in lambs born in shaded paddocks but these trends did not persist to weaning. Shade is needed to enhance animal welfare by alleviating the effect of high THI-values on hot days in an autumn lambing season.


Factors associated with inadequate receipt of components and use of antenatal care services in Nigeria: a population-based study.
Antenatal care (ANC) is an essential intervention to improve maternal and child health. In Nigeria, no population-based studies have investigated predictors of poor receipt of components and uptake of ANC at the national level to inform targeted maternal health initiatives. This study aimed to examine factors associated with inadequate receipt of components and use of ANC in Nigeria. The study used information on 20 405 singleton live-born infants of the mothers from the 2013 Nigeria Demographic and Health Survey. Multivariable logistic regression analyses that adjusted for cluster and survey weights were used to determine potential factors associated with inadequate receipt of components and use of ANC. The prevalence of underutilization and inadequate components of ANC were 47.5% (95% CI: 45.2 to 49.9) and 92.6% (95% CI: 91.8 to 93.2), respectively. Common risk factors for underutilization and inadequate components of ANC in Nigeria included residence in rural areas, no maternal education, maternal unemployment, long distance to health facilities and less maternal exposure to the media. Other risk factors for underutilization of ANC were home births and low household wealth. The study suggests that underutilization and inadequate receipt of the components of ANC were associated with amenable factors in Nigeria. Subsidized maternal services and well-guided health educational messages or financial support from the government will help to improve uptake of ANC services.


Hypothyroidism and abnormalities in the kinetics of thyroid hormone metabolism in rats treated chronically with polychlorinated biphenyl and polybrominated biphenyl.
Studies were directed at the question of whether polychlorinated biphenyl (PCB; Aroclor 1254) and polybrominated biphenyl (PBB; Fire Master BP-6), when administered in the diets of female Sprague-Dawley rats over long periods of time (5-7 months) and at low dosages (0, 1, 5, 10, and 50 ppm), would depress the thyroid. By examining serum T3 and T4, kinetics of T4 metabolism, and in vivo thyroid response to exogenous TSH injections, an estimate of the degree of hypothyroidism was made, and abnormalities in T4 disappearance from serum were encountered. Serum T3 and T4 levels were greatly suppressed in a dose-related manner by PCB or PBB treatment. There was a diminished response of serum T3 and T4 to TSH injection in rats pretreated with PCB or PBB (5 and 10 ppm), the exception being T3 in the 5 ppm PCB treatment group. Had the PCB and PBB treatment-induced suppression of T4 and T3 been on the hypothalamo-pituitary axis, the response of the treated rats to exogenous TSH might have exceeded that of controls; however, the opposite occurred. Disappearance of injected doses of L-[125I]T4 diminished as treatment concentrations of PCB or PBB increased. Disappearance slopes (r = 0.98) and fractional turnover rate constants (k) were decreased (t1/2 was lengthened) at each treatment level compared to the control values. The T4 distribution space (per 100 g BW) was expanded with increasing dosage by as much as 8-fold in the 50 pmm PCB treatment group. T4 MCRs were not increased by PCB or PBB treatment; thus, decreases in serum T3 and T4 were not caused by increased catabolism. T4 production rates were decreased at all treatment levels, but maximally 6-fold by 50 ppm PCB treatment. Together these data indicate that PCB-PBB-induced decreases in serum T3 and T4 result primarily from direct damage to the thyroid rather than any enhanced hepatic or other peripheral catabolism per se. Expanded T4 distribution space demonstrated that nonthyroid damage was also an important factor in reducing serum T4. Cell membrane damage associated with PCB-PBB intoxication may have expanded pools for T4 dilution. The findings are consistent with reported histological and ultrastructural damage caused by PCB and PBB. It also appears that TSH plays little role in PCB-PBB-induced hypothyroidism.


Effects of human cyclooxygenase-2 gene silencing on synovial cells of rheumatoid arthritis mediated by lentivirus.
The aim of the study is to screen the effective shRNA sequence which can silence the human COX-2 expression level in synovial cells of rheumatoid arthritis (RA) patient transfected by the lentivirus. Four pairs of hCOX-2 shRNA were designed and inserted into lentivirus to form pGPHI/GFP/Neo-shRNA vector. The reconstructed virus was transfected into synovial cells derived from RA patients, and then the expression level of hCOX-2 mRNA and the protein of the inflammatory factors including prostaglandin E2 (PGE2), vascular endothelial growth factor (VEGF), interleukin-1β (IL-1β) and tumour necrosis factor alpha (TNF-α) in the supernatants were examined with real-time PCR and ELISA, respectively. There was no obvious negative influence on cell growth and morphology after hCOX-2 shRNA gene transfection mediated by lentivirus. The hCOX-2 mRNA expression level, as well as the concentration of PGE2, VEGF, IL-1β and TNF-α, decreased significantly (p < .05). RNAi mediated by lentivirus can significantly inhibit hCOX-2 mRNA expression level in synovial cells of RA patients, so as to reduce the expression of inflammatory cytokines.