Effects of constant voltage on time evolution of propagating concentration polarization.
We extend the analytical theory of propagating concentration polarization (CP) to describe and compare the effects of constant-voltage versus constant-current conditions on the transient development of CP enrichment and depletion zones. We support our analysis with computational and experimental results. We find that at constant voltage, enrichment and depletion regions spread as t(1/2) as opposed to the previously observed t(1) scaling for constant current conditions. At low, constant voltages, the growth and propagation of CP zones can easily be misinterpreted as nonpropagating behavior.


Occupational Therapy in the Intensive Care Unit: A Systematic Review.
This paper is a synthesis of the available literature on occupational therapy interventions performed in the adult intensive care unit (ICU). The databases of Ovid MEDLINE, Embase, the Cochrane Library, ClinicalTrials.gov and CINAHL databases were systematically searched from inception through August 2016 for studies of adults who received occupational therapy interventions in the ICU. Of 1,938 citations reviewed, 10 studies met inclusion criteria. Only one study explicitly discussed occupational therapy interventions performed and only one study specifically tested the efficacy of occupational therapy. Future research is needed to clarify the specific interventions and role of occupational therapy in the ICU and the efficacy of these interventions.


Selected cases demonstrating the value of furosemide-primed 18F-FDG PET in identifying adrenal involvement.
The adrenals are often a site of metastatic spread of cancer, and evaluation of the adrenals is important in assessing the extent of disease involvement in several malignancies. PET with 18F-FDG has been found extremely effective in detecting adrenal involvement not identified on CT or not meeting the CT size criteria for malignancy. However, evaluation of the adrenals and of retroperitoneal adenopathy or other pathologic conditions with 18F-FDG PET can be complicated at times by normal accumulation of the tracer in the uppermost renal calyx because of its somewhat posterior orientation, particularly when it is dilated. It is not infrequent for physicians to report doubt about adrenal involvement and to suggest that the PET findings be correlated with CT findings. This problem can often be circumvented clinically by administering intravenous furosemide (dosage adjusted according to body weight) to remove 18F-FDG activity from the renal pelvicalyceal system and by rescanning approximately 15-20 min later using 1-2 bed positions that include the renal area. We present 5 case vignettes, with representative illustrations, providing convincing evidence of the usefulness of this simple, noninvasive interventional procedure in ruling out suspected adrenal involvement that is otherwise difficult to assess, thereby obviating any further confirmation.


Homing of mucosal leukocytes to joints. Distinct endothelial ligands in synovium mediate leukocyte-subtype specific adhesion.
Inflammation and infection of the gut can be followed by reactive arthritis at a distant joint. Leukocyte recruitment into synovium is essential for this process, but nothing is known about the endothelial adhesion molecules in synovial membrane which direct the homing of activated, gut-derived leukocytes to joints. Here we analyzed the expression of the known endothelial adhesion molecules in inflamed synovium and their function in binding of mucosal leukocytes. Intercellular adhesion molecule-1 (ICAM-1/CD54) and vascular adhesion protein-1 (VAP-1) were most prominently expressed in synovial vessels. All other adhesion molecules were found at lower levels in inflamed synovia, except mucosal addressin which was absent. Binding of macrophages isolated from lamina propria of the gut to synovial endothelium was almost entirely P-selectin-dependent. In contrast, small intestinal lymphocytes and immunoblasts both relied mainly on VAP-1 in recognition of synovial vessels. Thus, endothelial P-selectin and VAP-1 mediate binding of mucosal effector cells to synovium in a leukocyte subtype-selective manner. Antiadhesive therapy against these inducible molecules should ablate the pathogenetic cascade leading to inappropriate homing of leukocytes to joints in arthritis.


A case of severe Ebstein's anomaly with incompetent pulmonary valve.
A case of Ebstein's anomaly with functional pulmonary atresia diagnosed in utero is presented. The diagnosis was confirmed by postnatal echocardiographic, angiographic, and postmortem pathologic findings. On echocardiography the septal leaflet of the tricuspid valve was displaced towards the right ventricular apex. The tricuspid valve was moderately regurgitant and the arterial duct was patent. Continuous wave or color Doppler revealed serious reduction in forward flow from right ventricle through the pulmonary arteries; however, massive pulmonary regurgitation was observed. Pulmonary circulation was dependent on the ductal flow due to functional pulmonary atresia. Angiography revealed the massively enlarged right atrium, the absence of forward flow through the tricuspid valve, transfer of contrast material through the atrial septal defect to the left atrium, and the retrograde inflow of the pulmonary arteries from the aorta via the patent arterial duct. Ebstein's anomaly accompanied by functional pulmonary atresia is very rare. The fetal and neonatal presentation of this anomaly is associated with poor outcome.


Hydrogen-oxidizing electron transport components in nitrogen-fixing Azotobacter vinelandii.
Membranes from N2-fixing Azotobacter vinelandii were isolated to identify electron transport components involved in H2 oxidation. We found direct evidence for the involvement of cytochromes b, c, and d in H2 oxidation by the use of H2-reduced minus O2-oxidized absorption difference spectra. Carbon monoxide spectra showed that H2 reduced cytochrome d but not cytochrome o. Inhibition of H2 oxidation by cyanide was monophasic with a high Ki (135 microM); this was attributed to cytochrome d. Cyanide inhibition of malate oxidation showed the presence of an additional, low Ki (0.1 microM cyanide) component in the membranes; this was attributed to cytochrome o. However, H2 oxidation was not sensitive to this cyanide concentration. Chlorpromazine (at 160 microM) markedly inhibited malate oxidation, but it did not greatly inhibit H2 oxidation. Irradiation of membranes with UV light inhibited H2 oxidation. Adding A. vinelandii Q8 to the UV-damaged membranes partially restored H2 oxidation activity, whereas addition of UV-treated Q8 did not increase the activity. 2-n-Heptyl-4-hydroxyquinoline-N-oxide inhibited both H2 and malate oxidation.


Continuous dose-intense temozolomide and cisplatin in recurrent glioblastoma patients.
In glioblastoma multiforme (GBM), both temozolomide (TMZ) and cisplatin are very active at various toxic levels. Previous studies demonstrated that cisplatin with the standard regimen of TMZ is active in patients suffering from recurrent GBM, generating a moderate level of toxicity. Also, continuous dose-intense TMZ is a helpful therapy for patients with recurrent GBM. We have conducted a research to evaluate the security and effectiveness of cisplatin with constant dose-intense TMZ for reduplicative GBM. The time to progression (TTP) and progression-free survival (PFS) at 6 months (PFS-6) was the major end point. Toxicity, overall survival, and response are the secondary end points. GBM patients who suffered from progression or relapse after surgery, radiotherapy, and chemotherapy were qualified. Cisplatin 40, 30, and 30 mg were given on days 1, 2, and 3 before the corresponding TMZ doses, respectively. Without interruption, TMZ was given at a dose of 50 mg/m on everyday basis (dose-intense) until development or progression of unacceptable side effects. A cycle was defined as 28 days. Response Assessment in Neuro-Oncology criteria were utilized to evaluate the response. Twenty-seven patients in total (median Karnofsky performance status-80, ranging from 60 to 100; average age-56 years, ranging from 24 to 78 years) were accrued in the research. PFS-12 was 11.1% (95% confidence interval [CI], -0.7% to 22.9%), and PFS-6 was 37% (95% CI, 18.8%-55.2%). Twenty-three weeks was the median TTP (95% CI, 17-29 weeks). In the 27 evaluative patients, 6 partial responses were observed with an overall response rate of 22.2% (95% CI, 6.5%-37.9%), while no complete response was obtained. Toxicity was mostly of grades 1 to 2 amongst 116 therapy cycles. Hematological and gastroenterological toxicities were the major limiting side effect found in the research. One patient has received leukopenia World Health Organization grade 4 at cycle 5 during her treatment. Eight percent of patients had grades 3 to 4 vomiting/nausea. As a valuable therapeutic option, the innovative cisplatin with continuous dose-intense regimen of TMZ incurs an acceptable level of toxicity and shows active performance in patients with recurrent GBM.


Redox regulation of cellular activation.
Growing evidence has indicated that cellular reduction/oxidation (redox) status regulates various aspects of cellular function. Oxidative stress can elicit positive responses such as cellular proliferation or activation, as well as negative responses such as growth inhibition or cell death. Cellular redox status is maintained by intracellular redox-regulating molecules, including thioredoxin (TRX). TRX is a small multifunctional protein that has a redox-active disulfide/dithiol within the conserved active site sequence: Cys-Gly-Pro-Cys. Adult T cell leukemia-derived factor (ADF), which we originally defined as an IL-2 receptor alpha-chain/Tac inducer produced by human T cell lymphotrophic virus-I (HTLV-I)-transformed T cells, has been identified as human TRX. TRX/ADF is a stress-inducible protein secreted from cells. TRX/ADF has both intracellular and extracellular functions as one of the key regulators of signaling in the cellular responses against various stresses. Extracellularly, TRX/ADF shows a cytoprotective activity against oxidative stress-induced apoptosis and a growth-promoting effect as an autocrine growth factor. Intracellularly, TRX/ADF is involved in the regulation of protein-protein or protein-nucleic acid interactions through the reduction/oxidation of protein cysteine residues. For example, TRX/ADF translocates from the cytosol into the nucleus by a variety of cellular stresses, to regulate the expression of various genes through the redox factor-1 (Ref-1)/APEX. Further studies to clarify the regulatory roles of TRX/ADF and its target molecules may elucidate the intracellular signaling pathways in the responses against various stresses. The concept of "redox regulation" is emerging as an understanding of the novel mechanisms in the pathogenesis of several disorders, including viral infections, immunodeficiency, malignant transformation, and degenerative disease.


Fitting physiological models to data.
Methods of fitting models to experimental data obtained from biological systems are reviewed. The Michaelis-Menten model is used as the working example of a familiar and well-studied biological model. Criteria for selecting models include goodness of fit, freedom from systematic errors, and simplicity. A given model is usually fitted and the optimal parameters determined by minimization of an objective function, usually the sum of the squared errors. Freedom from systematic errors is best judged graphically. The important mathematical methods of fitting models are derived from the calculus and include linear and quadratic programming. The latter leads to minimization of the sum of squares of errors. Optimal search procedures, which also perform this minimization, are surveyed. Other properties of models, such as the proper number of parameters and whether linearization is appropriate, are discussed. The specialized problems of biological models and data are considered.


Outcomes of Patients with Newly Diagnosed Cardiac Myxoma: A Retrospective Multicentric Study.
The patient database at the First Department of Internal Medicine in Martin, the Central Slovak Institute for Cardiac and Vascular Diseases in Banska Bystrica, and the National Slovak Institute of Cardiovascular Diseases in Bratislava was searched to identify patients with benign tumors of the heart seen during the 5-year period between 2011 and 2016. Forty-one patients with primary cardiac myxomas were identified and their medical records were reviewed for details pertaining to presenting symptoms, staging modalities, treatment approaches, and outcomes. Most of the studied patients were diagnosed with echocardiography (n = 35, 85%). The occurrence of the tumor was higher in the female population (n = 25, 61%). The most common presenting symptoms were dyspnoea (n = 17, 42%), chest pain (n = 3, 7%), or pain and paraesthesia of the limbs (n = 2, 5%). Acute embolic event due to embolization of tumor fragments resulted in cerebral stroke (n = 5, 12%). All patients were treated by resection. Only one comorbid patient died due to multiple-organ dysfunction syndrome two weeks after the resection. The most common postoperative complication was bleeding (n = 2, 5%) and infection (n = 2, 5%). The early diagnosis and appropriate treatment are often curative, with very low risk of recurrence. Postoperative survival is high.


Nickel Porous Compacts Obtained by Medium-Frequency Electrical Resistance Sintering.
A commercially pure (c.p.) nickel powder was consolidated by Medium-Frequency Electrical Resistance Sintering (MF-ERS). In this consolidation technique, a pressure and the heat released by a high-intensity and low-voltage electrical current are concurrently applied to a metal powder mass. A nickel powder with a high tap porosity (86%) and a low applied pressure (only 100 MPa) is chosen in order to be able to obtain compacts with different levels of porosity, to facilitate the study of the porosity influence on the compact properties. The influence of current intensity and heating time on the global porosity values, the porosity and microhardness distribution, and the electrical conductivity of the sintered compacts is studied. The properties of the compacts consolidated by MF-ERS are compared with the results obtained by the conventional powder metallurgy route, consisting of cold pressing and furnace sintering. A universal equation to describe the porosity influence on all the analyzed properties of powder aggregates and sintered compacts is proposed and validated.


Obstetrician's risk perception on the prescription of magnesium sulfate in severe preeclampsia and eclampsia: A qualitative study in Brazil.
Magnesium sulfate (MgSO4) is the drug of choice for the prevention and control of seizures in the management of severe preeclampsia/eclampsia. Several barriers have been identified in the use of MgSO4, especially in low and middle-income settings. To describe the obstetrician's perception on possible reasons for underutilizing magnesium sulfate to treat preeclampsia/eclampsia. A qualitative clinical study, based on phenomenological reference by semi-structured interviews and open-ended discussions with obstetricians of the public healthcare system in primary care units (PCU) and referral maternity hospitals (RMH), in a southeastern Brazilian city. Fear of drug toxicity was the major cause for not prescribing the medication in PCU. Fear was justified by insufficient technical, structural and organizational resources of healthcare facilities and by a shortage of physicians properly trained for adequate drug use. Fear of toxicity of magnesium sulfate was the main barrier towards timely and proper drug use. Periodic skill development and training of obstetricians, along with integration of the medical team in the work environment may contribute to decrease fear, ensuring safety of drug prescription and thus possibly reducing adverse outcomes related to PE.


Implications of serum paraoxonase activity in obesity, diabetes mellitus, and dyslipidemia.
Human serum paraoxonase 1 (PON1) is an enzyme with esterase activity, and is physically bound to high-density lipoproteins (HDL). It plays a key role in the action of HDL toward protection of lipoprotein and biological membrane against oxidative damage. It may have a protective role against atherosclerosis by virtue of its action on hydrolyzing lipid peroxides and preventing accumulation of phospholipids in oxidized low-density lipoprotein (LDL). PON1 is hypothesized to be an indicator of the risk of atherosclerosis and coronary artery disease development. Numerous studies have implicated PON1 activity in relation to various endocrine disorders. The current article reviews the clinical perspectives of PON1 activity with regards to obesity, diabetes mellitus with its complications, and dyslipidemia.


The 10-year course of adult aggression toward others in patients with borderline personality disorder and axis II comparison subjects.
This study had two aims. The first was to assess and compare various types of aggressive behavior toward others reported by borderline patients and axis II comparison subjects over time. The second was to determine the best baseline and time-varying predictors of aggressive behavior in these borderline patients. At baseline, a series of interviews and self-report measures were administered to 290 borderline patients and 72 axis II comparison subjects. Measures assessing aggression toward others, axis I and II disorders as well as adult adversity were re-administered every two years over the course of ten years. It was found that borderline patients reported significantly higher rates of verbal, emotional, and physical aggression toward others than comparison subjects but the rates of these forms of aggression toward others declined significantly for those in both study groups. Multivariate analyses indicated that the strongest predictors of adult aggression towards others were severity of adult adversity and a substance use disorder. Taken together, these results suggest that borderline patients commonly report aggression toward others but that this aggression declines significantly over time. These results also suggest that this aggression toward others is most strongly associated with adult experiences of adversity and concurrent substance abuse.


WITHDRAWN:One-Stage Reconstruction of the Tongue using the Infrahyoid Myocutaneous Flap after Resection for Oral Cancer as an Alternative to Free Flaps.
Ahead of Print article withdrawn by publisher:OBJECTIVES/HYPOTHESIS:: The aim of this study was to describe our results in reconstructive surgery after cancer ablation using the less popular infrahyoid myocutaneous flap as an alternative method to free flaps. Infrahyoid muscles are very useful as a neurovascular myofascial flap in plastic reconstructive surgery of the upper aerodigestive tract, particularly in the restoration of the muscular components in small and medium tongue defects. The surgical technique and the postoperative outcomes are described. STUDY DESIGN:: Retrospective study. METHODS:: During the period 2000 to 2006, 32 patients with squamous cell carcinoma of the tongue were surgically treated using a pure infrahyoid myocutaneous neurovascular flap. RESULTS:: The flap was successful in all cases without flap necrosis, fistula or complications in the donor site. Spontaneous epithelization of the flap took about 2 months to complete, with no evidence of scarring and/or shrinkage. After radiation therapy, flap tissues remained sufficiently soft, trophic, and mobile. Ultrasound evaluation of tongue mobility performed at the time of discharging and 3 and 6 months after surgery, showed normal bolus propulsion. Cinefluoroscopy also showed good function of the reconstructed tongue. CONCLUSIONS:: Tongue reconstruction with a microvascular anastomosed flap can improve functional results after cancer resection. However, in our experience using monolateral or bilateral infrahyoid myocutaneous flap is less time consuming and reduces the complication rate and the operation time in both small and large defects. The main advantage of this flap is its voluntary innervation by the ansa cervicalis and the prevention of scarring and atrophy of the neotongue.


Physiological pharmacokinetic models: some aspects of theory, practice and potential.
Models are intellectual constructs that pattern selected relationships among the elements of one system to correspond in some way to elements of a second system. In pharmacokinetics, physiological models provide a clearly articulated, rational, explanatory basis for the integration of empirical data; they do this by partitioning the biological system into relevant components (tissues, organs, etc.) and linking them together through the circulatory system. Unlike conventional mammillary compartment models, there is a clear correspondence between model system elements and physiological entities. By virtue of their high degree of physical and biochemical relevance, these models can help provide deep insight into structure, function and mechanism. Pharmacokinetic (and potentially pharmacodynamic) response-time relationships can thus be understood in terms of interconnections and behavior of constituent subsystems. At their worst, these models provide stale or infertile views of reality and thus frustrate and alienate us with the triviality of their insights. At their best, they allow us to understand the accumulation of thought in pharmacokinetics and pharmacodynamics, and help with the integration of data and improvement of experimental design.


Effect of gamma-irradiation on H3 histone and DNA in solution.
Three methods, namely, absorbance of colour by reaction with Folin-Ciocalteau reagent, UV absorbance and fluorescence intensity measurements for detection of H3 histone in 0.15 M standard saline citrate (SSC) solution were compared. Maximum sensitivity was found with the Folin-Ciocalteau method. Effect of varying pH and of gamma- radiation on H3 histone and on interaction of H3 histone with DNA were studied. For this, solutions of H3 histone in SSC, in 0.9% NaCl, H3 histone + DNA in 0.9% NaCl were subjected to varying pH (1-10) and gamma- radiation (dose 10-50 Gy) and lambda(max) and Alambda(max) were monitored. From the molar ratios of histone and DNA in the complex, it was observed that at gamma -radiation dose of 50 Gy and pH 8.54, there was a depletion of 6-8 microg/ml of histone from the histone-DNA complex.


Effect of N-linked glycosylation on secretion and activity of recombinant DSPAalpha1 expressed in Pichia pastoris.
The thrombolytic agent DSPAalpha1 is currently undergoing clinical trials for the treatment of acute ischemic stroke and has shown good pharmacodynamic, pharmacokinetic and safety profiles. Here, the DSPAalpha1 gene, optimized for the preferred codons of yeast, was cloned into the Pichia pastoris strains GS115 and KM71. Both expression systems produced functional DSPAalpha1 into the broth medium under shaking flask growth conditions with the yield of about 70 mg/L, and 105 mg/L, respectively. In addition, three glycosylation minus DSPAalpha1 mutants, constructed by site-directed mutagenesis, were also expressed in Pichia pastoris. The mutant proteins were assayed by SDS-PAGE and fibrin degradation activities were evaluated. The secretion levels of all the mutants, especially N362Q and N117Q/N362Q, were so lower compared to the wild-type DSPAalpha1 that only minimal quantities of mutant protein could be recovered by purification from the culture medium. The protein specific activities from mutants (N117Q, N362Q) were less 25% than that of the wild type protein. These results imply that the N-linked carbohydrate chains (at N117 and N362) are vital for the enzymatic activity of rDSPAalpha1 and for its secretion from Pichia pastoris.


CT features of tuberculous intracranial abscesses in children.
Intracranial tuberculous (TB) abscesses still cause a diagnostic dilemma on both CT and MRI as they may mimic neoplasms. Recognition of TB abscesses may prompt further imaging and appropriate trial of therapy, and may reduce the need for biopsy. To report the CT features of eight intracranial TB lesions in children initially diagnosed as neoplasms and eventually treated as TB abscesses. We undertook a 3-year retrospective review of children with an initial CT diagnosis of intracranial neoplasm who were subsequently diagnosed as having TB abscesses. Eight patients out of 60 with an initial diagnosis of a neoplasm on CT were misdiagnosed and were ultimately determined to have TB abscesses after biopsy or a trial of anti-TB therapy. The most consistent constellation of findings for the lesions were low density (n = 5), ring enhancement (n = 8), cerebral hemisphere location (n = 7), mass effect (n = 6), surrounding oedema (n = 5) and absence of a soft-tissue-density mass (n = 8). In endemic regions, intracranial lesions with these appearances on CT should undergo further imaging and possibly a trial of anti-TB therapy before considering biopsy.


Electron spin resonance spectrometrical study of the melanins in the wool of some North European sheep in relation to their color inheritance.
Additional peaks that were known on the esr-spectrograms of red human and reddish-brown Karakul hair to be diagnostic traits of phaeomelanin esr-signal also were found on esr-spectrograms of the tan, but not of black or chocolate brown wool from Icelandic sheep. This tan color is thought to depend on the presence of phaeomelanin and is due to the top dominant allele at the A locus. The two methods of distinguishing between eu- and phaeomelanin-dependent brown colors--esr-spectrometrical and genetical--are in agreement for European as well as for Asiatic breeds. Both light and dark brown Soay fleece samples lacked the additional peaks and are interpreted as eumelanin pigmentation.


[Poly-beta-hydroxybutyric acid (PHB) films and plates in defect covering of the osseus skull in a rabbit model].
Titan plates have proven a success in the operative assistance of middle face fractures for stabile osteosynthesis. Also bioresorbant materials are being used increasingly. Films and plates made from poly-beta-hydroxybutyric acid (PHB) with two holes and bolts are tested subperiostally on the osseus skull of 15 rabbits or respectively on cut trough zygomatic arches. The test bodies and the surrounding tissue are explantated after a defined period and are clinically and histologically prepared. All implants healed well. There were no macroscopic or microscopic signs of inflammation. A very slow, clinically not recordable decomposition followed. A "leap" in the decomposition evidently took place between the 20th and 25th month. Only initial signs of resorbation were to be found microfocally on the surface of the implant until 20 months after implantation but no more test body could be detected after 25 months. PHB is suitable for defect covery of the osseus skull or respectively as osteosynthesis material for fractures of the visceral cranium.


[Transcription factor Ets-1 expression in human fetal membranes and its clinical significance].
To investigate the role of transcription factor Ets-1 involved in premature rupture of membranes(PROM)by detecting its expression and location in human fetal membranes. Between Feb. and Nov. 2007, 100 pregnant women who delivered in the First Affiliated Hospital, Chongqing Medical University were enrolled in this study. According to gestational weeks, rupture of amniochorionic membranes and delivery mode, those women were classified into preterm labor group, preterm premature rupture of membranes (PPROM) group, term labor group and term premature rupture of membranes (TPROM) group, matched with elective term cesarean sections women as control group. There were 20 pregnant women in every group. The expression and distribution of Ets-1 protein in fetal membranes were detected by immunohistochemical streptravidin-biotin peroxidase (SP) method and histoscore. In the mean time, 6 cases were chosen from each group randomly and reverse transcription-PCR was used to measure the Ets-1 mRNA expression. (1) The expression of Ets-1 mRNA in fetal membranes were 0.342 ± 0.016 in preterm labor group, 0.603 ± 0.027 in PPROM group, 0.325 ± 0.013 in term labor group, 0.582 ± 0.075 in TPROM group, 0.139 ± 0.012 in control group, respectively. When compared with that in control group, Ets-1 mRNA expression were significantly increased in both PPROM and TPROM group (P < 0.05). However, it did not show remarkably difference between preterm group and term labor group, as well as between PPROM and TPROM group (P > 0.05). (2) Ets-1 was in stromal layers of amniochorionic membranes and in both cytoplasm and nuclei of trophoblast, which were shown with diffuse intracellular positive granularities (brown-yellow) clearly. No expression of Ets-1 was observed in amniotic epithelial cells. (3) The expression of Ets-1 protein was 0.552 ± 0.018 in preterm labor group, 2.853 ± 0.174 in PPROM group, 0.538 ± 0.042 in term labor group, 2.731 ± 0.090 in TPROM group and 0.214 ± 0.013 in control group, respectively. Ets-1 protein was significantly increased in the stroma of both PPROM and TPROM group than that in control group (P < 0.05). However, no remarkable different expression of Ets-1 was observed between preterm and term labor group, so was that between PPROM and TPROM group (P > 0.05). Transcription factor Ets-1 is expressed in human amniochorionic membranes and it could be up-regulated in PROM.


[Safety and Efficacy of Amlodipine, Lisinopril and Rosuvastatin Therapy in Patients With Metabolic Syndrome and Nonalcoholic Fatty Liver Disease].
To evaluate the efficacy and safety of amlodipin, lisinopril and rosuvastatin therapy in metabolic syndrome and high cardiovascular risk patients with nonalcoholic fatty liver disease (NAFLD). 6 months randomized study of fixed combination of amlodipin and lisinopril with or without rosuvastatin of 20 patients with 2 grade of arterial hypertension, dyslipidemia with metabolic syndrome and nonalcoholic fatty liver disease (NAFLD). Efficacy and safety was revealed: office BP, ABPM, NAFLD Fibrosis scale, insulin resistance index (HOMA-IR), serum lipids were measured basically and after 6 months of therapy. 6 months amlodipin and lisinopril therapy results: office BP decreased from 153,4+/-2,9/83,3+/-2,5 to 131,0+/-2,4/79,9+/-4,5 mm Hg (=0,001, for systolic BP).159/91 to 132/77 mm Hg. 24-hours BP decreased from 153,6+/-3,6/89,5+/-3,2 to 127,1+/-3,0/73,5+/-2,9 (=0,002); in 85% of patients BP normalized. Low density lipoprotein cholesterol (LDL-C) decreased lower 2.5 mmol/l in all patients and lower 1.8 mmol/l in 45% patients on rosuvastatin therapy. Before therapy 3 patients had elevated ALT levels, after 6 months therapy all patients had normal levels of ALT and AST. ALT decreased from 33,7+/-4,3 to 23,2+/-3,5 U/l (=0,01). Alkaline phosphatase decreased from 65,4+/-4,1 to 51,1+/-6,9 U/l (=0,02), gamma glutamyl transpeptidase level was stable. NAFLD Fibrosis index revealed fibrosis and was stable -0,9+/-0,2 and -0,9+/-0,2 (>0,05). HOMA-IR decreased from 4.2+/-0,4 to 2,9+/-0,4 (=0,02). Some antihypertensive drugs and statins can be hepatotoxic especially in patients with metabolic syndrome and NAFLD. Antihypertensive drugs and statins with minimal liver metabolism can be preferable in NAFLD patients. Amlodipin, lisinopril and rosuvastatin therapy is effective and safe in patients with metabolic syndrome of high cardiovascular risk and liver steatosis.


Brief dynamic psychotherapy : patient suitability, treatment length, and outcome.
Forty-three neurotic outpatients were treated according to common practice with dynamic psychotherapy of brief to moderate length. Suitability for brief dynamic psychotherapy, measured by quality of interpersonal relations, was independent of DSM-III diagnoses. Suitability was a significant direct predictor of symptomatic and dynamic change 2 and 4 years after therapy. Treatment length added no explained outcome variance over patient characteristics. However, patients with high suitability had a relatively more favorable dynamic outcome with a brief, focused treatment approach, whereas patients with low suitability had relatively more favorable outcome with a longer, less focused treatment of more than 1 year's duration. The significant interaction emerged at 4-year follow-up.


[Diagnosis of a systolic murmur among young asymptomatic patient: An assessment of professional practices for the expertise in military medicine].
The finding of a systolic heart murmur is common in medical military practice. Albeit often benign among young healthy adults, it can reveal a valvular or a cardiac disease, which could worsen during workout or expose to risk of a sudden death. This study aims to evaluate the diagnostic efficiency of the military general practitioner when discovering a systolic murmur among young asymptomatic patients. During one year, this study involved all the general practitioners of the medical military centres of Brittany and the cardiologists of the military hospital in Brest. It prospectively enrolled a cohort of all military asymptomatic patients under 40, without any underlying known heart condition. Military general practitioners listed, thanks to an anonymous form, the main features of the systolic murmur and of the ECG and proposed an auscultatory diagnosis: innocent or organic murmur. Then cardiologists did the same and finally performed a transthoracic echocardiography giving the diagnosis. Fifty-eight patients were referred, 5 not meeting the inclusion criteria. Of the 53 patients included, military general practitioners found 46 innocent murmurs and 7 organic ones. Cardiologists found 51 innocent murmurs and 2 organic. Transthoracic echocardiography just took on one organic murmur (linked with a bicuspid aortic valve), spotted by the specialist, though judged innocent by the general practitioner. Most of innocent murmurs diagnosed by general practitioners (45/46) were confirmed. Regarding the seven organic murmurs, the main selected criteria (intensity over 3, orthostatic persistence, diffuse irradiation) are mostly in accordance with the literature, proving right medical instincts. Authors propose a practical management of systolic murmurs among asymptomatic young patients. Military general practitioners seem to master symptoms of organic murmur. This assessment argues for a promotion of a holistic clinical examination, which will help not only to rationalize the use of transthoracic echocardiography in economic terms but also to value the medical expertise.


Bioaerosols concentrations in working areas in biomethanization facilities.
This study sought to fill the gap in information about the type and the concentration of bioaerosols present in the air of biomethanization facilities (BF). Evaluation of bioaerosol composition and concentration was achieved in two biomethanization facilities located in Eastern Canada, during summer and winter. In order to have a thorough understanding of the studied environment, the methodology combined culture of bacteria and molds, qualitiative polymerase chain reaction (qPCR) for specific microorganisms, endotoxin quantification, and next-generation sequencing (NGS) for bacterial diversity. Results revealed that workers in biomethanization facilities are exposed to bioaerosols and pathogenic microorganisms similar to those found in composting plants. However, human exposure levels to bioaerosols are lower in BF than in composting plants. Despite these differences, use of personal protective equipment is recommended to lower the risks of health problems. Biomethanization is a new technology used in eastern Canada for waste management. In the next few years, it is expected that there will be an expansion of facilities in response of tight governmental regulations. Workers in biomethanization facilities are exposed to various amounts of bioaerosols composed of some harmful microorganisms. Therefore, monitoring this occupational exposure could be an interesting tool for improving worker's health.


Prevention of thrombosis by topical application of tissue factor pathway inhibitor in a rabbit model of vascular trauma.
The extrinsic pathway of coagulation is initiated when tissue factor complexes with factor VII. A naturally occurring protein inhibitor of this complex, tissue factor pathway inhibitor (TFPI), has recently been isolated and the cDNA coding for this protein cloned. We used a rabbit ear artery model of crush/avulsion injury and microvascular repair to investigate the efficacy of TFPI as a topically applied antithrombotic agent. Traumatized arteries treated through lumenal irrigation with normal saline vehicle (controls) achieved patency rates of 8% and 0% at 1 and 7 postoperative days, respectively. Heparin irrigation (10 U/ml) resulted in patencies of 40% at both evaluation times. In contrast, TFPI at a dose of 20 micrograms/ml (0.2 ml total volume; 10 minute exposure) yielded a 91% patency rate at 1 day and 73% at 7 days postoperatively (p < 0.0005 vs controls). Prothrombin time and activated partial thromboplastin time values were not altered after topical treatment with TFPI. Scanning electron microscopy revealed dramatically inhibited thrombogenesis upon the injured surfaces of TFPI-treated vessels. These results suggest that TFPI used as a topically applied antithrombotic agent is effective for the prevention of thrombosis in microvascular anastomoses.


[Level of implementation of the Program for Safety and Health at Work in Antioquia, Colombia].
This study describes the level of implementation of the Program for Safety and Health at Work in companies located in the Department of Antioquia, Colombia, and associated factors. A cross-sectional survey included 73 companies with more than 50 workers each and implementation of the program. A total of 65 interviews were held, in addition to 73 checklists and process reviews. The companies showed suboptimal compliance with the management model for workplace safety and health proposed by the International Labor Organization (ILO). The component with the best development was Organization (87%), and the worst was Policy (67%). Company executives contended that the causes of suboptimal implementation were the limited commitment by area directors and scarce budget resources. Risk management mostly aimed to comply with the legal requirements in order to avoid penalties, plus documenting cases. There was little implementation of effective checks and controls to reduce the sources of work accidents. The study concludes that workers' health management lacks effective strategies.


[Binding activity of purified anticartilage-antiparathyroid antibodies to the cartilage in vitro (author's transl)].
We studied the binding activities especially the binding to the cartilage of the specific antibodies, which were purified from a new therapeutic agent of osteo-arthrosis, Artroglobina using several tissue materials. A purified specific antibodies pre-adsorbed with the pig liver and muscle homogenates lost the binding activity to the pig heart but retained the specific activity to the pig cartilage. The same results were obtained with the tissues from the rat and the hen. It also had the same activity on human cartilage, and the adsorption with the cartilage from either pig or human led the complete loss of the binding activity to the human cartilage. Evidence of the specific activity of these purified specific antibodies to the human cartilage in vitro suggests that further studies are warranted as a similar specific binding reaction of Artroglobina to the cartilage, in situ may occur of patients with osteo-arthritis and who are being treated clinically.


Glomerular structural quantities in baseline biopsies from cadaveric donor kidney pairs.
Glomerular structural parameters were estimated in kidney biopsies from 11 cadaveric donors at the time of transplantation. The main purpose was to compare the biopsies from the right and left kidney from each donor. Mean glomerular volume was determined by light microscopy. The ultrastructural parameters were basement membrane thickness and volume fractions of mesangial regions with either the tuft or total glomerulus, (i.e. the tuft plus the urinary space in between the capillaries) as reference spaces. Further, the mesangial composition was determined as the volume fraction of basement membrane-like material to total mesangial regions (Vv(BMLM/mes]. The structural quantities conformed with those obtained in living kidney donors. The coefficient of variation (CV) for the group of 11 cases was highest for the mean glomerular volume (0.26) and lowest for the Vv(BMLM/mes) (0.10). The coefficient of error (CE) of the two independent determinations of structural parameters in each individual was well below 5%. The findings therefore demonstrate that, with the methods used, a renal biopsy gives valid and reliable information for that particular individual - at least in cases with 'normal' structures.


Revealing thermodynamics of DNA origami folding via affine transformations.
Structural DNA nanotechnology, as exemplified by DNA origami, has enabled the design and construction of molecularly-precise objects for a myriad of applications. However, limitations in imaging, and other characterization approaches, make a quantitative understanding of the folding process challenging. Such an understanding is necessary to determine the origins of structural defects, which constrain the practical use of these nanostructures. Here, we combine careful fluorescent reporter design with a novel affine transformation technique that, together, permit the rigorous measurement of folding thermodynamics. This method removes sources of systematic uncertainty and resolves problems with typical background-correction schemes. This in turn allows us to examine entropic corrections associated with folding and potential secondary and tertiary structure of the scaffold. Our approach also highlights the importance of heat-capacity changes during DNA melting. In addition to yielding insight into DNA origami folding, it is well-suited to probing fundamental processes in related self-assembling systems.


Diagnostic uses of electrical pacing.
Diagnostic pacing has proven useful for the study of a great variety of clinical problems. Rapid atrial pacing is an excellent means of stressing the heart, particularly in patients with ischemic heart disease. Pacing-induced tachycardia has been used to provoke typical coronary pain and to produce hemodynamic, metabolic, and left ventricular contractile changes in patients with coronary artery disease. Because this heart stress is reproducible, it has also been valuable in assessing response to medical and surgic al therapy in patients with angina. Electrophysiologically, pacing has been used to clarify mechanisms of normal and abnormal function of the sinus node and A-V conduction. The pre-excitation states have been more precisely defined, and the introduction of programmed electrical stimuli into the cardiac cycle has helped elucidate the nature of re-entry supraventricular tachycardias.


The risk of suicidal intention in severe mental illness: An ecological perspective.
Guided by the ecosystem theory model framework, we aimed to explore the influence of three ecological dimensions (social, family and psychological factors) on suicidal intention in people with severe mental illness (SMI). We hypothesized that three factors influence suicidal intention, and that psychological factors may play a mediating role in the influence of social and family factors on suicidal intention. We collected 994 patients with SMI aged 18 and above from May 2021 to March 2022 in the Fourth Hospital of Fuzhou City. We used logistic regression to analyse the association between social, family, psychological factors and suicidal intention. Furthermore, we explored the mediating effects among the influencing factors. Younger male patients with schizophrenia were more likely to have suicidal intention due to psychosocial family factors (p < .05). Social factors (poor interpersonal relations, social retreat, social activities outside the home), family factors (parental functions, activities within the family, family functions), psychological factors (anxiety, depression, interest in the outside world, overt aggression, lack of accountability and planning) were all independent risk factors for suicidal intention in patients. Mediation analysis showed anxiety and depression mediated the role of social and family factors on suicidal intention (p < .05). Social, family and psychological factors were important risk factors for suicidal intention, with anxiety and depression being partial mediators for suicidal intention. Therefore, interventions that enhance family and social functioning and reduce anxiety and depression may be effective in reducing suicidal intention in SMI.


Grid-based molecular footprint comparison method for docking and de novo design: application to HIVgp41.
Scoring functions are a critically important component of computer-aided screening methods for the identification of lead compounds during early stages of drug discovery. Here, we present a new multigrid implementation of the footprint similarity (FPS) scoring function that was recently developed in our laboratory which has proven useful for identification of compounds which bind to a protein on a per-residue basis in a way that resembles a known reference. The grid-based FPS method is much faster than its Cartesian-space counterpart, which makes it computationally tractable for on-the-fly docking, virtual screening, or de novo design. In this work, we establish that: (i) relatively few grids can be used to accurately approximate Cartesian space footprint similarity, (ii) the method yields improved success over the standard DOCK energy function for pose identification across a large test set of experimental co-crystal structures, for crossdocking, and for database enrichment, and (iii) grid-based FPS scoring can be used to tailor construction of new molecules to have specific properties, as demonstrated in a series of test cases targeting the viral protein HIVgp41. The method is available in the program DOCK6.


Localization of an antithrombin exosite that promotes rapid inhibition of factors Xa and IXa dependent on heparin activation of the serpin.
We have previously shown that exosites in antithrombin outside the P6-P3' reactive loop region become available upon heparin activation to promote rapid inhibition of the target proteases, factor Xa and factor IXa. To identify these exosites, we prepared six antithrombin-alpha 1-proteinase inhibitor chimeras in which antithrombin residues 224-286 and 310-322 that circumscribe a region surrounding the reactive loop on the inhibitor surface were replaced in 10-16-residue segments with the homologous segments of alpha1-proteinase inhibitor. All chimeras bound heparin with a high affinity similar to wild-type, underwent heparin-induced fluorescence changes indicative of normal conformational activation, and were able to form SDS-stable complexes with thrombin, factor Xa, and factor IXa and inhibit these proteases with stoichiometries minimally altered from those of wild-type antithrombin. With only one exception, conformational activation of the chimeras with a heparin pentasaccharide resulted in normal approximately 100-300-fold enhancements in reactivity with factor Xa and factor IXa. The exception was the chimera in which residues 246-258 were replaced, corresponding to strand 3 of beta-sheet C, which showed little or no enhancement of its reactivity with these proteases following pentasaccharide activation. By contrast, all chimeras including the strand 3C chimera showed essentially wild-type reactivities with thrombin after pentasaccharide activation as well as normal full-length heparin enhancements in reactivity with all proteases due to heparin bridging. These findings suggest that antithrombin exosites responsible for enhancing the rates of factor Xa and factor IXa inhibition in the conformationally activated inhibitor lie in strand 3 of beta-sheet C of the serpin.


Four-base codon-mediated incorporation of non-natural amino acids into proteins in a eukaryotic cell-free translation system.
Various four-base codons have been shown to work for the introduction of non-natural amino acids into proteins in an Escherichia coli cell-free translation system. Here, a four-base codon-mediated non-natural mutagenesis was applied to a eukaryotic rabbit reticulocyte cell-free translation system. Mutated streptavidin mRNAs containing four-base codons were prepared and added to a rabbit reticulocyte lysate in the presence of tRNAs that were aminoacylated with a non-natural amino acid and had the corresponding four-base anticodons. A Western blot analysis of translation products indicated that the four-base codons CGGU, CGCU, CCCU, CUCU, CUAU, and GGGU were efficiently decoded by the aminoacyl-tRNAs having the corresponding four-base anticodons. In contrast, the four-base codons AGGU, AGAU, CGAU, UUGU, UCGU, and ACGU were not decoded. The stop codon-derived four-base codons UAGU, UAAU, and UGAU were found to be inefficient, whereas the amber codon UAG and opal codon UGA were efficient for the incorporation of non-natural amino acids. The application of the expanded genetic code in a eukaryotic cell-free system opens the possibility of a four-base codon-mediated incorporation of non-natural amino acids into proteins in living eukaryotic cells.


[Orthokeratology in myopic children].
Orthokeratology is reversible clinical procedure which can reduce myopia using contact lenses made of high gas permeable material with 4 curves reverse geometry shape. The aim of the paper is to evaluate vision acuity and progression of myo,ia and corneal curvature during use of overnight RGP lenses. The studies have been peforrmed in 132 patients (264 eyes) in age 5 - 18 years (average 12.5 years) with myopia from -1.50 Dsph to -5.50 Dsph and astigmatism from 0.25 Dsph to 1.25 Dsph. In all patients cornea radius (automatic keratorefractometer) and coreal refractive power (coreat topography) was measured before and after 3 months of we- se ot aring during night RGP lenses. Refraction was measured with the use of autokeratorefraktometer after 2 to 6 years of wearing lenses. In all patients reduction of corneal refractive power (on average 3.05 Dsph) and increase of corneal radiuses (on average 0.4 mm) has been observed. After 2 to 6 years of wearing during night RGP lenses refraction was the same in 48.5% of children, worsened in 31.8% of -0.50 Dsph and progressed of -1.00 Dsph in 19.7% of patients. Orthokeratology reduces myopia due to temporary changes in corneal curvature. orthokeratology, myopia, corneal radius, corneal topography.


Chronic kidney disease after myeloablative allogeneic hematopoietic stem cell transplantation.
Because survival of recipients of allogeneic hematopoietic stem cell transplantation (HSCT) has improved, long-term complications become more important. We studied the incidence and risk factors of chronic kidney disease in these patients and evaluated associated posttransplant complications and mortality. We performed a retrospective cohort study of 266 adults who received myeloablative allogeneic HSCT and who survived for >6 months in an 11-year period at a Dutch university medical center. Primary outcome was the incidence of chronic kidney disease defined as a glomerular filtration rate (GFR) of <60 mL/min/1.73 m(2). Chronic kidney disease developed in 61 (23%) of 266 patients, with a cumulative incidence rate of 27% at 10 years. Severe kidney disease (GFR of <30 mL/min/1.73 m(2)) developed in 3% of patients. Only 6 patients developed the thrombotic microangiopathic syndrome SCT nephropathy, and 2 of them needed dialysis. Pretransplant risk factors for chronic kidney disease were lower GFR at day 0 (P < .0001, odds ratio [OR] 0.95 95% confidence interval [CI] 0.93-0.97), female gender, and higher age (P = .001 and P < .0001, respectively). The occurrence of hypertension after transplantation was associated with chronic kidney disease (P < .0001, OR 0.34 95% CI 0.18-0.62). Mortality was 39% after a mean follow-up of 5.1 years. There was no significant difference in survival between patients with and without chronic kidney disease. Chronic kidney disease is a common late complication of myeloablative allogeneic HSCT. Because of the natural decline in renal function with time there is a risk of developing end-stage renal disease in the future. SCT nephropathy seems to be a specific cause of chronic kidney disease that is typically associated with severe kidney disease.


Inhibitors of SRC kinases impair antitumor activity of anti-CD20 monoclonal antibodies.
Clinical trials with SRC family kinases (SFKs) inhibitors used alone or in a combination with anti-CD20 monoclonal antibodies (mAbs) are currently underway in the treatment of B-cell tumors. However, molecular interactions between these therapeutics have not been studied so far. A transcriptional profiling of tumor cells incubated with SFKs inhibitors revealed strong downregulation of MS4A1 gene encoding CD20 antigen. In a panel of primary and established B-cell tumors we observed that SFKs inhibitors strongly affect CD20 expression at the transcriptional level, leading to inhibition of anti-CD20 mAbs binding and increased resistance of tumor cells to complement-dependent cytotoxicity. Activation of the AKT signaling pathway significantly protected cells from dasatinib-triggered CD20 downregulation. Additionally, SFKs inhibitors suppressed antibody-dependent cell-mediated cytotoxicity by direct inhibition of natural killer cells. Abrogation of antitumor activity of rituximab was also observed in vivo in a mouse model. Noteworthy, the effects of SFKs inhibitors on NK cell function are largely reversible. The results of our studies indicate that development of optimal combinations of novel treatment modalities with anti-CD20 mAbs should be preceded by detailed preclinical evaluation of their effects on target cells.


Artificial Intelligence-Enabled Medical Analysis for Intracranial Cerebral Hemorrhage Detection and Classification.
Intracranial hemorrhage (ICH) becomes a crucial healthcare emergency, which requires earlier detection and accurate assessment. Owing to the increased death rate (around 40%), the earlier recognition and classification of disease using computed tomography (CT) images are necessary to ensure a favourable prediction and restrain the existence of neurologic deficits. Since the manual diagnosis approach is time-consuming, automated ICH detection and classification models using artificial intelligence (AI) models are required. With this motivation, this study introduces an AI-enabled medical analysis tool for ICH detection and classification (AIMA-ICHDC) using CT images. The proposed AIMA-ICHDC technique aims at identifying the presence of ICH and identifying the different grades. In addition, the AIMA-ICHDC technique involves the design of glowworm swarm optimization with fuzzy entropy clustering (GSO-FEC) technique for the segmentation process. Besides, the VGG-19 model was executed for generating a collection of feature vectors and the optimal mixed-kernel-based extreme learning machine (OMKELM) model is utilized as a classifier. To optimally select the weight parameter of the MKELM technique, the coyote optimization algorithm (COA) was utilized. A wide range of simulation analyses are carried out under varying aspects. As part of the AIMA-ICHDC method, ICH can be detected and graded using a single sample. For segmentation, the AIMA-ICHDC technique uses the GSO-FEC method, which is the design of glowworm swarm optimization (GSO). The comparative outcomes highlighted the betterment of the AIMA-ICHDC technique compared to the recent state-of-the-art ICH classification approaches in terms of several measures.


Synthesis and pharmacological evaluation of new esters of 2- and 4-alkylamino-1,8-naphthyridine-3-carboxylic acids endowed with positive inotropic properties.
In order to gain insight into structure-activity relationships concerning the positive inotropic effect of N-heterocycles, a series of 1,8-naphthyridines was synthesized by two different methods. First, 4-hydroxy substituted derivatives were accessible by cyclization of 2-vinylamino-1,8-naphthyridines using diphenyl-ether followed by chlorination and nucleophilic reactions with various amino compounds. Second, 2-amino-nicotinic acid was transformed to 2-alkylamino-1,8-naphthyridines involving a variation of the Friedländer synthesis as well as many subsequent steps. The effect of the compounds on myocardial contractility was assessed in guinea pig left atria paced at 3 Hz. In general, the concentrations for positive inotropism ranged in between 10(-6)-10(-4) mol/l. The compounds differed considerably with respect to the efficacy of the increase in contractile force. The pharmacological investigations appear to demonstrate the following requirements for the pharmacophoric structure. In connection with a lipophilic ester function in 3-position the target compounds have to contain an alkylamino side chain at C-4 bearing a pi-electron-rich center in a definite distance to the NH-function.


Comparison of the clinical efficacy of two different types of post systems which were restored with composite restorations.
To compare the efficacy of resin composite restorations, retained with either polyethylene or zirconia-rich glass fiber posts. Sixty-two single rooted maxillary and mandibular central incisor teeth in forty-four patients (15 males and 29 females; age range 15-32 years) were restored either with an ultrahigh molecular weight polyethylene (UHMWP) fiber post (Bondable Reinforcement Ribbon, DENSE, Ribbond, Seattle, WA, United States) or a zircon-rich glass fiber post (Snowpost, Lot H 040; Carbotech, Ganges, France). Then, direct resin composite restoration (Clearfil AP-X, Kuraray) was performed for both post systems in tooth color suitable. Patients were recalled for routine inspections at 6 mo, 1, 2 and 3 years. The restorations were assessed during each recall evaluation according to predetermined clinical and radiographic criteria (periapical lesion; marginal leakage and integrity; color stability; surface stain and loss of retention of the post or the composite build-up material). The follow-up data showed no significant difference in these criteria between polyethylene fibre posts and zirconia-rich glass fibre posts. The efficacy of resin composite restorations, retained with either polyethylene or zirconia-rich glass fiber posts were similar, suggesting that both types of fiber post can be used successfully to help retain resin composite restorations.


Labial Lipoblastoma in an Infant: An Uncommon Tumor at an Uncommon Site.
Lipoblastoma and lipoblastomatosis are benign fatty tumors of soft tissues that are unique to childhood. Occurrence of lipoblastoma in the labial region is infrequent and can cause diagnostic dilemma. Awareness about this entity is important to avoid hazardous treatment in young children. Here, we present a case of labial lipoblastoma in a 2-year-old child along with its differential diagnosis.


The phylogenetic position and speciation dynamics of the genus Perdix (Phasianidae, Galliformes).
The nuclear gene (c-mos) and mitochondrial genes (CYT B and ND2) sequences, representing 44 phasianid species and 26 genera (mainly distributed in China), were used to study the phylogeny of the genus Perdix, which comprises three partridge species. Maximum parsimony and Bayesian methods were employed, and the analysis of mitochondrial sequence data and the combined dataset showed that Perdix is specifically related either to typical pheasants or to Ithaginis. Phylogenetic trees also indicated that: (1) Perdix is monophyletic; (2) the Tibetan partridge (Perdix hodgsoniae) has been consistently placed as basal to all other Perdix, and the Daurian partridge (Perdix dauuricae) is placed sister to gray partridge (Perdix perdix); (3) the Daurian partridge subspecies przewalskii and Tibetan partridge subspecies hodgsoniae are basal to other subspecies in their species clade, respectively. Speciation in Perdix was likely promoted by the late Pliocene/early Pleistocene intensive uplift of the Tibetan Plateau and by Pleistocene glaciations.


Genetic Thinking in the Study of Social Relationships: Five Points of Entry.
For nearly a generation, researchers studying human behavioral development have combined genetically informed research designs with careful measures of social relationships such as parenting, sibling relationships, peer relationships, marital processes, social class stratifications, and patterns of social engagement in the elderly. In what way have these genetically informed studies altered the construction and testing of social theories of human development? We consider five points of entry where genetic thinking is taking hold. First, genetic findings suggest an alternative scenario for explaining social data. Associations between measures of the social environment and human development may be due to genes that influence both. Second, genetic studies add to other prompts to study the early developmental origins of current social phenomena in midlife and beyond. Third, genetic analyses promise to shed light on understudied social systems, such as sibling relationships, that have an impact on human development independent of genotype. Fourth, genetic analyses anchor in neurobiology individual differences in resilience and sensitivity to both adverse and favorable social environments. Finally, genetic analyses increase the utility of laboratory simulations of human social processes and of animal models.


Development of reference intervals for serum alkaline phosphatase among adults in Southern China traced to the new IFCC reference measurement procedure.
Serum alkaline phosphatase (ALP) plays a critical role in the diagnosis of various diseases, and the establishment of relevant, reliable reference intervals (RI) is key to avoiding misdiagnoses. In 2011, IFCC published the new reference measurement procedure (RMP) for the determination of serum ALP in which one of the main modifications was the measuring temperature of the assay. Here, the new RMP was used to help establish RIs for serum ALP concentrations in healthy Chinese Han. Volunteer individuals in Guangdong province, China (n=1622) were screened by questionnaire and laboratory testing for eligibility as a reference. Blood (20 mL) was collected and samples were measured by the Roche Modular system using the new RMP for the serum ALP compatible method. Partitioning of values by gender and/or age was evaluated with a standard normal deviate test after removing outliers. A simple non-parametric method for a two-sided 95% distribution of reference values was calculated. Serum ALP concentrations were obtained from the cohort of eligible reference individuals (n=658). The RI for serum ALP in males age 18-79 years was 48-131 U/L. Females were partitioned into two age groups based on statistical analysis, 18-49 years and 50-79 years, and the RIs derived were 40-106 U/L and 57-159 U/L, respectively. RIs for serum ALP for Chinese Han individuals in between the ages of 18 and 79 years were determined and required partitioning due to the higher ALP values of females age 50-79 years.


Foreign body ingestion and aspiration in dentistry: a review of the literature and reports of three cases.
This article reviews several cases of foreign body ingestion or inhalation reported in the literature. Prevention, complication and management of this event are discussed and three case reports presented. Two of the cases were bridge ingestion and one was ingestion of an orthodontic band. The three cases were managed by watchful waiting and the ingested foreign bodies came out in the stools without complications.


Amide I infrared spectral features characteristic of some untypical conformations appearing in the structures suggested for amyloids.
Amide I infrared (IR) spectral features are studied, by using the density functional theoretical method, for two untypical (but possibly rather prevalent) structures inspired from those recently suggested for amyloids: a structure consisting of loop regions in the (alpha L, alpha R) conformation stacked to form an alpha-sheet, and a structure involving some main-chain peptide groups (of any residues) and some side-chain amide groups of glutamine and asparagine residues closely located with each other. The amide I vibrational (off-diagonal) coupling constants are examined by extracting them from the calculated Cartesian-based force constants with the average partial vector method and by comparing them with those estimated on the basis of the transition dipole coupling mechanism. It is suggested that the amide I IR band characteristic of the alpha-sheet conformation in dry environment (without hydrogen bonding to solvent water molecules) is located in a high-frequency region (approximately >1670 cm(-1), somewhat higher than that of alpha-helix), because of the dependence of the diagonal (uncoupled) frequency and the off-diagonal coupling constant on the Phi and Psi dihedral angles. It is also shown that the amide I vibrations of the closely located peptide and amide groups are strongly coupled through-space with each other, and in the presence of this type of strong vibrational coupling, a noticeable change in the IR intensity upon (13)C=O substitution may occur even for a mode that arises mainly from an unsubstituted group and is not much shifted in frequency. The meaning of these results in the interpretation of observed amide I spectral profiles, especially the possible usefulness of IR spectroscopic measurements for detecting those untypical structures in the process of amyloid formation, is also discussed.


Fine-tuning nanoparticle size by oligo(guanine)n templated synthesis of CdS: an AFM study.
We are presenting a method for modulating the size of CdS nanoparticles by templating their formation with oligo(guanine)n oligomers where n varied from 5 to 20. The variation in template length resulted in observable changes in the size distribution of the CdS nanoparticles. Statistical analysis of AFM images showed a general trend whereby the CdS average height decreased for longer oligoGn and increased for shorter oligoGn. Concomitantly, shorter oligoGn yielded more dispersed populations, while longer oligoGn gave less dispersed populations. This synthetic methodology could be extended to the synthesis of other nanoparticles and even to mixed-metal nanoparticles resulting in a powerful method for fine-tuning size-dependent properties.


CDP-choline protects motor neurons against apoptotic changes in a model of chronic glutamate excitotoxicity in vitro.
Cytidine-5-diphosphocholine (CDP-choline, citicoline) is an endogenous nucleoside involved in generation of phospholipids, membrane formation and its repair. It demonstrates beneficial effects in certain central nervous system injury models, including cerebral ischaemia, neurodegenerative disorders and spinal cord injury. Defective neuronal and/or glial glutamate transport is claimed to contribute to progressive loss of motor neurons (MNs) in amyotrophic lateral sclerosis (ALS). Our previous ultrastructural studies, performed on an organotypic tissue culture model of chronic glutamate excitotoxicity, documented a subset of various modes of MN death including necrotic, apoptotic and autophagocytic cell injury. The aim of this ultrastructural study was to determine the potential neuroprotective effect of CDP-choline on neuronal changes in a glutamate excitotoxic ALS model in vitro. Organotypic cultures of the rat lumbar spinal cord subjected to 100 microM DL-threo-beta-hydroxyaspartate (THA) were pretreated with 100 microM of CDP-choline. The exposure of spinal cord cultures to CDP-choline and THA distinctly reduced the development of typical apoptotic changes, whereas both necrotic and autophagocytic THA-induced MN injury occurred. These results indicate that CDP-choline treatment might exert a neuroprotective effect against neuronal apoptotic changes in a model of chronic excitotoxicity in vitro.


DIAGNOSIS AND MANAGEMENT OF MYCOBACTERIOSIS IN A COLONY OF LITTLE PENGUINS (EUDYPTULA MINOR).
A group of zoo-housed little penguins (Eudyptula minor) was diagnosed with mycobacteriosis. While undergoing multidetector computed tomography (MDCT) imaging for an unrelated research project, pulmonary lesions were detected in multiple individuals. In general, birds appeared healthy and free of outward signs of disease. After the loss of three individuals, polyclonal mycobacterial disease due to Mycobacterium avium-intracellulare complex was confirmed. Surviving birds were treated with rifampin (45 mg/kg), ethambutol (30 mg/kg), clarithromycin (10 mg/kg), and enrofloxacin (30 mg/kg) compounded into a single capsule administered once a day in food. After 3 mo of therapy, MDCT imaging documented a decrease in nodule size and number in all remaining birds, with further improvement documented after 13 mo of treatment. MDCT imaging was invaluable for diagnosing disease, documenting disease progression over time, and assessing response to therapy. Early initiation of therapy before the development of outward signs of disease led to resolution of mycobacterial pulmonary lesions in multiple penguins. Mycobacterial disease in this group of little penguins, as well as previously published reports, suggests that the species is at increased risk for developing mycobacteriosis.


Visceral abdominal obesity--is there an increased prevalence in men presenting with testicular teratoma?
There is evidence to suggest a link between the accumulation of visceral abdominal adipose tissue and an increased incidence of prostate, endometrial, breast, and colonic cancer. To investigate whether an increase in ratio of visceral to subcutaneous abdominal adipose tissue is demonstrated in patients with testicular teratoma. Following ethical approval, 22 male patients who had undergone staging computed tomography (CT) between 2004 and 2007 for testicular teratoma were identified from our database. Abdominal adipose tissue distribution for these 22 patients was compared with that of 22 control patients, standardized for age, sex, and body mass index. Visceral and subcutaneous adipose tissue volumes were calculated from a single axial CT slice at the level of the umbilicus. A two-sample t test for the difference in volume ratio between the two groups was used. A P value of < 0.05 was considered statistically significant. There was a statistically significant difference in the mean ratio of visceral to subcutaneous volumes between the teratoma patients and controls (P=0.02). The ratio in teratoma patients was 1.56 times greater than seen in control patients. Patients with testicular teratoma have a relatively greater proportion of abdominal visceral adipose tissue compared with controls. This is concordant with published literature for other malignancies.


Phage Therapy: Future Inquiries.
Western scientists have steadily been gaining interest in phage therapy since the mid-1980's due to the rising problem of antibiotic resistance. Its introduction in the 20th century by Felix d'Herelle marked the beginning for the uses of bacteriophages as antibacterial agents. However, a lack in understanding phage biology, as well as the arrival of broad-spectrum antibiotics deprioritized using phage therapy to treat bacterial infections in the West. With the advent of molecular biology, we are now better able to understand the predator-prey relationships with which phage co-evolve with their hosts as well as the specificity of phage-host interactions which could lend itself into personalized treatments for infection. These discoveries give us greater insights on how to most effectively use bacteriophage as potential therapeutic agents. It is encouraging to note that bacteriophages are used as food additives in the U.S., suggesting that the FDA acknowledges the positive potential of bacteriophages for human applications. Unfortunately, there are only a few examples to date of bacteriophages used on humans in controlled clinical trials. Rigorous studies in-vitro and especially in-vivo are critically important to avoid the mishaps of our predecessors. Phage biologists must strive to meet regulatory standards and to design thorough, rugged studies in order to establish a substantiated need for phage therapy in health care.


Malignant mixed müllerian tumor of the fallopian tube.
Malignant mixed Müllerian tumor (MMMT) of the fallopian tube is an extremely rare neoplasm with a poor prognosis. To date, only 37 cases have been reported. The primary treatment for this tumor is surgery. Chemotherapy has been used with some success. The role of radiotherapy is less clear. A case of malignant mixed Müllerian tumor of the fallopian tube occurring in a 63- year- old woman, presenting with postmenopausal vaginal spotting for 7 months, is reported.


Folic acid and lipoprotein lipase from aorta and blood plasma of atherosclerotic rats.
The lipoprotein lipase activity is somehow associated with atherosclerosis, and some publications report a protective effect of this enzyme against infiltration of lipids. In this publication, an atherogenic diet was associated with a decrease of this enzyme in aorta and blood plasma of rats. After administration of folic acid, a significant increase of the clearing factor activity was observed.


Classification of taste responses in brain stem: membership in fuzzy sets.
1. Classification methods in sensory systems in general, and gustation in particular, tend to place each of the relevant objects, such as stimuli or neurons, into one class each. Some of these methods are based on the responsiveness of neurons to various stimuli; in these, each group must contain a variety of nonidentical members because of the individuality of each neuron or stimulus. 2. The "fuzzy" set method is appropriate for more accurate classification in such heterogeneous populations. In this method each member is given graded membership in several sets rather than membership in only one set. In the present paper we subjected previously published data on the responses of individual taste neurons to a variety of stimuli to fuzzy set analysis. 3. We found that the amounts of response of 46 neurons in the solitary nucleus of the rat to NaCl, HCl, sucrose, quinine HCl, and KCl could accurately be accounted for by giving each a grade of membership in three sets; the same held in the parabrachial nucleus of the rat for the responses of 41 neurons to the first four of these stimuli. The response was calculated as the sum of the products of the stimulus times neuron ratings in each set. 4. Temporal patterns of response have often been related, but with only moderate success, to the identity of the stimulus or neuron. These patterns could be accurately accounted for with the present method. Each of the products of designated parts of the stimulus ratings times the neuron ratings gave the basis for accurate description of the temporal course of the response of each neuron to each stimulus. 5. This method appears to account for the varieties of amount and temporal pattern of response of taste neurons with a simple mathematical process of few parameters. This suggests that within the known complexities of receptor mechanisms and mechanisms of neural processing, the neural message is reduced to a rather simple form. 6. The fuzzy set approach, which is based on disclosing underlying sets rather than placement of heterogeneous members into one of several essentialistic groups, may be useful in disclosure of the underlying mechanisms producing the neural responses in taste.


Robotic Mitral Valve Repair Through Nonresectional Posterior Leaflet Remodeling.
The nonresectional posterior leaflet remodeling technique through free margin running suture (FMRS) has been recently introduced for the management of complex degenerative lesions of the posterior mitral leaflet. It aims at providing a novel tool in the mitral surgeon's armamentarium to improve the reproducibility and durability of repair, namely in cases characterized by more severe degenerative disease (Barlow and extensive fibroelastic deficiency lesions). Although FMRS can be performed through any surgical access, its features render it particularly adapted to minimally invasive mitral surgery. We describe for the first time the characteristics of FMRS in the context of robotic-assisted mitral repair. A stepwise approach is employed for presentation. The diffusion of robotic-assisted mitral repair has been limited by both economic and reproducibility issues; we hypothesize that FMRS may be helpful in improving the reproducibility of minimally invasive and robotic-assisted mitral surgery. We also discuss the initial clinical results of FMRS.


[Quality measurement using administrative data in mandatory quality assurance].
For several years, the use of administrative data in mandatory quality measurement has been requested by several stakeholders in Germany. Main advantages of using administrative data include the reduction of documentary expenditures and the possibility to perform longitudinal quality analyses across different healthcare units. After a short introduction, a brief overview of the current use of administrative data for mandatory quality assurance as well as current developments is given, which will then be further exemplified by decubital ulcer prophylaxis. By using administrative data coding expenditures in this clinical area could be reduced by nine million data fields. At the same time the population analysed was expanded resulting in a more than tenfold increase in potentially quality-relevant events. Finally, perspectives, further developments, possibilities as well as limits of quality measurement with administrative data are discussed.


Taxonomy of Trichophyton interdigitale (Trichophyton mentagrophytes var. interdigitale) by restriction enzyme analysis of mitochondrial DNA.
The relationship between Trichophyton interdigitale (Trichophyton mentagrophytes var. interdigitale) and the other members of the T. mentagrophytes complex was studied by restriction enzyme analysis of mitochondrial DNA (mtDNA). The mtDNA of 22 isolates of T. interdigitale from Japanese patients with dermatophytosis was extracted, digested with the restriction enzymes Hae III, Msp I, or Hind III, and the restriction profiles obtained compared with those of Arthroderma simii, Arthroderma benhamiae and Arthroderma vanbreuseghemii. The restriction profiles obtained for T. interdigitale were identical to those of A. vanbreuseghemii. Thus, these two species are considered to be closely related.


Case Report: Human Bocavirus Associated Pneumonia as Cause of Acute Injury, Cologne, Germany.
Although the human bocavirus (HBoV) is known since a decade, limited information about its pathogenesis is available due to the lack of an animal model. Thus, clinical cases and studies are the major source of novel information about the course of infection and the related pathophysiology.In this context, a clinical case of an adult patient suffering from severe HBoV-pneumonia is described that was associated with loss of consciousness followed by acute rib fracture and subsequent neurological disorder.Following initial global respiratory dysfunction the clinical respiratory symptoms recovered but the neurological symptoms maintained after weaning and intensive care in the stroke unit. During the initial phase, an acute active HBoV infection was confirmed by positive polymerase chain reactions from bronchoalveolar lavage fluid and serum.The case further demonstrates that HBoV can cause severe pneumonia, induce secondary disease also in adults, and may be associated with neurological symptoms as previously assumed.


Metal Exposure and Associated Health Risk to Human Beings by Street Dust in a Heavily Industrialized City of Hunan Province, Central China.
Fifty-five urban street dust samples were collected from Zhuzhou, an industrial city in central China and analyzed for a range of toxic elements. Potential carcinogenic and non-carcinogenic health effects on children and adults due to exposure to street dust were assessed. Concerning the two subgroups, the child cohort is confronted with considerably greater health risks than adults. According to the Hazard Quotient (HQ) method, ingestion of dust particles poses primary risk to children and adults, followed by dermal contact and inhalation for all of the metals investigated except Hg, for which inhalation of its elemental vapor constitute a slightly higher risk than ingestion. For children, Pb, As, Cd, Cr, Hg and Sb exposure were deemed as the highest contributors to non-cancer health risks, while As and Cr represent an enhanced cancer risk for children. For adults, risk indicator values for both cancer and non-cancer effects obtained were within the safety threshold. In a comparison with other locations within and outside mainland China, exposure to arsenic is prominent for the population of Zhuzhou, indicating more attention and preventive actions should been taken.


Repair of Cranial Bone Defects Using rhBMP2 and Submicron Particle of Biphasic Calcium Phosphate Ceramics with Through-Hole.
Recently a submicron particle of biphasic calcium phosphate ceramic (BCP) with through-hole (donut-shaped BCP (d-BCP)) was developed for improving the osteoconductivity. This study was performed to examine the usefulness of d-BCP for the delivery of osteoinductive rhBMP2 and the effectiveness on cranial bone regeneration. The d-BCP was soaked in rhBMP2 solution and then freeze-dried. Scanning electron microscope (SEM), energy dispersive spectroscopy (EDS), and Raman spectroscopy analyses confirmed that rhBMP2 was well delivered onto the d-BCP surface and the through-hole. The bioactivity of the rhBMP2/d-BCP composite was validated in MC3T3-E1 cells as an in vitro model and in critical-sized cranial defects in C57BL/6 mice. When freeze-dried d-BCPs with rhBMP2 were placed in transwell inserts and suspended above MC3T3-E1, alkaline phosphatase activity and osteoblast-specific gene expression were increased compared to non-rhBMP2-containing d-BCPs. For evaluating in vivo effectiveness, freeze-dried d-BCPs with or without rhBMP2 were implanted into critical-sized cranial defects. Microcomputed tomography and histologic analysis showed that rhBMP2-containing d-BCPs significantly enhanced cranial bone regeneration compared to non-rhBMP2-containing control. These results suggest that a combination of d-BCP and rhBMP2 can accelerate bone regeneration, and this could be used to develop therapeutic strategies in hard tissue healing.


Analyzing Criteria Affecting the Functionality of G-Quadruplex-Based DNA Aptazymes as Colorimetric Biosensors and Development of Quinine-Binding Aptazymes.
A DNA aptazyme consists of an aptamer domain and a DNAzyme module, in which the DNAzyme activity can be regulated by the aptamer-target interaction. The complex of G-quadruplex (GQ) and hemin is a peroxidase-mimicking DNAzyme and has become increasingly popular as a reporter system for biosensing applications. The development of GQ-based aptazymes is of high interest as they can be used as label-free biosensors for the real-time detection of pathogens. Herein, we rationally designed ca. 200 GQ-based aptazyme candidates and evaluated the suitability of 14 aptamers targeting quinine, Protein A, Staphylococcus enterotoxin B, and ATP for this detection concept. As a result, six novel aptazymes were developed for the specific detection of quinine based on two quinine-binding aptamers. The rest of designed probes, however, hardly showed significant functionality. To uncover the reasons, we performed enzyme-linked oligonucleotide assays to find how the affinity of aptamers is affected once conjugated to the DNAzyme sequence or upon integration into the aptazyme probe. Furthermore, we investigated the impact of the structure-switching functionality in the parent aptamer and the effect of the reaction matrix on the efficiency of probes.


A Combinatorial Approach to Induce Sensory Axon Regeneration into the Dorsal Root Avulsed Spinal Cord.
Spinal root injuries result in newly formed glial scar formation, which prevents regeneration of sensory axons causing permanent sensory loss. Previous studies showed that delivery of trophic factors or implantation of human neural progenitor cells supports sensory axon regeneration and partly restores sensory functions. In this study, we elucidate mechanisms underlying stem cell-mediated ingrowth of sensory axons after dorsal root avulsion (DRA). We show that human spinal cord neural stem/progenitor cells (hscNSPC), and also, mesoporous silica particles loaded with growth factor mimetics (MesoMIM), supported sensory axon regeneration. However, when hscNSPC and MesoMIM were combined, sensory axon regeneration failed. Morphological and tracing analysis showed that sensory axons grow through the newly established glial scar along "bridges" formed by migrating stem cells. Coimplantation of MesoMIM prevented stem cell migration, "bridges" were not formed, and sensory axons failed to enter the spinal cord. MesoMIM applied alone supported sensory axons ingrowth, but without affecting glial scar formation. In vitro, the presence of MesoMIM significantly impaired migration of hscNSPC without affecting their level of differentiation. Our data show that (1) the ability of stem cells to migrate into the spinal cord and organize cellular "bridges" in the newly formed interface is crucial for successful sensory axon regeneration, (2) trophic factor mimetics delivered by mesoporous silica may be a convenient alternative way to induce sensory axon regeneration, and (3) a combinatorial approach of individually beneficial components is not necessarily additive, but can be counterproductive for axonal growth.


Hypolipidemic activity of Hibiscus rosa sinensis root in rats.
The hypolipidemic activity of Hibiscus rosa sinensis (family Malvaceae) root extract was studied on triton and cholesterol-rich high fat diet (HFD) induced models of hyperlipidemia in rats. In triton WR-1339-induced hyperlipidemia, feeding with root extract (500 mg/kg body wt/day p.o.) exerted lipid-lowering effect, as assessed by reversal of plasma levels of total cholesterol (TC), phospholipids (PL) and triglycerides (TG) and reactivation of post-heparin lipolytic activity (PHLA) of plasma. The other model was fed with cholesterol-rich HFD and root extract (500 mg/kg body wt/ day p.o.) simultaneously for 30 days. This also caused lowering of lipid levels in plasma and liver homogenate and reactivation of plasma PHLA and hepatic total lipoprotein lipase activity. The hypolipidemic activity of Hibiscus rosa sinensis root was compared with a standard drug guggulipid (200 mg/kg body wt/day p.o.), a known lipid- lowering agent in both models. Histopathological findings in rat liver supported the protective role of H. rosa sinensis root extract in preventing cholesterol-rich HFD-induced hepatic steatosis.


Dual trigger for final oocyte maturation in expected normal responders with a high immature oocyte rate: a randomized controlled trial.
To evaluate whether dual trigger could improve reproductive outcomes in women with low oocyte maturation rates compare to human chorionic gonadotropin (hCG) trigger. This study included expected normal ovarian responders younger than 40 years old whose immature oocyte rate in the previous cycle was more than 50% at the reproductive center from July 2021 to November 2022. A total of 73 patients were enrolled at trigger, including 34 in the hCG trigger group and 39 in the dual trigger group (co-administration of gonadotrophin releasing hormone (GnRH) agonist and hCG, 40 and 34 h prior to oocyte retrieval, respectively). The primary outcome was oocyte maturation rate. There was no significant difference in the number of oocytes retrieved between the two study groups, but the oocyte maturation rate was higher in dual trigger group (84.0% [14.0%] vs. 55.5% [19.8%], p < 0.001). Moreover, there were also higher cumulative pregnancy rate (69.4% vs. 40.0%, p = 0.035) and cumulative live birth rate (66.7% vs. 36.0%, p = 0.022) in dual trigger group. For normal responders with low oocyte maturation rates, the dual trigger may be more effective than the conventional hCG trigger. ClinicalTrials.gov, identifier ChiCTR2100049292.


Silent uterine perforation by an IUCD inserted during the puerperium.
A 38-year-old lady, with a history of recent caesarean section, was diagnosed with a silent uterine perforation by a copper intrauterine contraceptive device under fluoroscopic examination. The incidence of uterine perforation and the increased risk in the puerperium are discussed. The use of ultrasound as the first line investigation is recommended.


COVID-19 and its effects on the digestive system.
Coronavirus disease 2019 (COVID-19) is caused by infection of the coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with typical respiratory symptoms. SARS-CoV-2 invades not only the respiratory system, but also other organs expressing the cell surface receptor angiotensin converting enzyme 2. In particular, the digestive system is a susceptible target of SARS-CoV-2. Gastrointestinal symptoms of COVID-19 include anorexia, nausea, vomiting, diarrhea, abdominal pain, and liver damage. Patients with digestive damage have a greater chance of progressing to severe or critical illness, a poorer prognosis, and a higher risk of death. This paper aims to summarize the digestive system symptoms of COVID-19 and discuss fecal-oral contagion of SARS-CoV-2. It also describes the characteristics of inflammatory bowel disease patients with SARS-CoV-2 infection and discusses precautions for preventing SARS-CoV-2 infection during gastrointestinal endoscopy procedures. Improved attention to digestive system abnormalities and gastrointestinal symptoms of COVID-19 patients may aid health care providers in the process of clinical diagnosis, treatment, and epidemic prevention and control.


Identification of small molecule binding molecules by affinity purification using a specific ligand immobilized on PEGA resin.
We investigated the application of resins used in solid-phase synthesis for affinity purification. A synthetic ligand for FK506-binding protein 12 (SLF) was immobilized on various resins, and the binding assays between the SLF-immobilized resins and FK506-binding protein 12 (FKBP12) were performed. Of the resins tested in this study, PEGA resin was the most effective for isolating FKBP12. This matrix enabled the isolation of FKBP12 from a cell lysate, and the identification of SLF-binding peptides from a phage cDNA library. We confirmed the interaction between SLF and these peptides using a cuvette type quartz crystal microbalance (QCM) apparatus. Our study suggests that PEGA resin has great potential as a tool not only for the purification and identification of small-molecule binding proteins but also for the selection of peptides that recognize target molecules.


T1-mapping in the heart: accuracy and precision.
The longitudinal relaxation time constant (T1) of the myocardium is altered in various disease states due to increased water content or other changes to the local molecular environment. Changes in both native T1 and T1 following administration of gadolinium (Gd) based contrast agents are considered important biomarkers and multiple methods have been suggested for quantifying myocardial T1 in vivo. Characterization of the native T1 of myocardial tissue may be used to detect and assess various cardiomyopathies while measurement of T1 with extracellular Gd based contrast agents provides additional information about the extracellular volume (ECV) fraction. The latter is particularly valuable for more diffuse diseases that are more challenging to detect using conventional late gadolinium enhancement (LGE). Both T1 and ECV measures have been shown to have important prognostic significance. T1-mapping has the potential to detect and quantify diffuse fibrosis at an early stage provided that the measurements have adequate reproducibility. Inversion recovery methods such as MOLLI have excellent precision and are highly reproducible when using tightly controlled protocols. The MOLLI method is widely available and is relatively mature. The accuracy of inversion recovery techniques is affected significantly by magnetization transfer (MT). Despite this, the estimate of apparent T1 using inversion recovery is a sensitive measure, which has been demonstrated to be a useful tool in characterizing tissue and discriminating disease. Saturation recovery methods have the potential to provide a more accurate measurement of T1 that is less sensitive to MT as well as other factors. Saturation recovery techniques are, however, noisier and somewhat more artifact prone and have not demonstrated the same level of reproducibility at this point in time.This review article focuses on the technical aspects of key T1-mapping methods and imaging protocols and describes their limitations including the factors that influence their accuracy, precision, and reproducibility.


Liaison psychiatry for older adults in the general hospital: service activity, development and outcomes.
Aims and method This study used data collected to describe the activity, case-load characteristics and outcome measures for all patients seen during a 6-year period. The service reviewed 2153 patients over 6 years with referral rates and case-load characteristics comparable to those described in a previous study period. The team saw 82% of patients on the day they were referred. Data and outcome measures collected showed significant complexity in the cases seen and statistically significant improvement in Health of the Nation Outcome Scales (HoNOS) scores following service input. Clinical implications The outcome measures used were limited, but the study supports the need for specialist liaison psychiatry for older adults (LPOA) services in the general hospital. The Framework of Outcome Measures - Liaison Psychiatry has now been introduced, but it remains unclear how valid this is in LPOA. It is of note that cost-effectiveness secondary to service input and training activities are not adequately monitored. Declaration of interest None.


Experimental strategies for research on multiple chemical sensitivity.
Skepticism about the validity of the multiple chemical sensitivity (MCS) syndrome stems in part from the lack of supporting experimental data. Performing the relevant experiments requires investigators to take account of broad variations in sensitivity and the need to establish reproducibility. The research approach best suited for MCS studies is the single-subject design. In contrast with conventional group designs, such designs emphasize repeated observations on individual subjects. Repeated observations of this kind constitute a time series in which successive measurements are serially or autocorrelated. One statistical method that bypasses the serial correlation problem is randomization tests. Explicit time series analyses take account of this aspect and can correct for it to determine the impact of an intervention such as a chemical exposure.


COVID-WideNet-A capsule network for COVID-19 detection.
Ever since the outbreak of COVID-19, the entire world is grappling with panic over its rapid spread. Consequently, it is of utmost importance to detect its presence. Timely diagnostic testing leads to the quick identification, treatment and isolation of infected people. A number of deep learning classifiers have been proved to provide encouraging results with higher accuracy as compared to the conventional method of RT-PCR testing. Chest radiography, particularly using X-ray images, is a prime imaging modality for detecting the suspected COVID-19 patients. However, the performance of these approaches still needs to be improved. In this paper, we propose a capsule network called COVID-WideNet for diagnosing COVID-19 cases using Chest X-ray (CXR) images. Experimental results have demonstrated that a discriminative trained, multi-layer capsule network achieves state-of-the-art performance on the COVIDx dataset. In particular, COVID-WideNet performs better than any other CNN based approaches for diagnosis of COVID-19 infected patients. Further, the proposed COVID-WideNet has the number of trainable parameters that is 20 times less than that of other CNN based models. This results in fast and efficient diagnosing COVID-19 symptoms and with achieving the 0.95 of Area Under Curve (AUC), 91% of accuracy, sensitivity and specificity respectively. This may also assist radiologists to detect COVID and its variant like delta.


[Goldboom's syndrome: prolonged febrile syndrome with dysproteinemia. Case report].
Goldbloom syndrome is a rare clinical entity, of unknown etiology that happens almost exclusively in pediatric population. It is a prolonged febrile syndrome with periosteal hyperostosis and dysproteinemia, and often simulates an hematooncology or lymphoproliferative disease. The diagnosis is to rule out the different causes of bone pain associated with hypergammaglobulinemia, hypoalbuminemia, high erythrocyte sedimentation rate and periostitis at the radiographies. Symptomatology, radiology and laboratory parameters refer in a variable time, usually from 3 to 12 months. We report the case of a six-year-old boy with diffuse bone pain, prolonged febrile syndrome (of 8 months of evolution), weight loss and elevated acute phase reactants with dysproteinemia (hypergammaglobulinemia and hypoalbuminemia). Goldbloom syndrome should be considered in patients with prolonged febrile syndrome and cortical hyperostosis after the exclusion of infectious, lymphoproliferative or inflammatory disease.