In vitro evaluation of antibacterial and immunomodulatory activities of Pelargonium reniforme, Pelargonium sidoides and the related herbal drug preparation EPs 7630.
The importance of Pelargonium species, most notably Pelargonium reniforme and Pelargonium sidoides, in traditional medicine in the Southern African region is well documented. Nowadays, a modern aqueous-ethanolic formulation of the roots of P. sidoides (EPs) 7630) is successfully employed for the treatment of ear, nose and throat disorders as well as respiratory tract infections. To provide a scientific basis of its present utilization in phytomedicine, EPs 7630, extracts and isolated constituents of the titled Pelargoniums with emphasis on P. sidoides were evaluated for antibacterial activity and for their effects on nonspecific immune functions. The samples exhibited merely moderate direct antibacterial capabilities against a spectrum of Gram-positive and Gram-negative bacteria. Functional bioassays including an in vitro model for intracellular diseases, a fibroblast-lysis assay (tumour necrosis factor (TNF) activity), a fibroblast-virus protection assay (IFN activity) and a biochemical assay for nitric oxides revealed significant immunomodulatory properties. Gene expression experiments (iNOS, IFN-alpha, IFN-gamma, TNF-alpha, Interleukin (IL)-1, IL-10, IL12, IL-18) not only confirmed functional data, they also clearly showed differences in the response of infected macrophages when compared to that of noninfected cells. ELISA confirmed the protein production of TNF-alpha, IL-1alpha and IL-12, while FACS analyses reaffirmed the cytokines IL-1alpha and IL-12 at the singular cell level. The current data provide convincing support for the improvement of immune functions at various levels, hence, validating the medicinal uses of EPs 7630. Despite considerable efforts, the remedial effects cannot yet be related to a chemically defined principle.


Adjustments of global and local hindlimb properties during terrestrial locomotion of the common quail (Coturnix coturnix).
Previous research has resulted in increasing insight into neuro-mechanical control strategies during perturbed locomotion. In contrast, more general analyses on simple model (template)-related parameters during avian terrestrial locomotion are still rare. Quail kinematic data obtained using X-ray videography combined with ground reaction force measurements were used as a basis to investigate how 'global' template and 'local' leg joint parameters in this small, predominantly terrestrial bird change with speed and gait. Globally, quail locomotion approximates a spring-like behavior in all investigated gaits. However, ground reaction forces are more vertically oriented, which may help to balance the trunk. At the joint level, practically all the spring-like work was found to occur in the intertarsal joint (ITJ). From walking to grounded running, the local stiffness of the ITJ decreases similarly to the reduction observed in global leg stiffness. Thus, in gaits without aerial phases the quails may modulate ITJ stiffness to regulate global leg stiffness, and therefore gait changes, to a significant degree. At higher speeds both global leg compression and stiffness are increased (the latter to values not significantly different to those obtained during walking). This enables the animals to shorten contact time and to generate aerial phases (running). However, we did not observe a change in the stiffness in the ITJ with a change of gait from grounded running to running. We hypothesize that a more extended leg at touch-down, controlled by the joint angles in the knee and ITJ, has an important influence in the leg stiffness adjustment process during running.


Transcription factor E is a part of transcription elongation complexes.
A homologue of the N-terminal domain of the alpha subunit of the general eukaryotic transcription factor TFE is encoded in the genomes of all sequenced archaea, but the position of archaeal TFE in transcription complexes has not yet been defined. We show here that TFE binds nonspecifically to single-stranded DNA, and photochemical cross-linking revealed TFE binding to a preformed open transcription bubble. In preinitiation complexes, the N-terminal part of TFE containing a winged helix-turn-helix motif is cross-linked specifically to DNA of the nontemplate DNA strand at positions -9 and -11. In complexes stalled at +20, TFE cross-linked specifically to positions +9, +11, and +16 of the non-template strand. Analyses of transcription complexes stalled at position +20 revealed a TFE-dependent increase of the resumption efficiency of stalled RNA polymerase and a TFE-induced enhanced permanganate sensitivity of thymine residues in the transcription bubble. These results demonstrate the presence of TFE in early elongation complexes and suggest a role of TFE in stabilization of the transcription bubble during elongation.


Metoclopramide test in the diagnosis of isolated hypogonadotrophic hypogonadism.
The responses of serum prolactin (Prl) to metoclopramide and LH and FSH to GnRH were studied simultaneously in 9 boys with hypogonadotrophic hypogonadism (HH), 7 boys with constitutional delay of puberty (D) and 15 controls. Metoclopramide increased the Prl levels in all groups. The boys with HH had lower Prl responses than the controls, whereas the boys with D had similar responses to the controls. Of the 9 boys with HH, 8 had subnormal Prl responses, 3 subnormal LH and none subnormal FSH. A metoclopramide test is clearly more sensitive than a GnRH test in differentiating HH and D and appears to make the differentiation between these two conditions clearer.


Glutathione levels during the mosquito life span with emphasis on senescence.
Glutathione levels were determined in mosquitoes of all ages of the life span. Specific analyses for reduced (GSH) and oxidized (GSSG) glutathione were used and validated to ensure minimal autoxidation of GSH and conversion of these forms. Indeed GSH accounted for greater than 97% of the total glutathione (GSH + GSSG) content in all samples. Marked changes occurred during the life span, and the highest levels of GSH and total glutathione were found during larval growth and metamorphosis (P less than 0.001). Thereafter the levels decreased in the early adult, plateaued in the mature, and decreased 46% in the old and very old mosquito (P less than 0.001). This aging-specific decrease was a general phenomenon, for it occurred in all body regions of both sexes. Starvation up to 3 days did not affect the GSH levels. The importance of these changes in glutathione is its relationship to the reducing and biosynthetic capacities of different life span stages. Of special interest is the senescence decrease which can lead to lower biosynthetic activity and also impaired detoxification capacity.


[Hypermobility syndrome. When too much activity causes pain].
Hypermobility of joints and spine is a consequence of abnormal laxity of ligaments, joint capsules and intervertebral discs. Hypermobility per se is a state, not a disease. However, it may lead to generalized arthralgia or localized symptoms (frequent ankle sprains, knee effusions, dislocations of the shoulders of recurrent episodes of back pain). These events may occur even after minor strains. Young women are preferentially affected. The term "hypermobility syndrome" is defined as a combination of hypermobility with arthralgia, low back pain, frequent dislocation or sprains. It is often the result of a hereditary disorder of connective tissue. Individuals with hypermobility are at increased risk for premature osteoarthrosis or polytopic disc degeneration of the spine. However, the vast majority of hyperlax individuals are free of symptoms. Those with symptoms who do not develop osteoarthrosis or disc degeneration usually experience spontaneous improvement with increasing age, thus losing their juvenile hyperlaxity. This usually occurs between the ages of thirty and forty. The present review article also provides guidelines for management and patient information.


Infants aged 12 months use the gender feature in determiners to anticipate upcoming words: an eye-tracking study.
We investigated online early comprehension in Italian children aged 12 and 20 months, focusing on the role of morphosyntactic features (i.e., gender) carried by determiners in facilitating comprehension and anticipating upcoming words. A naturalistic eye-tracking procedure was employed, recording looking behaviours during a classical Looking-While-Listening task. Children were presented with sentences and pictures of two objects representing nouns characterised by either the same gender (determiner was uninformative) or a different gender (determiner was informative). As expected, 20-month-old children recognised the target picture when this was named, and they were faster in the different-gender condition. Interestingly, 12-month-old infants identified the target picture only when presented with an informative determiner (different-gender condition). These results suggest that, as early as 12 months of age and with an improvement seen at 20 months of age, toddlers can extract and use determiner gender features to enhance comprehension and make predictions about upcoming words.


Determinants of children's exposure to environmental tobacco smoke (ETS): a study in Southern Germany.
Maternal smoking has been repeatedly found to be the most important determinant of children's exposure to environmental tobacco smoke (ETS). Here, we further investigated predictors for the urinary cotinine/creatinine ratio (CCR, ng/mg) in 1220 preschool children for the year 1996. Children from smoking homes (35.1%) had significantly higher CCR than children from nonsmoking homes (mean: 55.5 vs. 14.9 ng/mg). The level of education of the parents was a strong predictor for CCRs even after adjusting for number of cigarettes smoked, maternal smoking and dwelling space. Additionally, dwelling space was inversely related to children's urinary cotinine level. The CCR- levels in children investigated in 1996 and 1998 were significantly correlated (Pearson's r=0.67). The parents of 806 children agreed for a visit to their homes. In 79 of the 536 (14.7%) of the self-reported, nonsmoking households, smoking was admitted during the visit. The mean urinary CCR of these children was 25.2 ng/mg. We conclude that in addition to parental smoking behaviour, other variables such as dwelling space and social and educational status predict the children's exposure to ETS. Our data also revealed that a considerable percentage of parents denied the ETS exposure of their children at home.


The synthesis and the in vitro cytotoxicity studies of bisnaphthalimidopropyl polyamine derivatives against colon cancer cells and parasite Leishmania infantum.
Bisnaphthalimidopropyl derivatives (BNIPSpd, BNIPDaoct, BNIPDanon, BNIPDadec, BNIPDpta and BNIPDeta) were synthesised in yields ranging from 50% to 70% and their cytotoxicity against colon cancer cells (Caco-2) and the parasite Leishmania infantum determined using the MTT assay. Cytotoxicity within Caco-2 cells was manifested with IC(50) values between 0.3 and 22 microM. Compounds with the central longer alkyl chains exhibited the highest cytotoxicity. Against L. infantum, IC(50) values were encompassed within a narrower concentration range of 0.47-1.54 microM. In the parasites, the presence of nitrogen in the central chain and the length of the central alkyl chains did not especially enhance cytotoxicity. This may be due to the way these compounds are transported in the cells.


A qualified endorsement of embryonic stem cell research, based on two widely shared beliefs about the brain-diseased patients such research might benefit.
Are there persuasive approaches to embryonic stem cell (ESC) research that appeal, not just to those fellow-citizens in one's own ideological camp, nor just to those undecided citizens in the middle, but to those citizens on the other side of the issue? I believe that there are such arguments and in this short paper I try to develop one of them. In particular, I argue that certain beliefs shared by some proponents and some opponents of ESC research--beliefs about the personal identity and moral status of those who are victims of terrible brain diseases--are beliefs that should lead us to adopt a qualified endorsement of ESC research.


[Influence of chronic HBV infection and interferon therapy on somatic development of children].
Interferon alpha (IFN) is the most common treatment in chronic hepatitis B in children. Its impact on the development of children is still discussed. The assessment of body mass and body height of children after interferon therapy and the influence of chronic HBV infection on these parameters. The study concerned 64 children who suffered chronic hepatitis B. Among them 36 boys and 12 girls were treated with interferon alpha and 18 boys and 4 girls not treated. They were compared with a control group (416 boys and 457 girls). Scatter plots and chi-square test were used in analysis. Treated and not treated children were found in 3 distinguish zones: middle zone M+/- 1/2 SD, above and below it. Body mass: in the middle zone about 30% boys and 25% girls were found. In the high zone 20% boys and 40% girls. In low zone 45% boys and 30% girls. Body height: in the middle zone there were 30% boys as well as 40% girls. In high zone 35% boys and 30% girls. In low zone 30% boys and 25% girls were found. The comparison of frequency of treated and not treated children represented in the three zones was not statistically significant. Among sick children (treated and not treated together) about 60% boys and about 43% girls were characterized by lower weight than arithmetic mean of a population study. According to height about 40% boys and about 37% girls were found to be under mean of control group. 1. Interferon alpha can be used in chronic hepatitis B in children as a drug which does not cause permanent disturbances of body mass and body height 2. Children with chronic hepatitis B infection must be treated early to stop growth retardation.


Green spaces in a tertiary care children's hospital: Benefits, taxonomic survey, and perspective.
Humans coming in contact with natural green spaces experience beneficial physical, mental, and social effects. For the primary purpose of describing plant species found in the gardens of Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" (Autonomous City of Buenos Aires), a taxonomic survey was carried out between December 2013 and November 2016. A secondary objective was to review the extent of knowledge on how natural green spaces affect the health of hospitalized patients. There are 69 plant species from 47 botanical families; of these, only 8% are native. The recommendation is to increase the number of native species and coordinate those aspects related to their preservation. This survey, which is part of a plan that will include the dissemination of knowledge, understanding and awareness of green spaces and health, and the quantification of such specific effects in this hospital, will deepen and promote the interaction of patients, families, and health care providers with natural green spaces.


T lymphocyte activation in systemic lupus erythematosus analysed by proliferative response to nucleoplasmic proteins on nitrocellulose immunoblots.
Polyclonal B cell activity in systemic lupus erythematosus (SLE) may be under T cell control. The use of nitrocellulose immunoblots for the analysis of recognition by peripheral blood lymphocytes of nucleoplasmic proteins in SLE patients led to the characterization of significant proliferative responses to 68K (U1 RNP); SS-B; B-B' and D (Sm) antigen in 15 of 20 patients. Variations of proliferative response were parallel to disease activity over a follow-up period of greater than or equal to 6 months, conferring some prognostic value to the assay of lymphocyte response to nucleoplasmic antigens. The pattern of reactivity differs from the corresponding serum antibody profile, and purified T cell suspensions (greater than 95% pure) were shown to proliferate in response to soluble nucleoplasmic antigens, indicating that T and B cell repertoires against nucleoplasmic proteins may differ. This suggests that activated helper T cells contribute to the fine modulation of B cell reactivity to subcellular particles to determine the particular antibody profile of the patients.


An unexpected cause of a recurrent cerebral hemorrhage.
A 4-year-old previously healthy boy presented with a non-traumatic right parietal hemorrhage. A second life-threatening left cerebral hemorrhage occurred three weeks later and was decompressed with a craniotomy. Transthoracic echocardiography revealed a hypermobile elongated tumor of the mitral valve. The cardiac tumor was successfully resected three weeks after the craniotomy. Histological examination of the cardiac tumor revealed a papillary lesion of spindle cells with smooth muscle cell differentiation. In view of the histological findings and the clinical symptoms, a cellular myofibroblastic tumor was considered the most likely diagnosis in our patient. Although a cardiac tumor is a rare cause of a cerebral hemorrhage, a cardiac evaluation is recommended in pediatric patients with a cerebral hemorrhage of unknown etiology.


Left ventricular pressure-volume relationships during normal growth and development in the adult rat--studies in 8- and 50-week-old male Wistar rats.
Left ventricular (LV) pressure-volume relations provide relatively load-independent indexes of systolic and diastolic LV function, but few data are available on pressure-volume relations during growth and development in the normal adult heart. Furthermore, to quantify intrinsic ventricular function the indexes should be normalized for heart weight. However, in many studies the indexes are reported in absolute terms, or body weight-correction is used as a surrogate for heart weight-correction. We determined pressure-volume relations in young (8-week-old, n = 13) and middle-aged (50-week-old, n = 19) male Wistar rats in relation to their heart and body weights. The animals were anaesthetized and a 2F pressure-conductance catheter was introduced into the LV to measure pressure-volume relations. Heart and body weights were significantly higher in the 50-week-old rats, whereas the heart-to-body weight ratio was significantly lower (2.74 +/- 0.32 vs. 4.41 +/- 0.37 mg g(-1), P < 0.001). Intrinsic systolic function, quantified by the slopes of the end-systolic pressure-volume relation (E(ES)), the dP/dt(MAX) vs. end-diastolic volume relation (S-dP), and the preload recruitable stroke work relation (PRSW), normalized for heart weight, was slightly decreased in the 50-week-old rats (S-dP: -6%, P < 0.004; PRSW: -3%, P < 0.06). Heart weight-corrected diastolic indexes were not significant different. The absolute indexes qualitatively showed the same results, but body-weight corrected pressure-volume indexes showed improved systolic function and significantly depressed diastolic function. Intrinsic systolic function slightly decreases from the juvenile to the middle-aged period in normal male Wistar rats. Furthermore, correction of pressure-volume indexes for body weight is not an adequate surrogate for heart weight-correction in these animals.


Social-economic context of parent care: explaining Chinese caregivers' psychological and emotional well-being.
This paper explores Chinese familial caregivers' depression and subjective burdens among the current caregivers. Data were collected in 1997-1999 with 110 caregivers who were then taking care of physically dependent parents or parents-in-law. Regression analyses were conducted to assess the factors that influence caregivers depression and subjective burden. Findings suggest that family and individual economic conditions are related to caregivers' depression. Caregivers' involvement in caregiving tasks is associated with caregivers' subjective burden. Poorer self-perceived health is related to higher report of caregivers' depression. The author argues that poorer health and unemployment at the time of drastic social and economic changes in China may have created psychological and emotional anxieties and depression for caregivers. The lack of financial and social stability may have deleterious effect for current caregivers in the future when they grow older and have to be cared for by their one-child generation children.


Encapsulation of Thymol in Biodegradable Nanofiber via Coaxial Eletrospinning and Applications in Fruit Preservation.
The application of the nanofiber film in the field of food preservation was an emerging research direction in recent years. With the functionalization of nanofibers, the quality and safety of food can be better guaranteed. In the present work, thymol as an antibacterial agent was encapsulated into poly(lactide- co-glycolide) to form core-shell nanofibers by coaxial electrospinning. With such a core-shell nanofiber film, thymol can be slowly released to headspace between food and the nanofiber film, inhibiting the growth of bacteria on the surface of food. The morphology and core-shell structure of nanofibers were confirmed by scanning electron microscopy and transmission electron microscopy. The antibacterial and fruit preservation abilities of the nanofiber film were tested on strawberries. Studies have shown that it can effectively inhibit the growth of bacteria, fungi, and yeast and extend the shelf life of fruit. This novel antibacterial packaging material with excellent biocompatibility, biodegradability, and good sustained release performance would have a broad application prospect in the field of food preservation.


Pre-mRNA splicing and the nuclear matrix.
We examined the relationship between pre-mRNA splicing and the nuclear matrix by using an in vivo system that we have developed. Plasmids containing the inducible herpesvirus tk gene promoter linked to an intron-containing segment of the rabbit beta-globin gene were transfected into HeLa cells, and then the promoter was transactivated by infection with a TK- virus. Northern analysis revealed that the globin pre-mRNA and all its splicing intermediates and products are associated with the nuclear matrix prepared from such transfected cells. When the nuclear matrix was incubated with a HeLa cell in vitro splicing extract in the presence of ATP, the amount of matrix-associated precursor progressively decreased without a temporal lag in the reaction, with a corresponding increase in free intron lariat. Thus, most of the events of the splicing process (endonucleolytic cuts and branching) occur in this in vitro complementation reaction. However, ligation of exons cannot be monitored in this system because of the abundance of preexisting mature mRNA. Since the matrix is not a self-splicing entity, whereas the in vitro splicing system cannot process efficiently deproteinized matrix RNA, we conclude from our in vitro complementation results (which can be reproduced by using micrococcal nuclease-treated splicing extract) that the nuclear matrix preparation retains parts of preassembled ribonucleoprotein complexes that have the potential to function when supplemented with soluble factors (presumably other than most of the small nuclear ribonucleoproteins known to participate in splicing) present in the HeLa cell extract.


Cyclooxygenase-2-mediated metabolism of arachidonic acid to 15-oxo-eicosatetraenoic acid by rat intestinal epithelial cells.
Rat intestinal epithelial cells that permanently express the cyclooxygenase-2 (COX-2) gene (RIES cells) were used to investigate COX-2-mediated arachidonic acid (AA) metabolism. A targeted chiral lipidomics approach was employed to quantify AA metabolites that were secreted by the cells into the culture media. When intact RIES cells were treated with calcium ionophore A-23187 (1 microM) for 1 h, 11-(R)-hydroxyeicosatetraenoic acid (HETE) was the most abundant metabolite, followed by prostaglandin (PG) E 2, 15-(S)-HETE, 15-oxo-eicosatetraenoic acid (ETE), and 15-(R)-HETE. Incubation for a further 23 h after the calcium ionophore was removed resulted in a substantial increase in PGE 2 concentrations while HETE and 15-oxo-ETE concentrations decreased to almost undetectable levels. A similar metabolic profile was observed when RIES cells were treated with increasing concentrations of AA for 24 h. Incubation of the RIES cells with 10 microM AA revealed that maximal concentrations of 11-(R)-HETE, 15-(S)-HETE, and 15-oxo-ETE occurred after 10 min of incubation when the 15-( S)-HETE concentrations were approximately twice that of PGE 2. There was a gradual decrease in the concentrations of HETE and 15-oxo-ETE over time, whereas PGE 2 concentrations increased steadily until they reached a maximum after 24 h of incubation. The ratio of PGE 2 to 15-(S)-HETE was then approximately 20:1. 15-(S)-HETE and 15-oxo-ETE concentrations declined in the cell media during prolonged incubations with pseudo-first-order rate constants of 0.0121 and 0.0073 min(-1), respectively. 15-(S)-HETE was shown to undergo metabolism primarily to 15-oxo-ETE, which was further metabolized to a glutathione (GSH) adduct. The GSH adduct of 15-oxo-ETE was further metabolized in the extracellular milieu to a cysteinylglycine adduct. Thus, we have established for the first time that 15-oxo-ETE can be formed biosynthetically from AA, that 15-(S)-HETE is its immediate precursor, and that 15-oxo-ETE forms a GSH adduct. For ionophore-A-23187-stimulated cells and at early time points for AA-stimulated cells, 11-(R)-HETE was the major eicosanoid to be secreted into the media. Adding increasing concentrations of AA to cells in culture made it possible to estimate with surprising accuracy endogenous eicosanoid production using regression analyses. Thus, after 24 h in the absence of added AA, 11-(R)-HETE and 15-(R)-HETE were estimated to be present at concentrations close to the detection limit of our very sensitive assay. These data further highlight the importance of endogenous COX-2-mediated lipid peroxidation and illustrate the necessity to monitor eicosanoid formation from endogenous stores of AA in cell culture experiments.


Microcirculation and the physiome projects.
The Physiome projects comprise a loosely knit worldwide effort to define the Physiome through databases and theoretical models, with the goal of better understanding the integrative functions of cells, organs, and organisms. The projects involve developing and archiving models, providing centralized databases, and linking experimental information and models from many laboratories into self-consistent frameworks. Increasingly accurate and complete models that embody quantitative biological hypotheses, adhere to high standards, and are publicly available and reproducible, together with refined and curated data, will enable biological scientists to advance integrative, analytical, and predictive approaches to the study of medicine and physiology. This review discusses the rationale and history of the Physiome projects, the role of theoretical models in the development of the Physiome, and the current status of efforts in this area addressing the microcirculation.


Cutaneous paresthesia after internal plate fixation of clavicle fractures and underlying anatomical observations.
To assess the clinical and anatomical causes of cutaneous paresthesia after internal fixation of clavicle fractures.This study included 135 patients who underwent internal fixation of clavicle fractures from May 2013 to June 2016 at the First and Second Affiliated Hospital of Guangxi Medical University. The incidence of postoperative supraclavicular nerve injury, the duration of numbness, and improvements after plate removal were retrospectively analyzed. Seven human cadaver specimens were subsequently dissected to analyze the supraclavicular nerve and its relationship to numbness.Of the 135 patients who underwent internal fixation of clavicle fractures, 26 (19.3%) experienced postoperative cutaneous paresthesia, with 22 (16.3%) and 4 (2.8%) experiencing numbness and pain, respectively. The most intense numbness occurred during the first operative month. Of the 22 patients with numbness, 1 (4.5%), 1 (4.5%), and 20 (90.1%) patients reported mild, moderate, and severe numbness, respectively. Two patients described increased awareness of numbness when in contact with clothes, 2 were psychologically affected by numbness, and 20 (90.1%) reported reduced severity of numbness over time. At the last follow-up, numbness was found to persist in 2 (1.5%) patients. None of the patients was bothered by numbness. Cadaver dissection showed that the supraclavicular nerve emerged from the 1/2 posterior edge of the cervical sternocleidomastoid muscle and subsequently divided into 3 branches, with the lateral branch 2.26 ± 1.17 cm from the lateral margin of the acromion, the middle branch near the mid-clavicle, and the medial branch 2.03 ± 0.85 cm from the sternal lateral margin.Cutaneous paresthesia is common following internal fixation of the clavicle. Anatomic analysis showed that the nerve could be easily injured during clavicle operation. Numbness improved in most patients, but persisted for up to 2 years and was even permanent in a few. Most patients considered numbness as an insignificant factor in their daily lives.


Repeated measurements of airway and parenchymal mechanics in rats by using low-frequency oscillations.
For studies investigating the mechanisms underlying the development of allergic conditions such as asthma, noninvasive methodologies for separating airway and parenchymal mechanics in animal models are required. To develop such a method, seven Brown Norway rats were studied on three occasions over a 14-day period. After the baseline measurements, on the third day inhaled methacholine was administered. Once lung function returned to the baseline level, a thoracotomy was performed to compare the lung mechanics in the intact- and open-chest conditions. On each occasion, the rats were anesthetized, paralyzed, and intubated. Small-amplitude oscillations between 0.5 and 21 Hz were applied through a wave tube to obtain respiratory impedance (Zrs). Esophageal pressure was measured to separate Zrs into pulmonary (ZL) and chest wall (Zw) components. A model containing a frequency-independent resistance and inertance and a tissue component, including tissue damping and elastance, was fitted to Zrs, ZL, and Zw spectra. Measurements of Zrs, ZL, or Zw and the model parameters calculated from them did not differ among tests. The number of animals required to show group changes in lung mechanics was significantly lower when animals were measured noninvasively than when the group changes were calculated from open-chest measurements. In conclusion, the method reported in this study can be used to separate airway and lung tissue mechanics noninvasively over a series of tests and can detect pulmonary constrictor responses for the airways and the parenchyma separately.


Knowledge, Attitude and Behaviours towards Recommended Vaccinations among Healthcare Workers.
Healthcare workers (HCWs) are an important group of professionals exposed to biological risk during their work activities. So, the aim of this study is to perform a survey on the knowledge, attitude and behaviour of Italian HCWs towards the vaccinations recommended by the Ministry of Health. A cross-sectional study was carried out during the period September 2014-August 2015 in the Lazio region. The study was conducted by recruiting HCWs and biomedical students. The sample was comprised of 571 responders, of whom 12.4% were physicians, 18.9% were nurses, 34.3% were other HCW, and 34.3% were biomedical students (medical and nurses students). Hepatitis B virus (HBV) is perceived as a risk for personal health by 457 (80%) participants; TB is also worrying (434; 76%). Moreover, HBV (70.9%) and tuberculosis (TB) (79.2%) are perceived as a risk for health, while influenza is not considered so by most participants (46.2%). There is an underestimation of the role of influenza, perceived as a risk for 137 respondents (24%). The vaccination rate among these HCWs is highest for Hepatitis B virus (HBV) (82%), and lowest for influenza (28.5%) and varicella (40.3%). The vast majority of responders are in favour of HBV (77.8%) and TB (64.8%) vaccines. For other vaccinations there is less interest (between 33% and 40% for measles, mumps, rubella, pertussis and influenza). This study shows that knowledge of recommended occupational vaccinations is insufficient in HCWs, with few exceptions represented by HBV and TB. There is a need for novel approaches in this field, with the aim of enhancing vaccine coverage among HCW.


Absidia corymbifera infections in neonates.
We report the first two documented cases of neonatal zygomycosis caused by Absidia corymbifera. A premature infant developed disseminated disease from a cutaneous site with pulmonary, gastrointestinal, and cerebral involvement. The infant died despite amphotericin B therapy and surgical debridement. The second case occurred in a full-term infant with congenital heart disease and fungal pneumonitis. Zygomycosis was not suspected because of underlying cardiac disease and a complicated postoperative course, and this infant also died. Absidia joins a growing list of opportunistic fungal pathogens of the compromised neonate.


[Clinical efficacy of adductor canal blockade combined with transcutaneous electrical acupoint stimulation for total knee arthroplasty].
To evaluate the efficacy of adductor canal block (ACB) combined with transcutaneous electrical acupoint stimulation (TEAS)for postoperative analgesia and early functional exercise after total knee arthroplasty (TKA). A total of 84 patients underwent primary unilateral TKA from January 2019 to August 2020 were selected, including 45 males and 39 females, aged 66-77 (72.8±8.9) years;body mass index (BMI) was for 19-25 (23.6±3.5) kg /m2. They were divided into adductor canal block combined with transcutaneous electrical acupoint stimulation group (TEAS+ACB group)and simple adductor canal block group (ACB group) according to random number table method, 42 cases in each group. ACB was performed in ACB group during the operation. And TEAS was performed in TEAS+ACB group on bilateral lower limbs in 1-7 days postoperative on the basis of ACB. VAS scores at 6, 12, 24, 48, 72 h after surgery, knee function at 1, 2, 3, 7 days after surgery, knee motion at 7 days after surgery and length of hospitalization days were recorded and compared between the two groups. There were no significant differences in VAS of rest pain and activity pain in postoperative 6, 12 h between two groups (P>0.05), but the VAS of TEAS+ACB group was lower at 24, 48, 72 h after surgery(P<0.05). There was no significant difference in at 1 day postoperatively between two groups(P>0.05) , but the knee function of TEAS+ACB group was better than that of the ACB group in 2, 3, 7 days postoperatively (P<0.05). The length of hospitalization days in were less than in ACB group. On the 7th day after operation, the knee motion of TEAS+ACB group was greater than that of the ACB group (P<0.05). TEAS combined with ACB has a better postoperative analgesic efficacy than simple ACB, and can promote early functional exercise of patients. It is safe and effective for postoperative analgesia after TKA.


Comparative analysis of targeted metabolomics: dominance-based rough set approach versus orthogonal partial least square-discriminant analysis.
Metabolomics is an emerging field that includes ascertaining a metabolic profile from a combination of small molecules, and which has health applications. Metabolomic methods are currently applied to discover diagnostic biomarkers and to identify pathophysiological pathways involved in pathology. However, metabolomic data are complex and are usually analyzed by statistical methods. Although the methods have been widely described, most have not been either standardized or validated. Data analysis is the foundation of a robust methodology, so new mathematical methods need to be developed to assess and complement current methods. We therefore applied, for the first time, the dominance-based rough set approach (DRSA) to metabolomics data; we also assessed the complementarity of this method with standard statistical methods. Some attributes were transformed in a way allowing us to discover global and local monotonic relationships between condition and decision attributes. We used previously published metabolomics data (18 variables) for amyotrophic lateral sclerosis (ALS) and non-ALS patients. Principal Component Analysis (PCA) and Orthogonal Partial Least Square-Discriminant Analysis (OPLS-DA) allowed satisfactory discrimination (72.7%) between ALS and non-ALS patients. Some discriminant metabolites were identified: acetate, acetone, pyruvate and glutamine. The concentrations of acetate and pyruvate were also identified by univariate analysis as significantly different between ALS and non-ALS patients. DRSA correctly classified 68.7% of the cases and established rules involving some of the metabolites highlighted by OPLS-DA (acetate and acetone). Some rules identified potential biomarkers not revealed by OPLS-DA (beta-hydroxybutyrate). We also found a large number of common discriminating metabolites after Bayesian confirmation measures, particularly acetate, pyruvate, acetone and ascorbate, consistent with the pathophysiological pathways involved in ALS. DRSA provides a complementary method for improving the predictive performance of the multivariate data analysis usually used in metabolomics. This method could help in the identification of metabolites involved in disease pathogenesis. Interestingly, these different strategies mostly identified the same metabolites as being discriminant. The selection of strong decision rules with high value of Bayesian confirmation provides useful information about relevant condition-decision relationships not otherwise revealed in metabolomics data.


Interventions to treat mental disorders during pregnancy: A systematic review and multiple treatment meta-analysis.
For women suffering from an antepartum mental disorder (AMD), there is lack of evidence-based treatment algorithms due to the complicated risk-benefit analysis for both mother and unborn child. We aimed to provide a comprehensive overview of pharmacological and non-pharmacological interventions to treat AMD and performed a meta-analysis of the estimated treatment effect on the psychiatric symptoms during pregnancy. MedLine, PsycINFO and Embase databases were searched by two independent reviewers for clinical trials with a control condition on treatment of women with AMD, i.e. major depressive (MDD), anxiety, psychotic, eating, somatoform and personality disorders. We inventoried the effect of the treatment, i.e. decrease of psychiatric symptoms at the end of the treatment or postpartum. We adhered to the PRISMA-protocol. Twenty-nine trials were found involving 2779 patients. Trials studied patients with depressive disorders (k = 28), and anxiety disorders (k = 1). No pharmacological trials were detected. A form of psychotherapy, like Cognitive Behavioural Therapy (g = -0.61; 95%CI:-0.73 to -0.49, I2 = 0%; k = 7) or Interpersonal Psychotherapy (g = -0.67; 95%CI:-1.27 to -0.07; I2 = 79%; k = 4), holds robust benefit for pregnant women with MDD. Body-oriented interventions (g = -0.43; 95%CI:-0.61 to -0.25; I2 = 17%; k = 7) and acupuncture (g = -0.43; 95%CI:-0.80 to -0.06; I2 = 0%; k = 2) showed medium sized reduction of depressive symptoms. Bright light therapy (g = -0.59; 95%CI:-1.25 to 0.06; I2 = 0%; k = 2), and food supplements (g = -0.51; 95%CI:-1.02 to 0.01; I2 = 20%; k = 3) did not show significant treatment effects. One study was found on Integrative Collaborative Care. This meta-analysis found a robust moderate treatment effect of CBT for MDD during pregnancy, and to a lesser extent for IPT. As an alternative, positive results were found for body-oriented interventions and acupuncture. No evidence was found for bright light therapy and food supplements. Only non-pharmacological trials on women with MDD were found. Research on a wider range of AMD is needed.


Highly reversible lithium storage in Bacillus subtilis -directed porous Co₃O₄ nanostructures.
In this work, a simple, high-yield biomineralization process is reported for cobalt oxide nanostructures using Gram-positive bacteria, Bacillus subtilis , as the soft templates. Rod-type cobalt oxide is prepared at room temperature through an electrostatic interaction between the functional surface structures of the bacteria and the cobalt ions in an aqueous solution. Additionally, porous Co₃O₄ hollow rods are formed through a subsequent heat treatment at 300 °C. These rods have a high surface area and exhibited an excellent electrochemical performance for rechargeable Li-ion batteries. This facile, inexpensive, and environmentally benign synthesis for transition metal oxides with unique nanostructures can be used for several practical applications, such as batteries, catalysts, sensors, and supercapacitors.


The complete chloroplast genome of Gracilariopsis lemaneiformis (Rhodophyta) gives new insight into the evolution of family Gracilariaceae.
The complete chloroplast genome of Gracilariopsis lemaneiformis was recovered from a Next Generation Sequencing data set. Without quadripartite structure, this chloroplast genome (183,013 bp, 27.40% GC content) contains 202 protein-coding genes, 34 tRNA genes, 3 rRNA genes, and 1 tmRNA gene. Synteny analysis showed plasmid incorporation regions in chloroplast genomes of three species of family Gracilariaceae and in Grateloupia taiwanensis of family Halymeniaceae. Combined with reported red algal plasmid sequences in nuclear and mitochondrial genomes, we postulated that red algal plasmids may have played an important role in ancient horizontal gene transfer among nuclear, chloroplast, and mitochondrial genomes. Substitution rate analysis showed that purifying selective forces maintaining stability of protein-coding genes of nine red algal chloroplast genomes over long periods must be strong and that the forces acting on gene groups and single genes of nine red algal chloroplast genomes were similar and consistent. The divergence of Gp. lemaneiformis occurred ~447.98 million years ago (Mya), close to the divergence time of genus Pyropia and Porphyra (443.62 Mya).


Coordinatively Unsaturated Metallates of Cobalt(II), Nickel(II), and Zinc(II) Guarded by a Rigid and Narrow Void.
Both natural enzymatic systems and synthetic porous material catalysts utilize well-defined and uniform channels to dictate reaction selectivities on the basis of size or shape. Mimicry of this design element in homogeneous systems is generally difficult owing to the flexibility inherent in most small molecular species. Herein, we report the synthesis of a tripodal ligand scaffold that orients a narrow and rigid cavity atop accessible metal coordination space. The permanent void is formed through a macrocyclization reaction whereby the 3,5-dihydroxyphenyl arms are covalently linked through methylene bridges. Deprotonative metallation leads to anionic and coordinatively unsaturated complexes of divalent cobalt, nickel, and zinc. An analogous series of trigonal monopyramidal complexes bearing a nonmacrocyclized variant of the tripodal ligand are also reported. Physical characterization of the coordination complexes has been carried out using multiple spectroscopic techniques (NMR, EPR, and UV-vis), cyclic voltammetry, and X-ray diffraction. Complexes of the macrocyclized [LOCH2O]3- ligand retain a rigid cavity upon metallation, with this cavity guarding the entrance to the open axial coordination site. Through a combination of spectroscopic and computational studies, it is shown that acetonitrile entry into the void is sterically precluded, disrupting anticipated coordination at the intracavity site.


Cyanogenic Derivatives as Chemical Markers for the Authentication of Commercial Products of Bamboo Shoots.
The authentication of bamboo shoots found in the marketplace is complex because the chemical profile of processed and unprocessed material is different. During processing, heat derivatives of the potentially toxic cyanogenic glycoside taxiphyllin are produced. Here, we report the isolation and structure elucidation of the two major diarylbutenedinitrile derivatives, which are cis and trans isomers of the rare 2,3-bis(4-hydroxyphenyl)but-2-enedinitrile from a commercial extract of bamboo shoots. These compounds, absent in fresh bamboo shoots, were produced by boiling the shoots of Bambusa vulgaris and were associated with a decrease in levels of taxiphyllin. Furthermore, (E)-2,3-bis(4-hydroxyphenyl)but-2-enedinitrile was quantified in all 16 of the commercial products tested. Its abundance was found to be highly variable, ranging from 1 to 3 mg/g in preserved bamboo shoots and from 10 to 160 mg/mL in commercial aqueous extracts. Of the 15 authenticated bamboo samples tested for taxiphyllin, it was found only in the shoots of B. vulgaris and Gigantochloa verticillata, which represent two edible bamboo species. Our results indicate that diarylbutenedinitriles can be used as markers for the authentication of boil-processed bamboo shoots obtained from taxiphyllin-containing edible species and organs.


Halogenation of A-frame μ-carbido complexes: synthesis of μ2-halocarbynes.
The reaction of [Rh2(μ-C)Cl2(PPh3)4] with bis(diphenylphosphino)methane (dppm) affords the A-frame μ-carbido complex [Rh2(μ-C)Cl2(μ-dppm)2], halide metathesis of which provides [Rh2(μ-C)Br2(μ-dppm)2]. The reactions of the former with PhICl2 or the latter with [pyH][Br3] provide rare examples of μ2-halocarbyne ligands in the complexes [Rh2(μ-CX)(μ-X)X4(μ-dppm)2] (X = Cl, Br).


Negative Binomial Mixed Models for Analyzing Longitudinal Microbiome Data.
The metagenomics sequencing data provide valuable resources for investigating the associations between the microbiome and host environmental/clinical factors and the dynamic changes of microbial abundance over time. The distinct properties of microbiome measurements include varied total sequence reads across samples, over-dispersion and zero-inflation. Additionally, microbiome studies usually collect samples longitudinally, which introduces time-dependent and correlation structures among the samples and thus further complicates the analysis and interpretation of microbiome count data. In this article, we propose negative binomial mixed models (NBMMs) for longitudinal microbiome studies. The proposed NBMMs can efficiently handle over-dispersion and varying total reads, and can account for the dynamic trend and correlation among longitudinal samples. We develop an efficient and stable algorithm to fit the NBMMs. We evaluate and demonstrate the NBMMs method via extensive simulation studies and application to a longitudinal microbiome data. The results show that the proposed method has desirable properties and outperform the previously used methods in terms of flexible framework for modeling correlation structures and detecting dynamic effects. We have developed an R package NBZIMM to implement the proposed method, which is freely available from the public GitHub repository http://github.com//nyiuab//NBZIMM and provides a useful tool for analyzing longitudinal microbiome data.


Endodontic therapy for a fused mandibular molar.
Variations in tooth morphology present a clinical challenge when endodontic treatment is required. A case of conservative endodontic therapy for a fused mandibular second and third molar is presented.


The Eating and Drinking Ability Classification System in a population-based sample of preschool children with cerebral palsy.
To determine (1) the reproducibility of the Eating and Drinking Ability Classification System (EDACS); (2) EDACS classification distribution in a population-based cohort with cerebral palsy (CP); and (3) the relationships between the EDACS and clinical mealtime assessment, other classifications, and health outcomes. This was a cross-sectional population-based cohort study of 170 children with CP at 3 years to 5 years (mean 57.6mo, standard deviation [SD] 8.3mo; 105 males, n=65 females). Functional abilities were representative of a population sample (Gross Motor Function Classification System level I=74, II=34, III=21, IV=18, V=23). The EDACS was the primary classification of mealtime function. The Dysphagia Disorders Survey was the clinical mealtime assessment. Gross motor function was classified using the Gross Motor Function Classification System. EDACS classification had 88.3% intrarater agreement (κ=0.84, intraclass correlation coefficient=0.95; p<0.001) and 51.7% interrater agreement (κ=0.36, intraclass correlation coefficient=0.79; p<0.001). In total, 56.5% of children were classified as EDACS level I. There was a strong stepwise relationship between the Dysphagia Disorders Survey and EDACS (r=0.96, p<0.001). Parental stress (odds ratio=1.3, p=0.05) and feeding tubes (odds ratio=6.4, p<0.001) were significantly related to more limited function on the EDACS. The EDACS presents a viable adjunct to clinical assessment of feeding skills in children with CP for use in surveillance trials and clinical practice. A rating addendum would be a useful contribution to the tool to enhance reproducibility.


Avoiding postnatal undernutrition of VLBW infants during neonatal intensive care: evidence and personal view in the absence of evidence.
Inadequate nutrient intakes in the first postnatal weeks play a crucial role in the aetiology of postnatal growth restriction of very low birthweight (VLBW) infants. Efforts to improve early nutrition in these infants led to a significant reduction in postnatal growth failure. Initiation of enhanced parenteral nutrition immediately after birth and utilisation of the large potential of early enteral nutrition seem pivotal. Nevertheless, it remains challenging to further reduce the initial drop in weight and head circumference z-score and to improve body composition and linear growth. This review will summarise data on how near-fetal postnatal weight gain in VLBW infants can be achieved and makes suggestions for early nutrition of VLBW infants.


Update: Cytokine Dysregulation in Chronic Nonbacterial Osteomyelitis (CNO).
Chronic nonbacterial osteomyelitis (CNO) with its most severe form chronic recurrent multifocal osteomyelitis (CRMO) is a non-bacterial osteitis of yet unknown origin. Secondary to the absence of both high-titer autoantibodies and autoreactive T lymphocytes, and the association with other autoimmune diseases, it was recently reclassified as an autoinflammatory disorder of the musculoskeletal system. Since its etiology is largely unknown, the diagnosis is based on clinical criteria, and treatment is empiric and not always successful. In this paper, we summarize recent advances in the understanding of possible etiopathogenetic mechanisms in CNO.


BTB/POZ domain-containing protein 7: epithelial-mesenchymal transition promoter and prognostic biomarker of hepatocellular carcinoma.
Epithelial-mesenchymal transition (EMT) is a critical step in the metastasis of hepatocellular carcinoma (HCC). BTB/POZ domain-containing protein 7 (BTBD7) regulates EMT-associated proteins implicated in HCC progression. However, the role(s) of BTBD7 in HCC have not been identified. Using highly metastatic HCC HCCLM3 cells, immortalized L02 hepatocytes, metastatic HCC animal models, and three independent cohorts of HCC patient specimens, we aimed to determine the involvement of BTBD7 in HCC metastasis. We show that BTBD7 messenger RNA and protein was highly expressed in HCC cells and tumor tissues, with such expression being associated with: enhanced cell motility, venous invasion, and poor prognosis. BTBD7 promoted HCC angiogenesis and metastasis in vitro and in vivo, but did not influence cell proliferation or colony formation. BTBD7 enhancement of HCC invasion and EMT phenotype occurred through activation of a RhoC-Rock2-FAK-signaling pathway, resulting in matrix metalloproteinase-2/9 production and microvessel formation. Applying a predictive risk score model, Cox regression analysis revealed that high BTBD7 expression integrated with high microvessel density was a powerful independent predictive factor of HCC clinical outcome. The present study identifies BTBD7 as a novel candidate prognostic factor and a potential therapeutic target of HCC. (HEPATOLOGY 2013; 57:2326-2337).


[Laboratory diagnosis of intestinal micro-parasitosis in AIDS patients: state of the art].
The diarrhea, often associated with growing thin and weight loss, is important for nutritional state and quality of life in AIDS patients. It was demonstrated that patients with AIDS who present diarrhea have a greater degree of immunosuppression than those without diarrhea, predisposing the gastrointestinal tract to the action of protozoa, bacterial, viral, fungal pathogens which may cause morbidity and death. HIV-patients are particularly susceptible to protozoa infections. Cryptosporidium infection is among the most common causes of enteric disease but Microsporidium (Enterocytozon bieneusi) and Cyclospora are emerging as potentially important enteric pathogens in AIDS patients. In spite of frequent interest of gastrointestinal tract the knowledge of diarrhea syndromes AIDS-related are often greatly limited by diagnostic difficulties. A review is made of the different laboratory methods employed in intestinal microparasitosis in the light of considerable dangerousness and aggressiveness of some protozoa on HIV-patients. The methods for the diagnosis of intestinal microparasitosis are based particularly on direct diagnosis (macroscopic or microscopic examination at fresh or after concentration) or an immunological diagnosis. The laboratory methods available at present permit to evidence different protozoa not evidenced in the past and without invasive techniques. The etiological diagnosis of diarrhea in AIDS-patients is often difficult and/or disappointing. Epidemiological knowledge on protozoa pathology has been limited by diagnostic difficulties but their identification is important particularly because an increasing therapeutic regimens are now available to treat these infections.


Schistosoma mansoni: further studies of the interaction between schistosomula and granulocyte-derived cationic proteins in vitro.
Purified eosinophil and neutrophil cationic proteins isolated from the lysosomal secretion granules of human leucocytes have been tested for cytotoxic capacity against lung-stage schistosomula of Schistosoma mansoni in vitro. Eosinophil cationic protein (ECP) caused paralysis but not death at high concentration; this effect was reversible and involved no gross pathological manifestations. Eosinophil protein X (EPX) and neutrophil cationic protein (NCP) were highly toxic at concentrations of 10(-5) mol/l, and induced paralysis at sublethal concentrations. These two proteins exerted their cidal effect principally against the subtegumental musculature and internal tissues of the parasite rather than against the surface syncytium and tegumental outer membrane. ECP and NCP were shown to bind to lung worms at paralysing concentrations, but this binding occurred independently of the charge on the parasite surface. Of several control proteins tested, only protamine was capable of destroying lung-stage parasites; the manifestations of damage were different, however, from those induced by the granulocyte-derived proteins. Parallel assays demonstrated that EPX also possessed cytotoxic capacity against newly transformed schistosomula, but it was less efficient than ECP in this respect. The data are discussed in relation to potential post-skin mechanisms of challenge attrition in the immunized host.


Simplified model for nonlinear noise calculation in coherent optical OFDM systems.
A simplified closed form expression for the noise power due to four-wave mixing in coherent OFDM systems is derived. The proposed model is in very good agreement with the exact model. The derived analytical expressions can be used in performance evaluation of systems employing CO-OFDM with any number of subcarriers and/or as an integral part of physical layer aware routing algorithms.


Effect of Laughter Yoga on Sleep and Quality of Life in Individuals With Fecal Ostomies: A Randomized Controlled Trial.
The aim of this study was to evaluate the effect of laughter yoga on the quality of life and sleep quality in individuals with fecal ostomies. This was randomized controlled trial. The sample comprised 55 individuals with an ostomy who received care at Ankara University's I˙bni Sina Hospital Stoma Therapy Unit in Ankara, Turkey. Data were collected over a 2-month period (January and February 2020). Participants were allocated into an intervention group (n = 27) who received a yoga therapy intervention and a control group (n = 28) who received no intervention via simple randomization. Demographic and pertinent clinical variables were obtained during a baseline visit in both groups, along with the Pittsburgh Sleep Quality Index (PSQI) and Stoma-Quality of Life (Stoma-QOL) instruments. The intervention group received laughter yoga weekly over a period of 8 weeks. Mean scores on the PSQI and the Stoma-QOL at baseline were compared. Participants in the intervention had a significant decline in mean PSQI scores (6.85 vs 5.48, P = .044) indicating improvement in sleep quality following the intervention. Analysis revealed no significant difference in mean Stoma-QOL scores (P = .077). Control group participants had no significant difference in either mean PSQI or Stoma-QOL scores following data collection at the end of 8 weeks. Laughter yoga had a positive effect on the sleep quality in individuals with fecal ostomies. Further research is recommended to evaluate the effect of the number of laughter yoga sessions on the sleep quality and quality of life in individuals with ostomies.


Efficacy of Adding Midazolam to Bupivacaine for Transversus Abdominis Plane Block on Postoperative Analgesia after Hysterectomy: A Randomized Controlled Study.
Different adjuncts have been utilized to promote the quality and prolong the duration of local anesthetics for a variety of regional block techniques. This study aimed to assess the effects of midazolam coadministered with bupivacaine in transversus abdominis plane (TAP) block on the 24-h morphine consumption, the postoperative analgesia duration and adverse effects. A prospective, randomized, controlled double-blind trial that was carried out at a university hospital. Eighty-two females subjected to open total abdominal hysterectomy under general anesthesia were involved in this trial. Participants were allocated randomly to either of two groups (41 each). Control group: received TAP block with 20 mL of 0.25% bupivacaine or midazolam group: received TAP block using the same volume of bupivacaine plus 50 μg/kg midazolam/side. Postoperative cumulative 24-h morphine consumption, analgesia duration, pain score, sedation score, and adverse events were recorded. Student's t-test, Mann-Whitney U-test, and Chi-square test were used. Patients in the midazolam group had a lower cumulative 24-h morphine consumption [median doses (interquartile range): 15 (10-19.50) mg compared to 25 (17.50-37) mg, P < 0.001], lower postoperative pain score at rest at the 4th, 6th, and 12th h (P = 0.01, 0.02, and 0.02, respectively) and on movement at 2, 4, 6, and 12 h (P < 0.001), longer time till the first postoperative demand for rescue analgesia (430.11 ± 63.02 min) compared to 327.78 ± 61.99 min (P < 0.001), and less sedation, nausea and/or vomiting, and pruritus. Adding midazolam as a bupivacaine adjuvant for TAP block reduces the 24-h morphine consumption, extends the postoperative analgesia duration, and decreases the incidence of adverse effects following abdominal hysterectomy.


Effect of methylphenidate on young adult's vigilance and event-related potentials.
Two studies were conducted on the effects of methylphenidate (20 mg) on young adults' event-related potentials. Although this stimulant elevated heart rate in study 1 (n = 14), it failed to affect either performance or amplitude of the late positive component (LPC) obtained from two versions of the continuous performance test (CPT). Because performance on these tasks was nearly error-free, we conducted study 2 (n = 23) to test the hypothesis that methylphenidate enlarges LPC amplitude only in more challenging tests than those used in study 1. In study 2, although heart rate was again elevated by the 20 mg dose of methylphenidate, LPC amplitude and performance were again unaffected in the two tasks employed in study 1 or in an easy tone discrimination procedure. However, in a more difficult version of CPT (10% errors of omission), both accuracy and amplitude of the concurrently obtained LPC were increased by methylphenidate. Similarly, in a choice-reaction time test, the stimulant increased speed as well as CNV amplitude. Our interpretation of the results is based on the view that LPC reflects the number of attentional resources committed to a stimulus during the evaluation stage. Thus, increases in LPC amplitude by methylphenidate are obtained only in tasks in which the subject may profit from the recruitment of additional attentional resources.


Mother-infant interaction and breastfeeding outcome 6 weeks after birth.
This study explored the relationship of early postpartum maternal-infant interactions to breastfeeding outcome at 6 weeks postpartum. Prospective, comparative descriptive study. Women, Infants, and Children Supplemental Nutrition Program and Comprehensive Perinatal Services Programs in northern California. Forty-two Latina participants were recruited in the 3rd trimester of pregnancy. Eligibility criteria included age 18 years or older, primiparous at recruitment, antepartum desire to breastfeed 8 weeks or longer postpartum, planned hospital birth, full-term vaginal birth of a healthy newborn, and an uncomplicated, immediate postpartum course for mother and newborn, including being discharged together. The study examined breastfeeding dyads' early postpartum scores on Barnard's Nursing Child Assessment Feeding Scale (NCAFS) in relation to breastfeeding outcome 6 weeks postpartum. NCAFS tests were performed 28-90 hours postpartum in the participants' homes, and breastfeeding status was assessed by phone contact 6 weeks postpartum. Dyads continuing to breastfeed at 6 weeks postpartum had significantly higher early postpartum NCAFS scores than did dyads who had weaned from the breast by 6 weeks postpartum. Optimal maternal-infant interactions, as evidenced by higher scores on Barnard's NCAFS, were related to longer breastfeeding duration. Lower scores on the NCAFS, suggesting difficulties in maternal-infant interaction, were related to weaning earlier than planned.


The many facets of the Wilms' tumour gene, WT1.
Over the years, many apparently contradictory findings and functions have been ascribed to the protein product of the WT1 tumour suppressor gene. These include being a transcriptional activator or repressor, a function in transcription versus RNA metabolism, and these days even a function as oncogene or tumour suppressor gene. To fully understand the role of WT1 in different diseases and normal development, we will need to understand these contradictions. In this review, we will discuss the present state of knowledge and suggest that a role for WT1 in influencing the mesenchymal-epithelial state of cells might be a common function that could explain many of the previously described findings.


Preanalytical quality control program - an overview of results (2001-2005 summary).
Preanalytical variables, such as sample collection, handling, transport, and storage, may affect patient results. The number of errors in the preanalytical phase may decrease by following standardized procedures. A retrospective analysis (2001-2005) of results obtained through the Spanish Society of Clinical Chemistry and Molecular Pathology Quality Assessment Program for the Preanalytical Phase has been carried out to summarize data regarding the main factors affecting the preanalytical phase quality. In such a program, participants are asked to register rejections and causes for rejection of routine or stat samples usually and locally collected at their laboratories. Results discussed refer to 105 laboratories. Of the 4,715,132 tubes expected to be received during the data collection period among participating laboratories and according to determinations included by clinicians in the request form, 32,977 (0.699%) offered a cause for rejection. Whole blood-EDTA samples and serum samples accounted for 75.6% of all samples collected among laboratories, although they only corresponded to 55.8% of all registered rejections. In total, 81% of rejections arose as a result of the following reasons: "specimen not received" (37.5%), "hemolysis" (29.3%), and "clotted sample" (14.4%). Moreover, plasma-citrate-erythrocyte sedimentation rate exhibited the highest percentage of rejection (1.473%), whereas the lowest rate corresponded to whole blood-EDTA (0.381%). Overall percentage of rejection is similar to previously published data. As some of the included variables have turned out to be irrelevant, the program has been simplified from the year 2006 onwards.


[Urodynamic findings in anamnestic urge incontinence (author's transl)].
Cystometric finding of 93 urge incontinent and 157 not urge incontinent women were compared by evaluating the following 4 parameters: uninhibited detrusor contractions, first desire to void, maximum cystometric capacity and bladder compliance. Of these 4 parameters only uninhibited detrusor contractions were significant for the urodynamic diagnostic evaluation of urge incontinence. Bladder compliance especially showed no correlation to anamnestic urge incontinence.


Molecular Mechanisms Regulating Cell Fusion and Heterokaryon Formation in Filamentous Fungi.
For the majority of fungal species, the somatic body of an individual is a network of interconnected cells sharing a common cytoplasm and organelles. This syncytial organization contributes to an efficient distribution of resources, energy, and biochemical signals. Cell fusion is a fundamental process for fungal development, colony establishment, and habitat exploitation and can occur between hyphal cells of an individual colony or between colonies of genetically distinct individuals. One outcome of cell fusion is the establishment of a stable heterokaryon, culminating in benefits for each individual via shared resources or being of critical importance for the sexual or parasexual cycle of many fungal species. However, a second outcome of cell fusion between genetically distinct strains is formation of unstable heterokaryons and the induction of a programmed cell death reaction in the heterokaryotic cells. This reaction of nonself rejection, which is termed heterokaryon (or vegetative) incompatibility, is widespread in the fungal kingdom and acts as a defense mechanism against genome exploitation and mycoparasitism. Here, we review the currently identified molecular players involved in the process of somatic cell fusion and its regulation in filamentous fungi. Thereafter, we summarize the knowledge of the molecular determinants and mechanism of heterokaryon incompatibility and place this phenomenon in the broader context of biotropic interactions and immunity.


Evaluation and comparison of antinociceptive activity of aspartame with sucrose.
Artificial sweeteners are low-calorie substances used to sweeten a wide variety of foods. At present they are used increasingly not only by diabetics, but also by the general public as a mean of controlling the weight. This study was carried out to evaluate and compare antinociceptive activity of the artificial sweeteners, aspartame and sucrose and to study the mechanisms involved in this analgesic activity. Forty eight white albino Wistar rats were divided into two groups of 24 rats each. Group 1 received sucrose and group 2 received aspartame solution ad libitum for 14 days as their only source of liquid. On 14(th) day, both groups of rats were divided into 3 subgroups having 8 rats each. Group Ia and IIa served as control. Group Ib and IIb were given naloxone and Ic and IIc received ketanserin, the opioid and serotonergic receptor antagonists, respectively. Tail withdrawal latencies (tail flick analgesiometer) and paw licking/jumping latencies (Eddy's hot plate method) were increased significantly in both aspartame and sucrose group. The analgesia produced by aspartame was comparable with sucrose. The opioid receptor antagonist naloxone and the 5-HT(2A/2C) serotonergic receptor antagonist ketanserin partly reversed the antinociceptive effect of these sweeteners. Thus, the artificial sweetening agent aspartame showed antinociceptive activity like sucrose in rats. Reduction in antinociceptive activity of aspartame and sucrose by opioid and serotoninergic antagonists demonstrate the involvement of both opioid and serotonergic system.


Biodegradation and kinetics of organic compounds and heavy metals in an artificial wetland system (AWS) by using water hyacinths as a biological filter.
The objective of the present study was to investigate the ability of water hyacinth (Eichhornia crassipes) to absorb organic compounds (potassium hydrogen phthalate, sodium tartrate, malathion, 2,4-dichlorophenoxy acetic acid (2,4-D), and piroxicam). For the aforementioned purpose, an artificial wetland system (AWS) was constructed and filled with water hyacinth collected from the Valsequillo Reservoir, Puebla, Mexico. Potassium hydrogen phthalate and sodium tartrate were measured in terms of chemical oxygen demand (COD) and biological oxygen demand (BOD). The present study indicated that the water hyacinths absorbed nearly 1.8-16.6 g of COD kg-1 dm (dry mass of water hyacinth), while the absorbance efficiency of BOD was observed to be 45.8%. The results also indicated that the maximum absorbance efficiency of malathion, 2,4-D, and piroxicam was observed to be 67.6%, 58.3%, and 99.1%, respectively. The kinetics of organic compounds fitted different orders as malathion followed a zeroth-order reaction, while 2,4-D and piroxicam followed the first-order reactions. Preliminary assessment of absorption of heavy metals by the water hyacinth in the AWS was observed to be (all values in mg g-1) 7 (Ni), 13.4 (Cd), 16.3 (Pb), and 17.5 (Zn) of dry biomass, thus proving its feasibility to depurate wastewater.


The GLU298ASP variant of nitric oxide synthase interacts with asymmetric dimethyl arginine in determining cardiovascular mortality in patients with end-stage renal disease.
Impaired nitric oxide generation and accumulation of the endogenous inhibitor of nitric oxide synthase (NOS), asymmetric dimethylarginine (ADMA), have been identified as strong predictors of cardiovascular outcomes in patients with end-stage renal disease (ESRD). We evaluated the role of endothelial NOS (eNOS) gene polymorphisms and its interaction with plasma ADMA in the high cardiovascular complications rate of these patients. The relationship between the Glu298Asp variant of eNOS and all-cause and cardiovascular mortality was assessed in a cohort study including 261 ESRD patients that were followed up for an average of 42 months. During the follow-up period, 138 patients died, 81 of them (i.e. 59% of total deaths) of cardiovascular causes. On univariate Cox's regression analysis, eNOS genotype tended to be related to all-cause death but failed to reach formal statistical significance (P for trend=0.11). However, eNOS genotype showed a significant association with cardiovascular mortality in statistical models, including traditional risk factors and factors peculiar to ESRD, and became even stronger when plasma ADMA was forced into the Cox model (P=0.006). Furthermore, the risk of cardiovascular death was maximum in heterozygotes and homozygotes patients carrying the risk allele and in those having high ADMA levels (hazard ratio=2.71, 95% confidence interval 1.38-5.35, P=0.004) compared to those having just one of these two risk factors. The T allele of the Glu298Asp polymorphism predicts cardiovascular mortality and interacts with plasma ADMA in determining this outcome in dialysis patients.


Evaluation of the Microbact-24E bacterial identification system.
The Microbact 24E (MB24E) system is a commercial microsystem for the identification of common clinical isolates of Enterobacteriaceae and non-fermenting Gram negative bacilli, and consists of dehydrated substrates distributed in the wells of microtitre trays. This system was compared with the API20E for the identification of 386 bacterial isolates, which included 284 clinical and 102 environmental organisms. There was 97% and 91% agreement for the identification of clinical isolates of Enterobacteriaceae and other Gram negative bacilli, respectively. The identification of environmental isolates by both systems was less satisfactory. The API20E has a more extensive database than the MB24E and is thus more reliable for the identification of rare or unusual organisms, but the MB24E is cheaper, is easy and convenient to use, and is suitable for a routine microbiology laboratory.


Treatment. Disease-modifying therapies.
Many patients with systemic lupus can be treated effectively with antimalarials and nonsteroidal anti-inflammatory drugs without ever having to take systemic corticosteroids at all or for any significant length of time. On the other hand, some patients with life-threatening disease, active major organ disease, or intolerable corticosteroid toxicities should be given immunosuppressive drugs, plasmapheresis, and/or other therapies in addition to corticosteroids early in their disease course, before permanent, end-organ damage occurs and before the predictable serious and debilitating toxicities of prolonged, daily high-dose corticosteroids develop. Just as lupus patients now routinely undergo detailed serologic testing, it is conceivable that, in the future, routine determination of human leukocyte antigen (HLA) haplotypes45 and T-cell subsets88a will help define, at disease onset, those patients who are destined to have severe disease. Perhaps this knowledge, combined with a better understanding of the exact mechanisms of action of these disease-modifying therapies, will allow a more rational approach to the treatment of SLE.


Modulation of altered hepatic foci induction by diallyl sulphide in Wistar rats.
Diallyl sulphide (DAS) is a sulphur-containing volatile compound present in garlic (Allium sativum). It has been shown to inhibit a number of chemically induced forms of cancer in experimental animals. The present study demonstrates the inhibitory effect of DAS on the development of diethylnitrosamine (DEN) initiated and 2-acetyl-aminofluorene (2-AAF) promoted preneoplastic altered hepatic foci (AHF) in Wistar rats. AHF were scored and analysed by quantitative stereology using the Image Analysis system from frozen liver sections stained for biological markers, namely glutathione S-transferase, placental form (GST-P), gamma-glutamyl transpeptidase (GGT), adenosine triphosphatase (ATPase), glucose-6-phosphatase (G6 Pase) and alkaline phosphatase (AlkPase). DAS-supplemented rats were found to restore the near-normal levels of enzymes GST-P and GGT when exposed to DEN and 2-AAF. DAS administration following DEN and 2-AAF exposure led to the restoration of enzymic activity of ATPase, G6 Pase and AlkPase, as evident by number and area of the foci. These findings suggest the protective role of DAS in rat hepatocarcinogenesis, by suppressing DEN- and 2-AAF-induced AHF development.


Frequent promoter methylation and gene silencing of CDH13 in pancreatic cancer.
It has recently been reported that CDH13 expression is silenced by aberrant methylation of the promoter region in several cancers. We examined the methylation status of the CDH13 gene in pancreatic cancer using methylation-specific PCR (MSP), and detected aberrant methylation of CDH13 in all 6 pancreatic cancer cell lines examined. To confirm the status of the CDH13 gene in relation to the methylation pattern, we next examined CDH13 expression in these cell lines using reverse transcription (RT)-PCR. As expected, no CDH13 expression was detected in any of the 6 pancreatic cancer cell lines. Moreover, 5-aza-2'-deoxycytidine (5-aza-dC) treatment of CDH13-methylated cell lines led to restoration of CDH13 expression. Among primary pancreatic cancers, 19 of 33 (58%) cases exhibited CDH13 methylation, while no cases exhibited it in corresponding normal pancreatic tissues. CDH13 methylation was detected even in relatively early pancreatic cancers, such as stage II cancers and cancers less than 2 cm in diameter. Our results suggest that the aberrant methylation of CDH13 occurs frequently in pancreatic cancer, even at a relatively early stage.


SwissParam 2023: A Modern Web-Based Tool for Efficient Small Molecule Parametrization.
Most steps of drug discovery are now routinely supported and accelerated by computer-aided drug design tools. Among them, structure-based approaches use the three-dimensional structure of the targeted biomacromolecule as a major source of information. When it comes to calculating the interactions of small molecules with proteins using the equations of molecular mechanics, topologies, atom typing, and force field parameters are required. However, generating parameters for small molecules remains challenging due to the large number of existing chemical groups. The SwissParam web tool was first released in 2011 with the aim of generating parameters and topologies for small molecules based on the Merck molecular force field (MMFF) while being compatible with the CHARMM22/27 force field. Here, we present an updated version of SwissParam, providing various new features, including the possibility to setup covalent ligands. Molecules can now be imported from different file formats or via a molecular sketcher. The MMFF-based approach has been updated to provide parameters and topologies compatible with the CHARMM36 force field. An option was added to generate small molecule parametrizations following the CHARMM General Force Field via the multipurpose atom-typer for CHARMM (MATCH) approach. Additionally, SwissParam now generates information on probable alternative tautomers and protonation states of the query molecule so that the user can consider all microspecies relevant to its compound. The new version of SwissParam is freely available at www.swissparam.ch and can also be accessed through a newly implemented command-line interface.


[Management of patients with iatrogenic bile duct injury].
The aim of this study is to present an analysis of 30 patients with major bile duct injuries in a single hospital centre. From January 2001 to December 2006, a prospective database was kept of all patients with a bile duct injury (BDI) following laparoscopic cholecystectomy (LC). Patients' charts were reviewed to analyse perioperative surgical management. Over 6 years, 30 patients were treated for a major BDI. Patient demographics were not notable for 16 women (53%) and 14 men (47%) with a mean age of 58.9 years. Twenty of them sustained their BDI at another hospital. The mean interval from the time of BDI to referral was 17.4 days. A total of 30 patients underwent definitive biliary reconstruction, including 17 hepaticojejunostomies (56.7%), 8 end-to-end repairs (20%), 2 choledochoduodenostomies (6.7%), 3 liver transplantations (10%), 1 hepatectomy and 1 Whipple (3.3%). There were 2 deaths in the postoperative period (6.7%). Thirteen (43.3%) sustained at least 1 postoperative complication. The most common complications were cholangitis (20%), and intra-abdominal abscess/biloma (23.3%). The mean postoperative length of stay was 17.46 days. Bile duct injury is a serious complication that affects mostly individuals with benign disease. Various subsequent procedures (surgical and/or endoscopic) are almost always necessary for its correction, with a high socioeconomic cost that imposes great suffering on the patients and their relatives. Clearly, all efforts should be made to prevent such accidents.


Clear Cell Sarcoma Of Metatarsus.
We report a case of clear cell sarcoma in the third metatarsus of the right foot. This type of tumor is very rare and scantily reported in literature. A 42-year-old Caucasian male presented with a nodular ulcerated mass on the dorsal side of the left foot. X-rays demonstrated a nodular solid lesion which dislodged the third metatarsus. A biopsy revealed a neoplastic proliferation with a sarcoma clear cell profile; because of the aggressive nature of this type of neoplasm, we performed a trans-tibial amputation according to Bugess to achieve a better functionality for the patient. The present study underlines clinical, morphological, as well as imaging and therapeutic aspects of a rare neoplasm such as clear cell sarcoma. The location site is also quite unusual - the metatarsus of the foot. The histological and immunohistochemical data were suggestive of the diagnosis of clear cell sarcoma of metatarsus. After MRI and a bone scan, the surgical treatment suggested the extension over the forefoot and the ankle and therefore a trans-tibial amputation was made.


Light-harvesting macroring accommodating a tetrapodal ligand based on complementary and cooperative coordinations.
A porphyrin macroring, mimicking the light-harvesting complex of photosynthetic purple bacteria, was synthesized by self-assembling trisporphyrinatoZn(II) complexes with imidazolyl substituents at both molecular terminals. Very strong complementary coordination of imidazolyl to Zn(II) afforded exclusively the cyclic trimer of trisporphyrin under dilute conditions at 27 degrees C in CHCl3/MeOH = 9/1 (v/v). 1H NMR spectra of the macroring indicate the existence of two topological isomers, one symmetric and one asymmetric. Use of three noncoordinated porphyrinatoZn(II) sites allows a tetrapodal ligand to be incorporated into the cavity of the macroring. A Job plot and the clear bending behavior on UV-vis titration indicated the formation a 1:1 complex; the heterogeneity of two topological isomers was not observed, and both isomers similarly accommodated the tetrapodal ligand. The association constant obtained by curve fitting analysis was 8 x 108 M-1 in toluene. This large association constant reflects the cooperative nature of three coordination sites.


Dissociation of double-headed cytoplasmic dynein into single-headed species and its motile properties.
Cytoplasmic dynein is a minus-end directed microtubule motor and plays important roles in the transport of various intracellular cargoes. Cytoplasmic dynein comprises two identical heavy chains and forms a dimer (double-headed dynein); the total molecular weight of the cytoplasmic dynein complex is about 1.5 million. The dynein motor domain is structurally very different from those of kinesin and myosin, and our understanding of the mechanisms of dynein energy transduction is limited mainly because of the difficulty in obtaining a sufficient quantity of purified and active cytoplasmic dynein. We purified cytoplasmic dynein, which was free from dynactin and other dynein-associated proteins. The purified cytoplasmic dynein was active in an in vitro motility assay. The controlled dialysis of the purified dynein against 4 M urea resulted in its complete dissociation into monomeric species (single-headed dynein). The separation of the dynein heads by the treatment was reversible. The MgATPase activities of the single-headed and reconstituted double-headed dynein were comparable to that of intact dynein. The double-headed dynein bundled microtubules in the absence of ATP; the single-headed dynein did not. The single-headed dynein produced in vitro microtubule-gliding motility at velocities very similar to those of double-headed dynein at various ATP concentrations. These results indicate that a single cytoplasmic dynein heavy chain is sufficient to produce robust microtubule motility. Application of the double- and single-headed dynein molecules in various assay systems will elucidate the mechanism of action of the cytoplasmic dynein.


The Effects of Direct-To-Consumer-Advertising on Mental Illness Beliefs and Stigma.
Despite widespread use, little is known about how video direct-to-consumer-advertising (DTCA) influences beliefs about or stigma towards mental illness. The purpose of this study was to examine the effects of a medication advertisement on beliefs and stigma towards one mental disorder-bipolar disorder. A total of 424 participants were randomly assigned to view a medication or automobile advertisement and completed measures of beliefs and stigma towards bipolar disorder before and immediately after the advertisement. The medication advertisement did not lead to changes in perception of biological etiology, but did lead to increases in perception of prevalence, treatability, and controllability. No substantive changes were noted in stigma. In contrast to previous research and speculation, DTCA did not have an immediate, substantial impact on stigma or contribute to the "medicalization" of mental disorders.


Misuse of multinomial logistic regression in stroke related health research: A systematic review of methodology.
Multinomial logistic regression (MLR) is often used to model the association between a nominal outcome variable and one or more covariates. The results of MLR are interpreted as relative risk ratios (RRR) and warrant a more coherent interpretation than ordinary logistic regression. Some authors compare the results of MLR to ordinal logistic regression (OLR), irrespective of the fact that these estimate different quantities. We aim to investigate the time trends in the use and misuse of MLR in studies including stroke patients, specifically the extent to which (1) the results are denoted as anything other than RRR, (2) comparisons are made of results with results of OLR and (3) results have been interpreted coherently. Secondarily, we examine the use of model validation techniques in studies with predictive aims. We searched EMBASE and PubMed for articles using MLR on populations of stroke patients. Identified studies were screened, and information pertaining to our aims was extracted. A total of 285 articles were identified through a systematic literature search, and 68 of these were included in the review. Of these, 60 articles (88%) did not denote exponentiated coefficients of MLR as relative risk ratios but rather some other measure. Additionally, 63 articles (93%) interpreted the results of MLR in a non-coherent manner. Two articles attempted to compare MLR results with those of OLR. Nine studies attempted to use MLR for predictive means, and three used relevant validation techniques. From these findings, it is clear that the interpretation of MLR is often suboptimal.


Influence of oxygen tension, biomass concentration, and specific growth rate on the rheological properties of a filamentous fermentation broth.
The influence of oxygen tension, biomass concentration, and specific growth rate on the rheological properties of an Aspergillus niger fermentation broth was investigated by growing the fungus in continuous culture. The rheological properties were measured on-line using an impeller rheometer system. The effect of the specific growth rate on broth rheology was strongly influenced by the dissolved oxygen, (DO) concentration in the broth. At DO concentrations above 10% of saturation, K increased with the dilution rate, and at DO concentrations below 10% of saturation, K decreased with increasing dilution rate. The largest influence of a change in the DO concentration on the viscosity of the broth was found at the lowest growth rates and the lowest DO concentrations. K/x, a term that gives a simple description of the structure or the morphology of the culture, was found to increase with biomass concentration.


Prenatal sonographic evaluation of two intracranial teratomas.
Prenatal sonographic evaluation is of utmost importance in the detection of congenital anomalies. At the Ultrasound Section of our Radiology service, we incidentally detected fetal intracranial neoplasms in two different patients using non-invasive imaging. Our presumptive diagnosis in both cases was a teratoma, the most common brain tumor in the perinatal period. Subsequent confirmation was provided with pathological samples obtained at autopsy in both patients, revealing immature teratomas. Fetal intracranial tumors are so rare and incredibly, these two unique cases presented in our section within just a few months of one another.


Supporting and retaining Village Health Teams: an assessment of a community health worker program in two Ugandan districts.
Uganda's national community health worker program involves volunteer Village Health Teams (VHTs) delivering basic health services and education. Evidence demonstrates their positive impact on health outcomes, particularly for Ugandans who would otherwise lack access to health services. Despite their impact, VHTs are not optimally supported and attrition is a growing problem. In this study, we examined the support needs and existing challenges of VHTs in two Ugandan districts and evaluated specific factors associated with long-term retention. We report on findings from a standardized survey of VHTs and exploratory interviews with key stakeholders and draw conclusions that inform efforts to strengthen and sustain community health care delivery in Uganda. A mixed-methods approach was employed through a survey of 134 individual VHT members and semi-structured interviews with six key stakeholders. Descriptive and bivariate regression analysis of quantitative survey data was performed along with thematic analysis of qualitative data from surveys and interviews. In the regression analysis, the dependent variable is 10-year anticipated longevity among VHTs, which asked respondents if they anticipate continuing to volunteer as VHTs for at least 10 more years if their current situation remains unchanged. VHTs desire additional support primarily in the forms of money (e.g. transportation allowance) and material supplies (e.g. rubber boots). VHTs commonly report difficult working conditions and describe a lack of respect from their communities and other health workers. If their current situation remains unchanged, 57% of VHTs anticipate remaining in their posts for at least 10 years. Anticipated 10-year longevity was positively associated with stronger partnerships with local health center staff and greater ease in home visiting. Supporting and retaining Uganda's VHTs would be enhanced by building stronger partnerships between VHTs and other health workers and regularly providing supplies and transportation allowances. Pursuing such measures would likely improve equity in access to healthcare for all Ugandans.


Diaphragmatic changes in emphysema.
The diaphragms and lungs of 95 men were quantitatively examined at autopsy, and the following observations were made. The area of the whole diaphragm had a significant inverse correlation (r= -0.412, P less than 0.001) with the percentage of the lung occupied by emphysematous lesions. Most of the reduction in the area of the whole diaphragm associated with advanced emphysema occured in the muscular portion; in contrast, the thickness of the diaphragm was not affected by percentage of the lung occupied by emphysematous lesions. Neither body height nor postmortem lung volume had as close a relation to area of the whole diaphragm as did percentage of the lung occupied by emphysematous lesions. The conclusion drawn from these observations is that the diaphragm area reduction associated with emphysema is related to altered thoracic shape, probably diaphragm flattening in particular, and is better described as contracture than as atrophy. It is speculated that these morphologic changes contribute to the altered diaphragmatic function characteristic of chronic obstructive pulmonary disease, and thereby to the ventilatory abnormalities seen in patients with this disorder.


Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis.
To determine the comparative effectiveness and safety of psychological interventions for chronic low back pain. Systematic review with network meta-analysis. Medline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS, and CINAHL from database inception to 31 January 2021. Randomised controlled trials comparing psychological interventions with any comparison intervention in adults with chronic, non-specific low back pain. Two reviewers independently screened studies, extracted data, and assessed risk of bias and confidence in the evidence. Primary outcomes were physical function and pain intensity. A random effects network meta-analysis using a frequentist approach was performed at post-intervention (from the end of treatment to <2 months post-intervention); and at short term (≥2 to <6 months post-intervention), mid-term (≥6 to <12 months post-intervention), and long term follow-up (≥12 months post-intervention). Physiotherapy care was the reference comparison intervention. The design-by-treatment interaction model was used to assess global inconsistency and the Bucher method was used to assess local inconsistency. 97 randomised controlled trials involving 13 136 participants and 17 treatment nodes were included. Inconsistency was detected at short term and mid-term follow-up for physical function, and short term follow-up for pain intensity, and were resolved through sensitivity analyses. For physical function, cognitive behavioural therapy (standardised mean difference 1.01, 95% confidence interval 0.58 to 1.44), and pain education (0.62, 0.08 to 1.17), delivered with physiotherapy care, resulted in clinically important improvements at post-intervention (moderate quality evidence). The most sustainable effects of treatment for improving physical function were reported with pain education delivered with physiotherapy care, at least until mid-term follow-up (0.63, 0.25 to 1.00; low quality evidence). No studies investigated the long term effectiveness of pain education delivered with physiotherapy care. For pain intensity, behavioural therapy (1.08, 0.22 to 1.94), cognitive behavioural therapy (0.92, 0.43 to 1.42), and pain education (0.91, 0.37 to 1.45), delivered with physiotherapy care, resulted in clinically important effects at post-intervention (low to moderate quality evidence). Only behavioural therapy delivered with physiotherapy care maintained clinically important effects on reducing pain intensity until mid-term follow-up (1.01, 0.41 to 1.60; high quality evidence). For people with chronic, non-specific low back pain, psychological interventions are most effective when delivered in conjunction with physiotherapy care (mainly structured exercise). Pain education programmes (low to moderate quality evidence) and behavioural therapy (low to high quality evidence) result in the most sustainable effects of treatment; however, uncertainty remains as to their long term effectiveness. Although inconsistency was detected, potential sources were identified and resolved. PROSPERO CRD42019138074.


Hydrogen bonds in ionic liquids revisited: (35/37)Cl NMR studies of deuterium isotope effects in 1-n-butyl-3-methylimidazolium chloride.
Detailed knowledge of the structure, dynamics, and interionic interactions of ionic liquids (ILs) is critical to understand their physicochemical properties. In this letter, we show that deuterium isotope effects on the chloride ion 35/37Cl NMR signal represent a useful tool in the study of interionic hydrogen bonds in imidazolium chloride ILs. Sizable Delta35/37Cl(H,D) values obtained for the model system 1-n-butyl-3-methylimidazolium chloride ([C4mim]Cl) upon deuteriation of the imidazolium C-2 and C-2,4,5 positions, of nearly 1 and 2 ppm, respectively, show that the approach can readily identify and differentiate Cl...H hydrogen bonds between the anion and cation. Our study is one of a few examples in which hydrogen-bonding in ILs has been investigated using deuterium isotope effects and, to our knowledge, the only one employing 35/37Cl NMR to detect these interactions. The methodology described could be easily extended to the study of other systems bearing NMR-active nuclei.


Non-alignment stagnation-point flow of a nanofluid past a permeable stretching/shrinking sheet: Buongiorno's model.
The paper deals with a stagnation-point boundary layer flow towards a permeable stretching/shrinking sheet in a nanofluid where the flow and the sheet are not aligned. We used the Buongiorno model that is based on the Brownian diffusion and thermophoresis to describe the nanofluid in this problem. The main purpose of the present paper is to examine whether the non-alignment function has the effect on the problem considered when the fluid suction and injection are imposed. It is interesting to note that the non-alignment function can ruin the symmetry of the flows and prominent in the shrinking sheet. The fluid suction will reduce the impact of the non-alignment function of the stagnation flow and the stretching/shrinking sheet but at the same time increasing the velocity profiles and the shear stress at the surface. Furthermore, the effects of the pertinent parameters such as the Brownian motion, thermophoresis, Lewis number and the suction/injection on the flow and heat transfer characteristics are also taken into consideration. The numerical results are shown in the tables and the figures. It is worth mentioning that dual solutions are found to exist for the shrinking sheet.