Exploring the effect of intravenous lipid emulsion in acute methamphetamine toxicity.
The increasing use of methamphetamine (METH) in the last decades has made it the second most abused drug. Advancs in the area of intravenous lipid emulsion (ILE) have led to its potential application in the treatment of poisoning. The present study aims to investigate the potential role of ILE as an antidote for acute METH poisoning. Two groups of six male rats were treated by METH (45 mg/kg), intraperitoneally. Five to seven min later, they received an infusion of 18.6 ml/kg ILE 20% through the tail vein or normal saline (NS). Locomotor and behavioral activity was assessed at different time after METH administration. Body temperature and survival rates were also evaluated. Brain and internal organs were then removed for histological examination and TUNEL assay. ILE therapy for METH poisoning in rats could prevent rats mortalities and returned the METH-induced hyperthermia to normal rates (P<0.05). ILE reduced freezing and stereotyped behaviors and increased rearing responses (P<0.05). Locomotor activity also returned to control levels especially during the last hours of the experiment. ILE administration decreased the prevalence of pulmonary emphysema in the lungs (P<0.05 and P<0.01) and percentages of TUNEL positive cells in the brain (P<0.05), in comparison with the control group. ILE could reduce the severity of METH- induced toxicity as well as mortality rate in the animals. Intravenous infusion of lipid emulsion may save the life of patients with acute METH intoxication who do not respond to standard initial therapy.


Nanotherapeutics relieve rheumatoid arthritis.
Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease associated with persistent multiarticular synovitis, cartilage destruction, and even loss of joint function. Although remarkable progress has been made in the clinical treatment of RA, long-term administration of anti-rheumatic drugs still suffers quite a few drawbacks, including high dose and high frequency of drug use, as well as dysfunction of the heart, liver, kidney, and so forth. For the above problems, nanotherapeutic agents are developed to avert non-specific binding and upregulate the efficacy by improving the accumulation of drugs in lesion tissues. In this article, some of the most frequently used anti-RA agents were summarized, and the recent treatment of RA with passive or active targeting nanotheranostics was systematically illustrated. In addition, the prospect of nanovehicles in clinical therapy of RA was discussed and predicted.


Magnetic relaxation switch and fluorescence dual-mode biosensor for rapid and sensitive detection of ricin B toxin in edible oil and tap water.
The ultrasensitive and rapid detection of ricin B toxin (RTB) is essential for food safety and environmental monitoring. Herein, a dual-mode magnetic relaxation switch (MRS) and fluorescence (FL) biosensing strategy was developed to efficiently detect RTB using fluorescent magnetic nanoparticles (MNP300@SiO2(FITC)). Meanwhile, the as-prepared composite MNP300@SiO2(FITC) exhibited superior biocompatibility and increased FL readout and was coupled with aptamer (Apt) to form a captured probe. Magnetic nanoparticles, 30 nm in diameter (MNP30), were coupled to a Blocker to form a paired probe to compete with RTB for Apt binding. The presence of the RTB triggered the dual-mode detection switch, thus, weakening the magnetic and fluorescent signals. Compared with the single-mode detection method, the Δ T2 and Δ FL intensity here exhibited an excellent linear relationship with logarithm of RTB concentrations at 0.001-500 ng/mL and 0.005-500 ng/mL, and obtained ultrahigh sensitivities of 0.8 pg/mL and 3 pg/mL, respectively. In addition, the dual-mode biosensor gained satisfactory spiked recoveries and relative standard deviations for quantitative detection of spiked RTB in edible oil and tap water samples. To our knowledge, this is the first study to describe the accurate quantification of RTB using a sensitive MRS-FL biosensor. We anticipate that this strategy will provide novel avenues for the development of dual-mode sensing assays.


Development and characterization of repellent formulations based on nanostructured hydrogels.
Diseases caused by insects could lead to epidemic scenarios in urban areas and insect repellents are a shield against a wide range of insects, but they need to be safe without compromising efficacy. Ethyl butylacetylaminopropionate (EB) is a synthetic mosquito repellent, which could be used in products for adults and children due to its low-allergenic potential. The aim of this study was to develop and characterize EB and Poloxamer 407 nanoemulsions regarding their droplets mean size, pH, rheological properties, cytotoxicity and in vitro permeation profile. The developed formulations (F1 with 12.5% of EB and F2 with 25% of EB) were compared with a commercial formulation containing 12.5% of EB. Droplets mean size was determined by DLS, and for both nanoemulsions they were around 200 nm; however, the commercial formulation presented a droplets mean size of 10 nm, which could contribute to its high permeation. F1 and F2 presented a gel-like behavior, however F2 presented lower viscosity due to the presence of more EB between the polymer chains preventing them to interact with each other. Also, F2 was less retained by the epidermis when compared to F1 probably due to its lower viscosity. For the cytotoxicity assay only F2, which presented the highest concentration of EB was tested, and it was not toxic to the cells. This result could be also extended to F1 which presented half the EB concentration. The present study demonstrated that EB and Poloxamer 407 nanoemulsions are promising as new insect-repellent formulations.


Scrape cytology assessment of margins of lumpectomy specimens in breast cancer.
In cases of breast carcinoma in which only lumpectomy is performed, it is necessary to ascertain that the surgical margins were adequate, i.e., free of tumor. Since the histologic methods used for this purpose are either unreliable or very cumbersome, scrape cytology was evaluated as a method for the examination of lumpectomy margins. In 30 cases examined both cytologically and histologically, a very good correlation was found between the two methods. The scrape cytology method has the advantage of being much easier and quicker and is thus recommended for routine use.


Synthesis and cytotoxic activity of novel A-ring cleaved ursolic acid derivatives in human non-small cell lung cancer cells.
Ursolic acid (UA) is a pentacyclic triterpenoid with recognized anticancer properties. We prepared a series of new A-ring cleaved UA derivatives and evaluated their antiproliferative activity in non-small cell lung cancer (NSCLC) cell lines using 2D and 3D culture models. Compound 17, bearing a cleaved A-ring with a secondary amide at C3, was found to be the most active compound, with potency in 2D systems. Importantly, even in 3D systems, the effect was maintained albeit a slight increase in the IC50. The molecular mechanism underlying the anticancer activity was further investigated. Compound 17 induced apoptosis via activation of caspase-8 and caspase-7 and via decrease of Bcl-2. Moreover, induction of autophagy was also detected with increased levels of Beclin-1 and LC3A/B-II and decreased levels of mTOR and p62. DNA synthetic capacity and cell cycle profiles were not affected by the drug, but total RNA synthesis was modestly but significantly decreased. Given its activity and mechanism of action, compound 17 might represent a potential candidate for further cancer research.


Analysis of the service telessaúde-COVID in a municipality of Minas Gerais.
to analyze the sociodemographic and clinical profile of patients treated by the remote care service "Telessaúde-COVID" and the factors associated with positive results for COVID-19. an exploratory and analytical study, carried out based on the analysis of patient records treated by a remote care service called "Telessaúde-COVID". Characteristics of the patients treated and variables related to the service's functioning were evaluated. A descriptive, inferential analysis was performed by logistic regression. 1,854 new patients were evaluated and an estimate of 8,630 visits. Female patients were predominant (60.9%), aged between 20 and 59 years (75.9%). The most frequent signs and symptoms were: headache (41.8%), cough (33.3%) and runny nose (30.0%). Of the total number of patients, 66.4% were reported as suspected case of COVID-19 and 14.5% tested positive for COVID-19. The age of 60 years or more was more common among confirmed cases (26.6%). Most patients (80.4%) did not require face-to-face assistance. Confirmed cases of COVID-19 were associated with the age of the patients (OR 1,020; IC95% 1,007 - 1,032); home contact with a confirmed/suspected case (OR 1,902; IC95% 1,178 - 3,070); presence of nausea/vomiting (OR 2,403; IC95% 1,148 - 5,029) and changes in smell (OR 2,827; IC95% 1,294 - 6,176). "Telessaúde-COVID" was relevant in the management and notification of cases, avoiding the search for face-to-face consultations without clinical indication. Among the suspected cases, positivity for COVID-19 was associated with aging, history of home contact, gastrointestinal and olfactory symptoms.


Pathologic and molecular heterogeneity in imatinib-stable or imatinib-responsive gastrointestinal stromal tumors.
Gastrointestinal stromal tumor (GIST) is the most common sarcoma of the intestinal tract. Nearly all tumors express KIT protein, and most have an activating mutation in either KIT or PDGFRA. Therapy with selective tyrosine kinase inhibitors achieves a partial response or stable disease in approximately 80% of patients with advanced GIST. However, after an initial clinical response, some patients develop imatinib resistance. Our goal was to investigate the spectrum of pathologic response and molecular alterations in a group of GIST patients, clinically defined as having imatinib-stable/imatinib-responsive lesions, who underwent surgical resection. Forty-three tumor nodules from 28 patients were available for pathologic and molecular analysis, which included genotyping for primary and secondary KIT/PDGFRA-mutations, cell cycle alterations, and biochemical activation status of KIT and downstream targets. The transcriptional changes of a subset of these tumors were compared with a group of imatinib-naive GISTs on a U133A Affymetrix expression platform. The histologic response did not correlate with imatinib therapy duration or with proliferative activity. Second-site KIT mutation was identified in only one tumor nodule. Activation of KIT and downstream targets was consistent in all tumors analyzed. Ultrastructurally, a subset of tumors showed a smooth muscle phenotype, which correlated with overexpression of genes involved in muscle differentiation and function. The histologic response to imatinib is heterogeneous and does not correlate well with clinical response. Second-site KIT mutations are rare in imatinib-responsive GISTs compared with imatinib-resistant tumors. The gene signature of imatinib-response in GISTs showed alterations of cell cycle control as well as up-regulation of genes involved in muscle differentiation and function.


The paradox of the paroxysm: can seizure precipitants help explain human ictogenesis?
An epileptic brain is permanently in a diseased state, but seizures occur rarely and without warning. Here we examine this paradox, common to paroxysmal diseases. We review the problem in the context of the prototypic acquired epilepsies of the medial temporal lobe. We ask how an epileptic temporal lobe differs from a healthy one and examine biological mechanisms that may explain the transition to seizure. Attempts to predict seizure timing from analyses of brain electrical activity suggest that the neurological processes involved may be initiated significantly before a seizure. Furthermore, whereas seizures are said to occur without warning, some patients say they know when a seizure is imminent. Several factors, including sleep deprivation, oscillations in hormonal levels, or withdrawal from drugs, increase the probability of a seizure. We ask whether these seizure precipitants might act through common neuronal mechanisms. Several precipitating factors seem to involve relief from a neurosteroid modulation of gamma-amino butyric acid receptor type A (GABAA) receptors. We propose tests of this hypothesis.


[Influence of the dentate fascia on the sensory responses of neurons in hippocampal field CA3].
In experiments with unanaesthetized rabbits the influences of electric stimulation of the dentate fascia (DF) on the extracellularly recorded spontaneous and evoked activity of the CA3 neurones were investigated. Stimulation of a fixed locus in the DF during recording in the CA3 by a microelectrode, shifted along the longitudinal axis of the hippocampus, supported the notion of the topical, "segmental" organization of connections between the DF and CA3. A relatively narrow "active zone" (approximately 700 nm) appeared in the CA3 during the threshold DF stimulation: it was bordered by zones with predominantly inhibitory responses to stimulation. The CA3 neurones in the "active zone" rapidly lost their reactivity to sensory stimuli. In the "inhibitory" and "zero" zones the normal level of reactivity to sensory stimuli was preserved.


Machine Learning Approach to Analyze the Surface Properties of Biological Materials.
Similar to how CRISPR has revolutionized the field of molecular biology, machine learning may drastically boost research in the area of materials science. Machine learning is a fast-evolving method that allows for analyzing big data and unveiling correlations that otherwise would remain undiscovered. It may hold invaluable potential to engineer novel functional materials with desired properties, a field, which is currently limited by time-consuming trial and error approaches and our limited understanding of how different material properties depend on each other. Here, we apply machine learning algorithms to classify complex biological materials based on their microtopography. With this approach, the surfaces of different variants of biofilms and plant leaves can not only be distinguished but also correctly classified according to their wettability. Furthermore, an importance ranking provided by one of the algorithms allows us to identify those surface features that are critical for a successful sample classification. Our study exemplifies how machine learning can contribute to the analysis and categorization of complex surfaces, a tool, which can be highly useful for other areas of materials science, such as damage assessment as well as adhesion or friction studies.


Molecularly targeted therapy in renal cell carcinoma: where do we go from here?
The angiogenic phenotype of renal cell carcinoma results from vascular endothelial growth factor pathway activation. Several different strategies targeting various aspects of the pathway have emerged as clinically relevant therapeutics in metastatic renal cell carcinoma. Key clinical data regarding these approaches are presented in this article. Furthermore, there are several considerations as to the further development of these agents and their appropriate application in metastatic renal cell carcinoma, such as timing of therapy, choice of initial therapy, continued role of debulking nephrectomy and toxicity concerns. These issues are discussed in light of current data and strategies for further drug development are presented.


Implementation of a multidisciplinary team that includes a registered dietitian in a neonatal intensive care unit improved nutrition outcomes.
This study determined whether nutrition outcomes of neonates who were receiving neonatal intensive care were improved with the implementation of a fully functioning multidisciplinary team that included a registered dietitian. A medical record review was conducted of neonates with birth weights of 1500 g or less who were cared for in Sanford Children's Hospital neonatal intensive care unit from January 1 to December 31, 2001 (prior to functioning multidisciplinary team establishment) and January 1 to December 31, 2004 (subsequent to establishment of a multidisciplinary team). Data from charts in the 2 time periods were examined for differences in nutrition outcomes. Outcome variables included length of stay, birth weight, discharge weight, weight gained for specified time periods, weight at full feeds, weight gain per day, length, head circumference, and number of days to start enteral feeding. Analysis of covariance, controlling for the effect of birth weight, was used to determine differences and was considered significant at P < .05. The mean length of stay (65 days, 95% confidence interval [CI]: 48-68 vs 72 days, 95% CI: 53-73) was not different for the 2 periods. The mean weight at the beginning of enteral feeding was significantly less in the period prior to the establishment of the multidisciplinary team (1099 g, 95% CI: 955-1165 vs 1164 g, 95% CI: 1067-1211, respectively). Weight at discharge, total weight gained, total daily weight gained, daily weight gain from birth to the initiation of enteral feeds, daily weight gain from birth to full feeds, and head circumference growth were significantly greater for neonates in the postgroup than in the pre-multidisciplinary team group. Implementation of a multidisciplinary team that included a registered dietitian improved the nutrition outcomes of low birth weight infants in a neonatal intensive care unit.


Complications of radiotherapy: improving the therapeutic index.
For every course of radiotherapy treatment, the potential benefit has to be weighed against the risk of normal tissue damage. Radiation-induced proctitis during and after radical radiotherapy for prostate cancer can be decreased by reducing both the size of the target volume and the margins required around this volume. In the future, target volumes could be reduced by both CT/MRI co-registration and dose painting using MR spectroscopy of choline and citrate in the prostate. Improved immobilisation and image-guided radiotherapy should allow reduced margins without compromising the effectiveness of treatment. Similarly, in breast radiotherapy treatment, lung and cardiac complications can be reduced by better patient positioning and ensuring that doses to the heart and lung are minimised during radiotherapy treatment planning. Cosmesis can be improved by using 3D breast planning techniques rather than the conventional 2D approach. These ongoing improvements and developments in radiotherapy treatment planning are leading to treatments which offer both better tumour volume coverage, and are minimising the risk of treatment-related complications. In time, these changes should allow the escalation in dose delivered to the tumour volume with the potential for increased cure rates.


RNA-Seq derived identification of differential transcription in the chrysanthemum leaf following inoculation with Alternaria tenuissima.
A major production constraint on the important ornamental species chrysanthemum is black spot which is caused by the necrotrophic fungus Alternaria tenuissima. The molecular basis of host resistance to A. tenuissima has not been studied as yet in any detail. Here, high throughput sequencing was taken to characterize the transcriptomic response of the chrysanthemum leaf to A. tenuissima inoculation. The transcriptomic data was acquired using RNA-Seq technology, based on the Illumina HiSeq™ 2000 platform. Four different libraries derived from two sets of leaves harvested from either inoculated or mock-inoculated plants were characterized. Over seven million clean reads were generated from each library, each corresponding to a coverage of >350,000 nt. About 70% of the reads could be mapped to a set of chrysanthemum unigenes. Read frequency was used as a measure of transcript abundance and therefore as an identifier of differential transcription in the four libraries. The differentially transcribed genes identified were involved in photosynthesis, pathogen recognition, reactive oxygen species generation, cell wall modification and phytohormone signalling; in addition, a number of varied transcription factors were identified. A selection of 23 of the genes was transcription-profiled using quantitative RT-PCR to validate the RNA-Seq output. A substantial body of chrysanthemum transcriptomic sequence was generated, which led to a number of insights into the molecular basis of the host response to A. tenuissima infection. Although most of the differentially transcribed genes were up-regulated by the presence of the pathogen, those involved in photosynthesis were down-regulated.


High-Quality MAPbBr3 Cuboid Film with Promising Optoelectronic Properties Prepared by a Hot Methylamine Precursor Approach.
Though CH3NH3PbBr3 single crystals are frequently applied in various optoelectronic devices due to their favorable cuboid geometry, superior optoelectronic properties, and better stability than CH3NH3PbI3, CH3NH3PbBr3 polycrystalline films normally show poorer morphology with scattered crystals than their iodide counterparts, inherently due to their different crystallization habits. In this work, a facile process based on a hot methylamine-based precursor with high viscosity and concentration is demonstrated to counteract rapid ion diffusion. The precursor also has special features including a large colloidal size, a solid form at room temperature, and fast crystallization offered by the easy evacuation of methylamine. CH3NH3PbBr3 films composed of tightly aligned CH3NH3PbBr3 cuboids on micron scale are obtained. Wide channel (100 μm) photodetectors made from the CH3NH3PbBr3 films show promising photoresponse and fast response speeds on par with those based on single crystals, suggesting high film quality and good optoelectronic connections between neighboring cuboids.


Examining Predictors of Depression and Anxiety Symptom Change in Cognitive Behavioral Immersion: Observational Study.
Depressive and anxiety disorders are the most common mental disorders, and there is a critical need for effective, affordable, and accessible interventions. Cognitive Behavioral Immersion (CBI) is a novel group-based cognitive behavioral skills training program delivered by lay coaches in the metaverse that can be accessed through various modalities including virtual reality (VR) head-mounted displays or flat-screen devices. Combining its ability to offer empirically supported therapy skills in a digital setting that can still facilitate interpersonal variables (eg, working alliance and sense of social support) with the aid of lay coaches, CBI has the potential to help fill this critical need. This study had 2 primary aims. First, we aimed to examine changes in depression and anxiety symptoms in a sample of individuals who participated in CBI. Second, we aimed to examine 2 interpersonal process variables (working alliance and web-based social support) as predictors of symptom changes. We predicted CBI participants would experience depression and anxiety symptom improvements and that such improvements would be associated with an increase in both interpersonal process variables. The study sample consists of 127 participants who endorsed clinical levels of depression or anxiety symptoms during their first CBI session and attended at least 2 sessions. Participants were asked to complete self-report measures of depression symptoms, anxiety symptoms, alliance, and web-based social support throughout their participation in CBI. Repeated measures ANOVAs determined that depression and anxiety symptom scores differed significantly across sessions (Ps<.01). We also found participants' web-based social support predicted improvement in depression symptoms (P=.01), but neither the alliance nor web-based social support predicted change in anxiety symptoms (Ps>.05). We also observed a significant difference in anxiety symptoms between participants who used a VR head-mounted display to access CBI and those who did not, such that participants who used VR head-mounted displays endorsed lower anxiety symptoms than those who did not at nearly every session (P=.04). Participation in CBI is associated with both depression and anxiety symptom improvement. Web-based social support may play an important role in fostering changes in depression symptoms. Future studies are encouraged to continue examining the process of change in CBI with special attention paid to methods that can elucidate causal mechanisms of change.


X-chromosome inactivation in monozygotic twins with systemic lupus erythematosus.
The hypothesis that a low concordance rate in monozygotic (MZ) twins with systemic lupus erythematosus (SLE) may be accounted for by differences in X-chromosome inactivation was examined. Five MZ twin pairs, four discordant and one concordant, were recruited, zygosity confirmed by DNA fingerprinting, and their pattern of X-chromosome inactivation in DNA samples prepared from peripheral blood and buccal cells were examined. X-chromosome inactivation was assessed by the methylation status of the CpG region near trinucleotide repeats in exon 1 of the androgen receptor gene on X-chromosome after digestion with the methylation-sensitive enzyme HpaII or HhaI and PCR amplification. X-chromosome inactivation patterns were found to be the same between affected and non-affected twins in all four discordant twin pairs, with random patterns in two pairs and skewed patterns in the others. The concordant twins demonstrated the same random patterns. X-chromosome inactivation was also examined from buccal smear DNA and shown to have the same pattern as that noted from peripheral blood DNA in one informative twin pair. Differences in X-chromosome inactivation patterns were not observed in these five MZ twin pairs. The results could not support the hypothesis that differences in X-chromosome inactivation is the mechanism accounting for the low concordance rate noted in MZ twins with SLE.


Synthesis of iodobiaryls and dibenzofurans by direct coupling at BDD anodes.
The first direct oxidative phenol-arene cross-coupling reactions of an iodine-containing guaiacol derivative and the possible over-oxidation products of electron-rich phenols are described. Hereby, a "green" and targeted synthesis for dibenzofurans was developed.


Consumer preferences for pig welfare - Can the market accommodate more than one level of welfare pork?
The purpose of the present paper is to investigate the market potential of pork labelled to indicate medium and high levels of animal welfare. The paper asks, in particular, whether there is a risk that Danish consumers will abandon high level welfare pork if less expensive products with a medium level of animal welfare became available. The study was based on an online questionnaire with a choice experiment involving 396 Danish respondents. The results indicated that the Danish market could accommodate more than one pork product with a welfare label but the price differential separating medium and high level animal welfare pork will have to be quite narrow. In addition, full willingness-to-pay of consumers who want to buy high level welfare pork cannot be relied upon to incentivise new consumers to buy medium welfare pork. Further, raising brand awareness in the shopping situation and improving consumer's understanding of brand attributes for high level welfare brands were found to be vital.


Isradipine: a new calcium antagonist with strong vasodilatory but negligible cardiodepressive effects.
To assess the effects of intravenous isradipine (0.5 mg) on left ventricular function in patients pretreated with the beta-blocker propranolol (0.1 mg/kg i.v.), 10 patients were studied during cardiac catheterization for suspected coronary artery disease (confirmed in 6). All patients had normal ejection fractions at rest. Following propranolol, isradipine significantly reduced mean aortic pressure (baseline: 112 mm Hg; propranolol: 107 mm Hg; isradipine: 92 mm Hg) and left ventricular systolic pressure (149 vs. 144 vs. 117 mm Hg, respectively). Propranolol alone significantly decreased heart rate, which then increased after isradipine (75 vs. 66 vs. 70 beats/min, respectively). Cardiac index was depressed with propranolol but normalized with isradipine (3.8 vs. 3.0 vs. 3.7 L/min/m2, respectively) as was mean pulmonary artery pressure (16 vs. 18 vs. 16 mm Hg, respectively). Left ventricular contractility decreased significantly during beta-blocker infusion and reached baseline values with isradipine (2,270 vs. 2,080 vs. 2,320 mm Hg/s, respectively). Parallel to dP/dtmax, systolic wall tension decreased as a consequence of the reduction of left ventricular volume and afterload (1,223 vs. 1,332 vs. 905 units, respectively). It is concluded that isradipine effectively reduces cardiac afterload with no sign of intrinsic cardiodepression.


Comparison of effects of transcutaneous electrical nerve stimulation of auricular, somatic, and the combination of auricular and somatic acupuncture points on experimental pain threshold.
This study compared the effects of high intensity, low frequency transcutaneous electrical nerve stimulation of auricular, somatic, and combined auricular and somatic acupuncture points on experimental pain threshold measured at the wrist. Sixty-seven healthy adults, aged 18 to 39 years, were assigned randomly to one of four groups: 1) the Auricular Group (n = 17) received TENS to auricular acupuncture points, 2) the Somatic Group (n = 17) received TENS to somatic acupuncture points, 3) the Combined Group (n = 17) received TENS to both auricular and somatic acupuncture points, and 4) the Control Group (n = 16) received no TENS and served as controls. Pain threshold was measured immediately before and after treatment or rest. Pain threshold significantly increased (p less than .05) in the Auricular, Somatic, and Combined Groups following treatment, with no statistically significant differences in mean pain threshold change scores among treatment groups. The Control Group demonstrated no statistically significant change in pain threshold. The results indicate that TENS applied to any of the three sets of acupuncture points equally increases pain threshold, thus possibly increasing options in choosing stimulation sites for treating patients with pain.


Evaluation of Borama tuberculosis control program in Somaliland, Somalia.
The Borama TB program in Somalia lost resources for TB operations in 2003. We evaluated the impact of the loss on the program. Pre-event (2002-2003) and post-event (2007) design were used. All TB patients registered in Borama and a sample of four months from Hargeisa (comparison) TB patients in both periods were abstracted. The following TB treatment outcomes were estimated: treatment success, treatment failure, case fatality, treatment interruption and transfer rates, along with percentage of patients with sputum specimen prior to treatment, percentage of patients from neighboring countries, and monthly average patients enrolled in treatment. The pre-event to post-event outcomes and measures were compared using descriptive and multivariate analyses. In total, 3,367 TB cases were abstracted. In Borama, the TB treatment success rate increased 6% in the post-event. The treatment failure and interruption rates both declined 75%. Monthly average TB patients declined 55%. Percentage of patients smear tested prior to the initiation of the treatment declined 9%. Percentage of TB patients from neighboring countries and other parts of Somalia declined 51%. Treatment interruption/transfer rates declined significantly in the post-event, compared to the pre-event period. Treatment failure/death rate did not change in the post-event period. In Hargeisa, the treatment success, failure/death, and interruption/transfer rates were similar in both periods. The RR did not change in these measures after adjusting for age and gender. This study indicates a significant setback to the Borama TB control program in the majority of measures evaluated, except the TB success rate.


Dorsal gradient networks in the Drosophila embryo.
Here, we describe one of the major maternal regulatory gradients, Dorsal, and threshold outputs of gene expression that result from the graded distribution of this transcription factor. The analysis of a large number of authentic and synthetic target genes suggests that the Dorsal gradient directly specifies at least four, and possibly as many as seven, different thresholds of gene activity and tissue differentiation. These thresholds initiate the differentiation of the three primary embryonic tissues: the mesoderm, neurogenic ectoderm, and dorsal ectoderm. Moreover, primary readouts of the Dorsal gradient create asymmetries that subdivide each tissue into multiple cell types during gastrulation. Dorsal patterning thresholds represent the culmination of one of the most complete gene regulation network known in development, which begins with the asymmetric positioning of the oocyte nucleus within the egg chamber and leads to the localized activation of the Toll-Dorsal signaling pathway in ventral regions of the early embryo.


Design and fabrication of a novel prism for micro-optical system.
This study presents a special k-type (45°, 135°) microprism structure design for the lateral-type semiconductor laser of optical systems. This study combines front- and back-side inclined exposure technology to develop a k-type microprism structure and replaces the optical prism manufactured through traditional machine processing or injection molding with a new polymer (thick-film negative photoresists) micro-optical prism structure. To obtain the optimal structural surface roughness (12-15 nm at 400 μm×400 μm area), the percentage of polymer material loss caused by the solvent was controlled. This roughness level meets Blu-ray specifications (λ/10, λ=405 nm).


Oblique Lumbar Interbody Fusion From L2 to S1: 2-Dimensional Operative Video.
This surgical video demonstrates the technique of an oblique lumbar interbody fusion (OLIF) in the lumbar spine from L2 to L5 as well as an oblique approach to the L5-S1 level. It demonstrates the surgical approach, technical nuances of OLIF, and pearls of the surgery. The video discusses the importance of the release of the disc space to allow for height restoration and deformity correction, endplate preparation to enhance arthrodesis, and appropriate implant sizing. The concept of the approach is the minimally invasive blunt dissection through the abdominal wall musculature and mobilization of the retroperitoneal fat. Unlike the transpsoas approach, the surgery is performed anterior to the psoas, avoiding the lumbar plexus.1 For L5-S1, the approach is still performed in the lateral position but with an oblique approach. A vascular surgeon performs the L5-S1 approach, and the disc space is accessed through the iliac bifurcation.2 The discectomy and interbody fusion are performed similarly to a standard anterior lumbar interbody fusion (ALIF), but in a lateral position and at an oblique angle. The patient consented to this procedure and for filming a video of this case.


Scrotal haematoma: the most common complication of no-scalpel vasectomy.
to study the complications of no scalpel vasectomy such as scrotal haematoma, infection, scrotal sinus, and failure, recanalization, and sperm granuloma. A retrospective, descriptive study carried out in Dept. of Obs/ Gyn, Tribhuvan University Teaching Hospital Kathmandu Nepal. Among 926 no scalpel vasectomy clients 5(0.53%) had scrotal haematoma, 4(0.43%) with had infection, 3(0.32%) had scrotal sinus; there were 2 cases each vasectomy failure who could not achieve azospermia and 2 with recanalization while there was only one case of sperm granuloma. the most common complication of no-scalpel vasectomy was scrotal haematoma and other complications are wound infection, scrotal sinus, vasectomy failure and sperm granuloma. Key words: no scalpel vasectomy, scrotal haematoma, scrotal sinus, sperm granuloma.


Therapeutic Potential for Cannabinoids in Sports Medicine: Current Literature Review.
Cannabidiol and other cannabinoids are being used more frequently for sports medicine-related conditions. This review will help sports medicine clinicians answer questions that their athletes and active patients have about the potential effectiveness of cannabinoids on common sports medicine conditions. In the article, the authors compare cannabidiol and delta-9-tetrahydrocannabinol effects, noting the difference on the endocannabinoid and nonendocannabinoid receptors. The theoretical benefits of these two compounds and the current legality in the United States surrounding cannabidiol and delta-9-tetrahydrocannabinol use also are addressed.


Contributors to posttraumatic stress symptoms in women sex workers.
Previous research has demonstrated that women who sell sex (women sex workers [WSWs]) consistently report high levels of posttraumatic stress symptoms. The present study explores multiple factors that may contribute to the variation in WSWs' experiences of posttraumatic stress symptoms, including workers' racial identity, experiences of discrimination and control over their working conditions, the site of selling sex, and their clients' perceived sexual entitlement and violence. The study sample consisted of 314 self-identified WSWs. Online invitations to participate in a 30-min survey were sent to WSWs in the United States and Canada who advertise their services online on sites such as Facebook, the Erotic Review, and Backpages. The hypothesized structure of associations between the variables was tested using structural equation modeling. The model accounted for 68% of the variation in the traumatic stress reported, with direct and indirect effects for workers' racial identity, the site where they sell sex, and experiences of discrimination, especially by police. Clients' violence, on the contrary, was indirectly associated with traumatic stress, as violent clients were also significantly more likely to be perceived as sexually entitled, which, in turn, was the strongest predictor of higher traumatic stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Long-term perfusion culture of hybridoma: a "grow or die" cell cycle system.
In order to elucidate the hybridoma life cycle and the limiting factors in perfusion systems, we performed cultures in a stirred tank bioreactor, coupled to an external tangential flow filtration unit. Cell density and antibody production in perfusion were consistent with previous studies. The average life span of the cells (2.1-2.2 days), antibody, productivity per cell produced (30-38 mg/10(9) cells) and cell size diameter evolution appeared similar to values observed in batch cultures. These observations highly suggest a similar "grow or die" life cycle. Cell and antibody production, strictly related to the medium perfusion rate, seem to be under the control of the nutrient availability. A hypothesis to explain such a life cycle of hybridoma cells in perfusion systems and a model for viable and dead cell density is proposed.


The inferior capsular shift operation for instability of the shoulder. Long-term results in 34 shoulders.
We reviewed 26 patients with 34 shoulders treated by the inferior capsular shift operation for inferior and multidirectional instability. The mean follow-up was 8.3 years. In total, 12 shoulders showed voluntary subluxation. Eight operations used an anterior and posterior approach, 11 were by the posterior route, and 15 shoulders had an anterior approach. In 30 shoulders (85%) the outcome was satisfactory and 20 (59%) scored good or excellent results on the Rowe system. Instability had recurred in nine shoulders (26%) from three months to three years after the operation. Six of the 12 shoulders with voluntary subluxation (50%) had recurrence, as against three of the other 22 (14%), a statistically significant difference. The operation is therefore not indicated for voluntary subluxation. The 19 shoulders which had been assessed in 1987 at a mean of 3.5 years after surgery, were also reviewed in 1995 and found to have no significant changes in instability or Rowe score. This shows that the capsular shift appeared to have maintained its tension over an eight-year period. After the use of a posterior approach, 64% of the shoulders showed a posterolateral defect on radiographs of the humerus.


Ultrafast MR imaging of the abdomen: echo planar imaging and diffusion-weighted imaging.
Ultrafast MRI technique has become available with the introduction of new generation MR scanners for abdominal imaging. However, there is no consensus about the optimal imaging acquisition at the present time. Because single shot echo planar imaging (EPI) technique is based on high technology and had just applied in clinical imaging, further clinical investigation will be needed. Currently, the hypersensitivity to magnetic inhomogeneity and local magnetic susceptibility and the low spatial resolution may limit the widespread application of EPI technique. In addition to providing information for morphologic diagnosis, EPI will be more widely used for functional and qualitative diagnosis. Diffusion-weighted imaging can be used for differentiation of solid tumors according to their different cellular construction, evaluation of cystic lesions based on the different viscosity of their contents, and assessment of diffused pathologic changes in the parenchyma of solid organs. In addition to the previous parameters such as proton density and T1 and T2 values, diffusion factors may provide important information for the qualitative and dynamic evaluation of abdominal pathologic changes. Even though there are many difficulties that must be solved for diffusion-weighted imaging, a more wide application of this technique is expected through technologic improvement.


Transduction mechanisms in vertebrate olfactory receptor cells.
Considerable progress has been made in the understanding of transduction mechanisms in olfactory receptor neurons (ORNs) over the last decade. Odorants pass through a mucus interface before binding to odorant receptors (ORs). The molecular structure of many ORs is now known. They belong to the large class of G protein-coupled receptors with seven transmembrane domains. Binding of an odorant to an OR triggers the activation of second messenger cascades. One second messenger pathway in particular has been extensively studied; the receptor activates, via the G protein Golf, an adenylyl cyclase, resulting in an increase in adenosine 3',5'-cyclic monophosphate (cAMP), which elicits opening of cation channels directly gated by cAMP. Under physiological conditions, Ca2+ has the highest permeability through this channel, and the increase in intracellular Ca2+ concentration activates a Cl- current which, owing to an elevated reversal potential for Cl-, depolarizes the olfactory neuron. The receptor potential finally leads to the generation of action potentials conveying the chemosensory information to the olfactory bulb. Although much less studied, other transduction pathways appear to exist, some of which seem to involve the odorant-induced formation of inositol polyphosphates as well as Ca2+ and/or inositol polyphosphate -activated cation channels. In addition, there is evidence for odorant-modulated K+ and Cl- conductances. Finally, in some species, ORNs can be inhibited by certain odorants. This paper presents a comprehensive review of the biophysical and electrophysiological evidence regarding the transduction processes as well as subsequent signal processing and spike generation in ORNs.


Polarization-maintaining fiber-optic-grating vector vibroscope.
A fiber-optic vector vibroscope based on orthogonal polarization cladding-to-core recoupling is demonstrated. A compact structure in which a short section of polarization-maintained (PM) fiber stub containing a straight fiber Bragg grating (FBG) is spliced to another single-mode fiber. Two well-defined orthogonally polarized cladding modes reflected by the PM-FBG are recoupled at the junction and the coupling intensity shows an extremely high sensitivity to bending in the corresponding orthogonal directions. Both the orientation and amplitude of the vibrations can be determined unambiguously via dual-path power detection of these recoupled orthogonal-polarimetric cladding modes (LP(1,12) and LP(1,13)). Since spectral information is not required, temperature changes do not affect the sensor response, and power fluctuations can be referenced out by monitoring the power in the core mode (LP(0,1)) resonance.


The tuning fork test--a useful tool for improving specificity in "Ottawa positive" patients after ankle inversion injury.
The Ottawa ankle rules are a clinical instrument calibrated towards a high sensitivity in order not to miss any fractures of the ankle or mid-foot. This is at the cost of a mean specificity of around only 32%. The aim of this study was to determine the suitability of tuning fork testing in combination with existing Ottawa guidance for increasing the specificity in detecting fractures of the lateral malleolus. A prospective pilot study was carried out, in which a single trained investigator examined all patients with already "Ottawa positive" findings for possible lateral malleolus injury by applying a tuning fork (C(o) 128 Hz). The tuning fork test findings were compared with formal reports of plain ankle radiographs using simple cross-table analysis. The observed prevalence of ankle fractures was 5 of 49 (10%). Sensitivity and specificity were calculated as 100% and 61%, respectively, for tuning fork testing on the tip of the lateral malleolus (TLM), and as 100% and 95%, respectively, for testing on the distal fibula shaft (DFS). The associated positive and negative likelihood ratios were 2.59 and 0 (TLM), and 22 and 0 (DFS), respectively. The data were significant, with p = 0.014 (TLM) and p<0.001 (DFS). This study suggests that additional tuning fork testing of "Ottawa positive" patients may lead to a marked reduction in ankle radiographs, with consequently reduced radiation exposure and journey time. This may be particularly relevant in situations where radiological facilities are not readily available (expedition medicine) or where access to these has to be prioritised (major incidents, natural catastrophes).


The evaluation and management of the acutely agitated elderly patient.
Delirium is an organic mental syndrome defined by a global disturbance in consciousness and cognition, which develops abruptly and often fluctuates over the course of the day. It is precipitated by medical illness, substance intoxication/withdrawal or medication effect. Delirium is associated with significant morbidity and mortality, and is a leading presenting symptom of illness in the elderly. Elderly patients with altered mental status, including agitation, should be presumed to have delirium until proven otherwise. The clinical manifestations of delirium are highly variable. A mental status evaluation is crucial in the diagnosis of delirium. Medical evaluation and stabilization should occur in parallel. Life-threatening etiologies including hypoxia, hypoglycemia and hypotension require immediate intervention. The differential diagnosis of etiologies of delirium is extensive. Patients with delirium need thorough evaluations to determine the underlying causes of the delirium. Pharmacological agents should be considered when agitated patient has the potential to harm themselves or others, or is impeding medical evaluation and management. Unfortunately, the evidence to guide pharmacologic management of acute agitation in the elderly is limited. Current pharmacologic options include the typical and atypical antipsychotic agents and the benzodiazepines. These therapeutic options are reviewed in detail.


Characteristics of vessels wall, myocardium and epicardial fat in patients with heart failure with preserved ejection fraction with and without metabolic syndrome.
The structure of the vessels wall and myocardium is an independent predictor of cardiovascular events among patients with heart failure (HF). There is a data that metabolic syndrome (MS) accelerates the progression of structural and functional disorders of the vessel wall and myocardium. Epicardial fat thickness was shown to correlates with visceral fat thickness and to be an independent predictor of cardiovascular diseases. To investigate the characteristics of vessels wall, myocardium and epicardial fat in patients with HF with preserved ejection fraction (HF-PEF) with and without MS. A total of 59 patients with HF-PEF were included. First group - patients without MS (n = 29), second group - patients with MS (n = 30). Following characteristics were evaluated: Arterial stiffness (stiffness index [SI]), reflection index (RI), augmentation index (Alp). The function of big vessels was evaluated by phase shift (PS), of the small vessels - by the occlusion index (OI). Investigations were performed by the device "angioscan." Sizes of the heart chambers and the thickness of the myocardium wall and epicardial fat thickness were evaluated echocardiographically. Among the patients from both groups significant changes of the vessels wall and myocardial structure were found. SI at the first group was 8.26 ± 1.72 m/s, at the second group - 9.62 ± 5.61 m/s (non-significant, P = 0.25). RI at the first group was 39.79 ± 18.12%, at the second - 31.43 ± 17.23% (non-significant, P = 0.086). Alp at the first group was 23.47 ± 14.69%, at the second - 11.16 ± 17.14% (significant, P = 0.011). PS at the first group was 8.05 ± 7.72 ms, at the second - 5.34 ± 4.4 ms (non-significant, P = 0.36). OI at the first group was 1.34 ± 0.58%, at the second - 1.46 ± 0.54% (non-significant, P = 0.46). Significant intergroup differences were found in the interventricular septum thickness: 10.3 ± 1.2 mm at the first group and 11.3 ± 1.6 mm at the second (P = 0.01); left ventricle wall thickness: 10.1 ± 1.1 mm at the first group and 11.3 ± 1.6 mm - at the second (P = 0.001); left ventricle myocardium mass: 157.75 ± 46.11 g at the first group and 201.19 ± 58.82 g - at the second (P = 0.005). The epicardial fat thickness was 14.8 ± 1.8 mm at the first group and 36.7 ± 1.7 mm - at the second group (significant, P = 0.001). Among patients with hypertension and HF-PEF with and without MS significant changes in the structure of the vessel wall and myocardium were found. The presence of MS lead to more pronounced myocardial remodeling. The epicardial fat thickness is significantly higher among patients MS.


Mammalian Fuel Cells Produce Electric Current.
The increasing concern about climate change has led scientists around the world to develop clean energy technologies that may replace the traditional use of fossil fuels. A promising approach is the utilization of unicellular organisms as electron donors in bio-fuel cells. To date, this method has been limited to microorganisms such as bacteria, yeast, and microalgae. In this work, we show for the first time the concept of using mammalian cell cultures and organoids as electron donors in biofuel cells. We apply cyclic voltammetry to show that upon association of ARPE19 cells with the anode, they release reducing molecules to produce electricity. Furthermore, we apply 2D-fluorescence measurements and show that upon illumination, photosensitive stem cell-derived retinal organoids, which consist of rod photoreceptors and interneurons, secrete NADH and NADPH molecules that can donate electrons at the anode to produce photocurrent.


Serum beta 2-microglobulin after five-day administration of cisplatin.
Patients with testicular tumors receiving the Einhorn combination chemotherapy with cisplatinum administration for five consecutive days were evaluated for signs of glomerular filtration rate impairment by means of serum beta 2-microglobulin measurements before and on days 2 and 5 after cessation of cisplatin administration and then before repeated cycles of the same chemotherapeutic regimen. Though no significant changes in the level of serum beta 2-microglobulin could be found, an evident increase in the values was seen indicating that in more aggressive cisplatin administration schedules not only tubular impairment might contribute to possible nephrotoxic effects.


Difunctionalization of Styrenes with Perfluoroalkyl and tert-Butylperoxy Radicals: Room Temperature Synthesis of (1-(tert-Butylperoxy)-2-perfluoroalkyl)-ethylbenzene.
A novel strategy for the difunctionalization of styrenes was developed. This synthesis includes the use of electrophilic perfluoroalkyl and tert-butylperoxy radicals and produces (1-(tert-butylperoxy)-2-perfluoroalkyl)ethylbenzene at room temperature, which has been traditionally difficult to synthesize. With at least four radical species included in the transformation, its high chemoselectivity was extraordinary; the results were further elucidated using computational studies. The methodology also holds a good potential for application as a result of its mild reaction conditions, ease of further modification, and insensitivity to moisture and air.


Substance use disorders and criminal justice contact among those with co-occurring antisocial and borderline personality disorders: Findings from a nationally representative sample.
One variant of borderline personality disorder (BPD), frequently encountered in forensic and correctional samples, is the 'dissocial' subtype that combines borderline and antisocial traits. We tested the hypothesis that this subtype, defined by the co-occurrence of antisocial personality disorder (ASPD) and BPD (ASPD + BPD), would be associated with high rates of substance use disorder and contact with the criminal justice (CJ) system in a large nationally representative sample of North American adults (N = 36 309). Results suggested that the dissocial variant of BPD was associated with a high risk for substance use disorders and CJ contact. The odds of these outcomes were significantly raised about fivefold in ASPD + BPD individuals in comparison with those who lacked either an ASPD or BPD diagnosis. ASPD + BPD, compared with BPD alone, was also associated with significantly (p < 0.0001) greater severity of borderline symptoms. Although CJ contact appears to be strongly driven by ASPD, substance use, primarily driven by severity of borderline symptoms, added to the risk of CJ contact. It is suggested that, in the 11th Revision of the International Classification of Diseases terms, the dissocial borderline variant is a severe form of personality disorder characterized by high levels of traits within domains of negative emotionality and dissociality. Further studies will be required to verify this suggestion. © 2020 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.


Investigating DNA migration in pulsed fields using a miniaturized FIGE system.
PFGE is a well-established technique for fractionation of DNA fragments ranging from kilobases to megabases in length. But many of these separations require an undesirable combination of long experiment times (often approaching tens of hours) and application of high voltages (often approaching tens of kV). Here, we present a simple miniaturized FIGE apparatus capable of separating DNA fragments up to 32.5 kb in length within 3 h using a modest applied potential of 20 V. The device is small enough to be imaged under a fluorescence microscope, permitting the migrating DNA bands to be observed during the course of the separation run. We use this capability to investigate how separation performance is affected by parameters including the ratio of forward and backward voltage, pulse time, and temperature. We also characterize the dependence of DNA mobility on fragment size N, and observe a scaling in the vicinity of N(-0.5) over the size range investigated. The high speed, low power consumption, and simple design of this system may help enable future studies of DNA migration in PFGE to be performed quickly and inexpensively.


[Factors associated with job satisfaction of human resources in healthcare].
Healthcare employee satisfaction is an important criterion for the efficiency of human resource management and prognostic impact factor for high turnover of staff. Furthermore, job satisfaction positively affects patient satisfaction, which is an important indicator for quality of care. The goal of our study was to identify factors associated with job satisfaction in healthcare organizations in Ukraine. We conducted sociological and psychological survey of 190 healthcare professionals (81% response rate) in Kherson City Hospital. Job satisfaction and organizational climate was assessed through developed questionnaire, "Test Motype" method of Gerchikov (motivational profile designing) and "Diagnosis Syndrome emotional burnout" method of Boyko. Spearman rank correlation was used for analysis. Job satisfaction positively correlated with personnel age and time record, career prospects, professional development, superior-subordinate, peer-to-peer and patient communications (p<0,01 for all), teamwork environment, among executives with achievement and affiliation motivations (р<0,001, accordingly). It negatively correlated with reward-oriented and lumpen-style motivational profile (р<0,001 and <0,01, accordingly). Job satisfaction did not correlate with responsibility of executives, factors for satisfaction of job description, working conditions and range of wages (all p> 0.05). Based on findings we developed dual job satisfaction-dissatisfaction approach specific for healthcare employee in Ukraine. This model includes internal factors such as work experience, career prospects, professional motivation; external factors such as leadership, governance, work environment, customer satisfaction and preventive factors such as staff role, job description, company policies, salary and benefits.


Integration of Postcoordination Content into a Clinical Interface Terminology to Support Administrative Coding.
Clinical interface terminologies (CITs) consist of terms designed for clinical documentation and, through mappings to standardized vocabularies, to support secondary uses of patient data, including clinical decision support, quality measurement, and billing for health care services. The latter purpose requires maps to administrative coding systems, such as the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), for diagnoses in the United States. The transition from ICD-9-CM to ICD-10-CM posed a challenge to CIT users due to the substantially increased details in ICD-10-CM. To address this, we developed a content layer within a CIT that provides postcoordination prompts for the details required for accurate ICD-10-CM coding. We developed content to support prompting for and capture of additional information specified by the user in a single, clinically relevant term that is added to the patient's record, and whose mapping to other coding systems (like Systematized Nomenclature of Medicine-Clinical Terms [SNOMED CT]) reflects the details added during postcoordination. We worked with clinical information system developers to incorporate this into user interfaces, and with end-users to refine the design. While the prompts were designed around the precoordinated elements implicit in ICD-10-CM, irregularities in ICD-10-CM required some additional design measures, such as providing postcoordination options that interpolate gaps in ICD-10-CM to avoid user confusion. The system we describe has been implemented by ∼30,000 health care provider organizations, with content that covers the vast majority of encounter diagnoses. User feedback has been largely positive, though concerns have been raised about expanding postcoordination content beyond that required for ICD-10-CM coding. We have demonstrated the design and development of what, to our knowledge, is the first system that uses postcoordination to capture ICD-10-CM-relevant details in a CIT while also reflecting the details added by the user in maps to other vocabularies.


Structure, force balance, and topology of Earth's magnetopause.
The magnetopause deflects the solar wind plasma and confines Earth's magnetic field. We combine measurements made by the four spacecraft of the Magnetospheric Multiscale mission to demonstrate how the plasma and magnetic forces at the boundary affect the interaction between the shocked solar wind and Earth's magnetosphere. We compare these forces with the plasma pressure and examine the electron distribution function. We find that the magnetopause has sublayers with thickness comparable to the ion scale. Small pockets of low magnetic field strength, small radius of curvature, and high electric current mark the electron diffusion region. The flow of electrons, parallel and antiparallel to the magnetic field, reveals a complex topology with the creation of magnetic ropes at the boundary.


Description of a new species of Cephalaeschna (Odonata: Anisoptera: Aeshnidae) from northern Vietnam.
A new aeshnid species, Cephalaeschna yanagisawai sp. nov. from northern Vietnam (Hoang Lien National Park, Lai Chau Province, 103°45'E, 22°20'N, 1900~2000 m a.l.s.), is described and illustrated. This species can be differentiated from the other species of the genus by body maculation, the morphology of the male anal appendages, and female postero-ventral S10 tergite projecting posteriorly, which is a rare feature in the genus.


Adjuvant chemotherapy in T3 carcinoma of the bladder. A prospective trial: preliminary report.
We report the early results of a multi-centre, randomised prospective trial of neoadjuvant and maintenance chemotherapy with methotrexate (MTX) in 376 patients with advanced (T3) carcinoma of the bladder. In patients under 65 years of age, treatment consisted of radical radiotherapy (64 Gy) or, in some centres, pre-operative radiotherapy (44 Gy) and elective cystectomy. All patients over 65 had radical radiotherapy. MTX was administered to 188 patients. There was no increase in toxicity attributable to the MTX. MTX did not significantly increase the proportion of patients whose tumours responded to radiotherapy; 50% (70/141) responded to radiotherapy and 56% (76/136) to MTX radiotherapy. The development of metastases and survival was also similar in both groups (3-year survival: radiotherapy 37.3%, MTX + radiotherapy 38.6%). We report the logistic difficulties of the administration of prolonged courses of maintenance chemotherapy. Further controlled trials of neo-adjuvant chemotherapy in advanced bladder cancer are required, involving more active regimes.


CD38 and bone marrow microenvironment.
This review summarizes the events ruled by CD38 shaping the bone marrow environment, recapitulating old and new aspects derived from the body of knowledge on the molecule. The disease models considered were myeloma and chronic lymphocytic leukemia (CLL). CD38 has been analyzed considering its twin function as receptor and enzyme, roles usually not considered in clinics, where it is used as a routine marker. Another aspect pertaining basic science concerns the role of the molecule as a member of an ectoenzyme network, potentially metabolizing soluble factors not yet analyzed (e.g., NAD+, ATP, NAM) or influencing hormone secretion (e.g., oxytocin). The last point is focused on the use of CD38 as a target of an antibody-mediated therapeutic approach in myeloma and CLL. A recent observation is that CD38 may run an escape circuit leading to the production of adenosine. The generation of local anergy may be blocked by using anti-CD38 antibodies. Consequently, not only might CD38 be a prime target for mAb-mediated therapy, but its functional block may contribute to general improvement in cancer immunotherapy and outcomes.


Ocular lymphoproliferative disorders.
Ocular lymphoproliferative disorders are a heterogenous group of pathologic disorders with significant impact on quality of life and, at times, may be life-threatening. Due to the rarity of these disorders, information regarding proper diagnosis, treatment, and prognosis is limited. This review summarizes the key features of the unique diseases within this group of lymphoproliferative disorders, with a focus on disease presentation, diagnostic considerations, and treatment and prognosis. High-quality data from recent studies have provided answers regarding clinical outcomes for subsets of ocular lymphoproliferative disorders and are included herein. New diagnostic techniques are also discussed as well as current treatment strategies. Ocular lymphoproliferative disorders are a rare group of diseases. Key features of each disease is presented in this review in a concise and readable format, as well as updated information regarding diagnostic considerations and treatment options.


Lenvatinib with etoposide plus ifosfamide in patients with refractory or relapsed osteosarcoma (ITCC-050): a multicentre, open-label, multicohort, phase 1/2 study.
Tyrosine kinase inhibitors have shown activity in osteosarcoma and might enhance the efficacy of chemotherapy. We aimed to determine the recommended phase 2 dose and antitumour activity of lenvatinib with etoposide plus ifosfamide in patients with refractory or relapsed osteosarcoma. This multicentre, open-label, multicohort, phase 1/2 trial was done at 17 hospitals in six countries. Eligible patients were aged 2-25 years, had relapsed or refractory osteosarcoma, measurable or evaluable disease per Response Evaluation Criteria in Solid Tumors version 1.1, Lansky play-performance score or Karnofsky performance score of 50% or higher, up to one previous VEGF or VEGF receptor-targeted therapy, and a life expectancy of at least 3 months. This study includes a combination dose-finding phase 1 part (cohort 3A) and a phase 2 combination expansion in patients with osteosarcoma (cohort 3B). Lenvatinib was administered orally at a starting dose of 11 mg/m2 per day, capped at 24 mg per day, and etoposide (100 mg/m2 per day) plus ifosfamide (3000 mg/m2 per day) were administered intravenously on days 1-3 of each 21-day cycle for a maximum of five cycles. Lenvatinib monotherapy continued after these five cycles until disease progression, toxic effects, or patient choice to discontinue. The phase 1 primary endpoint was to determine the recommended phase 2 dose by evaluating dose-limiting toxicity and the phase 2 primary endpoint was progression-free survival at 4 months. Progression-free survival was measured in the full analysis set, which included all patients enrolled for efficacy outcomes; safety was assessed in all patients who received any study drug. This study is registered with ClinicalTrials.gov, NCT02432274. 30 patients were screened for enrolment into cohort 3A between May 9, 2016, and June 3, 2019, and 22 patients for enrolment into cohort 3B between Sept 13, 2018, and July 18, 2019. Eight patients from cohort 3A and two from cohort 3B were ineligible for enrolment in the study. In phase 1, dose-limiting toxicities were observed in three patients (one in the lenvatinib 11 mg/m2 combination group and two in the 14 mg/m2 combination group) and the recommended phase 2 dose was determined as lenvatinib 14 mg/m2 per day (with daily dose cap of 24 mg) and etoposide 100 mg/m2 per day plus ifosfamide 3000 mg/m2 per day administered intravenously on days 1-3 of each 21-day cycle for a maximum of five cycles. 35 patients from phase 1 (cohort 3A; n=15) and phase 2 (cohort 3B; n=20) were treated at the recommended phase 2 dose and their results were pooled. Progression-free survival at 4 months was 51% (95% CI 34-69) in 18 of 35 patients per the binomial estimate. The most common grade 3-4 treatment-emergent adverse events were neutropenia (27 [77%] of 35), thrombocytopenia (25 [71%]), anaemia (19 [54%]), and decreased white blood cell count (19 [54%]). 26 [74%] of 35 patients had serious treatment-emergent adverse events and no treatment-related deaths occurred. Lenvatinib with etoposide plus ifosfamide shows promising antitumour activity with no new safety signals in patients with refractory and relapsed osteosarcoma. These findings warrant further investigation in an ongoing randomised phase 2 study (NCT04154189). Eisai and Merck Sharp & Dohme.


A new method simplifying collection of serial specimens for gonadotropin determinations.
Patterns of gonadotropin levels have been compared in specimens of serum, 24-h urine collections, and first morning urine voidings collected throughout a menstrual cycle from 8 sexually mature, young women. Quantities of gonadotropins in first morning voidings were found to provide a reliable estimate of 24-h excretion of these hormones and demonstrate the same patterns of change as do serum and 24-h urine specimens. Thus first morning voidings satisfactorily overcome logistical problems inherent is serial serum and 24-h urine sampling for studying gonadotropin excretion patterns.


Displacement of a mandibular third molar root fragment into the pterygomandibular space.
Displacement of root fragments into adjacent anatomical areas is an uncommon complication of the removal of teeth. This paper describes the management of a mandibular third molar root fragment that was forced into the antero-inferior aspect of the pterygomandibular space. The importance of tomographical radiographs in the visualization of the displaced root is also discussed.


DNA mismatch repair: molecular mechanisms and biological function.
DNA mismatch repair (MMR) guards the integrity of the genome in virtually all cells. It contributes about 1000-fold to the overall fidelity of replication and targets mispaired bases that arise through replication errors, during homologous recombination, and as a result of DNA damage. Cells deficient in MMR have a mutator phenotype in which the rate of spontaneous mutation is greatly elevated, and they frequently exhibit microsatellite instability at mono- and dinucleotide repeats. The importance of MMR in mutation avoidance is highlighted by the finding that defects in MMR predispose individuals to hereditary nonpolyposis colorectal cancer. In addition to its role in postreplication repair, the MMR machinery serves to police homologous recombination events and acts as a barrier to genetic exchange between species.


Determinants of heart rate turbulence after ventricular premature beats in healthy volunteers.
A decline in the acceleration of the heart rate (HR, heart rate turbulence, HRT) after a ventricular premature capture is associated with increased mortality in patients suffering from coronary artery disease. The physiological properties of HRT have not been evaluated in a large human cohort. In 95 healthy individuals, HRT parameters onset (TO) and slope (TS) as well as the turbulence timing (TT) were calculated from 24-hour Holter ECGs. With the help of a simple, linear, weighted regression model, gender specific differences of TO and TS were compared. A multiple linear regression model served to evaluate the influence of age and the basic HR preceding the ventricular premature contraction (VPC) on HRT. The median of TT is present in regression line #5. We discovered that, in men and women, TO is reduced as basic HR rises (p<0.01). In contrast, analysis of TS showed a divergence: in men, TS declines as basic HR increases. However, basic HR modifies TS in women to some extent (p<0.01). A multiple, linear regression model revealed a decrease of HRT with increasing age in men. The acceleration of HR after a ventricular premature beat occurred within the first 11 beats in more than 75% of our healthy individuals. An increased HR prior to VPC affects HRT in men. Increasing age leads to an attenuation of HRT in men and to a reduction of TO in women. These results emphasise the significance of the physiological properties of HRT when using HRT for risk stratification, especially in elderly patients.


[Na-Ca-exchange as a mechanism regulating spontaneous contractions of isolated individual cardiomyocytes].
The frequency (f) of spontaneous contractions (SC) were registered on single enzymatically isolated cardiomyocytes of adult rats using current-carrying electrode through which current (50-200 nA) was passed. Cell motion on the electrode during SC caused current oscillations, measured by an amplifier. The actions of Na+, K+, Ca2+, caffeine, epinephrine and isoptin on fSC have been studied. The data obtained suggest that spontaneous contractions of isolated cardiomyocytes are related to increased intracellular Ca2+ concentration due to Na-Ca exchange. Cyclic contractions can possibly be accounted for by the work of sarcoplasmic reticulum.


Education in practice: a colorectal link-nurse programme.
This article illustrates the planning, implementation, evaluation and personal implications of a link-nurse programme for colorectal cancer nursing. The programme was designed to maintain a patient-centred support service and continue the provision of bowel cancer education and support to nurses in the clinical environment. Literature on previous link-nurse schemes, and the recent legislation on education and cancer nursing provides the background on which this programme is based. The use of educational theory supplies the theoretical underpinnings for this approach to learning, and evaluation findings are reported from both the group's and the individual's viewpoints. The programme increased the link nurses' awareness of the patient's pathway, support and information needs and the role of the multidisciplinary team in managing care. Sufficient time, support and encouragement from ward teams and clinical managers were seen as vital to the success of the programme, and specific benefits and challenges when establishing this type of practice based education for nurses are explored.


Clinical and radiological evolution of cerebral amyloid angiopathy-related inflammation in the context of anti-PD-1 immunotherapy.
Immune-related adverse events (irAEs) are a frequent complication of immunotherapy, but neurological irAEs are rare and varied. Here, we present a case of cerebral amyloid angiopathy-related inflammation (CAA-ri) attributable to nivolumab monotherapy, which has not been previously reported. The context of immunotherapy and availability of serial imaging also provide unique insights into the pathogenesis and evolution of CAA-ri. Routine surveillance neuroimaging in a patient with metastatic melanoma, in remission after treatment with nivolumab, demonstrated progressive microhaemorrhages and associated oedema, suspicious for CAA-ri. These changes progressed despite cessation of nivolumab. The patient was initially asymptomatic, but later developed an acute confusional state, warranting brain biopsy, which confirmed the diagnosis of CAA-ri. Treatment with methylprednisolone resulted in resolution of the oedema, and a marked decrease in the subsequent accumulation of microhaemorrhages. The temporal evolution prior to symptom development and subsequently related to treatment suggests that inflammation may be an important component of the pathogenesis of CAA-ri, rather than simply a secondary response. Given that immunotherapy is in its relative infancy, it is important to consider rare irAEs in patients exhibiting unusual imaging findings.


17 beta-Estradiol and tamoxifen prevent the over-glycosylation of rat trabecular bone collagen induced by ovariectomy.
We have recently demonstrated that ovariectomy in the rat causes over-glycosylation of collagen which is restricted to trabecular bone. In order to obtain further evidence, we studied whether estrogen or tamoxifen treatment prevented over-glycosylation of trabecular bone collagen. Forty one-hundred-day-old female rats were subjected to ovariectomy (n = 30) or sham-operation (n = 10). Starting the day of the operation, sham-operated rats were treated with vehicle, while ovariectomized rats were divided into three groups and treated with vehicle (n = 10), estrogen (n = 10) or tamoxifen (n = 10). Five rats from each group were sacrificed at 115 and 145 days of age. Femurs and tibiae were separated into cortical and trabecular bone, demineralized, hydrolyzed and analyzed by HPLC for hydroxylysine glycoside and hydroxyproline content. Hydroxylysine glycoside content was expressed as a molar ratio with hydroxyproline. The results can be summarized as follows: 1) cortical bone collagen glycosylation did not vary among the different groups; 2) over-glycosylation of trabecular bone collagen observed in the ovariectomized rats was prevented by the administration of either 17 beta-estradiol or tamoxifen. These data demonstrated that estrogens affect glycosylation of trabecular bone collagen.


NUBPL, a novel metastasis-related gene, promotes colorectal carcinoma cell motility by inducing epithelial-mesenchymal transition.
Nucleotide binding protein-like, NUBPL, is an assembly factor for human mitochondrial complex I, which is the biggest member of the mitochondrial respiratory chain. However, the relationship between NUBPL and carcinoma progression remains unknown. In this study, NUBPL was characterized for its role in colorectal cancer (CRC) and the underlying molecular mechanisms. Data (n = 197) from the Oncomine database revealed that mRNA levels of NUBPL were remarkably overexpressed in CRC tissues compared with normal tissues. In addition, immunohistochemical analysis of 75 pairs of CRC and non-tumor tissues showed that the expression level of NUBPL was significantly higher in CRC tissues, and its expression level was positively associated with lymph node metastasis (P = 0.028) and advanced staging (P = 0.030). Expression of NUBPL in metastatic lymph nodes of CRC patients was also detected by immunohistochemical staining and high expression levels of NUBPL were observed. Overexpression of NUBPL significantly promoted the migration and invasion ability of CRC cell lines SW480 and SW620, whereas knockdown of NUBPL lead to an opposite effect. Our further study found that NUBPL could induce epithelial-mesenchymal transition (EMT), characterized by downregulation of epithelial markers (E-cadherin) and upregulation of mesenchymal markers (N-cadherin and vimentin). Moreover, NUBPL was able to activate ERK, which is believed to promote EMT and tumor metastasis. Inhibition of ERK suppressed the NUBPL-induced changes in EMT and cell motility. These data showed that NUBPL plays a vital role in CRC migration and invasion by inducing EMT and activating ERK. It might be a novel therapeutic target for CRC.


Efficacy and safety of Suanzaoren decoction for primary insomnia: a systematic review of randomized controlled trials.
Insomnia is a widespread human health problem, but there currently are the limitations of conventional therapies available. Suanzaoren decoction (SZRD) is a well known classic Chinese herbal prescription for insomnia and has been treating people's insomnia for more than thousand years. The objective of this study was to evaluate the efficacy and safety of SZRD for insomnia. A systematic literature search was performed for 6 databases up to July of 2012 to identify randomized control trials (RCTs) involving SZRD for insomniac patients. The methodological quality of RCTs was assessed independently using the Cochrane Handbook for Systematic Reviews of Interventions. Twelve RCTs with total of 1376 adult participants were identified. The methodological quality of all included trials are no more than 3/8 score. Majority of the RCTs concluded that SZRD was more significantly effective than benzodiazepines for treating insomnia. Despite these positive outcomes, there were many methodological shortcomings in the studies reviewed, including insufficient information about randomization generation and absence of allocation concealment, lack of blinding and no placebo control, absence of intention-to-treat analysis and lack of follow-ups, selective publishing and reporting, and small number of sample sizes. A number of clinical heterogeneity such as diagnosis, intervention, control, and outcome measures were also reviewed. Only 3 trials reported adverse events, whereas the other 9 trials did not provide the safety information. Despite the apparent reported positive findings, there is insufficient evidence to support efficacy of SZRD for insomnia due to the poor methodological quality and the small number of trials of the included studies. SZRD seems generally safe, but is insufficient evidence to make conclusions on the safety because fewer studies reported the adverse events. Further large sample-size and well-designed RCTs are needed.


Key points of basic theories and clinical practice in rAd-p53 ( Gendicine ™) gene therapy for solid malignant tumors.
Wild-type p53 gene is an essential cancer suppressor gene which plays an important role in carcinogenesis and malignant progressions. The p53 gene family participates in almost all the key procedures of cancer biology, such as programmed cell death, angiogenesis, metabolism and epithelial-mesenchymal transition. The mutation or functional defects of the p53 gene family are detected in most of the solid malignant tumors, and the restoration of the p53 gene by adenovirus-mediated gene therapy becomes a promising treatment for cancer patients now. In the present review, the potential therapeutic effects of recombinant adenovirus p53 rAd-p53 ( Gendicine ™) were reviewed to explore the biological mechanism underlying the adenovirus-mediated p53 gene therapy. Then, the key points of the drug administration were discussed, including the routes of administration, dosage calculation and treatment cycles, based on findings of the preclinical and clinical trials in order to establish a standard treatment for the p53 gene therapy. As an important part of the combined therapy for the cancer patients, the adenovirus-mediated p53 gene therapy was blossomed to be a promising treatment strategy. A new evaluation criteria and guideline for the gene therapy is urgently needed for the further clinical practice.


The Investigation of the Diversity of Lactobacilli Spp. and Assessment Their Some Probiotic Properties in Traditional Dairy Products in East Azerbaijan Province in Iran.
Nowadays, there is an increasing interest in the production of functional foods, particularly probiotic foods. Lactic acid bacteria (LAB) particularly strains of Lactobacillus are important bacteria in food microbiology and human nutrition due to their ability to fermented food production and have received considerable attention as probiotics. The traditional fermented dairy foods as a rich source of wild LAB can introduce new Lactobacillus strain with probiotic properties into food products. So, the present study was aimed to isolate and identify Lactobacilli spp. in traditional dairy products and to assess some of their probiotic properties. For this study, fifty samples including homemade yogurt and cheese were purchased from several rural areas and the intragenic transcribed spacer-PCR (16-23s rDNA) was used for identification of Lactobacilli. Some probiotic properties were assayed including resistant to acid and bile, antimicrobial activity, and antibiotic susceptibility. The isolates were characterized as L.plantarum, L.casei, L.paracasei and L.rhamnosus. Out of the fifty-six isolates identified phenotypically as lactobacillus, twenty-four strains were tolerant to pH 2.5 and 0.3% bile salt after 3 h of incubation and only 6 strains showed antimicrobial activity and antibiotic susceptibility. In conclusion, six strains showed potentially probiotic properties including resistant to acid and bile, antimicrobial activity and antibiotic susceptibility. So, we can consider these strains as native probiotic but extra examinations were required for introduction into food products.


Bioengineering Vascular Networks to Study Angiogenesis and Vascularization of Physiologically Relevant Tissue Models in Vitro.
Angiogenesis assays are essential for studying aspects of neovascularization and angiogenesis and investigating drugs that stimulate or inhibit angiogenesis. To date, there are several in vitro and in vivo angiogenesis assays that are used for studying different aspects of angiogenesis. Although in vivo assays are the most representative of native angiogenesis, they raise ethical questions, require considerable technical skills, and are expensive. In vitro assays are inexpensive and easier to perform, but the majority of them are only two-dimensional cell monolayers which lack the physiological relevance of three-dimensional structures. Thus, it is important to look for alternative platforms to study angiogenesis under more physiologically relevant conditions in vitro. Accordingly, in this study, we developed polymeric vascular networks to be used to study angiogenesis and vascularization of a 3D human skin model in vitro. Our results showed that this platform allowed the study of more than one aspect of angiogenesis, endothelial migration and tube formation, in vitro when combined with Matrigel. We successfully reconstructed a human skin model, as a representative of a physiologically relevant and complex structure, and assessed the suitability of the developed in vitro platform for studying endothelialization of the tissue-engineered skin model.


Partial deletion of the long arm of chromosome 11: ten Japanese children.
The clinical features of partial deletion 11q were correlated with the size of the deleted region. Ten Japanese children with partial deletion of 11q were investigated. They were divided into three groups. Three patients in the first group had interstitial deletions and preserved subband q24.1. Six patients in the second group demonstrated terminal deletion of 11q including subband q24.1, with typical features of 11q- syndrome (Jacobsen syndrome). The third group included only one patient, who had terminal deletion of 11q without characteristics of typical 11q- syndrome. Prominent features of patients in the first group included severe mental and motor developmental delay, seizures, cleft lip and palate, and ophthalmological findings. Patients in the second group showed mild to moderate developmental delays without deterioration. Abnormalities in neuroimages, high intensity in the cerebral white matter in T2-weighted magnetic resonance (MR) images, and recurrent infections were not observed after the age of 7 years. The subject in the third group, with the smallest amount of deleted chromosome, did not show developmental delays, suggesting that some unknown genes related to developmental delays may be located adjacent to subband q24.1. Variation in the deleted parts of 11q resulted in different clinical features in each group.


Exogenous gene integration mediated by genome editing technologies in zebrafish.
Genome editing technologies, such as transcription activator-like effector nuclease (TALEN) and the clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated protein (Cas) systems, can induce DNA double-strand breaks (DSBs) at the targeted genomic locus, leading to frameshift-mediated gene disruption in the process of DSB repair. Recently, the technology-induced DSBs followed by DSB repairs are applied to integrate exogenous genes into the targeted genomic locus in various model organisms. In addition to a conventional knock-in technology mediated by homology-directed repair (HDR), novel knock-in technologies using refined donor vectors have also been developed with the genome editing technologies based on other DSB repair mechanisms, including non-homologous end joining (NHEJ) and microhomology-mediated end joining (MMEJ). Therefore, the improved knock-in technologies would contribute to freely modify the genome of model organisms.


Bone regeneration by grafting of cultured human bone.
A 3-mL sample of bone marrow was collected from the iliac bones of 27 orthopedic patients (8 men and 19 women with a mean age of 56.1 years [range, 17 to 76 years]), followed by culture in standard culture medium (minimal essential medium containing 15% fetal bovine serum). In all 7 patients randomly selected from these 27 patients, significant in vitro osteogenic ability of marrow mesenchymal cells was demonstrated by scanning electron microscopy and biochemical analyses. In all 27 cases, to investigate the in vivo osteogenic potential of this human cultured bone, porous ceramics were impregnated with marrow cells and subcultured in osteogenic culture medium (standard medium supplemented with sodium beta-glycerophosphate, vitamin C phosphate, and dexamethasone). After 3 weeks of subculture, the cultured artificial bones of the cultured bone/porous ceramics were grafted into the abdominal cavity of nude mice. Histological and biochemical (alkaline phosphatase activity and human osteocalcin) examinations indicated that the cultured artificial bone possessed significant ability to regenerate bone. This result suggests that the bone-regenerating ability of human marrow cells may not depend on age, and that cultured artificial bone may be useful for bone regeneration treatment if appropriate cultured marrow cells can be successfully prepared.


In vitro skin decontamination of paraoxon - wet-type cleansing effect of selected detergents.
The aim of this study was to determine optimal conditions for in vitro skin decontamination using water and detergents as decontamination agents and to test the cleansing efficiency of selected detergents. Experiments were performed using a peristaltic pump for showering of pig skin in modified static diffusion cells. Several conditions were tested including different flow rates (from 5 to 33 ml s-1), quantity of rinsing fluid (from 40 to 400 ml) and concentration of detergents (2; 5; 10%). Further, several types of detergents/commercial decontamination agents were evaluated under the selected conditions to find the most effective means of decontamination. The amount of paraoxon removed from the skin surface following wet-type decontamination was detected in the rinsing fluid spectrophotometrically after hydrolysis of paraoxon - a model contaminant. The efficacy of rinsing by water/Spolapon AES 253 increased with flow rate up to 25 ml s-1 and a rinsing volume of 200 ml. Lutensol AT 25 achieved maximum efficacy at the lowest tested concentration (2%). A flow rate of 16 ml s-1, rinsing volume of 100 ml (values from the middle part of the sigmoid curve) and 5% concentration of decontaminant solution were used for further evaluation of detergents as cleansing agents under the selected conditions. Cetylpyridinium bromide (cationic surfactant), carbethopendecinii bromidum (cationic surfactant) and polyoxyethylene-10-tridecyl ether (non-ionic surfactant), SDS (anionic surfactant), althosan MB (cationic surfactant), sodium dodecylbenzene sulphonate (anionic surfactant), neodekont (mixture), tergitol NPX (non-ionic surfactant), Korynt P (non-ionic surfactant) were found to be the most effective. These decontaminants were able to wash away more than 92% of paraoxon from the contaminated skin.


Management of Snapping Scapula Syndrome.
Snapping scapula syndrome is a rare condition caused by the disruption of the gliding articulation between the anterior scapula and the posterior chest wall. The etiology of snapping scapula syndrome is multifactorial, and contributing factors include scapular dyskinesis, bursitis from repetitive use or trauma, and periscapular lesions. Although the majority of cases are initially treated with nonoperative modalities, recalcitrant snapping scapula syndrome can warrant surgical management. This report describes a 34-year-old amateur weight lifter with a 1-year history of increasing pain and fullness over his posterior shoulder region. He reported full shoulder motion associated with an audible, palpable, and painful crepitus, exacerbated with overhead movement and wall pushups. Previous periscapular stabilization exercises and corticosteroid injection yielded minimal resolution of his symptoms. Prior to being referred to the authors' clinic, the patient was evaluated at an outside facility and deemed a suboptimal candidate for arthroscopic bursectomy because of the large size and location of this lesion. Magnetic resonance imaging showed a large polylobulated fluid collection causing scapulothoracic distention. There was no evidence of osseous abnormalities originating from the scapular body. Computed tomography-guided placement of methylene blue and contrast dye was used to facilitate localization and, in an effort to minimize recurrence, ensure the complete removal of bursal tissue. During 8 weeks, this patient recovered unremarkably and returned to full-duty activities with resolution of symptoms. The authors present the management of chronic and recalcitrant snapping scapula syndrome, and report the open excision of the largest scapulothoracic bursal lesion described, to their knowledge, in the English literature. [Orthopedics. 2016; 39(4):e783-e786.].


[Abrikosov's tumor located in the breast].
The paper reports on the clinical case of a mammary tumour, Abrikosov's tumour, a are histopathologic occurrence. Clinical, histopathologic and therapeutic aspects are revealed. This case enriches the literature data on this peculiar form of tumour with mammary location.


Two hundred liver hanging maneuvers for major hepatectomy: a single-center experience.
To establish the indications of the liver hanging maneuver for major hepatectomy. The liver hanging maneuver, which is a technique of passing a tape along the retrohepatic avascular space and suspending the liver during parenchymal transection, facilitates anterior approach of major hepatectomy. However, the feasibility and limits of this maneuver have never been established in patients with different clinical backgrounds. Medical records of 242 consecutive patients considered for major hepatectomy using the hanging maneuver were reviewed. Among 242 patients, 14 patients (6%) were considered to have contraindication for this maneuver preoperatively because of tumor infiltration to anterior surface of retrohepatic inferior vena cava (IVC). It was successful in 201 patients with overall feasibility of 88%. The feasibility increased significantly in the recent years as compared with the initial years (94% in 2003-2005 vs. 76% in 2000-2002, P < 0.0001). Bleeding during the retrohepatic dissection occurred in 5 patients (2%), which was minor due to injury of hepatic capsule in 3 (1%) and major due to injury of short hepatic vein in 2 (1%). In all cases, bleeding stopped spontaneously. The maneuver was abandoned in 27 patients, including 15 related to severe adhesion between liver and IVC. Univariate analysis showed that adhesion between IVC and liver was the only significant negative predictor affecting the feasibility. Cirrhosis, large tumor, preoperative radiologic treatments did not influence on the feasibility. The liver hanging maneuver has 94% feasibility in recent years. Absolute contraindication is tumor infiltration to the retrohepatic avascular space. Adhesion between the IVC and liver has a negative impact of the feasibility. According to this indication, the hanging maneuver is easily achievable without risk of the major bleeding during the retrohepatic dissection.


In vivo cartilage repair using adipose-derived stem cell-loaded decellularized cartilage ECM scaffolds.
We have previously reported a natural, human cartilage ECM (extracellular matrix)-derived three-dimensional (3D) porous acellular scaffold for in vivo cartilage tissue engineering in nude mice. However, the in vivo repair effects of this scaffold are still unknown. The aim of this study was to further explore the feasibility of application of cell-loaded scaffolds, using autologous adipose-derived stem cells (ADSCs), for cartilage defect repair in rabbits. A defect 4 mm in diameter was created on the patellar groove of the femur in both knees, and was repaired with the chondrogenically induced ADSC-scaffold constructs (group A) or the scaffold alone (group B); defects without treatment were used as controls (group C). The results showed that in group A all defects were fully filled with repair tissue and at 6 months post-surgery most of the repair site was filled with hyaline cartilage. In contrast, in group B all defects were partially filled with repair tissue, but only half of the repair tissue was hyaline cartilage. Defects were only filled with fibrotic tissue in group C. Indeed, histological grading score analysis revealed that an average score in group A was higher than in groups B and C. GAG and type II collagen content and biomechanical property detection showed that the group A levels approached those of normal cartilage. In conclusion, ADSC-loaded cartilage ECM scaffolds induced cartilage repair tissue comparable to native cartilage in terms of mechanical properties and biochemical components.


Allometry of some woody plant species in a Brazilian savanna after two years of a dry season fire.
Studies of allometry are important in explaining effects of fire and herbivory, for estimating biomass in forests, and so on. There has been extensive research on plant allometry in temperate and tropical forests, showing that plant architecture often adjusts to the elastic similarity model, but not in Brazilian savannas (cerrado). We studied allometry of Dalbergia miscolobium, Diospyros hispida, Erythroxylum suberosum, Miconia albicans, M. ligustroides, Schefflera vinosa, and Xylopia aromatica in a cerrado sensu stricto area that was affected by a fire in August 2006. We expected that the study species would not adjust to any of the allometric models considered common for forest species ("constant stress", "elastic similarity", and "geometric growth"), and that there would be differences in allometry in burnt and unburnt patches. We sampled two species in 60 5 × 5 m contiguous plots placed in three transects, and five species in 100 5 × 5 m contiguous plots placed in five transects, where we measured the diameters at soil level (DSL) and the heights of all shoots. We used standardized major axis regressions on log-transformed data. The regression slope between the height and DSL was higher than 1.0 (p < 0.05) for four species, showing a greater height than would be expected under geometric growth, not predicted by theoretical models. We found significant differences (p < 0.05) in regression slopes and/or correlation coefficients between burnt and unburnt plots for five species, indicating that fire may influence plant allometry in the Brazilian cerrado, and that such a response is highly variable between species.