Nephrotoxicity of contrast media assessed by occlusion arteriography.
The authors describe an experimental model for the study of nephrotoxicity induced by contrast media, based on a standardized injection combined with occlusion of the renal artery so as to expose the kidney to a high concentration of contrast medium for ten minutes. Iopamidol, ioxaglate, and both isosmolar and hyperosmolar saline were well tolerated, but diatrizoate caused marked radiological and pathological changes. This model may be helpful in studies of the mechanisms underlying contrast medium nephrotoxicity and evaluating differences in toxicity between contrast agents.


Establishment and Verification of Neural Network for Rapid and Accurate Cytological Examination of Four Types of Cerebrospinal Fluid Cells.
Fast and accurate cerebrospinal fluid cytology is the key to the diagnosis of many central nervous system diseases. However, in actual clinical work, cytological counting and classification of cerebrospinal fluid are often time-consuming and prone to human error. In this report, we have developed a deep neural network (DNN) for cell counting and classification of cerebrospinal fluid cytology. The May-Grünwald-Giemsa (MGG) stained image is annotated and input into the DNN network. The main cell types include lymphocytes, monocytes, neutrophils, and red blood cells. In clinical practice, the use of DNN is compared with the results of expert examinations in the professional cerebrospinal fluid room of a First-line 3A Hospital. The results show that the report produced by the DNN network is more accurate, with an accuracy of 95% and a reduction in turnaround time by 86%. This study shows the feasibility of applying DNN to clinical cerebrospinal fluid cytology.


Thrombospondin 1 expression and angiogenesis in breast carcinoma and their relation with platelet activity.
This study investigates angiogenesis and the expression of thrombospondin 1 in invasive ductal carcinoma of the breast and their possible relation to platelet counts and platelet activity. The study included 20 cases of invasive ductal carcinoma. Platelet activity was evaluated by determining thromboxane B2 and cyclic guanosine monophosphate (cGMP) levels by enzyme immunoassay (EIA).Thrombospondin (TSP) 1 and CD34 expression was studied immunohistochemically. Mean platelet count of the patient group was significantly greater than the mean platelet count of the control group (P < 0.05). The platelet counts were positively correlated with tumour size (r=0.609; P < 0.01). Platelet counts were higher in the patients who had grade 3 microvessel density (P < 0.05). The mean basal platelet cGMP level in the patient group was significantly lower than it was in the control group (P < 0.05). Focal TSP immunoreactivity was detectable in 5 (20%) cases in the tumour cells, and in 9 (45%) cases in the stroma. We did not find any correlation between TSP-1 staining and angiogenesis, platelet counts, platelet activity, and the histological prognostic parameters. Our study confirms the essential role of platelets in tumour growth and angiogenesis. Decreased levels of cGMP in the patient group may cause platelet hyperreactivity. Although thrombospondin 1 may be upregulated in malignant breast tissue, this is not sufficient for tumour growth and dissemination according to our results.


Copeptin does not accurately predict disease severity in imported malaria.
Copeptin has recently been identified to be a stable surrogate marker for the unstable hormone arginine vasopressin (AVP). Copeptin has been shown to correlate with disease severity in leptospirosis and bacterial sepsis. Hyponatraemia is common in severe imported malaria and dysregulation of AVP release has been hypothesized as an underlying pathophysiological mechanism. The aim of the present study was to evaluate the performance of copeptin as a predictor of disease severity in imported malaria. Copeptin was measured in stored serum samples of 204 patients with imported malaria that were admitted to our Institute for Tropical Diseases in Rotterdam in the period 1999-2010. The occurrence of WHO defined severe malaria was the primary end-point. The diagnostic performance of copeptin was compared to that of previously evaluated biomarkers C-reactive protein, procalcitonin, lactate and sodium. Of the 204 patients (141 Plasmodium falciparum, 63 non-falciparum infection), 25 had severe malaria. The Area Under the ROC curve of copeptin for severe disease (0.66 [95% confidence interval 0.59-0.72]) was comparable to that of lactate, sodium and procalcitonin. C-reactive protein (0.84 [95% CI 0.79-0.89]) had a significantly better performance as a biomarker for severe malaria than the other biomarkers. C-reactive protein but not copeptin was found to be an accurate predictor for disease severity in imported malaria. The applicability of copeptin as a marker for severe malaria in clinical practice is limited to exclusion of severe malaria.


Alterations in Gut Microbiota Are Correlated With Serum Metabolites in Patients With Insomnia Disorder.
This study aimed to investigate insomnia-related alterations in gut microbiota and their association with serum metabolites. A total of 24 patients with insomnia disorder and 22 healthy controls were recruited. The fecal and serum samples were collected. The 16s rRNA sequencing and bioinformatics analysis were conducted to explore insomnia-related changes in the diversity, structure, and composition of the gut microbiota. UPLC-MS was performed to identify insomnia-related serum metabolites. Spearman correlation analysis was used to investigate the correlations between insomnia-related gut bacteria and the serum metabolites. Despite the nonsignificant changes in the diversity and structure of gut microbiota, insomnia disorder patients had significantly decreased family Bacteroidaceae, family Ruminococcaceae, and genus Bacteroides, along with significantly increased family Prevotellaceae and genus Prevotella, compared with healthy controls. Genus Gemmiger and genus Fusicatenibacter were dominant in patients with insomnia disorder, whereas genus Coprococcus, genus Oscillibacter, genus Clostridium XI, and family Peptostreptococcaceae were dominant in healthy controls. The UPLC-MS analysis identified 97 significantly decreased metabolites and 74 significantly increased metabolites in the serum samples of patients with insomnia disorder, compared with those of healthy controls. KEGG enrichment analysis revealed 1 significantly upregulated metabolic pathway and 16 downregulated metabolic pathways in patients with insomnia disorder. Furthermore, Spearman correlation analysis unveiled significant correlations among the altered bacteria genus and serum metabolites. Patients with insomnia disorder have differential gut microbiota and serum metabolic profiles compared with healthy controls. The alterations in gut microbiota were correlated with specific serum metabolites, suggesting that some serum metabolites might mediate gut microbiota-brain communication in the pathogenesis of insomnia disorder.


GNSS spoofing detection using a maximum likelihood-based sliding window method.
The Global Navigation Satellite System is vulnerable to interference signals that can potentially disable the system, because the signal strength tends to be very weak. Interference such as jamming, which disables the receiver via excessively high signal strength in the satellite navigation frequency band, and spoofing, which induces the receiver to output erroneous position and time data via signals similar to actual navigation signals, disrupt satellite navigation systems. As the threat of interference is increasing, considerable research effort has been expended in an attempt to deal with it in various ways. Spoofing attacks are especially difficult to detect. This paper deals with a technique to detect a spoofing signal and to mitigate attacks on satellite navigation systems. The satellite navigation signal is influenced by the navigation satellite itself and errors due to environmental factors, and spoofing signal detection should be well reflected in the navigation signal. Especially, in the case of mobile receivers, it is not easy to detect a spoofing signal because the exact position of the receiver cannot be known. To detect a spoofing signal, additional hardware may be required; in some cases, heterogeneous sensors, such as inertial sensors, may be used. The technique introduced in this paper effectively discriminates spoofing signals based only on receiver measurements, without the need for additional devices. It generates test statistics based on the pseudorange, which is the measured value of the receiver position, and detects spoofing signals by setting the monitoring interval according to a "sliding window". Because the proposed method uses output data and measurements obtained from the receiver, it can be applied to general receivers at low cost.


Stochastic resonance in the driven Ising model on small-world networks.
We investigate the stochastic resonance phenomena in the field-driven Ising model on small-world networks. The response of the magnetization to an oscillating magnetic field is examined by means of Monte Carlo dynamic simulations, with the rewiring probability varied. At any finite value of the rewiring probability, the system is found to undergo a dynamic phase transition at a finite temperature, giving rise to double resonance peaks. While the peak in the ferromagnetic phase grows with the rewiring probability, which in the paramagnetic phase tends to reduce, indicating opposite effects of the long-range interactions on the resonance in the two phases.


[Diversity and Community Structure of Airborne Fungi in Different Working Areas of Composting Plants].
Composting plants are an important source of airborne fungi. At present, no research has been reported on differences in the types and abundance of escaped fungi in different working areas, which makes it very difficult to comprehensively assess the ecological health risks of the air in composting plants. In light of this situation, this study collected air samples from the composting, packaging, office, and downwind areas of the composting plants and used high-throughput sequencing technology to analyze and compare the biological diversity and community structure of airborne fungi in the four areas. The source of airborne fungi in offices and downwind areas was further traced. The results showed that the highest abundance and diversity of airborne fungi were found in the packing and composting areas of the composting plants. Ascomycota and Basidiomycota were two fungal phyla with the highest relative abundance in the four regions. Overall, the distribution of dominant fungal genera differed; Trichocomaceae and Davidiella were the dominant genera in three areas of the composting plants. Among the 136 detected fungal genera, the number of endemic airborne fungal genera in the composting and packaging area was the largest, and 52.94% of the fungal genera was shared by the four areas. At the level of fungal genera, the community structures in the air in three areas of the composting plants were similar. The statistical difference analysis results of the key genera in different areas of the composting plants showed that the number of different fungal genera between the downwind, packaging, and composting areas was the largest, and no statistically different fungal genera were detected in the air between the packaging and composting areas. The Source Tracker analysis results showed that the contribution percentage of the packaging and composting areas to the airborne fungi in the office and downwind areas was between 9.52%-15.85%. The results of this study will provide basic data for evaluating the relationship between airborne fungal exposure and human health in different areas of the composting plant, as well as its ecological impact on the surrounding air environment.


Architecture and Dynamics of the Wounding-Induced Gene Regulatory Network During the Oolong Tea Manufacturing Process (Camellia sinensis).
Understanding extensive transcriptional reprogramming events mediated by wounding during the oolong tea manufacturing process is essential for improving oolong tea quality. To improve our comprehension of the architecture of the wounding-induced gene regulatory network, we systematically analyzed the high-resolution transcriptomic and metabolomic data from wounding-treated (after turnover stage) tea leaves at 11 time points over a 220-min period. The results indicated that wounding activates a burst of transcriptional activity within 10 min and that the temporal expression patterns over time could be partitioned into 18 specific clusters with distinct biological processes. The transcription factor (TF) activity linked to the TF binding motif participated in specific biological processes within different clusters. A chronological model of the wounding-induced gene regulatory network provides insight into the dynamic transcriptional regulation event after wounding treatment (the turnover stage). Time series data of wounding-induced volatiles reveal the scientific significance of resting for a while after wounding treatment during the actual manufacturing process of oolong tea. Integrating information-rich expression data with information on volatiles allowed us to identify many high-confidence TFs participating in aroma formation regulation after wounding treatment by using weighted gene co-expression network analysis (WGCNA). Collectively, our research revealed the complexity of the wounding-induced gene regulatory network and described wounding-mediated dynamic transcriptional reprogramming events, serving as a valuable theoretical basis for the quality formation of oolong tea during the post-harvest manufacturing process.


Beak and oral lesions in broiler breeding fowl.
Beak, tongue and other oral lesions were observed in broiler breeding fowl reared under a regime of separate sex feeding. Seventy four per cent of the male birds examined at necropsy, at 60 weeks of age, had beak lesions. Severe beak lesions, in both male and female birds, resulted in pronounced beak deformities which made feeding difficult or impossible. Beak lesions occurred at a number of sites on maxillae and mandibles but the pathogenesis of all lesions, including those of the tongue and oral cavity, appeared to be similar. It is postulated that the primary event was either direct or indirect injury of the epidermis, followed by bacterial infection and tissue necrosis. Dermatitis may arise in a number of ways and certain husbandry systems may encourage beak trauma. Because pronounced beak deformities and concurrent osteomyelitis were the usual outcome of progressive lesions, special vigilance is required to identify and cull affected birds whose welfare is seen to be at risk.


Bipartite graph-based collaborative matrix factorization method for predicting miRNA-disease associations.
With the rapid development of various advanced biotechnologies, researchers in related fields have realized that microRNAs (miRNAs) play critical roles in many serious human diseases. However, experimental identification of new miRNA-disease associations (MDAs) is expensive and time-consuming. Practitioners have shown growing interest in methods for predicting potential MDAs. In recent years, an increasing number of computational methods for predicting novel MDAs have been developed, making a huge contribution to the research of human diseases and saving considerable time. In this paper, we proposed an efficient computational method, named bipartite graph-based collaborative matrix factorization (BGCMF), which is highly advantageous for predicting novel MDAs. By combining two improved recommendation methods, a new model for predicting MDAs is generated. Based on the idea that some new miRNAs and diseases do not have any associations, we adopt the bipartite graph based on the collaborative matrix factorization method to complete the prediction. The BGCMF achieves a desirable result, with AUC of up to 0.9514 ± (0.0007) in the five-fold cross-validation experiments. Five-fold cross-validation is used to evaluate the capabilities of our method. Simulation experiments are implemented to predict new MDAs. More importantly, the AUC value of our method is higher than those of some state-of-the-art methods. Finally, many associations between new miRNAs and new diseases are successfully predicted by performing simulation experiments, indicating that BGCMF is a useful method to predict more potential miRNAs with roles in various diseases.


Behaviour Therapy and Behaviour Modification Background and Development.
This manuscript is part of a special issue to commemorate professor Paul Eelen, who passed away on August 21, 2016. Paul was a clinically oriented scientist, for whom learning principles (Pavlovian or operant) were more than salivary responses and lever presses. His expertise in learning psychology and his enthusiasm to translate this knowledge to clinical practice inspired many inside and outside academia. Several of his original writings were in the Dutch language. Instead of editing a special issue with contributions of colleagues and friends, we decided to translate a selection of his manuscripts to English to allow wide access to his original insights and opinions. Even though the manuscripts were written more than two decades ago, their content is surprisingly contemporary. This manuscript is a transcription of a lecture that was published in 1980. It was Paul Eelen's first public presentation after a two-year study in the United States, which has inspired much of his later thinking. The text can be viewed as a manifesto for behaviour therapy as it was then advancing in Belgium and the Netherlands. This presentation was given as the introduction to the L.A.P.P. seminar day held October 27, 1980, which was themed: Behaviour modification. The lecture was published as: Eelen, P. (1980). Gedragstherapie en gedragsmodificatie: Achtergronden. Leuvens Bulletin L. A. P. P., 39, 1-19.


Generation of neural stem cell-like cells from bone marrow-derived human mesenchymal stem cells.
Under appropriate culture conditions, bone marrow (BM)-derived mesenchymal stem cells are capable of differentiating into diverse cell types unrelated to their phenotypical embryonic origin, including neural cells. Here, we report the successful generation of neural stem cell (NSC)-like cells from BM-derived human mesenchymal stem cells (hMSCs). Initially, hMSCs were cultivated in a conditioned medium of human neural stem cells. In this culture system, hMSCs were induced to become NSC-like cells, which proliferate in neurosphere-like structures and express early NSC markers. Like central nervous system-derived NSCs, these BM-derived NSC-like cells were able to differentiate into cells expressing neural markers for neurons, astrocytes, and oligodendrocytes. Whole-cell patch clamp recording revealed that neuron-like cells, differentiated from NSC-like cells, exhibited electrophysiological properties of neurons, including action potentials. Transplantation of NSC-like cells into mouse brain confirmed that these NSC-like cells retained their capability to differentiate into neuronal and glial cells in vivo. Our data show that multipotent NSC-like cells can be efficiently produced from BM-derived hMSCs in culture and that these cells may serve as a useful alternative to human neural stem cells for potential clinical applications such as autologous neuroreplacement therapies.


Strain Structure and Dynamics Revealed by Targeted Deep Sequencing of the Honey Bee Gut Microbiome.
Host-associated microbiomes can be critical for the health and proper development of animals and plants. The answers to many fundamental questions regarding the modes of acquisition and microevolution of microbiome communities remain to be established. Deciphering strain-level dynamics is essential to fully understand how microbial communities evolve, but the forces shaping the strain-level dynamics of microbial communities remain largely unexplored, mostly because of methodological issues and cost. Here, we used targeted strain-level deep sequencing to uncover the strain dynamics within a host-associated microbial community using the honey bee gut microbiome as a model system. Our results revealed that amplicon sequencing of conserved protein-coding gene regions using species-specific primers is a cost-effective and accurate method for exploring strain-level diversity. In fact, using this method we were able to confirm strain-level results that have been obtained from whole-genome shotgun sequencing of the honey bee gut microbiome but with a much higher resolution. Importantly, our deep sequencing approach allowed us to explore the impact of low-frequency strains (i.e., cryptic strains) on microbiome dynamics. Results show that cryptic strain diversity is not responsible for the observed variations in microbiome composition across bees. Altogether, the findings revealed new fundamental insights regarding strain dynamics of host-associated microbiomes.IMPORTANCE The factors driving fine-scale composition and dynamics of gut microbial communities are poorly understood. In this study, we used metagenomic amplicon deep sequencing to decipher the strain dynamics of two key members of the honey bee gut microbiome. Using this high-throughput and cost-effective approach, we were able to confirm results from previous large-scale whole-genome shotgun (WGS) metagenomic sequencing studies while also gaining additional insights into the community dynamics of two core members of the honey bee gut microbiome. Moreover, we were able to show that cryptic strains are not responsible for the observed variations in microbiome composition across bees.


Perspectives on the Role of Biopsy for Management of T1 Renal Masses: Survey Results From Two Regional Quality Improvement Collaboratives.
To understand perspectives on renal mass biopsy, a survey was distributed to urologists in the Michigan Urological Surgery Improvement Collaborative and Pennsylvania Urologic Regional Collaborative. Renal mass biopsy (RMB) may reduce treatment of benign renal neoplasms; however, utilization varies widely. Michigan Urological Surgery Improvement Collaborative and Pennsylvania Urologic Regional Collaborative are two quality improvement collaboratives that include a "real-world" collection of urologists from academic- and community-based settings. A 12-item survey assessing current RMB utilization, patient- and tumor-specific factors, adverse events, impact on management, and simulated patient scenarios was distributed. Responses are reported using descriptive statistics. Many responders (n = 54) indicated using RMB in less than 25% of cT1a (59%) and cT1b (85%) tumors. The most important patient-specific factors on the decision to recommend RMB were possible metastasis to the kidney (94%), patient comorbidity as a risk factor for active treatment (89%), and patient age (81%). The most important tumor-specific factors were the presence of bilateral tumors (81%), tumor size (70%) and perceived potential of performing nephron-sparing surgery (67%). Ten responders (19%) noted barriers to RMB in their practice, 23 (43%) recalled experiences with complications or poor outcomes, and 43 (80%) reported experiences where the results of RMB altered management. When presented with simulated patients, few urologists (9%-20%) recommended RMB in younger patients with any sized mass. Recommendations varied based on patient age, comorbidity, and tumor size. Understanding perspectives on RMB usage is essential prior to implementing quality improvement efforts. Most urologists participating in two statewide collaboratives infrequently recommend RMB. Optimizing RMB utilization may help reduce unnecessary treatments.


ADPglucose Pyrophosphorylase from the CAM Plants Hoya carnosa and Xerosicyos danguyi.
ADPglucose pyrophosphorylase from the Crassulacean acid metabolism plants Hoya carnosa and Xerosicyos danguyi were partially purified to study their regulatory and kinetic properties. The molecular weight of the native enzymes from both plants was determined to be about 209,000. The enzyme from both plants was found to be activated by glycerate 3-phosphate and inhibited by inorganic phosphate. The kinetic constants for the substrates and Mg(2+) are reported. The significance of the activation by glycerate 3-phosphate and inhibition by inorganic phosphate of ADPglucose synthesis catalyzed by the H. carnosa and X, danguyi enzymes is discussed. ADPglucose synthesized by the above enzymes was found to be the most effective donor of the glucosyl portion to alpha-glucan primer in the starch synthase reaction observed in CAM plants.


Aerial distribution of ONRAB baits as a tactic to control rabies in raccoons and striped skunks in Ontario, Canada.
During August 2006 and 2007, baits containing oral rabies vaccine, live adenovirus vector, known as ONRAB , were aerially distributed in SW Ontario, Canada. Bait acceptance during 2006 was 62 and 74% in raccoons (Procyon lotor) in areas baited at 150 baits/km(2) and 75 and 77% in plots baited at 300 baits/km(2). During 2007, bait acceptance for raccoons ranged between 59% and 80%, and 83% and 87%, in areas baited at 75 and 400 baits/km(2), respectively. Bait acceptance by skunks varied among plots (5-24%). Rabies virus-specific seroconversion during 2006 averaged 66 and 81% in raccoons in areas baited at 150 and 300 baits/km(2), respectively. During 2007, seroconversion by raccoons was 76 and 84% in areas baited at 75 and 400 baits/km(2), respectively. Seroconversion by skunks varied among plots (17-51%). Vaccine efficacy, as judged by the percentage of animals that consumed a bait and seroconverted, averaged 79 and 87% during 2006 for raccoons in areas baited at 150 and 300 baits/km(2), respectively, and 81 and 90% in areas baited during 2007 at 75 and 400 baits/km(2), respectively. Because tetracycline marking was poor in skunks, an estimate of vaccine efficacy was not possible. Aerial distribution of ONRAB vaccine baits seems to be a feasible tactic for controlling rabies in skunks and raccoons.


Hemostatic efficacy evaluation of radiation-crosslinked carboxymethyl cellulose granules and kappa-carrageenan/polyethylene oxide/polyethylene glycol dressing in rat bleeding models.
Carboxymethyl cellulose granules (CMC-G) and kappa-carrageenan/polyethylene oxide/polyethylene glycol dressing (KPP-D) hemostatic agents, developed through radiation-induced crosslinking and sterilization, were tested in Sprague-Dawley rats using three bleeding models: (a) deep wound with the puncture of femoral artery; (b) aortic puncture; and (c) partial nephrectomy. Dressing and granules were applied in the animals without sustained compression and monitored for a period of 7 or 14 days. Comparisons were made against the commercial chitosan-based agent, Celox (CLX). Primary outcomes observed were bleeding time, the incidence of re-bleeding, animal survival, as well as gross and microscopic changes. The KPP-D group showed the shortest bleeding time for all bleeding models (a. 2.75 ± 0.64, b. 1.63 ± 0.54, c. 2.05 ± 0.62), significantly faster than all the other treatment groups. KPP-D also registered the highest survival rate of 100% with no display of gross abnormalities. CMC-G showed comparable bleeding time with CLX products but had a better survival rate at 98% compared to 96%. The incidence of re-bleeding was greater in CLX treated groups as well as more occurrence of granular adhesions that impacted mortality outcomes. Findings indicate the efficacy of KPP-D in the treatment of severe hemorrhage due to traumatic injury and intraoperative cases, while CMC-G was more suited for external trauma. Complications arising from inflammation, granules deposition, and adhesions emphasize stringent handling and removal of granular hemostat as a critical consideration in hemostat development and testing.


Cellular characterisation of p53 mutants with a single missense mutation in the beta-strand 326-333 and correlation of their cellular activities with in vitro properties.
Recent evidence has shown that missense mutations in the p53 tetramerisation domain can inactivate the protein. However, most of these studies have been done only in vitro or concern proteins whose physico-chemical properties have not been fully investigated. Alanine mutants of the beta-strand 326-333 from the tetramerisation domain have been characterized in vitro and studied for their thermodynamic stability. They therefore offer a unique opportunity to establish a correlation between in vitro and cellular activities of proteins with a mutated tetramerisation domain. The eight mutant proteins resulting from the mutation of the eight residues of the beta-strand 326-333 to alanine were analysed for their ability to stimulate transcription, to inhibit the growth of Saos-2 cells and to repress the promoter of the multidrug resistance gene 1. The experimental results show a perfect correlation between in vitro and cellular data. The Leu330Ala and Ile332Ala proteins are inactive, the Phe328Ala protein has a moderate activity. The Glu326Ala, Tyr327Ala, Thr329Ala, Gln331Ala and Arg333Ala proteins show activity similar to that of wild-type protein. This work is based on an exhaustive analysis of p53 mutants both in vitro and in cells and shows that mutations in the tetramerisation domain might be of importance in cancer development since they inactivate the p53 protein.


Semen quality and waiting time to pregnancy explored using association mining.
Assessment of semen quality is a key pillar in the evaluation of men from infertile couples. Usually, semen parameters are interpreted individually because the interactions between parameters are difficult to account for. To determine how combinations of classical semen parameters and female partner age were associated with waiting time to pregnancy (TTP). Semen results of 500 fertile men, information of TTP, and partner age were used for regressions and to detect breaking points. For a modified Association Rule Mining algorithm, semen parameters were categorized as High, Medium, and Low. Men ≤32.1 years and women ≤32.9 years had shorter TTP than older. Decreasing TTP was associated with increasing level of individual semen parameters up to threshold values: sperm concentration 46 mill/mL, total sperm count 179 mill, progressive motility 63%, and normal morphology 11.5%. Using association mining, approximately 100 combinations of semen parameters and partner age were associated with TTP. TTP ≤ 1 month often co-occurred with high percentages of progressive motility (≥62%) and morphologically normal spermatozoa (≥10.5%). Furthermore, TTP ≤ 1 did not tend to appear with lower percentages of these two semen parameters or high partner age (≥32 years). However, high percentages of motile or normal spermatozoa could not compensate for sperm concentration ≤42 mill/mL or total sperm count ≤158 mill. The prolonging effect of high partner age could not be compensated for by the man's semen quality. Using association mining, we observed that TTP was best predicted when combinations of semen parameters were accounted for. Sperm counts, motility, and morphology were all important, and no single semen parameter was inferior. Additionally, female age above 32 years had a negative impact on TTP that could not be compensated for by high semen parameters of the man.


[New approaches to the treatment of advanced ovarian cancer].
With this research work our aim is to summarise the bulgarian and the experience of foreign /western/ authors in the field of treatment of the advanced ovarian cancer. We summerised the experience from the treatment of 250 patients for 5 years period /from 2000 till 2006/. On the basis from the results of treatment we tried to produce algorrhythm, which can be used from the oncogynaecologists in their everyday practice. We are convinced that with the development of the oncogynaecological science and practice this algorrhythm can be bettered. The main therapeutical approaches for the treatment of the advanced ovarian cancer include: primary cytoreductive surgery, neoadjuvant and adjuvant chemotherapy, interval debulking, second look laparotomy, intestinal resections and anastomosis. Very often is made resection of the bladder and reanastomosis of the ureters. The use of new chemotherapeutics, radiotherapy, hormonal medicaments and immunotherapy will better the fight against the advanced ovarian cancer.


[Lung cancer surgery with combined resection of the chest wall].
Lung cancer invading the chest wall is classified as T3 in the TNM classification, and surgical resection is the first choice of treatment if it is resectable. Factors affecting survival are still unclear except for the completeness of resection and degree of lymph node involvement. Recently, multidisciplinary treatments that include induction chemoradiation followed by surgery for superior sulcus non-small cell lung cancers have been reported with favorable results. Similarly, there is an ongoing phase II study of preoperative chemoradiotherapy for lung cancer with chest wall invasion, the results of which are expected soon. Based on recent evidence, platinum-based adjuvant chemotherapy after complete resection should be considered. We present strategies and techniques for radical combined resection of the chest wall, especially resection of the rib heads with chisels, and reconstruction with prostheses.


Reshaping Food Policy and Governance to Incentivize and Empower Disadvantaged Groups for Improving Nutrition.
The coronavirus disease 2019 (COVID-19) pandemic has exacerbated global malnutrition challenges, disrupted food supply chains, and left poor and vulnerable people unable to produce and access safe and affordable food, especially in developing countries. Food policy and governance are currently malfunctioning, despite their recognized roles in improving food security and public nutrition in many local and national contexts. This article reviews existing food policies and governance with implications for disadvantaged groups in the food systems, particularly smallholder farmers, women, and small- and medium-sized enterprises (SMEs), highlighting the importance of reshaping food policies and governance. To end malnutrition in the post-COVID era, multiple sectors, including health, agriculture, social protection, education, and infrastructure, must make greater collaborative efforts to develop and implement food and nutrition policies. Several recommendations for reshaping food policy interventions and governance are summarized.


Down-regulation of c-Myc and Max genes is associated to inhibition of protein phosphatase 2A in K562 human leukemia cells.
Treatment of the human myeloid leukemia K562 cells with the protein phosphatase inhibitors okadaic acid or calyculin A resulted in down-regulation of both c-myc and max genes at the mRNA and protein levels. The extent of the down-regulation was similar for both genes and was dependent on the dose and on the treatment time. Interestingly, c-myc and max down-regulation was concomitant with apoptosis induced by okadaic acid and calyculin A in K562 cells. The expression of c-myc and max returned to control levels after the removal of okadaic acid from the media, although apoptosis was irreversible. These effects were observed at okadaic acid concentrations (15 nM) that inhibited the activity of protein phosphatase type 2A but not of phosphatase type 1. We conclude that the inhibition of protein phosphatase 2A is associated to decreased levels of c-Myc/Max heterodimers in K562 cells.


Efficiently Computing Excitations of Complex Systems: Linear-Scaling Time-Dependent Embedded Mean-Field Theory in Implicit Solvent.
Quantum embedding schemes have the potential to significantly reduce the computational cost of first-principles calculations while maintaining accuracy, particularly for calculations of electronic excitations in complex systems. In this work, I combine time-dependent embedded mean field theory (TD-EMFT) with linear-scaling density functional theory and implicit solvation models, extending previous work within the ONETEP code. This provides a way to perform multilevel calculations of electronic excitations on very large systems, where long-range environmental effects, both quantum and classical in nature, are important. I demonstrate the power of this method by performing simulations on a variety of systems, including a molecular dimer, a chromophore in solution, and a doped molecular crystal. This work paves the way for high accuracy calculations to be performed on large-scale systems that were previously beyond the reach of quantum embedding schemes.


The influence of autoantibodies to myeloperoxidase on neutrophil function and intracellular signaling.
Autoantibodies to myeloperoxidase (MPO) are associated with small vessel systemic vasculitis. Interactions of these autoantibodies with MPO target antigen, Fcgamma receptors and Beta2 integrins at the neutrophil surface, can set in train a sequence of intracellular signal transduction events that culminate with functional responses. These include a respiratory burst with release of superoxide ions, degranulation, cytokine release, enhanced adhesion and induction of an accelerated apoptotic program.


Curcumin-polymeric nanoparticles against colon-26 tumor-bearing mice: cytotoxicity, pharmacokinetic and anticancer efficacy studies.
Curcumin (CUR), can inhibit proliferation and induce apoptosis of tumor cells, its extreme insolubility and limited bioavailability restricted its clinical application. An innovative polymeric nanoparticle of CUR has been developed to enhance the bioavailability and anti-cancer efficacy of CUR, in vitro and in vivo. Cationic copolymer Eudragit E 100 was selected as carrier, which can enhance properties of poor bioavailable chemotherapeutic drugs (CUR). The CUR-loaded Eudragit E 100 nanoparticles (CENPs) were prepared by emulsification-diffusion-evaporation method. The in vitro cytotoxicity study of CENPs was carried out using sulphorhodamine B assay. Pharmacokinetic and anti-cancer efficacy of CENPs was investigated in Wister rats as well as colon-26 tumor-bearing mice after oral administration. CENPs showed acceptable particle size and percent entrapment efficiency. In vitro cytotoxicity studies in terms of 50% cell growth inhibition values demonstrated ∼19-fold reduction when treated with CENPs as compared to pure CUR. ∼91-fold increase in Cmax and ∼95-fold increase in AUC0-12h were observed indicating a significant enhancement in the oral bioavailability of CUR when orally administered as CENPs compared to pure CUR. The in vivo anti-cancer study performed with CENPs showed a significant increase in efficacy compared with pure CUR, as observed by tumor volume, body weight and survival rate. The results clearly indicate that the developed polymeric nanoparticles offer a great potential to improve bioavailability and anticancer efficacy of hydrophobic chemotherapeutic drug.


A novel gammaherpesvirus in a large flying fox (Pteropus vampyrus) with blepharitis.
A novel gammaherpesvirus was identified in a large flying fox (Pteropus vampyrus) with conjunctivitis, blepharitis, and meibomianitis by nested polymerase chain reaction and sequencing. Polymerase chain reaction amplification and sequencing of 472 base pairs of the DNA-dependent DNA polymerase gene were used to identify a novel herpesvirus. Bayesian and maximum likelihood phylogenetic analyses indicated that the virus is a member of the genus Percavirus in the subfamily Gammaherpesvirinae. Additional research is needed regarding the association of this virus with conjunctivitis and other ocular pathology. This virus may be useful as a biomarker of stress and may be a useful model of virus recrudescence in Pteropus spp.


Reconsidering the relation between parental functioning and child externalizing behaviors: A meta-analysis on child-driven effects.
Guided by multiple theories illustrating the transactional nature of the relation between parents' and children's behaviors, the present meta-analysis provides synthesized evidence on the strength of child-driven effects in eliciting changes in parents' psychological stress and parenting practices. A meta-analysis of 45 independent samples with 640 effect sizes found significant positive associations between children's externalizing behaviors and parents' subsequent functioning (r = .087, 95% CI [.07, .10]). These associations were net of parents' functioning at baseline, and the strength of these associations was statistically comparable with the effects of parents on children's externalizing behaviors (r = .075, 95% CI [.06, .09]). In addition, the strength of the child-driven effects did not vary as a function of child gender, age, or the time interval between assessments. The implications of these findings with respect to research on the dynamic relation between parenting functioning and children's adjustment are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Multimodal Deformation of Liquid Metal Multimaterial Composites as Stretchable, Dielectric Materials for Capacitive Pressure Sensing.
Traditional electronic devices are composed of rigid materials and components that tend to be unsuitable for soft robotic and stretchable electronic applications, such as wearable or continuous pressure sensing. However, deformable materials have the potential to improve upon traditional devices through enhanced sensitivity and responsiveness, better conformability and biocompatibility at the human-machine interface, and greater durability. This work presents deformable composite materials composed of the gallium-indium-tin alloy galinstan (GaInSn) that combines the conductivity of a metal and the intrinsic deformability of a liquid. Dispersing galinstan in an elastomer allows for the formation of deformable dielectric materials that have tunable mechanical and electrical behavior, for example, modulus and relative permittivity. Galinstan composites have been shown previously to have a minimal modulus impact on the elastomer but concurrently achieve impressive dielectric performance. However, galinstan dispersions can be costly and face challenges of mechanical and electrical reliability. Thereby, this work investigates multimaterial composites composed of galinstan and a rigid filler, either iron or barium titanate, with respect to morphology, mechanical behavior, dielectric behavior, and pressure sensing performance for the purpose of achieving a balance between a low modulus and superior electrical performance. By combining galinstan and rigid fillers, it was found that the mechanical and electrical properties, such as modulus, permittivity, loss behavior, sensitivity, and linearity of the multimaterial composites can be improved by tuning filler formulation. This suggests that these dielectric materials can be used for sensing applications that can be precisely calibrated to specific material properties and the needs of the user. These deformable multimaterial composites, found to be stretchable and highly responsive in sensing applications, will expand the current mechanical abilities of deformable dielectric materials to improve soft robotic and stretchable electronic devices.


Magnetic microgels and nanogels: Physical mechanisms and biomedical applications.
Soft micro- and nanostructures have been extensively developed for biomedical applications. The main focus has been on multifunctional composite materials that combine the advantages of hydrogels and colloidal particles. Magnetic microgels and nanogels can be realized by hybridizing stimuli-sensitive gels and magnetic nanoparticles. They are of particular interest since they can be controlled in a wide range of biological environments by using magnetic fields. In this review, we elucidate physical principles underlying the design of magnetic microgels and nanogels for biomedical applications. Particularly, this article provides a comprehensive and conceptual overview on the correlative structural design and physical functionality of the magnetic gel systems under the concept of colloidal biodevices. To this end, we begin with an overview of physicochemical mechanisms related to stimuli-responsive hydrogels and transport phenomena and summarize the magnetic properties of inorganic nanoparticles. On the basis of the engineering principles, we categorize and summarize recent advances in magnetic hybrid microgels and nanogels, with emphasis on the biomedical applications of these materials. Potential applications of these hybrid microgels and nanogels in anticancer treatment, protein therapeutics, gene therapy, bioseparation, biocatalysis, and regenerative medicine are highlighted. Finally, current challenges and future opportunities in the design of smart colloidal biodevices are discussed.


Effects of environmental enrichment on ERK1/2 phosphorylation in the rat prefrontal cortex following nicotine-induced sensitization or nicotine self-administration.
Rats raised in an enriched condition (EC) exhibit alterations in the neurobiological and behavioral response to nicotine compared with rats reared in an impoverished condition (IC) or a standard condition (SC). The current study determined whether environmental enrichment differentially regulates extracellular signal-regulated kinase1/2 (ERK1/2) activity in the prefrontal cortex in rats following nicotine sensitization or nicotine self-administration. Under the saline control condition, EC rats displayed diminished baseline activity and greater sensitization to repeated administration of nicotine compared with IC and SC rats. After repeated saline injections, the basal levels of phosphorylated ERK1/2 (pERK1/2) were higher in EC compared with IC and SC rats, which was negatively correlated with their respective baseline activities. Repeated nicotine (0.35 mg/kg) injections induced pERK1/2 to similar levels in SC and IC rats; however, the induction of pERK1/2 in EC rats by nicotine was not significantly different from saline controls, owing to their high baseline. In the self-administration paradigm, EC rats self-administered less nicotine (0.03 mg/kg/infusion) relative to IC or SC rats on a fixed ratio-1 schedule of reinforcement. Accordingly, no differences in pERK1/2 were found between EC and IC rats self-administering saline, whereas nicotine self-administration resulted in an increase in pERK1/2 in IC rats but not in EC rats. Furthermore, the levels of pERK1/2 in EC and IC rats were positively correlated with their respective total number of nicotine infusions. Thus, these findings suggest that environmental enrichment alters the basal and nicotine-mediated pERK1/2, which may contribute to enrichment-induced behavioral alterations in response to nicotine.


[Pneumoparotitis or pneumoparotid: a differential diagnosis to consider].
Childhood parotid swelling has a number of differential diagnosis mostly of inflammatory origin. Pneumoparotitis is an uncommon cause of parotid inflammation. It is caused by an excessive increase of intraoral pressure and secondary passage of air into the Stensen or Stenon duct and its glandular branches. Diagnostic clues can usually be obtained by a directed anamnesis. Ultrasonography (US) and computed tomography are essential diagnostic tools for this condition that has a benign course with spontaneous resolution in most cases. We present four cases of pneumoparotitis diagnosed by US in children 5 to 13 years of age. One of the cases occurred after the child chewed gum and made bubbles for a prolonged time-period and the other three after inflating baloons, making bubbles inside a pool and after playing the flute. All cases resolved spontaneously after two days. We suggest to consider pneumoparotitis in the differential diagnosis of parotid swelling in children.


[Androgen insensitivity syndromes].
The syndromes of androgen resistance illustrate a special field of endocrinology, that is pathology of target-tissues. These syndromes are responsible for male pseudohermaphroditism and provoke in XY subjects, with a normal testicular androgen secretion, abnormalities in the phenotype with all the possibilities from an "idealistically" female phenotype in the testicular feminization syndrome to an almost normal male phenotype in the mildest forms of the incomplete syndrome. Understanding of these syndromes has strongly benefited of progress in biochemistry and molecular biology concerning the mechanism of action of androgens. On the other hand, understanding androgen mechanism expanded markedly from parallel clinical observation and biochemical investigation permitted by methodological progress: plasma hormones assays, 5 alpha-reductase and androgen receptor qualitative and quantitative determinations. The complete form of the testicular feminization syndrome seems to be due--in most cases--to an absence of the androgen receptor whereas the incomplete forms of the syndrome are related either to insufficient amount or qualitative alteration of the receptor or to a defect of 5 alpha-reductase, the key-enzyme which transforms testosterone to its active metabolite dihydrotestosterone in androgen target-cells. In some cases (approximately equal to 10%) the mechanism of androgen insensitivity could not be identified. The abnormality might be downstream the receptor at various possible steps = binding of the complex androgen-receptor to the chromatin, transcription or post-transcription process. These cases can be useful models for understanding the ultimate steps of the androgen mechanism of action.


Soil-transmitted helminth infections among plantation sector schoolchildren in Sri Lanka: prevalence after ten years of preventive chemotherapy.
The plantation sector in Sri Lanka lags behind the rest of the country in terms of living conditions and health. In 1992, a sector-wide survey of children aged 3-12 years and women of reproductive age showed >90% prevalence of soil-transmitted helminth infections. Biannual mass de-worming targeting children aged 3-18 years started in 1994 and was continued until 2005. The present study was carried out to assess the status of infection four years after cessation of mass de-worming. A school-based cross-sectional survey was carried out. Faecal samples from approximately 20 children from each of 114 schools in five districts were examined using the modified Kato-Katz technique. Data regarding the school, the child's family and household sanitation were recorded after inspection of schools and households. Multivariate analysis was carried out using logistic regression, to identify risk factors for infection. Faecal samples were obtained from 1890 children. In 4/5 districts, >20% were infected with one or more helminth species. Overall combined prevalence was 29.0%; 11.6% had infections of moderate-heavy intensity. The commonest infection was Ascaris lumbricoides, present in all five districts, as was Trichuris trichiura. Hookworm was not detected in two districts. Multivariate analysis identified low altitude and maternal under-education as risk factors for all three infections. Poor household sanitation was identified as a risk factor for A. lumbricoides and hookworm, but not T. trichiura infections. The results indicate that regular mass de-worming of plantation sector children should be resumed along with more emphasis on better sanitation and health education. They show that even after 10 years of mass chemotherapy, prevalence can bounce back after cessation of preventive chemotherapy, if the initial force of transmission is strong and other long-term control measures are not concomitantly implemented.


Identification and absolute quantification of enzymes in laundry detergents by liquid chromatography tandem mass spectrometry.
In a stricter legislative context, greener detergent formulations are developed. In this way, synthetic surfactants are frequently replaced by bio-sourced surfactants and/or used at lower concentrations in combination with enzymes. In this paper, a LC-MS/MS method was developed for the identification and quantification of enzymes in laundry detergents. Prior to the LC-MS/MS analyses, a specific sample preparation protocol was developed due to matrix complexity (high surfactant percentages). Then for each enzyme family mainly used in detergent formulations (protease, amylase, cellulase, and lipase), specific peptides were identified on a high resolution platform. A LC-MS/MS method was then developed in selected reaction monitoring (SRM) MS mode for the light and corresponding heavy peptides. The method was linear on the peptide concentration ranges 25-1000 ng/mL for protease, lipase, and cellulase; 50-1000 ng/mL for amylase; and 5-1000 ng/mL for cellulase in both water and laundry detergent matrices. The application of the developed analytical strategy to real commercial laundry detergents enabled enzyme identification and absolute quantification. For the first time, identification and absolute quantification of enzymes in laundry detergent was realized by LC-MS/MS in a single run. Graphical Abstract Identification and quantification of enzymes by LC-MS/MS.


IL-23 drives pathogenic IL-17-producing CD8+ T cells.
IL-17-producing CD8(+) T cells (Tc17) appear to play a role in a range of conditions, such as autoimmunity and cancer. Thus far, Tc17 cells have been only marginally studied, resulting in a paucity of data on their biology and function. We demonstrate that Tc17 and Th17 cells share similar developmental characteristics, including the previously unknown promoting effect of IL-21 on Tc17 cell differentiation and IL-23-dependent expression of IL-22. Both STAT1 and STAT4 are required for optimal development of Tc17 cells and maximal secretion of cytokines. Tc17 cells are cytotoxic, and they can be either pathogenic or nonpathogenic upon adoptive transfer in the model of autoimmune diabetes. Tc17 cells treated with TGF-beta1 plus IL-6 are not diabetogenic, whereas IL-23-treated cells potently induce the disease. IL-17A and IL-17F are necessary but not sufficient for diabetes induction by Tc17 cells. Tc17 cells treated with TGF-beta1 plus IL-6 or IL-23 likely differ in pathogenicity due to their disparate capacity to attract other immune cells and initiate inflammation.


Development of rotating electrochemical detectors for capillary electrophoresis.
A rotating disk electrode (RDE) has been evaluated and optimized for the detection of electroactive species separated by capillary electrophoresis (CE). With catechol as a working model, the limit of detection was estimated to be 0.3 microM, i.e., approximately 2.5-fold better than that of the stationary disk electrode (0.7 microM). Separation efficiency was significantly improved as exemplified by an increase of theoretical plates from 26,000 plates/m at 0 rpm to 67,000 plates/m at 500 rpm. Of particular importance was the capability of RDE to alleviate electrode passivation and electrical interference associated with high separation potential fields. Therefore, rotation amperometry was especially useful for analytes such as phenolic compounds that tended to rapidly foul the electrode surface. The RDE/ CE system was capable of separation and determination of pentachlorophenol in contaminated soils, and the result obtained agreed well with conventional liquid chromatography, an EPA recommended procedure.


On the epistemology of mental illness.
The most important epistemological problem in psychiatry is the detection of malingering. This is a consequence of the fact that there is no objective way to confirm any psychiatric diagnosis. Psychiatric diagnosis is based on subjective complaints. The discovery of objective markers for psychiatric diagnosis is problematic because it presupposes we can tell valid from faked subjective symptoms. But this is the difficulty. If we use pervasive irrationality as a sign of mental illness, we encounter the problem of identifying pervasive irrationality. To understand someone's behaviour, we have to assume it is largely rational. This precludes us from using behaviour to separate genuine from faked mental illness. There are a number of strategies used to solve any epistemological problem, and the most successful is the hypothetico-deductive method. If we use this, we can solve our epistemological problem. Genuine mental illness can be identified when it is the best explanation of the person's overall behaviour. Consilience of inductions is critical in supporting the validity of such explanations. This implies that it is merely a hypothesis that mental illness exists, and that we might discover that many mental illnesses, perhaps all, do not exist. We must embrace this possibility--only if we take a risk will we gain any knowledge.


Personality factors related to black teenage pregnancy and abortion.
48 pregnant adolescents who applied for therapeutic abortions (TAs) were compared with 55 adolescents who planned to have their babies (Terms) and 67 adolescents who were not pregnant (Controls) on the California Psychological Inventory (CPI). All the subjects were single, black, and ages 15-16. CPI results point to psychological differences with the Controls being most socialized, followed by the TAs, and then the Terms. Term girls seem to be experiencing a void and appear to be trying to fill it by assuming an adult role and having a baby; the TAs do not seem to have these same needs. In addition, those girls who became pregnant and described the relationship with the putative father as casual, appear on the CPI to have more daily problems, lack socialization, be less clear thinking, and have poor self-control. Pregnant girls who have good communication with their mothers showed no differences on the CPI from girls with poor communication with their mothers.


California's Senate Bill 277: Local Health Jurisdictions' Experiences With the Elimination of Nonmedical Vaccine Exemptions.
Objectives. To understand the experiences of local health jurisdictions with Senate Bill 277 (SB277), the California law that eliminated nonmedical vaccine exemptions for public- and private-school entry.Methods. We conducted semistructured telephone interviews with health officers and local health department (LHD) staff in California between August and September 2017.Results. Two overall themes emerged: (1) vague legislative and regulatory language led to variation in the interpretation and implementation of SB277, and (2) lack of centralized review of medical exemptions allowed medical exemptions that are not consistent with valid contraindications for immunizations to be accepted. Variation in the interpretation and implementation was commonly reported with provisions related to individualized education programs and special education, and independent study programs and homeschooling. Without a centralized review of medical exemption requests, respondents reported variation in the interpretation of which specialties of physicians can write medical exemptions, which conditions constitute a valid contraindication for immunization, and the process for reporting a questionable or suspicious medical exemption.Conclusions. The regulatory language within SB277 led to variation in how the law was interpreted and implemented within and across LHD jurisdictions and school districts.


Differential Diagnostic Challenges in the COVID-19 Pandemic: Renal Abscess After SARS-CoV-2 Infection in a Young Adolescent.
BACKGROUND Prolonged fever in pediatric patients is often a diagnostic challenge. Clinicians tend to associate prolonged fever with COVID-19-related diseases in patients with a history of SARS-CoV-2 infection. Here we present a patient who was admitted with a clinical suspicion of multi-inflammatory syndrome in children (MIS-C) and was finally diagnosed with a renal abscess. CASE REPORT A 16-year-old girl with prolonged fever, bilateral non-purulent conjunctivitis, weight loss, muscle pain, general malaise, cough, and yellow sputum was admitted to Heim Pál National Pediatric Institute, Budapest, Hungary. She had proven SARS-CoV-2 infection 3 weeks prior to admission. Although inflammatory markers were elevated, repeated urine analyses, aerobic and anaerobic urine cultures, hemoculture, chest X-ray, and otorhinolaryngology examinations were negative. Based on clinical and laboratory criteria, the diagnosis of MIS-C was eventually ruled out. Abdominal ultrasound revealed a 17×20×15 mm simplex cyst at the edge of the parenchyma in the upper third of the left kidney. Magnetic resonance imaging was performed, showing a multi-compartment, septated, thick-walled parenchymal lesion of 50×40×52 mm in the upper pole of the right kidney, which showed signal characteristics of an abscess, and 20×16 mm and 8 mm lesions in the upper pole of the left kidney, which appeared to be cysts. After being unresponsive to intravenous wide-spectrum antibiotic therapy (meropenem 2 g tid for 5 days), surgical intervention was needed to remove the abscess. CONCLUSIONS This case demonstrates that during the COVID-19 pandemic, besides the obvious post-COVID etiology, other life-threatening conditions should be investigated in the first line.


Are fish less responsive to a flow stimulus when swimming?
Fish use the lateral line system to sense the water flow created by a predator's strike. Despite its potential importance to the survival of a diversity of species, it is unclear whether this ability becomes compromised when a fish swims. Therefore, the present study compared the behavioral responsiveness of swimming and motionless zebrafish (Danio rerio) larvae when exposed to the flow of a suction-feeding predator. This flow was generated with an impulse chamber, which is a device that we developed to generate a repeatable stimulus with a computer-controlled servo motor. Using high-speed video recordings, we found that about three-quarters (0.76, N=121) of motionless larvae responded to the stimulus with an escape response. These larvae were 66% more likely to respond to flow directed perpendicular than flow running parallel to the body. Swimming larvae exhibited a 0.40 response probability and were therefore nearly half as likely to respond to flow as motionless larvae. However, the latency between stimulus and response was unaffected by swimming or the direction of flow. Therefore, swimming creates changes in the hydrodynamics or neurophysiology of a larval fish that diminish the probability, but not the speed, of their response to a flow stimulus. These findings demonstrate a sensory benefit to the intermittent swimming behavior observed among a broad diversity of fishes.


Renal vascular reactivity to P(2)-purinoceptor activation in spontaneously hypertensive rats.
This study was performed to determine the possible contribution of an imbalance between P(2X) (vasoconstriction) and P(2Y) (vasodilation)-purinergic reactivity to the increased vascular resistance of spontaneously hypertensive rats (SHR). The vasoactive responses to alpha,beta-methylene ATP and 2-methylthio ATP specific agonists, respectively, for P(2X) and P(2Y) purinergic receptors were characterized in isolated perfused kidneys from Wistar Kyoto (WKY) and SHR. To analyze P(2X)- and P(2Y)-purinergic reactivity we used phenylephrine and barium chloride, or acethylcholine (ACh) and sodium nitroprusside (NP) as reference compounds, respectively. The renal vasculature from SHR showed markedly enhanced reactivity to alpha,beta-methylene ATP, phenylephrine and barium chloride. The dose-response curves were characterized by a similar threshold, with a greater maximal response. There were no significant differences in the dose-response curves or in maximal vasodilation to 2-methylthio ATP, ACh or NP when both groups were compared, except at the dose of 10(-6) g/g kidney weight of NP in which the SHR group showed an increased responsiveness. The results indicate that the increased responsiveness of kidneys from SHR to alpha,beta-methylene ATP may be due to nonspecific functional changes in the renal vasculature rather than to a specific alteration in the activity of renal P(2X)-purinoceptors. Our results also indicate that P(2Y)-purinergic reactivity, nitric oxide-induced vasodilation and the cGMP-dependent mechanisms of vasodilation are well preserved in SHR.


Immunohistochemical characterization of proliferation, oestrogen receptor and progesterone receptor expression in endometriosis: comparison of eutopic and ectopic endometrium with normal cycling endometrium.
Recent studies examining oestrogen and progesterone receptor status and the proliferative activity of endometriotic lesions have produced conflicting reports. This study aimed to clarify the receptor status and proliferative activity of eutopic and ectopic endometrium from women with endometriosis and endometrium from normal women. Progesterone and oestrogen receptor expression and proliferative activity were studied in eutopic and ectopic endometrium from 30 women with endometriosis and in endometrium from 30 normal cycling women using microwave-pretreated paraffin-embedded sections stained with an avidin-biotin peroxidase technique. Progesterone and oestrogen receptor expression in the control endometrium did not differ from that of eutopic endometrium from women with endometriosis. Oestrogen receptor expression in ectopic endometrium increased from the proliferative to the late secretory phase. Epithelial progesterone receptor expression decreased during the cycle. Oestrogen receptor expression in both epithelium and stroma of ectopic endometrium was significantly higher than in eutopic endometrium throughout the cycle. In contrast, stromal progesterone receptor expression tended to be reduced in ectopic endometrium compared with eutopic tissue. Epithelial progesterone receptor expression was increased in ectopic endometrium but only in the late secretory phase. Although proliferative activity in the epithelium of control and eutopic endometrium was reduced from the proliferative to the late secretory phase, stromal activity did not vary. The proliferative activity in ectopic endometrium remained low and constant throughout the cycle. In the proliferative and early secretory phases, the proliferative activity of eutopic endometrium was increased compared with ectopic endometrium, but in the late secretory phase, levels were comparable. These findings challenge previous reports which have suggested that oestrogen receptors are reduced in ectopic tissue. This may have clinical implications for the development of novel treatments for endometriosis.


Protective effects of quercetin on ultraviolet A light-induced oxidative stress in the blood of rat.
The oxidative effects of ultraviolet A (UVA) light (320-400 nm) and the antioxidant effects of quercetin were examined in rat blood. For this purpose, rats were divided into three groups: control, ultraviolet (UV) and ultraviolet + quercetin (UV + Q). The UV and UV + Q groups were irradiated for 4 h a day with UVA light (1.25 mW cm(2)) during periods of 3, 6 and 9 days. Quercetin (50 mg kg(-1) body wt.) was administered intraperitoneally in the UV + Q group rats before irradiation periods. Blood was taken 3, 6 and 9 days post-treatment. Plasma malondialdehyde (MDA) levels significantly increased after 9 days of daily exposure to UVA. Whole blood glutathione (GSH) levels significantly declined after 3-9 days of irradiation. Glutathione peroxidase activity on days 6 and 9 and glutathione reductase activities on days 3, 6 and 9 post-irradiation were diminished significantly. Superoxide dismutase and catalase activities decreased significantly 3-9 days post-irradiation. The administration of quercetin before the 9-day period of irradiation significantly reduced the increase in plasma MDA value. Whole blood GSH levels significantly decreased with the administration of quercetin on all days. Quercetin significantly increased antioxidant enzymes diminished by UVA irradiation. Exposure of rats to UVA light leads to oxidative stress, reflected by increased MDA and reduced antioxidant enzyme levels. The administration of quercetin appears to be a useful approach to reduce the damage produced by UVA radiation.


An examination of the relationships between home health service use and primary diagnosis of patient.
This paper analyses the relationships between home health service use and primary diagnosis of patient. Relationships examined include: patient distribution by diagnosis, visit distribution by diagnosis, average number of visits per patient and standard deviation, by diagnosis. Reliability of diagnosis as a predictor or service use is examined by a scatter graph comparison of the mean number of visits per patient, by diagnosis, between two randomly assigned groups of agencies. Survey data indicate that circulatory system diseases are the largest diagnostic category in both patient and visit count, constituting approximately 25% of all visits. Neoplasms (11% of visits) and diseases of the musculoskeletal system and connective tissue (10% of visits) are also strongly represented. Although the range of means for average number of visits is large, the scatter graph analysis gave evidence of relationship between diagnosis and service use.


Cell surface growth factor receptor molecules as targets for cancer therapy.
Extract: Molecular communication is essential for the coordinated development and life of multicellular organisms. This process involves sending, receiving and promoting signals by means of elaborate signal transduction networks. Important players for these processes are cell surface receptors which transmit signals across the cell's outer barrier, the cell membrane. The so-called receptor tyrosine kinases (RTKs) play a central role within this group of proteins by controlling a wide array of biological functions such as cell migration, proliferation, survival or differentiation. Concomitantly, deregulated signal transduction leads to aberrant cellular behavior and, as a consequence, can induce or contribute to various pathophysiological disorders such as cancer. Based on this rationale RTKs have been discovered as prime targets for therapeutic intervention and the first drugs that have been approved demonstrate the potential of this approach. A kinase is an enzyme that catalyzes the addition of a phosphoryl group to a molecule, an event called phosphorylation. Tyrosine kinase adds a phosphoryl group to the tyrosine residue of a protein.


Deep learning model inspired by lateral line system for underwater object detection.
Inspired by the lateral line systems of various aquatic organisms that are capable of hydrodynamic imaging using ambient flow information, this study develops a deep learning-based object localization model that can detect the location of objects using flow information measured from a moving sensor array. In numerical simulations with the assumption of a potential flow, a two-dimensional hydrofoil navigates around four stationary cylinders in a uniform flow and obtains two types of sensory data during a simulation, namely flow velocity and pressure, from an array of sensors located on the surface of the hydrofoil. Several neural network models are constructed using the flow velocity and pressure data, and these are used to detect the positions of the hydrofoil and surrounding objects. The model based on a long short-term memory network, which is capable of learning order dependence in sequence prediction problems, outperforms the other models. The number of sensors is then optimized using feature selection techniques. This sensor optimization leads to a new object localization model that achieves impressive accuracy in predicting the locations of the hydrofoil and objects with only 40% of the sensors used in the original model.


The development and evaluation of a web-based programme to support problem-solving skills following brain injury.
Cognitive impairments following brain injury, including difficulty with problem solving, can pose significant barriers to successful community reintegration. Problem-solving strategy training is well-supported in the cognitive rehabilitation literature. However, limitations in insurance reimbursement have resulted in fewer services to train such skills to mastery and to support generalization of those skills into everyday environments. The purpose of this project was to develop and evaluate an integrated, web-based programme, ProSolv, which uses a small number of coaching sessions to support problem solving in everyday life following brain injury. We used participatory action research to guide the iterative development, usability testing, and within-subject pilot testing of the ProSolv programme. The finalized programme was then evaluated in a between-subjects group study and a non-experimental single case study. Results were mixed across studies. Participants demonstrated that it was feasible to learn and use the ProSolv programme for support in problem solving. They highly recommended the programme to others and singled out the importance of the coach. Limitations in app design were cited as a major reason for infrequent use of the app outside of coaching sessions. Results provide mixed evidence regarding the utility of web-based mobile apps, such as ProSolv to support problem solving following brain injury. Implications for Rehabilitation People with cognitive impairments following brain injury often struggle with problem solving in everyday contexts. Research supports problem solving skills training following brain injury. Assistive technology for cognition (smartphones, selected apps) offers a means of supporting problem solving for this population. This project demonstrated the feasibility of a web-based programme to address this need.


The influence of social consensus information on intergroup attitudes: the moderating effects of ingroup identification.
Two studies examined the role of ingroup identification in the influence of social consensus information (information about others' beliefs) on intergroup attitudes. Research demonstrates that consensus information influences individuals' intergroup attitudes. However, the extent to which individuals identify with the group providing consensus information seems important to understanding consensus effects. In Study 1, 100 high or low ingroup identifiers received information that other ingroup members held favorable or unfavorable attitudes toward African Americans and then provided their own attitudes. In Study 2, 250 participants completed an ingroup identification manipulation (high, low, or control) before receiving favorable or no consensus information. Results of both studies demonstrated that ingroup identification moderated consensus effects, such that high identifiers were more susceptible to others' beliefs than individuals in the low identification and control conditions. In determining critical factors involved in consensus effects, we hope to create a useful method to promote favorable intergroup attitudes and behaviors.


Social determinants of health associated with psychological distress stratified by lifetime traumatic brain injury status and sex: Cross-sectional evidence from a population sample of adults in Ontario, Canada.
This study identified the social determinants of health (SDoH) associated with psychological distress in adults with and without a self-reported history of traumatic brain injury (TBI), stratified by sex. Data from the 2014-2017 cycles of the Centre for Addiction and Mental Health Monitor Survey, a representative survey of adults ≥18 years in Ontario, Canada, were analyzed (N = 7,214). The six-item version of the Kessler Psychological Distress Scale was used to determine moderate to severe psychological distress. Self-reported lifetime TBI was defined as a head injury resulting in a loss of consciousness for ≥5 minutes or at least one-night stay in the hospital (16.4%). Among individuals reporting a history of TBI, 30.2% of males and 40.1% of females reported psychological distress (p = 0.0109). Among individuals who did not report a history of TBI, 17.9% of males and 23.5% of females reported psychological distress (p<0.0001). Multivariable logistic regression analyses showed that the SDoH significantly associated with elevated psychological distress were similar between individuals with and without a history of TBI. This included unemployment, student, or 'other' employment status among both males and females; income below the provincial median and age 65+ among males; and rural residence among females. This study highlighted opportunities for targeted population-level interventions, namely accessible and affordable mental health supports for individuals with lower income. Notably, this study presented evidence suggesting adaptations to existing services to accommodate challenges associated with TBI should be explored, given the finite and competing demands for mental health care and resources.


Slr1670 from Synechocystis sp. PCC 6803 Is Required for the Re-assimilation of the Osmolyte Glucosylglycerol.
When subjected to mild salt stress, the cyanobacterium Synechocystis sp. PCC 6803 produces small amounts of glycerol through an as of yet unidentified pathway. Here, we show that this glycerol is a degradation product of the main osmolyte of this organism, glucosylglycerol (GG). Inactivation of ggpS, encoding the first step of GG-synthesis, abolished de novo synthesis of glycerol, while the ability to hydrolyze exogenously supplied glucoslylglycerol was unimpaired. Inactivation of glpK, encoding glycerol kinase, had no effect on glycerol synthesis. Inactivation of slr1670, encoding a GHL5-type putative glycoside hydrolase, abolished de novo synthesis of glycerol, as well as hydrolysis of GG, and led to increased intracellular concentrations of this osmolyte. Slr1670 therefore presumably displays GG hydrolase activity. A gene homologous to the one encoded by slr1670 occurs in a wide range of cyanobacteria, proteobacteria, and archaea. In cyanobacteria, it co-occurs with genes involved in GG-synthesis.


Mapping the lateral extent of human cadaver decomposition with soil chemistry.
Soil below decomposing cadavers may have a different lateral spatial extent depending upon whether scavengers have access to the human cadaver or not. We examined the lateral spatial extent of decomposition products to a depth of 7cm of soils beneath two decomposing corpses, one in which the subject was autopsied, unclothed and placed under a wire cage to restrict scavenger access and one in which the subject was not autopsied, unclothed and exposed to scavengers. The two bodies had accumulated degree days (ADD) of 5799 and 5469 and post mortem interval (PMI) of 288 and 248d, respectively. The spatial extent for dissolved organic carbon (DOC) and organic nitrogen (DON) for both bodies was large but similar suggesting some movement off site for both compounds. Mean DOC was 1087±727 and 1484±1236μgg(-1) dry soil under the two corpses relative to 150±68μgg(-1) in upslope control soils. Sulfate tended to have 'hot spots' of lower values relative to the control soils indicative of anaerobic respiration. pH was lower and electrical conductivity was higher in the soil under both decomposing cadavers relative to control soils. Some of the nutrients examined downslope of the human remains were significantly higher than control soils upslope suggesting movement of decomposition products off-site which could be an important factor when using human remains detector dogs.


Food safety in Vietnam: where we are at and what we can learn from international experiences.
Food-borne diseases are attracting a lot of attention in Vietnam as a result of repeated episodes of adulterated and unsafe food. In this paper, we provide some perspectives on food safety in Vietnam from the point of view of an international research institution working on food safety with partners in the country. We argue that one of the key issues of food safety in Vietnam is that certain food value chain stakeholders lack ethics, which leads to the production and trading of unsafe foods in order to make profits irrespective of adverse health effects on consumers. In turn, the shortfall in ethical behaviours around food can be attributed to a lack of incentives or motivating factors.Although food safety causes panic in the population, it is unclear how much contaminated food contributes to the burden of food-borne diseases and food poisonings in Vietnam. However, globally, the biggest health problem associated with food are infections from consuming food contaminated with viruses, bacteria or parasites. A major food safety challenge is the inappropriate way of communicating food risks to the public. Another key constraint is the inherent difficulty in managing food in wet markets and from smallholder production. On the other hand, local foods, and local food production and processing are an important cultural asset as well as being essential to food safety, and these aspects can be put at risk if food safety concerns motivate consumers to purchase more imported foods.In this paper, we also discuss good experiences in food safety management from other countries and draw lessons learnt for Vietnam on how to better deal with the current food safety situation.


[Subcranial subfrontal approach for the treatment of extensive cerebrospinal fluid leaks].
Over the time, the management of cerebrospinal fluid (CSF) rhinorrhea has been a major surgical challenge. In this paper, we will describe our experience using the extended anterior subcranial approach for the repair of extensive or previously treated CSF leaks. This approach consists of a nasoorbitofrontal bony flap, then an ethmoidectomy and sphenoidectomy are performed and the empty space is filled with subcutaneous fat, a pediculated periostal flap is dissected and layed extradurally at the base of the anterior cranial fossa. Between January 1994 and December 1999, we reviewed the charts of 7 men and 3 women with a mean age of 36.5 years. The etiology was traumatic in 8 cases. One patient had a spontaneous CSF leak, the other had a macroprolactinoma. The average duration of surgery was 5 hours. Patients were kept in the Intensive Care unit for an average period of 36 hours. The mean follow-up period was 30 months. The success rate was 100%. Postoperatively, all of our patients were anosmic, four of them had anosmia as a preoperative finding. Cosmetically, the skin incisions are limited to the bicoronal incision. Knowing that the classical subfrontal and endoscopic approaches have their definite indications, our experience with the extended anterior subfrontal approach in the treatment of extensive or multiple anterior fossa defects suggests that it is a reliable procedure, giving an excellent access with low morbidity, provided that the patients are selected properly.


Proof of principle of ocular sparing in dogs with sinonasal tumors treated with intensity-modulated radiation therapy.
Intensity-modulated radiation therapy (IMRT) allows optimization of radiation dose delivery to complex tumor volumes with rapid dose drop-off to surrounding normal tissues. A prospective study was performed to evaluate the concept of conformal avoidance using IMRT in canine sinonasal cancer. The potential of IMRT to improve clinical outcome with respect to acute and late ocular toxicity was evaluated. Thirty-one dogs with sinonasal cancer were treated definitively with IMRT using helical tomotherapy and/or dynamic multileaf collimator (DMLC) delivery. Ocular toxicity was evaluated prospectively and compared with a comparable group of historical controls treated with conventional two-dimensional radiotherapy (2D-RT) techniques. Treatment plans were devised for each dog using helical tomotherapy and DMLC that achieved the target dose to the planning treatment volume and limited critical normal tissues to the prescribed dose-volume constraints. Overall acute and late toxicities were limited and minor, detectable by an experienced observer. This was in contrast to the profound ocular morbidity observed in the historical control group treated with 2D-RT. Overall median survival for IMRT-treated and 2D-treated dogs was 420 and 411 days, respectively. Compared with conventional techniques, IMRT reduced dose delivered to eyes and resulted in bilateral ocular sparing in the dogs reported herein. These data provide proof-of-principle that conformal avoidance radiotherapy can be delivered through high conformity IMRT, resulting in decreased normal tissue toxicity as compared with historical controls treated with 2D-RT.


Maori health issues explored in an interprofessional learning context.
In New Zealand there is emphasis on improving access to primary healthcare, particularly for high health need populations such as Maori, the indigenous people of New Zealand. Critical to the development of the primary healthcare environment is building healthcare teams and better utilising health practitioners. This article reports on an interprofessional educational initiative where medical, nursing and pharmacy undergraduates learnt together in order to understand Maori health issues, how these are addressed by health services and also appreciate the contribution of different health professionals within the healthcare team. The educational initiative is described and interprofessional learning issues are explored across the different curricula structures of medicine, nursing and pharmacy.


New therapies for the pregnant patient with diabetes.
Gestational diabetes complicates 3-5% of pregnancies. Of diabetes seen during pregnancy, 10% is pregestational and the remaining 90% represents gestational diabetes. (1,2) Pregnancy in women with pregestational diabetes is especially high risk. Spontaneous abortion, preterm labor, congenital malformations, preeclampsia, macrosomia, birth injury, and cesarean section are all increased in these pregnancies. Deterioration of maternal health during pregnancy, especially in the setting of diabetes-induced end-organ disease, is a real concern. Vigilant surveillance and management of associated disorders such as retinopathy, nephropathy, and chronic hypertension are required. During the preinsulin era, maternal and perinatal mortality in pregnancies complicated by pregestational diabetes was approximately 50%. (1,2) Although modern obstetrical management and the appropriate use of insulin have dramatically improved maternal-fetal outcomes, pregnant patient with diabetes remains at increased risk for complications. There is no doubt that optimizing maternal glucose control is a key element in avoiding established perinatal risks. The most effective means to accomplish this control are topics of active research. Further, hormonal changes during pregnancy can make glycemic control difficult even for the most compliant and educated patient. This paper discusses several new approaches, either currently in practice or under consideration, to pregnancies complicated by diabetes, including oral hypoglycemic agents, lispro, the insulin pump, and transplantation.


Assessing the fate and effects of an insecticidal formulation.
A 3-yr study was conducted on a corn field in central Illinois, USA, to understand the fate and effects of an insecticidal formulation containing the active ingredients phostebupirim and cyfluthrin. The objectives were to determine the best tillage practice (conventional vs conservation tillage) in terms of grain yields and potential environmental risk, to assess insecticidal exposure using concentrations measured in soil and runoff water and sediments, to compare measured insecticidal concentrations with predicted concentrations from selected risk assessment exposure models, and to calculate toxicity benchmarks from laboratory bioassays performed on reference aquatic and terrestrial nontarget organisms, using individual active ingredients and the formulation. Corn grain yields were not significantly different based on tillage treatment. Similarly, field concentrations of insecticides were not significantly (p > 0.05) different in strip tillage versus conventional tillage, suggesting that neither of the tillage systems would enable greater environmental risk from the insecticidal formulation. Risk quotients were calculated from field concentrations and toxicity data to determine potential risk to nontarget species. The insecticidal formulation used at the recommended rate resulted in soil, sediment, and water concentrations that were potentially harmful to aquatic and terrestrial invertebrates, if exposure occurred, with risk quotients up to 34.


Post-Alignment Adjustment and Its Automation.
Multiple sequence alignment (MSA) is the basis for almost all sequence comparison and molecular phylogenetic inferences. Large-scale genomic analyses are typically associated with automated progressive MSA without subsequent manual adjustment, which itself is often error-prone because of the lack of a consistent and explicit criterion. Here, I outlined several commonly encountered alignment errors that cannot be avoided by progressive MSA for nucleotide, amino acid, and codon sequences. Methods that could be automated to fix such alignment errors were then presented. I emphasized the utility of position weight matrix as a new tool for MSA refinement and illustrated its usage by refining the MSA of nucleotide and amino acid sequences. The main advantages of the position weight matrix approach include (1) its use of information from all sequences, in contrast to other commonly used methods based on pairwise alignment scores and inconsistency measures, and (2) its speedy computation, making it suitable for a large number of long viral genomic sequences.


Scurvy: a rare cause of haemarthrosis.
A male in his 60s with a history of previously treated locally advanced head and neck cancer presented to the emergency department with atraumatic left knee pain and upper and lower extremity ecchymoses that had been present for 3 weeks. His initial laboratory results showed a normocytic anaemia, normal platelet count, slightly abnormal coagulation studies and normal inflammatory markers. Arthrocentesis of the left knee revealed haemarthrosis, and additional laboratory workup found an undetectable serum vitamin C (ascorbic acid) level consistent with scurvy. It was determined that scurvy had predisposed the patient to injury, leading to haemarthrosis. Following vitamin C supplementation, dietary and activity modifications, and acetaminophen as needed, the patient's serum vitamin C level normalised and his left knee pain and swelling improved. Scurvy is a rare cause of haemarthrosis, but it should be recognised in at-risk patients since treatment is effective.


Occult hepatitis B virus infection among Egyptian blood donors.
To identify blood donors with occult hepatitis B virus (HBV) infection (OBI) to promote safe blood donation. Descriptive cross sectional study was conducted on 3167 blood donors negative for hepatitis B surface antigen (HBsAg), hepatitis C antibody (HCV Ab) and human immunodeficiency virus Ab. They were subjected to the detection of alanine aminotransferase (ALT) and aspartate transaminase (AST) and screening for anti-HBV core antibodies (total) by two different techniques; [Monoliza antibodies to hepatitis B core (Anti-HBc) Plus-Bio-Rad] and (ARC-HBc total-ABBOT). Positive samples were subjected to quantitative detection of antibodies to hepatitis B surface (anti-HBs) (ETI-AB-AUK-3, Dia Sorin-Italy). Serum anti-HBs titers > 10 IU/L was considered positive. Quantitative HBV DNA by real time polymerase chain reaction (PCR) (QIAGEN-Germany) with 3.8 IU/mL detection limit was estimated for blood units with negative serum anti-HBs and also for 32 whose anti-HBs serum titers were > 1000 IU/L. Also, 265 recipients were included, 34 of whom were followed up for 3-6 mo. Recipients were investigated for ALT and AST, HBV serological markers: HBsAg (ETI-MAK-4, Dia Sorin-Italy), anti-HBc, quantitative detection of anti-HBs and HBV-DNA. 525/3167 (16.6%) of blood units were positive for total anti-HBc, 64% of those were anti-HBs positive. Confirmation by ARCHITECT anti-HBc assay were carried out for 498/525 anti-HBc positive samples, where 451 (90.6%) confirmed positive. Reactivity for anti-HBc was considered confirmed only if two positive results were obtained for each sample, giving an overall prevalence of 451/3167 (14.2%) for total anti-HBc. HBV DNA was quantified by real time PCR in 52/303 (17.2%) of anti-HBc positive blood donors (viral load range: 5 to 3.5 x 10(5) IU/mL) with a median of 200 IU/mL (mean: 1.8 x 10(4) ± 5.1 x 10(4) IU/mL). Anti-HBc was the only marker in 68.6% of donors. Univariate and multivariate logistic analysis for identifying risk factors associated with anti-HBc and HBV-DNA positivity among blood donors showed that age above thirty and marriage were the most significant risk factors for prediction of anti-HBc positivity with AOR 1.8 (1.4-2.4) and 1.4 (1.0-1.9) respectively. Other risk factors as gender, history of blood transfusion, diabetes mellitus, frequent injections, tattooing, previous surgery, hospitalization, Bilharziasis or positive family history of HBV or HCV infections were not found to be associated with positive anti-HBc antibodies. Among anti-HBc positive blood donors, age below thirty was the most significant risk factor for prediction of HBV-DNA positivity with AOR 3.8 (1.8-7.9). According to HBV-DNA concentration, positive samples were divided in two groups; group one with HBV-DNA ≥ 200 IU/mL (n = 27) and group two with HBV-DNA < 200 IU/mL (n = 26). No significant difference was detected between both groups as regards mean age, gender, liver enzymes or HBV markers. Serological profiles of all followed up blood recipients showed that, all were negative for the studied HBV markers. Also, HBV DNA was not detected among studied recipients, none developed post-transfusion hepatitis (PTH) and the clinical outcome was good. OBI is prevalent among blood donors. Nucleic acid amplification/HBV anti core screening should be considered for high risk recipients to eliminate risk of unsafe blood donation.


Characteristics of acute kidney injury in patients infected with the 2009 influenza A (H1N1) virus.
There have been few studies investigating acute kidney injury (AKI) in patients infected with the 2009 pandemic influenza A (H1N1) virus. Therefore, the objective of this study was to identify the factors associated with AKI in H1N1-infected patients. This was a study of 47 consecutive critically ill adult patients with reverse transcriptase-PCR-confirmed H1N1 infection in Brazil. Outcome measures were AKI (as defined by the Risk, Injury, Failure, Loss, and End-stage renal failure [RIFLE] criteria) and in-hospital death. AKI was identified in 25 (53%) of the 47 H1N1-infected patients. AKI was associated with vasopressor use, mechanical ventilation, high Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, and severe acidosis as well as with higher levels of C-reactive protein and lactic dehydrogenase upon intensive care unit (ICU) admission. A nephrology consultation was requested for 16 patients (64%), and 8 (50%) required dialysis. At ICU admission, 7 (15%) of the 25 AKI patients had not yet progressed to AKI. However, by 72 hours after ICU admission, no difference in RIFLE score was found between AKI survivors and nonsurvivors. Of the 47 patients, 9 (19%) died, all with AKI. Mortality was associated with mechanical ventilation, vasopressor use, dialysis, high APACHE II score, high bilirubin levels, and a low RIFLE score at ICU admission. Among critically ill H1N1-infected patients, the incidence of AKI is high. In such patients, AKI is mainly attributable to shock.


Using guideline-based clinical decision support in oncological multidisciplinary team meetings: A prospective, multicenter concordance study.
Multidisciplinary team meetings formulate guideline-based individual treatment plans based on patient and disease characteristics and motivate reasons for deviation. Clinical decision trees could support multidisciplinary teams to adhere more accurately to guidelines. Every clinical decision tree is tailored to a specific decision moment in a care pathway and is composed of patient and disease characteristics leading to a guideline recommendation. This study investigated (1) the concordance between multidisciplinary team and clinical decision tree recommendations and (2) the completeness of patient and disease characteristics available during multidisciplinary team meetings to apply clinical decision trees such that it results in a guideline recommendation. This prospective, multicenter, observational concordance study evaluated 17 selected clinical decision trees, based on the prevailing Dutch guidelines for breast, colorectal and prostate cancers. In cases with sufficient data, concordance between multidisciplinary team and clinical decision tree recommendations was classified as concordant, conditional concordant (multidisciplinary team specified a prerequisite for the recommendation) and non-concordant. Fifty-nine multidisciplinary team meetings were attended in 8 different hospitals, and 355 cases were included. For 296 cases (83.4%), all patient data were available for providing an unconditional clinical decision tree recommendation. In 59 cases (16.6%), insufficient data were available resulting in provisional clinical decision tree recommendations. From the 296 successfully generated clinical decision tree recommendations, the multidisciplinary team recommendations were concordant in 249 (84.1%) cases, conditional concordant in 24 (8.1%) cases and non-concordant in 23 (7.8%) cases of which in 7 (2.4%) cases the reason for deviation from the clinical decision tree generated guideline recommendation was not motivated. The observed concordance of recommendations between multidisciplinary teams and clinical decision trees and data completeness during multidisciplinary team meetings in this study indicate a potential role for implementation of clinical decision trees to support multidisciplinary team decision-making.