Microembolic signals within 24 hours of stroke onset and diffusion-weighted MRI abnormalities.
The clinical relevance of the microembolic signals (MES) detected by transcranial Doppler sonography (TCD) in acute stroke remains unclear. In a prospective study the authors analyzed the relationship between MES and the findings on diffusion-weighted magnetic resonance imaging (DWI) in acute stroke patients. We performed TCD for a period of 30 min to detect MES in patients within 24 h of stroke onset, and DWI was done within the initial 7 days. MES were assessed from Doppler waves obtained from the middle cerebral artery contralateral to the side of the neurological deficits. The acute ischemic lesions observed on DWI were classified by their diameter (small, medium or large) and by their site (cortical, superficial perforator territory, internal borderzone or deep perforator territory). We obtained Doppler waves from 39 vessels in 37 patients; 2 patients had bilateral deficits. MES were detected in 12 vessels (MES-positive group) and not detected in 27 vessels (MES-negative group). No significant differences in clinical features were observed between the 2 groups. The number of small lesions was significantly higher in the MES-positive group than in the MES-negative group (p = 0.02). The numbers of cortical and superficial perforator infarcts were significantly higher in the MES-positive group than in the MES-negative group (p = 0.002 and 0.02, respectively). In acute ischemic stroke, MES detected by TCD in the acute phase may produce small cortical and subcortical lesions found on DWI.


A method to avoid knot-tying in artificial chordae implantation for mitral valve repair.
Expanded polytetrafluoroethylene (ePTFE) neo-chordae implantation requires knot-tying inside the heart, which can be especially difficult if a minimally invasive approach is used. A system has been developed that allows the implantation of neo-chordae, without a need for knot-tying, in addition to a simultaneous and reversible length adjustment after the evaluation of valve continence using hydrostatic tests. The system consists of a suture with a needle at one end and a 20 mm pledgeted loop at the opposite end. The suture presents five stop-knots at constant (2 mm) intervals, starting 35 mm from the base of the loop. The suture is passed first through the leaflet, then through the papillary muscle, then inside a reversible noose-lace (cow-hitch) that is made on the loop. The noose-lace is closed under one of the knots of the suture coming from the papillary muscle. After closing the loop at a presumably optimal length, a hydrostatic test is performed. The chordal length can be modified by releasing the noose-lace and sliding it over another fixing-knot until an optimal distance is obtained. Fourteen patients underwent repair with this technique. No deaths or major adverse events occurred. All patients underwent echocardiography at discharge, and again at six and 12 months after surgery. Thirteen patients had no residual insufficiency, and one patient had mild postoperative insufficiency but without progression of regurgitation at the sixth postoperative month. This new technique facilitates artificial chordae implantation. The short-term results are satisfactory, but further follow up is required.


Intravital videomicroscopy of peritubular capillaries in renal ischemia.
The recent refinement and computerization of intravital microscopy have permitted us to monitor microcirculation in vivo with minimal invasion. Here, we report on the first findings made with the use of a pencil-lens intravital microscope as applied to the ischemic rat kidney. Peritubular capillary and glomerular blood flow were monitored under basal conditions, during renal artery occlusion, and immediately after release of the clamp. Erythrocyte velocity was calculated as an angle in consecutive spatiotemporal images. Intravital videomicroscopy during the reperfusion period showed intermittent cessation and partial recovery of blood flow in both peritubular and glomerular capillaries. Blood flow was uniformly orthograde under control conditions; however, the retrograde flow occurred on reperfusion. The patency of peritubular capillaries was partially compromised during the early reperfusion period but rapidly recovered. The recovery of glomerular microcirculation occurred faster than that of peritubular capillaries. We suggest that a functional vasculopathy develops very early in the course of ischemia-reperfusion in superficial cortical microvasculature and is more pronounced in peritubular capillaries, thus accounting for the development of patchy injury of tubular epithelia.


Study of adjuvant chemotherapy in osteogenic sarcoma.
Twelve patients with osteosarcoma but without metastases were treated with adjuvant chemotherapy following surgical amputation for the primary lesion. The chemotherapy regimen utilized vincristine, actinomycin D, and cyclophosphamide (in high pulse doses) administered intermittently over a 55-week period. Four of the 12 patients (33%) are surviving with no evidence of disease 54 months or longer from time of surgery. These results suggest that the 3-drug combination used in this study should be considered in the formulation of future multidrug adjuvant chemotherapy programs in the management of patients with osteosarcoma.


Regulation of the Activity in the p53 Family Depends on the Organization of the Transactivation Domain.
Despite high sequence homology among the p53 family members, the regulation of their transactivation potential is based on strikingly different mechanisms. Previous studies revealed that the activity of TAp63α is regulated via an autoinhibitory mechanism that keeps inactive TAp63α in a dimeric conformation. While all p73 isoforms are constitutive tetramers, their basal activity is much lower compared with tetrameric TAp63. We show that the dimeric state of TAp63α not only reduces DNA binding affinity, but also suppresses interaction with the acetyltransferase p300. Exchange of the transactivation domains is sufficient to transfer the regulatory characteristics between p63 and p73. Structure determination of the transactivation domains of p63 and p73 in complex with the p300 Taz2 domain further revealed that, in contrast to p53 and p73, p63 has a single transactivation domain. Sequences essential for stabilizing the closed dimer of TAp63α have evolved into a second transactivation domain in p73 and p53.


Scattering Inversion Study for Suspended Label-Free Lymphocytes with Complex Fine Structures.
Objective and Impact Statement. Distinguishing malignant lymphocytes from normal ones is vital in pathological examination. We proposed an inverse light scattering (ILS) method for label-free suspended lymphocytes with complex fine structures to identify their volumes for pathological state. Introduction. Light scattering as cell's "fingerprint" provides valuable morphology information closely related to its biophysical states. However, the detail relationships between the morphology with complex fine structures and its scattering characters are not fully understood. Methods. To quantitatively inverse the volumes of membrane and nucleus as the main scatterers, clinical lymphocyte morphologies were modeled combining the Gaussian random sphere geometry algorithm by 750 reconstructed results after confocal scanning, which allowed the accurate simulation to solve ILS problem. For complex fine structures, the specificity for ILS study was firstly discussed (to our knowledge) considering the differences of not only surface roughness, posture, but also the ratio of nucleus to the cytoplasm and refractive index. Results. The volumes of membrane and nucleus were proved theoretically to have good linear relationship with the effective area and entropy of forward scattering images. Their specificity deviations were less than 3.5%. Then, our experimental results for microsphere and clinical leukocytes showed the Pearson product-moment correlation coefficients (PPMCC) of this linear relationship were up to 0.9830~0.9926. Conclusion. Our scattering inversion method could be effectively applied to identify suspended label-free lymphocytes without destructive sample pretreatments and complex experimental systems.


Use of intra-articular carbon dioxide and air for MR arthrography: a feasibility study.
During animal experiments, carbon dioxide (CO(2)) and air were used as a novel contrast agent for direct magnetic resonance arthrography (MRAr). MRAr was performed after injection of CO(2) and air in the knee joints of two pigs. MR images of phantoms containing air, CO(2) and nitrogen were compared. After intra-articular injection, both present as a signal void on various sequences and permit sharp delineation of cartilage and other adjacent structures. Despite the potential for artefact generation, only a slight susceptibility artefact was seen after injection of CO(2) and air. In phantom experiments, air, CO(2) and nitrogen demonstrated identical slight regular susceptibility artefacts at the phantom margins. CO(2) MRAr can yield high contrast between cartilage, ligaments and synovium relative to the joint compartment. Therefore, this technique might be useful as an investigational method for the evaluation of cartilage surface lesions and possibly as an alternative contrast agent for clinical use.


Association of Long-Chain Noncoding RNA H19 and MEG3 Gene Polymorphisms and Their Interaction with Risk of Osteoarthritis in a Chinese Han Population.
Objective: To analyze the association of single nucleotide polymorphisms (SNPs) in the long-chain noncoding RNAs (lncRNAs) H19 and maternal expressed gene 3 (MEG3) with the risk of osteoarthritis (OA) in a Chinese Han population. Methods: A total of 230 patients with OA and 230 control subjects were recruited. Sanger sequencing was used to analyze the genotypes of the H19 gene rs217727 and rs3741219 loci and the MEG3 gene rs7158663 locus. Quantitative real-time reverse transcription-polymerase chain reaction was used to determine the levels of the microRNAs (miRNA) hsa-miR-4804-5p, hsa-miR-8071, hsa-miR-8072, hsa-miR-3960, hsa-miR-4307, and hsa-miR-1265 in the plasma. Results: The risk of OA was significantly increased by the A allele of the rs217727 locus of H19 (odds ratio = 1.27, 95% confidence interval [CI]: 1.09-1.42, p = 0.001). The H19 gene rs3741219 locus SNP had no significant correlation with the risk of OA (p > 0.05). The risk of OA in subjects carrying the rs7158663 locus A allele of MEG3 was 1.32 times higher compared with those carrying the G allele (95% CI: 1.16-1.50, p < 0.01). SNP rs217727 of H19 was associated with the plasma levels of lncRNA H19, hsa-miR-4804-5p, hsa-miR-8071, hsa-miR-8072, and hsa-miR-3960, and SNP rs7158663 in MEG3 was associated with the plasma levels of lncRNA MEG3, hsa-miR-4307, and hsa-miR-1265. Conclusion: Specific SNPs of the H19 rs217727 and MEG3 rs7158663 loci are associated with the risk of OA. The possible underlying molecular mechanisms, which remain to be confirmed, are their likely influence on the expression levels of the lncRNA H19 and MEG3, which in turn alters the expression level of their target miRNAs.


The roles of kisspeptin and gonadotropin inhibitory hormone in stress-induced reproductive disorders.
Several kinds of stress suppress the hypothalamic-pituitary-gonadal (HPG) axis and reproductive behavior in humans and animals. These changes can eventually cause diseases and disorders, such as amenorrhea and infertility. In previous studies, it has been shown that stress-related factors, e.g., corticotropin-releasing hormone, cortisol, and pro-inflammatory cytokines, promote the stress-induced suppression of the HPG axis. However, these mechanisms are not sufficient to explain how stress suppresses HPG axis activity, and it has been suggested that some other factors might also be involved. In the early 21st century, novel neuroendocrine peptides, kisspeptin and gonadotropin inhibitory hormone (GnIH)/RFamide-related peptide 3 (RFRP-3), which directly regulate GnRH/gonadotropin synthesis and secretion, were newly discovered. Growing evidence indicates that kisspeptin and GnIH/RFRP-3 play pivotal roles in the stress-induced disruption of the HPG axis and reproductive behavior in addition to their physiological functions. This review summarizes what is currently known about the roles of kisspeptin and GnIH/RFRP-3 in stress-induced reproductive disorders.


Quantitative statistical shape model-based analysis of humeral head migration, Part 2: Shoulder osteoarthritis.
We wanted to investigate the quantitative characteristics of humeral head migration (HHM) in shoulder osteoarthritis (OA) and their possible associations with scapular morphology. We quantified CT-scan-based-HHM in 122 patients with a combination of automated 3D scapulohumeral migration (=HHM with respect to the scapula) and glenohumeral migration (=HHM with respect to the glenoid) measurements. We divided OA patients in Group 1 (without HHM), Group 2a (anterior HHM) and Group 2b (posterior HHM). We reconstructed and measured the prearthropathy scapular anatomy with a statistical shape model technique. HHM primarily occurs in the axial plane in shoulder OA. We found "not-perfect" correlation between subluxation distance AP and scapulohumeral migration values (rs = 0.8, p < 0.001). Group 2b patients had a more expressed prearthropathy glenoid retroversion (13° vs. 7°, p < 0.001) and posterior glenoid translation (4 mm vs. 6 mm, p = 0.003) in comparison to Group 1. Binary logistic regression analysis indicated prearthropathy glenoid version as a significant predictor of HHM (χ² = 27, p < 0.001). Multivariate regression analysis showed that the pathologic version could explain 56% of subluxation distance-AP variance and 75% of the scapulohumeral migration variance (all p < 0.001). Herewith, every degree increase in pathologic glenoid retroversion was associated with an increase of 1% subluxation distance-AP, and scapulohumeral migration. The occurrence of posterior HHM is associated with prearthropathy glenoid retroversion and more posterior glenoid translation. The reported regression values of HHM in the function of the pathologic glenoid version could form a basis toward a more patient-specific correction of HHM.


Invar-based refractometer for pressure assessments.
Gas modulation refractometry (GAMOR) is a methodology that can mitigate fluctuations and drifts in refractometry. This can open up for the use of non-conventional cavity spacer materials. In this paper, we report a dual-cavity system based on Invar that shows better precision for assessment of pressure than a similar system based on Zerodur. This refractometer shows for empty cavity measurements, up to 104 s, a white noise response (for N2) of 3 mPa s1/2. At 4303 Pa, the system has a minimum Allan deviation of 0.34 mPa (0.08 ppm) and a long-term stability (24 h) of 0.7 mPa. This shows that the GAMOR methodology allows for the use of alternative cavity materials.


Base-Controlled Regiodivergent Azidation of Trifluoromethyl Alkenyl Triflates: Transition-Metal-Free Access to CF3-Containing Allyl Azides and Alkenyl Azides.
A base-controlled regiodivergent azidation of trifluoromethyl alkenyl triflates providing either (E)-3-azido-1-aryl-4,4,4-trifluorobut-1-ene (CF3-containing allyl azides) or (Z)-1-azido-1-aryl-4,4,4-trifluorobut-1-ene (CF3-containing alkenyl azides) is described. Catalyzed by Et3N, the azidation of trifluoromethyl alkenyl triflates with TMSN3 gave CF3-containing allyl azides. On the other hand, using stoichiometric DBU, the regioisomeric azidation products, CF3-containing alkenyl azides, were obtained in good yield. A further transformation for CF3-containing amines, triazoles, and azirines highlights the practical applicability of this transition-metal-free protocol.


Outcomes of gout in patients with cirrhosis: A national inpatient sample-based study.
Hyperuricemia is a prerequisite for the development of gout. Elevated serum uric acid (UA) levels result from either overproduction or decreased excretion. A positive correlation between serum UA levels, cirrhosis-related complications and the incidence of nonalcoholic fatty liver disease has been established, but it is unknown whether hyperuricemia results in worsening cirrhosis outcomes. We hypothesize that patients with cirrhosis will have poorer gout outcomes. To explore the link between cirrhosis and the incidence of gout-related complications. This was a cross-sectional study. The national inpatient sample was used to identify patients hospitalized with gout, stratified based on a history of cirrhosis, from 2001 to 2013 via the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Primary outcomes were mortality, gout complications and joint interventions. The χ 2 test and independent t-test were performed to assess categorical and continuous data, respectively. Multiple logistic regression was used to control for confounding variables. Patients without cirrhosis were older (70.37 ± 13.53 years vs 66.21 ± 12.325 years; P < 0.05). Most patients were male (74.63% in the cirrhosis group vs 66.83%; adjusted P < 0.05). Patients with cirrhosis had greater rates of mortality (5.49% vs 2.03%; adjusted P < 0.05), gout flare (2.89% vs 2.77%; adjusted P < 0.05) and tophi (0.97% vs 0.75%; adjusted P = 0.677). Patients without cirrhosis had higher rates of arthrocentesis (2.45% vs 2.21%; adjusted P < 0.05) and joint injections (0.72% vs 0.52%; adjusted P < 0.05). Gout complications were more common in cirrhosis. Those without cirrhosis had higher rates of interventions, possibly due to hesitancy with performing these interventions given the higher complication risk in cirrhosis.


Sodium setpoint and sodium gradient: influence on plasma sodium change and weight gain.
In hemodialysis and hemodiafiltration patients, the plasma sodium (PNa) measured before dialysis can be regarded as the sodium setpoint. By the end of dialysis, the PNa typically approximates the prescribed dialysate sodium (DNa), the difference between DNa and PNa being considered the sodium gradient. We determined the relationship between setpoint, gradient and pre- to postdialysis PNa change (delta PNa), and studied associations with dialysis-related variables. Cohort study. Measurements from 132 patients during 12 consecutive treatments included PNa and DNa concentrations, pre- to postdialysis body weight and predialysis systolic blood pressure. Sodium setpoints were normally distributed (137.9 ± 2.4 mmol/l), DNa prescriptions were non-normally distributed (138.9 ± 1.8 mmol/l). The sodium gradient correlated strongly with delta PNa (r = 0.76, p < 0.001). Both sodium gradient and delta PNa correlated with relative interdialytic weight gain (IDWG; r = 0.25, p = 0.004, and r = 0.44, p < 0.001, respectively), but not with predialysis systolic blood pressure. These correlations were consistent after exclusion of patients with urine volume >500 ml/day and patients undergoing sodium profiling, and increased after exclusion of patients with hemodiafiltration protocols. Predictors for having higher relative IDWG (≥2.8%) were delta PNa concentrations ≥0 mmol/l and younger age. Predictors for having a delta PNa concentration ≥0 mmol/l were lower sodium setpoints, higher DNa prescriptions, use of Nikkiso machines, sodium profiling and younger age. Patients with positive delta PNa despite negative gradients were significantly younger, used more Nikkiso machines and presented with higher IDWG. IDWG correlated with the sodium gradient and more strongly with delta PNa, suggesting the need for studying other outcomes, such as morbidity and mortality.


In vivo determination of subcutaneous and abdominal adipose tissue depots in German Holstein dairy cattle.
Ultrasonography was used as a noninvasive method for quantitative estimation of the subcutaneous and abdominal adipose tissue depots in dairy cattle. The prediction model was created and validated with a total of 29 German Holstein cows; 6 were in early lactation (≤100 d in milk [DIM]) and 16 were in advanced lactation (101 to 292 DIM). Seven cows were nonpregnant and nonlactating and had been off milk for 350 to 450 d. Transcutaneous assessment of the thickness of subcutaneous and retroperitoneal adipose tissue was done at 16 sites on the body surface of all cows. After completion of the ultrasonographic measurements, the cows were slaughtered and the adipose depots were separately weighed. A stepwise multivariate regression analysis of the ultrasonographic variables was performed to estimate the slaughter weights of the different fat depots. Slaughter weights of the fat depots ranged from 5.0 to 43.0 kg for subcutaneous adipose tissue (SCAT), from 13.7 to 98.8 kg for abdominal adipose tissue (AAT), from 3.4 to 30.3 kg for retroperitoneal adipose tissue (RPAT), from 5.2 to 39.6 kg for omental adipose tissue (OMAT), and from 4.0 to 35.8 kg for mesenteric adipose tissue (MAT). The relationship between calculated amount of fat and slaughter weight of fat had coefficients of determination () and root mean square errors (kg) of 0.88 and 3.4, respectively, for SCAT; 0.94 and 6.1, respectively, for AAT; 0.94 and 1.7, respectively, for RPAT; 0.83 and 3.2, respectively, for OMAT; and 0.95 and 1.6, respectively, for MAT. The accuracy of ultrasonographic measurement of the different fat depots appears sufficient for the quantitative assessment of internal and subcutaneous fat stores in cows. This method is noninvasive and therefore allows safe and repeated monitoring of the amount of stored fat in different adipose tissue depots of German Holsteins cows.


Mouse beta 2-microglobulin cDNA clones: a screening procedure for cDNA clones corresponding to rare mRNAs.
We have isolated three cDNA clones for beta 2-microglobulin, the small subunit of the major histocompatibility antigens. beta 2-Microglobulin makes up less than 0.1% of mouse liver protein, and its mRNA is approximately 0.03% of liver poly(A)+ mRNA. The cDNA clones were identified by screening 1400 cDNA clones made from 9--10S mouse liver poly(A)+ mRNA. The procedure for screening the cDNA clones involved binding pooled plasmid DNA to nitrocellulose filters and testing the ability of each filter to select beta 2-microglobulin mRNA. The filter-selected mRNAs were assayed for their ability to direct the synthesis of beta 2-microglobulin in translation reactions in vitro. The isolated clones were shown by nucleotide sequence analysis to encode beta 2-microglobulin. The positive-selection--hybridization assay has been modified to facilitate the screening of large numbers of cDNA clones, and the modified assay should allow the isolation of cDNAs corresponding to any mRNA whose in vitro translation products can be immunoprecipitated. These modifications are of particular value in the isolation of cDNA clones corresponding to rare species of mRNA.


Stereocontrolled Synthesis of Functionalized Azaheterocycles from Carbocycles through Oxidative Ring Opening/Reductive Ring Closing Protocols.
Fluorine-containing organic scaffolds are of significant interest in medicinal chemistry. The incorporation of fluorine into biomolecules can lead to remarkable changes in their physical, chemical, and biological properties. There are already many drugs on the market, which contain at least one fluorine atom. Saturated functionalized azaheterocycles as bioactive substances have gained increasing attention in pharmaceutical chemistry. Due to the high biorelevance of organofluorine molecules and the importance of N-heterocyclic compounds, selective stereocontrolled procedures to the access of new fluorine-containing saturated N-heterocycles are considered to be a hot research topic. This account summarizes the synthesis of functionalized and fluorine-containing saturated azaheterocycles starting from functionalized cycloalkenes and based on oxidative ring cleavage of diol intermediates followed by ring expansion with reductive amination.


Restricted, Repetitive Behaviors in Autism Spectrum Disorder and Obsessive-Compulsive Disorder: A Comparative Review.
This review paper critically examines literature regarding restricted and repetitive behaviors (RRBs) in Autism Spectrum Disorder (ASD) and Obsessive-Compulsive Disorder (OCD). The similar behavioral profiles of these disorders presents the potential for confusion regarding diagnoses and intervention efforts. As such, this review highlights the similarities and differences between RRBs in ASD and OCD. The developmental trajectories of RRBs are presented, followed by an exploration of three constructs implicated in RRB manifestation: anxiety, executive functioning, and sensory phenomena. While RRBs tend to develop with some similarity in both disorders, the differing role of anxiety highlights important distinctions between ASD and OCD. We urge researchers and clinicians to think critically about the dimensions that affect RRB presentation. Future research should use this review as a starting point to further elucidate the differences between RRBs in these two populations.


Resection of intradural intramedullary subependymoma of the cervicothoracic spine: 2-dimensional operative video.
This video presents the case of a 44-year-old male with a 2-year history of pain in the left upper extremity that had worsened over the course of the last 6 months with associated weakened grip strength and had extended into his right arm. T2-weighted sagittal and axial MRI demonstrated an expansive nonenhancing solid intramedullary lesion extending from C5 to T1. The patient underwent a C5-T1 laminectomy and laminoplasty with near-complete resection of the intradural intramedullary subependymoma. At 3 months' follow-up, he reported doing well and had experienced significant improvement in motor strength with ongoing therapies.


Reanimatology and its urgent problems.
Reanimatology is a science aimed at preventing central nervous system (CNS) destruction and completely restoring function after terminal states and clinical death. The most important present trends in reanimatology are the study of the limits of ischemic tolerance by cerebral cortical neurons and investigations into the basic mechanisms of pathology and viability during and after hypoxia. After terminal states there are changes in the content, electrophoretic patterns and physico-chemical properties of brain proteins, and in lysosomal and cytoplasmic hydrolase activities. Cell membrane permeability is increased and brain ATP content is decreased. At 14 to 21 days after resuscitation, brain RNA and later DNA levels are reduced, reflecting posthypoxic cerebral dysfunction. Guidelines for the prevention and therapy of postresuscitation encephalopathy are presented. There seem to be specific indications and contraindications for brain stimulation versus depression during recovery. There are advanced methods for treating clinical death. Treatments of postresuscitation pulmonary, cardiovascular, and renal complications using hemodialysis and blood detoxification appear promising.


Erythrocyte 2,3-diphosphoglycerate as related to diabetes and obesity.
2,3-Diphosphoglycerate was determined in the erythrocytes of 17 diabetic and 18 obese patients. Results for obese subjects were significantly (P less than .01) different from those obtained for 21 healthy subjects. Results for obese and diabetic patients also differed significantly (P less than .01) but not those for diabetic and healthy subjects. Hemoglobin, hematocrit, or bicarbonate measurements did not differ among the three groups.


Generation Z Nursing Students' Perceptions of Sustainable Production and Consumption Based on the Theory of Planned Behavior: A Qualitative Study.
Background and Purpose: 2030 Sustainable Development Goals, an in-depth understanding of undergraduate nursing students, and experiences are needed. This study aims to explore and describe the experiences and challenges faced by undergraduate nursing students concerning sustainable production and consumption based on the theory of planned behavior. Methods: An inductive design was used for this qualitative study, which included open-ended, and in-depth interviews with 24 undergraduate nursing students. Throughout the study, the authors followed the COREQ checklist. Results: The audio was recorded and lasted 24-48 minutes (x̄ = 30.8 minutes). The audio recordings were subjected to repeated listening, followed by the creation of observation notes for each interview and transcription of all the interviews. It was determined that data saturation had been achieved after the final interview. The participants confirmed the findings by reviewing daily summaries at the conclusion of the interview data. To analyze the data, the thick description method was employed. The coded similarity rate of the data set was calculated. The similarity rate in this study was 91.0%. Five themes were identified: (a) "behavioral beliefs," (b) "normative persons, organizations, and institutions," (c) "motive," (d) "facilitative," and (e) "challenges." Conclusions/Implications for Practice: The climate crises experienced during the formative years of undergraduate nursing students belonging to Generation Z, as well as the impact of pandemic diseases, have significantly influenced their views on sustainable production and consumption. In order to meet the needs of the socially conscious Generation Z, modern nursing education must incorporate advanced practices that reflect their values.


Biofilm Management in Wound Care.
After studying this article, the participant should be able to: 1. Understand the basics of biofilm infection and be able to distinguish between planktonic and biofilm modes of growth. 2. Have a working knowledge of conventional and emerging antibiofilm therapies and their modes of action as they pertain to wound care. 3. Understand the challenges associated with testing and marketing antibiofilm strategies and the context within which these strategies may have effective value. The Centers for Disease Control and Prevention estimate for human infectious diseases caused by bacteria with a biofilm phenotype is 65 percent and the National Institutes of Health estimate is closer to 80 percent. Biofilms are hostile microbial aggregates because, within their polymeric matrix cocoons, they are protected from antimicrobial therapy and attack from host defenses. Biofilm-infected wounds, even when closed, show functional deficits such as deficient extracellular matrix and impaired barrier function, which are likely to cause wound recidivism. The management of invasive wound infection often includes systemic antimicrobial therapy in combination with débridement of wounds to a healthy tissue bed as determined by the surgeon who has no way of visualizing the biofilm. The exceedingly high incidence of false-negative cultures for bacteria in a biofilm state leads to missed diagnoses of wound infection. The use of topical and parenteral antimicrobial therapy without wound débridement have had limited impact on decreasing biofilm infection, which remains a major problem in wound care. Current claims to manage wound biofilm infection rest on limited early-stage data. In most cases, such data originate from limited experimental systems that lack host immune defense. In making decisions on the choice of commercial products to manage wound biofilm infection, it is important to critically appreciate the mechanism of action and significance of the relevant experimental system. In this work, the authors critically review different categories of antibiofilm products, with emphasis on their strengths and limitations as evident from the published literature.


Uptake and toxicity of CuO nanoparticles to Daphnia magna varies between indirect dietary and direct waterborne exposures.
Research examining the direct and indirect ecological effects of nanomaterials in aquatic ecosystems is important for developing a more realistic understanding of the environmental implications of nanotechnology. Copper oxide nanoparticles (CuO NPs) are being used extensively in many industries but are considered highly toxic to aquatic species residing in surface waters. Few studies have addressed whether CuO NPs can be transferred through the aquatic food chain, and if such indirect exposure to nanomaterials impacts their toxicity. We investigated the uptake and trophic transfer of CuO NPs from the algae Chlorella vulgaris to the crustacean Daphnia magna and assessed bio-partitioning and resulting toxicity. We hypothesized that CuO NPs can be associated with algal cells and be transported to predators through feeding, and that the chronic toxicity can be altered in comparison to direct CuO NP exposure. For the indirect feeding exposure, algae pre-incubated with CuO NPs (Cu-algae) were washed to remove loose NPs and fed to D. magna while Cu uptake and toxicity were evaluated. For the direct waterborne exposures, a parallel group of D. magna were exposed to equivalent concentrations of CuO NPs while being fed unexposed algae. Using hyperspectral imaging we observed strong surface associations between pre-incubated CuO NPs and algae used in the feeding exposure, and quantified the average Cu content (0.15mg Cu/L) with ICP-OES. Cu accumulated in daphnid bodies to a greater extent in direct exposures, whereas molted carapaces and neonate offspring had more copper following the indirect feeding exposure, implying that D. magna may regulate internal Cu differently depending on the method of CuO NP delivery. Significantly higher D. magna mortality was observed following direct exposure relative to feeding exposure, and neonate production from adult daphnids exposed indirectly to CuO NPs was significantly reduced. Thus, nanoparticle interaction with biota at one trophic level may alter the biological response at the next trophic level in a way that is dependent on the delivery scenario. This study highlights the importance of evaluating potential ecological impacts of nanomaterials in more relevant, complex exposure scenarios.


Not good enough? Further comments to the wording, meaning, and the conceptualization of Internet Gaming Disorder.
In their commentary, Kuss, Griffiths, and Pontes (2016) criticize the use of the term "Internet" in the recently proposed diagnosis for Internet Gaming Disorder (IGD) and its use as one of the included diagnostic criteria. We agree with the exclusion of the term "Internet" in the diagnosis, but have some considerations to the comments regarding the nine criteria for IGD. Specifically, we discuss the meaning, the wording, and the importance of the criteria, as well as the importance of distress or functional impairment in the proposed diagnosis. We also address the possibility of categorizing IGD as a subtype of a general behavioral addiction diagnosis.


Model of the low temperature magnetic phases of gadolinium gallium garnet.
The magnetic behaviour of gadolinium gallium garnet in an external magnetic field at zero temperature is considered. For high fields a classical spin model of the gadolinium ions predicts a spin configuration that is periodic at the level of the smallest repeating unit cell. The quantum version of the model is treated via a truncated Holstein-Primakoff transformation with axes defined by the classical spin configuration, and the magnon excitation bands are calculated. The model predicts a transition in the field range of 1.9-2.1 T, sensitive to the direction of the applied field, which is caused by one or more magnon modes becoming soft as the field is decreased. In general the soft modes occur at incommensurate wavevectors and therefore break the periodicity of the spin configuration below the transition. One exception occurs when the field aligns with one of the principle crystal axes, in which case periodicity of the spin configuration is found to be maintained on a larger crystallographic cubic cell even below the transition. This simple case is studied in more detail. Comparisons are drawn with existing experimental data, and further experimental tests of the model are suggested.


Relationships of viscosity with contact hardness and modulus of bone matrix measured by nanoindentation.
Creep is an active form of time-dependent viscoelastic deformation that occurs in bone tissue during daily life. Recent findings indicate bone mineralization, which is involved in determining the elastic and plastic properties of bone matrix, can also contribute in controlling its viscoelastic property. Nanoindentation viscosity was used as a direct measure for the capacity of a material to resist viscous-like flow under loading. The objectives of this study were to examine (1) whether the nanoindentation viscosity obtained using the traditional viscoelastic Voigt model can describe creep response of bone matrix and (2) how the nanoindentation viscosity is related to contact hardness and elastic modulus. The Voigt model accurately described the creep behavior of bone matrix (r(2)>0.96, p<0.001). The nanoindentation viscosity had strong relationships with nanoindentation contact hardness (r(2)=0.94, p<0.001) and modulus (r(2)=0.83, p<0.001) independent of tissue ages of osteonal bone matrix. The strong positive relationships of nanoindentation viscosity with contact hardness and modulus can be interpreted as increases in the mineral portion of bone matrix may limit the interfibril motion of collagen while enhancing the mechanical stability of bone. We suggest that previous nanoindentation results can be reanalyzed to characterize the viscoelastic creep using the Voigt model.


Fine-needle aspiration cytology of endometrioid adenofibroma of the ovary.
We report the fine-needle aspiration (FNA) cytology findings of endometrioid adenofibroma arising in the ovary of a 60-year-old woman who presented with vaginal bleeding. Imaging studies revealed a large pelvic mass, which was sampled by computed tomography-guided FNA and core biopsy. The FNA yielded cellular smears composed of bland endometrioid cells and fragments of ovarian-type stroma. The core biopsy showed a biphasic process comprising bland endometrioid glands in a spindle-cell stroma. Immunohistochemical studies performed on the core showed the stroma to be CD10-negative and smooth muscle actin-positive. Subsequent resection of the tumor confirmed the diagnosis and revealed an adenocarcinoma arising in the tumor that was not sampled by FNA. To our knowledge, the cytologic features of ovarian endometrioid adenofibroma have not been previously described.


Public Views on Using Mobile Phone Call Detail Records in Health Research: Qualitative Study.
Mobile phone call detail records (CDRs) are increasingly being used in health research. The location element in CDRs is used in various health geographic studies, for example, to track population movement and infectious disease transmission. Vast volumes of CDRs are held by multinational organizations, which may make them available for research under various data governance regimes. However, there is an identified lack of public engagement on using CDRs for health research to contribute to an ethically founded framework. This study aimed to explore public views on the use of call detail records in health research. Views on using CDRs in health research were gained via a series of three public workshops (N=61) informed by a pilot workshop of 25 people. The workshops included an initial questionnaire to gauge participants' prior views, discussion on health research using CDRs, and a final questionnaire to record workshop outcome views. The resulting data were analyzed for frequencies and emerging themes. At the outset, most participants (66%, 40/61) knew that location data were collected by operators, but only 3% (2/61) knew they were being used for health research. Initially, the majority of the participants (62%, 38/61) was content for their anonymous CDRs to be used, and this increased (80%, 49/61) after the discussion explained that safeguards were in place. Participants highlighted that terms and conditions should be clearer, as should information to phone users on data collection, privacy safeguards, sharing, and uses in research. This is the first known study exploring public views of using mobile phone CDRs in health research. It revealed a lack of knowledge among the public on uses of CDRs and indicated that people are generally amenable to the use of anonymized data for research, but they want to be properly informed and safeguarded. We recommend that public views be incorporated into an ethically founded framework for the use of CDRs in health research to promote awareness and social acceptability in data use.


Cryopreservation of both male and female gametes leads to reduced embryo development and implantation potential.
The objective of this study was to investigate the effect of oocyte and sperm cryopreservation on donated eggs submitted to intracytoplasmic sperm injection (ICSI) cycles. Medical charts of 122 oocyte recipients undergoing 152 oocyte recipient ICSI cycles, from 2017 to 2018, in a private university-affiliated in vitro fertilization (IVF) centre, were reviewed in this historical cohort study. Cycles were divided into four groups according to the gamete status: the FO/FS Group, recipients in which fresh oocytes were injected with fresh sperm (n = 19); the FO/CrS Group, recipients in which fresh oocytes were injected with cryopreserved sperm (n = 14); the CrO/FS Group, recipients in which cryopreserved oocytes were injected with fresh sperm (n = 85); and the CrO/CrS Group, recipients in which cryopreserved oocytes were injected with cryopreserved sperm (n = 34). Generalized mixed models fit by restricted maximum likelihood, followed by Bonferroni post hoc test for the comparison of means amongst groups were used to investigate the effect of cryopreservation on recipient ICSI outcomes. The results were expressed as mean differences with 95% confidence intervals and P-values. The main outcome measure was the implantation rate. Normal day 3 cleavage speed, blastocyst development and implantation rates were significantly lower in the CrO/CrS Group compared with the FO/FS Group. In conclusion, embryo developmental competence and implantation potential were reduced when vitrified oocytes were injected with frozen sperm in an egg-sharing donation programme.


Hepatitis B infection in Vietnam: current issues and future challenges.
Hepatitis B virus (HBV) infection remains a major public health problem in Vietnam. Recent studies have found that prevalence of current HBV infection (HBsAg+) ranges from 10% to 20% in the general population and 20% to 40% among injecting drug users and HIV+ patients. However, HBV prevention and control in Vietnam relies heavily on universal infant vaccination program and HBsAg screening for blood donors. Currently, HBV prevention and control is underfunded by the government and receives little support from international agencies. HBV-related liver disease will continue to create a heavy burden for public health in Vietnam in the next several decades unless appropriate interventions are undertaken urgently. Establishment of a national strategy for HBV prevention and control is crucial to develop and implement effective interventions.


Essential Oil Microcapsules Immobilized on Textiles and Certain Induced Effects.
In order to obtain textile materials with potential utility in the development of cosmetic textiles, this study examined the deposition by padding of rose and sage microcapsules on woven textile structures, with different fiber compositions (100% cotton and 50% cotton/50% polyester). Cationization of the textile materials was performed to enhance the degree of uptake the pf the microcapsules on the fabrics' surface. A commercially acrylate-based binder was used to fix the microcapsules to the textile substrate and to improve the durability against external factors. The finished textile materials were characterized in terms of their physical-mechanical characteristics. The distribution of microcapsules on the fabrics surface before and after five washing cycles and 1000 abrasion cycles was investigated by scanning electron microscopy. The biocompatibility in terms of cell viability, cell membrane integrity and inflammation status of the functionalized fabrics was evaluated on CCD-1070Sk normal human dermal fibroblasts. The cell morphology was evaluated by F-actin staining using fluorescence microscopy and no significant changes were noticed after the incubation in the presence of fabrics compared with control. The in vitro biocompatibility evaluation on human skin cells confirmed the absence of cytotoxicity after the short-term exposure, supporting further in vivo use of these innovative textiles with improved properties.


Knobbed acrosome defect is associated with a region containing the genes STK17b and HECW2 on porcine chromosome 15.
Male infertility is an increasing problem in all domestic species including man. Localization and identification of genes involved in defects causing male infertility provide valuable information of specific events in sperm development. Correct condensation of the sperm head and development of the acrosome are required for fertile sperm. In the Finnish Yorkshire pig population a knobbed acrosome defect (KAD) has been reported which appears to be of genetic origin. In previous studies we have shown that a large number of affected spermatozoa have a cystic swelling anterior to the apical part of the acrosome. Characterization of the knobbed acrosome affected sperm revealed that both the acrosomal granules and chromatin are affected. This type of KAD appears to be a previously unknown and serious form of the defect. A genome wide scan with PorcineSNP60 Genotyping BeadChip defined the KAD associated region within 0.7 Mbp on porcine chromosome 15. Two genes, STK17b and HECW2, located within this region were sequenced. The expression of these genes appeared comparable in KA-affected and control boars. The known function of HECW2 in acrosome development highlighted this gene as a good candidate responsible for the KAD. One nonsynonymous SNP was identified within the HECW2 gene. However, as this mutation was found in homozygous state in individuals with normal sperm, this is not likely to be the causal mutation. In this study we identified two candidate genes for a severe defect affecting both the sperm acrosome and chromatin that causes infertility. One of these genes, HECW2, plays an important role in ubiquitination, a prerequisite for chromatin remodelling and acrosome formation, highlighting the involvement of this gene in the knobbed acrosome defect and male infertility.


The over expression of long non-coding RNA ANRIL promotes epithelial-mesenchymal transition by activating the ATM-E2F1 signaling pathway in pancreatic cancer: An in vivo and in vitro study.
This study aims to investigate the roles of lncRNA ANRIL in epithelial-mesenchymal transition (EMT) by regulating the ATM-E2F1 signaling pathway in pancreatic cancer (PC). PC rat models were established and ANRIL overexpression and interference plasmids were transfected. The expression of ANRIL, EMT markers (E-cadherin, N-cadherin and Vimentin) and ATM-E2F1 signaling pathway-related proteins (ATM, E2F1, INK4A, INK4B and ARF) were detected. Small molecule drugs were applied to activate and inhibit the ATM-E2F1 signaling pathway. Transwell assay and the scratch test were adopted to detect cell invasion and migration abilities. ANRIL expression in the PC cells was higher than in normal pancreatic duct epithelial cells. In the PC rat models and PC cells, ANRIL interference promoted the expressions of INK4B, INK4A, ARF and E-cadherin, while reduced N-cadherin and Vimentin expression. Over-expressed ANRIL decreased the expression of INK4B, INK4A, ARF and E-cadherin, but raised N-cadherin and Vimentin expressions. By inhibiting the ATM-E2F1 signaling pathway in PC cells, E-cadherin expression increased but N-cadherin and Vimentin expressions decreased. After ANRIL was silenced or the ATM-E2F1 signaling pathway inhibited, PC cell migration and invasion abilities were decreased. In conclusion, over-expression of lncRNA ANRIL can promote EMT of PC cells by activating the ATM-E2F1 signaling pathway.


Health and Environmental Co-Benefits of City Urban Form in Latin America: An Ecological Study.
We investigated the association of urban landscape profiles with health and environmental outcomes, and whether those profiles are linked to environmental and health co-benefits. In this ecological study, we used data from 208 cities in 8 Latin American countries of the SALud URBana en América Latina (SALURBAL) project. Four urban landscape profiles were defined with metrics for the fragmentation, isolation, and shape of patches (contiguous area of urban development). Four environmental measures (lack of greenness, PM2.5, NO2, and carbon footprint), two cause-specific mortality rates (non-communicable diseases and unintentional injury mortality), and prevalence of three risk factors (hypertension, diabetes, and obesity) for adults were used as the main outcomes. We used linear regression models to evaluate the association of urban landscape profiles with environmental and health outcomes. In addition, we used finite mixture modeling to create co-benefit classes. Cities with the scattered pixels profile (low fragmentation, high isolation, and compact shaped patches) were most likely to have positive co-benefits. Profiles described as proximate stones (moderate fragmentation, moderate isolation, and irregular shape) and proximate inkblots (moderate-high fragmentation, moderate isolation, and complex shape) were most likely to have negative co-benefits. The contiguous large inkblots profile (low fragmentation, low isolation, and complex shape) was most likely to have mixed benefits.


Hydration and dehydration behavior of aspartame hemihydrate.
Previous studies have shown that aspartame in the solid state can exist as a hemihydrate which occurs in two different polymorphic forms (I and II). The present work shows that equilibration of either hemihydrate at 25 degrees C with water vapor at relative humidities > or = 58% or with liquid water produces a 2.5-hydrate. Upon subjecting each of these crystalline hydrates to increasing temperature, the same crystalline anhydrate is formed which thermally cyclizes at a higher temperature to form the known compound 3-(carboxymethyl)-6-benzyl-2,5-dioxopiperazine. The activation energy of the cyclization reaction appears to depend on the degree of crystallinity of the anhydrate that is formed at a lower temperature. On increasing the temperature of the 2.5-hydrate, a hemihydrate intervenes before the anhydrate is formed. This intervening hemihydrate is similar to the commercial form (II) of aspartame hemihydrate but exhibits greater amorphous character. The techniques employed were Karl Fischer titrimetry, powder X-ray diffractometry, differential scanning calorimetry, thermogravimetric analysis, solid-state 13C nuclear magnetic resonance spectroscopy, and Fourier transform infrared absorption spectroscopy.


Prevalence & spectrum of congenital anomalies at a tertiary care centre in north India over 20 years (1998-2017).
Congenital anomalies lead to significant morbidity and mortality. Systematically published data on the prevalence and spectrum of congenital anomalies from India are scarce. This study was aimed to ascertain the prevalence, spectrum, trend, and outcome of congenital anomalies at a tertiary care centre in north India over two decades. Electronic records of all live births from January 1998 to December 2017 were retrieved, and the neonates with congenital anomaly were included in this retrospective analysis. International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10) was used for uniformity and international comparison. The further sub-categorization was done as per the WHO birth defects surveillance manual. The prevalence of individual as well as overall congenital anomalies was calculated. Run charts were used to analyze the trends. In the two decades studied (1998-2017), there were 86850 live births, of which 1578 [1.82%, 95% confidence interval (CI): 1.73-1.91%] neonates had a major congenital anomaly. The overall prevalence of anomalies was 182 (95% CI: 173-191) per 10,000 live births. Malformation of the circulatory system was the most common (28.0%) followed by musculoskeletal (18.6%) and urinary system (14.3%). Congenital anomaly-related death rate was 6.78 per 1000 live births. No significant trend was observed in the annual prevalence, individual malformations or contribution of congenital anomalies to overall mortality over the two decades. Our results showed a high prevalence of congenital anomalies which could be responsible for significant mortality, warranting the need for a national surveillance programme and birth defect services. It is important to have a national database to know the overall burden and spectrum of congenital anomalies in the country.


Safety assessment of Bacillus licheniformis Me1 isolated from milk for probiotic application.
In this study, an in vivo toxicological safety assessment of Bacillus licheniformis Me1, a native isolate from milk, was performed. An acute toxicity study in male albino Wistar rats demonstrated no treatment-related illness or mortality. A 90-day subchronic oral toxicity study using 2 doses (1.1 × 10(10) and 1.1 × 10(11) colony-forming unit [CFU]/kg body weight [BW], respectively) failed to show dose-dependent illness or mortality. Moreover, neither significant differences in serum biochemical and hematological analyses nor histopathological changes in organs or tissues were found when compared to the control groups. The no-observed-adverse-effect level (NOAEL) was found to be greater than 1.1 × 10(11) CFU/kg BW. The in vivo micronucleus assay in mice did not reveal any signs of genotoxic effect at any of the doses tested. Furthermore, dermal and acute eye irritation tests conducted in rabbits showed no edema or erythema and ocular lesions. These results suggest that B licheniformis Me1 can be considered safe for food industry applications.


Unique approach for calculation of absorption rate constant.
Several methods are employed to estimate an apparent first-order rate constant for absorption in a one-compartment model (Ka). These include curve-stripping, nonlinear least squares regression, and the Wagner-Nelson approach. The Wagner-Nelson method in particular requires extensive calculation and may be subject to error. A method for calculation of the absorption rate constant has been derived based on the relationship between area under the concentration-time curve, between time of maximum concentration (tmax) and infinity, and maximum concentration (cmax). The method obviates the need for large numbers of samples in the absorptive phase. The method also avoids extensive calculations and is less influenced by errors in data points prior to Cmax where the rate of change of concentration is very rapid and error is likely. The value for Ka is corrected for by the error found in tmax (calculated using the estimated Ka) relative to the observed tmax. The method has been tested on theoretical data with and without error generated using a range of a and KE. Errors in the estimate of Ka are proportional to error in the data.


Dual Chemodrug-Loaded Single-Walled Carbon Nanohorns for Multimodal Imaging-Guided Chemo-Photothermal Therapy of Tumors and Lung Metastases.
Tumor combination therapy using nano formulations with multimodal synergistic therapeutic effects shows great potential for complete ablation of tumors. However, targeting tumor metastases with nano structures is a major obstacle for therapy. Therefore, developing a combination therapy system able to target both primary tumors and their metastases at distant sites with synergistic therapy is desirable for the complete eradication of tumors. To this end, a dual chemodrug-loaded theranostic system based on single walled carbon nanohorns (SWNHs) is developed for targeting both primary breast tumors and their lung metastases. Methods: SWNHs were first modified simultaneously with poly (maleic anhydride-alt-1-octadecene) (C18PMH) and methoxypolyethyleneglycol-b-poly-D, L-lactide (mPEG-PLA) via hydrophobic-hydrophobic interactions and π-π stacking. Then cisplatin and doxorubicin (DOX) (2.9:1 molar ratio) were sequentially loaded onto the modified nanohorns in a noninterfering way. After careful examinations of the release profiles of the loaded drugs and the photothermal performance of the dual chemodrug-loaded SWNHs, termed SWNHs/C18PMH/mPEG-PLA-DOX-Pt, the dual drug chemotherapeutic and chemo-photothermal synergetic therapeutic effects on tumor cells were evaluated. Subsequently, the in vivo behavior and tumor accumulation of the drug-loaded SWNHs were studied by photoacoustic imaging (PAI). For chemo-photothermal therapy of tumors, 4T1 tumor bearing mice were intravenously injected with SWNHs/C18PMH/mPEG-PLA-DOX-Pt at a dose of 10 mg/kg b.w. (in SWNHs) and tumors were illuminated by an 808 nm laser (1W/cm2 for 5 min) 24 h post-injection. Results: DOX and cisplatin were loaded onto the modified SWNHs with high efficiency (44 wt% and 66 wt%, respectively) and released in a pH-sensitive, tandem and sustainable manner. The SWNHs/C18PMH/mPEG-PLA-DOX-Pt had a hydrodynamic diameter of 182 ± 3.2 nm, were highly stable in physiological environment, and had both dual drug chemotherapeutic (CI = 0.439) and chemo-photothermal synergistic antitumor effects (CI = 0.396) in vitro. Moreover, the dual drug-loaded SWNHs had a long blood half-life (10.9 h) and could address both the primary breast tumors and their lung metastases after intravenous administration. Consequently, chemo-photothermal combination therapy ablated the primary tumors and simultaneously eradicated the metastatic lung nodules. Conclusion: Our study demonstrates that SWNHs/C18PMH/mPEG-PLA-DOX-Pt is highly potent for chemo-photothermal combination therapy of primary tumors and cocktail chemotherapy of their metastases at a distant site.


Seasonal variation in air particulate matter (PM10) exposure-induced ischemia-like injuries in the rat brain.
Epidemiological studies imply a significantly positive association between particulate matter (PM) level and ischemic stroke hospitalization. However, considering that PM10 is highly heterogeneous and varies with season within the same location, existing experimental evidence remained low. In the present study, we first treated Wistar rats with PM10 samples collected from different seasons in Taiyuan, a typically coal-burning city of China, and determined ischemia-related markers in the cortex. The results indicated that PM10 exposure caused endothelial dysfunction, inflammatory response, and neuro-functional impairment similar to that of cerebral ischemia with season-dependent properties, and the winter sample presented the most obvious injuries. Then, we detected the chemical composition of PM10 samples followed by analysis of their correlation with the above biomarkers and found that winter PM10, characterized by higher polycyclic aromatic hydrocarbons (PAHs) and carbon load, played the major role in causing brain ischemia-like injuries among different season samples. Furthermore, by setting up an ischemic neuron model in vitro, we confirmed that winter PM10 presented the most serious aggravation on ischemia-produced injury outcome. This study provides experimental evidence for clarifying the association between season-dependent PM10 pollution in the atmospheric environment and an increased risk of ischemia-like injuries.


Insect pests of eucalypts in California: implications of managing invasive species.
For the first 150 years following their introduction, eucalypts planted in the California landscape were free of both insect pests and diseases. In the last 15 years, numerous herbivorous insect species have been introduced accidentally into the State and have caused significant damage to the trees. Several of these species, e.g. Phoracantha semipunctata (Fabricius), Phoracantha recurva Newman (Coleoptera: Cerambycidae) and Gonipterus scutellatus Gyllenhal (Coleoptera: Curculionidae), have also been introduced into other parts of the world where eucalypts are grown, whereas others, e.g. Glycaspsis brimblecombei Moore (Hemiptera: Spondyliaspidae) and Eucalyptolyma maideni Froggatt (Hemiptera: Spondyliaspidae), are currently restricted to California and Australia. Research programmes have provided management solutions to individual pest problems, but as more pest species are introduced, these solutions must be integrated across broad geographic, horticultural, and economic scales, in a systems approach.


An OCT Study of Anterior Nodular Episcleritis and Scleritis.
Anterior scleritis and episcleritis are a well-known presentation in tuberculosis. The case of a female patient with presumed tuberculous anterior scleritis and episcleritis is discussed in this article. Anterior segment OCT was efficient in diagnosis and evaluation of the therapeutic outcome. Antituberculosis chemotherapy was sufficient to achieve clinical remission.


Acute tuberculous myopericarditis mimicking acute myocardial infarction: A case report and literature review.
A number of cases of acute myopericarditis mimicking acute myocardial infarction (AMI) have previously been reported in the literature. However, to the best of our knowledge, such a case resulting from Mycobacterium tuberculosis infection has not previously been described. The present study reports the case of a 21-year-old male patient presenting with acute chest pain, in whom focal ST-segment elevation and elevated cardiac enzymes mimicked a diagnosis of AMI. However, acute tuberculous myopericarditis was diagnosed on the basis of a variety of imaging examinations, laboratory tests, as well as the changes observed in electrocardiograms (ECGs) and in the cardiac enzyme levels. The case highlights the importance of a detailed collection of medical history, comprehensive explanations of serial ECGs, thoracic computed tomography, echocardiogram and coronary angiography in the diagnosis and differentiation of acute tuberculous myopericarditis mimicking AMI.


Quantitation of estrogen receptor mRNA copy numbers in breast cancer cell lines and tumors.
Several clinical studies have suggested that the content of estrogen receptor (ER) in breast tumors influences the survival, tumor recurrence, and response to antiestrogen therapies. Therefore, the ability to precisely quantitate the ER content in tumor tissues will be of significant benefit to women with breast cancer. Although immunohistochemical and polymerase chain reaction (PCR) methods have been described for the detection and semiquantitation of ER, none of them precisely quantitate ER copy numbers in tumor samples. In the present report we describe a molecular approach to accurately quantitate ER mRNA copy numbers using a reverse-transcription PCR (RT-PCR) template competition method. A competitor template was devised by inserting unrelated nucleic acid sequences into an ER cDNA clone. A template competitive RT-PCR analysis was then performed to determine the number of copies of ER mRNA. As a standard of reference for the ER mRNA copy numbers from various samples, the mRNA copy numbers of a constitutively expressed gene, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), were also quantitated. The ER quantitations were performed in three positive cell lines, MCF-7, T47D, and ZR-75, and two positive tumor tissues by this approach. Our results described here show that among the cell lines studied, T47D expresses the highest copy numbers of ER. We also present here that ER as low as 10(3) copies per 10(5) copies of GAPDH can be detected and quantitated in tumor samples by the template competition method. In addition, the molecular approach can simultaneously detect, distinguish, and quantitate exon deletion variant copy numbers of ER. The results described in this report indicate that the ratios of exon 7 deletion variant to wild type in the tumor tissues are significantly higher than in the cell lines studied.


Gone with the weed: incidents of adolescent marijuana use in the United States, 1976-2021.
This study sought to examine grouped and right-censored (GRC) counts of adolescent marijuana use and estimate its temporal trajectories and sociodemographic disparities over almost half a century. After compiling 46 waves of nationally representative data from the Monitoring the Future (MTF) study from 1976 to 2021 (sample size = 491,348), we utilized an innovative modified Poisson (mixture) approach to analyze past-year marijuana use quantified by GRC counts. The overall reduction in incidence rates of marijuana use was attributable to an almost 40% reduction in the risk of marijuana use (with the proportion of at-risk adolescents at 51.36% in 1979 and 31.53% in 2021). Despite substantial changes over the study period, the recent incidence rates for at-risk individuals were similar to those in the early 1980s. Living in an intact family was a protective factor against adolescent marijuana use over time. The incidence rates of marijuana use among at-risk students, especially those from disadvantaged families, remained high over the study period. The modified Poisson (mixture) approach serves as the preferred tool for modeling GRC responses. It is essential to distinguish among risk, at-risk incidence, and overall incidence when assessing substance use and other risky behaviors.


Impact of renin-angiotensin-aldosterone system-blocking agents on the risk of contrast-induced acute kidney injury: a prospective study and meta-analysis.
We sought to assess the impact of the pretreatment with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) for coronary intervention on the risk of contrast-induced acute kidney injury (CI-AKI) after 72-hour postcontrast administration, together with a comprehensive meta-analysis in this aspect. In this prospective study, 401 patients referred for percutaneous coronary intervention were enrolled with 134 patients in non-renin-angiotensin-aldosterone system group, 204 patients in ACEIs group and 63 patients in ARBs group. For further meta-analysis, articles were identified through PubMed, EMBASE, Wanfang, and VIP. Data extraction and study quality were assessed in duplicate. Altogether, 14 qualified trials (including this prospective study) with 1960 patients taking ACEIs or ARBs and 1457 patients receiving no renin-angiotensin-aldosterone system blockers were analyzed. There was an overall 1.28-fold increased risk for CI-AKI in patients taking ACEIs or ARBs (odds ratio [OR] = 1.28; 95% confidence interval [CI], 0.79-2.09; P = 0.315). Overall changes in serum creatinine, estimated GFR, and blood urea nitrogen were also nonsignificant. Subgroup analyses identified a significantly increased risk for CI-AKI in patients taking ARBs (OR = 3.31; 95% CI, 1.89-5.78; P < 0.0005), and no significance was observed for patients taking ACEIs (OR = 0.86; 95% CI, 043-1.72; P = 0.664). Also, patients taking ARBs had serum creatinine markedly increased by 0.05 mg/dL (95% CI, 0.02-0.09; P = 0.005). The findings of this meta-analysis provide clear evidence for a deleterious impact of ARBs on the development of CI-AKI.


An Aspect of the History of Medicine in Ancient Korea as Examined through Silla Buddhist Monks'Annotations on the "Chapter on Eliminating Disease"in the Sutra of Golden Light (Suvarnabhāsa-sūtra).
Nearly nothing is known of medicine in ancient Korea due to insufficient materials. With several extant prescriptions and esoteric methods of treating diseases alone, it is impossible to gauge in depth the management of medicine during this period. If one exception were to be cited, that would be the fact that the annotations for understanding the contents on Indian medicine in the "Chapter on Eliminating Disease" in the Sutra of Golden Light, a Buddhist sutra originating from India, reflected the medical knowledge of Buddhist monks from Silla (57 BC-935 AD) who were active immediately after the nation's unification of the two other kingdoms on the Korean Peninsula (668 AD) such as Wonhyo (617-686 AD), Gyeongheung (620?-700? AD), and Seungjang (684-? AD). Along with those by other monks, these annotations are collected in the Mysterious Pivot of the Sutra of Golden Light, which was compiled by Gangyō(835-871 AD), a Japanese monk from the Heian era (794-1185 AD). Representative versions of the "Chapter on Eliminating Disease" in the Sutra of Golden Light include: a classical Chinese translation by the Indian monk Dharmakṣema (385-433 AD); the eight-volume edition by Chinese monk Baogui, which differs little from the preceding work in terms of the contents of the "Chapter on Eliminating Disease"; and the ten-volume edition by Yijing (635-713 AD), who had full-fledged knowledge of Indian medicine. When the contents of the annotations thus collected are examined, it seems that Wonhyo had not been aware of the existence of the ten-volume edition, and Gyeongheung and Seungjang most certainly used the ten-volume edition in their annotations as well. Especially noteworthy are Wonhyo's annotations on the Indian medical knowledge found in the "Chapter on Eliminating Disease" in the Sutra of Golden Light. Here, he made a bold attempt to link and understand consistently even discussions on Indian and Buddhist medicine on the basis of the traditional East Asian medical theory centering on the yin-yang and five phases (wuxing). In accordance with East Asia's theory of the seasonal five phases, Wonhyo sought to explain aspects of Indian medicine, e.g., changes in the four great elements (catvāri mahā-bhūtāni) of earth, water, fire, and wind according to seasonal factors and their effect on the internal organs; patterns of diseases such as wind (vāta)-induced disease, bile (pitta)-induced disease, phlegm (śleṣman)-induced disease, and a combination (saṃnipāta) of these three types of diseases; pathogenesis due to the indigestion of food, as pathological mechanisms centering on the theory of the mutual overcoming (xiangke) of the five phases including the five viscera (wuzang), five flavors (wuwei), and five colors (wuse). They existed in the text contents on Indian medicine, which could not be explicated well with the existing medical knowledge based on the theory of the five phases. Consequently, he boldly modified the theory of the five phases in his own way for such passages, thus attempting a reconciliation, or harmonization of disputes (hwajaeng), of the two medical systems. Such an attempt was even bolder than those by earlier annotators, and Wonhyo's annotations came to be accepted by later annotators as one persuasive explanation as well. In the case of Gyeongheung and Seungjang, who obtained and examined the ten-volume edition, a new classical Chinese translation produced following Wonhyo's death, annotated the "Chapter on Eliminating Disease" based on their outstanding proficiency in Sanskrit and knowledge of new Indian and Buddhist medicine. This fact signifies that knowledge of the eight arts of Ayurvedic medicine in India was introduced into Silla around the early 8th century. The medical knowledge of Wonhyo, Gyeongheung, and Seungjang demonstrates that intellectual circles in contemporary Silla were arenas in which not only traditional East Asian medicine as represented by works such as the Inner Canon of the Yellow Emperor (Huangdi Neijing) but also Indian medicine of Buddhism coexisted in almost real time.


Pancreatic islet neuropeptide Y overexpression has minimal effect on islet morphology and β-cell adaptation to high-fat diet.
Neuropeptide Y (NPY) is highly expressed in the hypothalamus, where it regulates feeding and energy homeostasis. Interestingly, NPY and its receptors are also expressed in peripheral tissues with roles in metabolism, including pancreatic islets. In islets, NPY is known to suppress insulin secretion acutely. In addition, the role of NPY in β-cell de-differentiation has been postulated recently. Therefore, we studied transgenic mice expressing NPY under rat insulin promoter (TG) to determine the effects of chronic up-regulation of NPY on islet morphology and function. NPY levels were 25 times higher in islets of TG mice compared with wild-type (WT) littermates, whereas no differences in NPY expression were noted in the brains of TG and WT mice. Islet NPY secretion was 2.3-fold higher in TG compared with WT mice. There were no significant changes in body weight, glucose tolerance, or insulin sensitivity in TG mice fed regular rodent diet or high-fat diet (HF). Islet β-cell area was comparable between TG and WT mice both on regular rodent and HF diets, indicating that NPY overexpression is insufficient to alter β-cell maturation or the compensatory increase of β-cell area on HF. One abnormality noted was that the glucose-stimulated insulin secretion in islets isolated from TG was reduced compared with those from WT mice on HF diet. Overall, an increase in islet NPY level has little impact on islet function and is insufficient to affect glucose homeostasis in mice.


Controlling dielectric and relaxor-ferroelectric properties for energy storage by tuning Pb0.92La0.08Zr0.52Ti0.48O3 film thickness.
The energy storage properties of Pb0.92La0.08Zr0.52Ti0.48O3 (PLZT) films grown via pulsed laser deposition were evaluated at variable film thickness of 125, 250, 500, and 1000 nm. These films show high dielectric permittivity up to ∼1200. Cyclic I-V measurements were used to evaluate the dielectric properties of these thin films, which not only provide the total electric displacement, but also separate contributions from each of the relevant components including electric conductivity (D1), dielectric capacitance (D2), and relaxor-ferroelectric domain switching polarization (P). The results show that, as the film thickness increases, the material transits from a linear dielectric to nonlinear relaxor-ferroelectric. While the energy storage per volume increases with the film thickness, the energy storage efficiency drops from ∼80% to ∼30%. The PLZT films can be optimized for different energy storage applications by tuning the film thickness to optimize between the linear and nonlinear dielectric properties and energy storage efficiency.


Management of overbite with the Invisalign appliance.
Most of the published literature on the management of overbite with the Invisalign appliance (Align Technology, Santa Clara, Calif) consists of case reports and case series. In this retrospective study of 120 patients, we sought to assess the nature of overbite changes with the Invisalign appliance. Records were collected from 3 practitioners, all experienced with the Invisalign technique. The patients were consecutively treated adults (>18 years old) who underwent orthodontic treatment only with the Invisalign appliance. Patients with major transverse or anteroposterior changes or extraction treatment plans were excluded. The study sample included 68 patients with normal overbites, 40 with deepbites, and 12 with open bites. Their median age was 33 years, and 70% of the patients were women. Cephalometric analyses indicated that the deepbite patients had a median overbite opening of 1.5 mm, whereas the open bite patients had a median deepening of 1.5 mm. The median change for the normal overbite patients was 0.3 mm. Changes in incisor position were responsible for most of the improvements in the deepbite and open bite groups. Minimal changes in molar vertical position and mandibular plane angle were noted. The Invisalign appliance appears to manage the vertical dimension relatively well, and the primary mechanism is via incisor movements.


Urban-suburban differences in the incidence of low birthweight in a metropolitan black population.
To study the urban-suburban differences in low birthweight among black Americans, 54,870 single births occurring to black mothers in the hospitals of Washington, DC, from 1980 to 1984 were analyzed. The observed data showed a 25% higher incidence of low birthweight (under 2501 gm) among infants born to urban mothers compared with those born to suburban mothers. Bivariate analysis showed that a greater proportion of urban mothers, compared with the proportion of suburban mothers, was teenage (23.6% vs 10.3%) and unmarried (67.6% vs 32.9%), had less than a high school education (31.7% vs 9.1%), and received inadequate prenatal care (34.3% vs 20.3%). The logit model fit to these data showed that by controlling for the above risk factors, the residential differences in the incidence of low birth rate were almost eliminated. Exploration of the medical risks associated with adverse pregnancy outcomes showed that the urban mothers had substantially higher rates for premature rupture of membrane, concurrent hypertension, pre-existing diabetes, hyperemesis, anemia, and narcotic addiction. The findings of the article underline the usefulness of studying intra-black differences rather than relying solely on race comparative research.


The unique evolution of the carbohydrate-binding module CBM20 in laforin.
Laforin catalyses glycogen dephosphorylation. Mutations in its gene result in Lafora disease, a fatal progressive myoclonus epilepsy, the hallmark being water-insoluble, hyperphosphorylated carbohydrate inclusions called Lafora bodies. Human laforin consists of an N-terminal carbohydrate-binding module (CBM) from family CBM20 and a C-terminal dual-specificity phosphatase domain. Laforin is conserved in all vertebrates, some basal metazoans and a small group of protozoans. The present in silico study defines the evolutionary relationships among the CBM20s of laforin with an emphasis on newly identified laforin orthologues. The study reveals putative laforin orthologues in Trichinella, a parasitic nematode, and identifies two sequence inserts in the CBM20 of laforin from parasitic coccidia. Finally, we identify that the putative laforin orthologues from some protozoa and algae possess more than one CBM20.


Visualizing the (Causal) Effect of a Continuous Variable on a Time-To-Event Outcome.
Visualization is a key aspect of communicating the results of any study aiming to estimate causal effects. In studies with time-to-event outcomes, the most popular visualization approach is depicting survival curves stratified by the variable of interest. This approach cannot be used when the variable of interest is continuous. Simple workarounds, such as categorizing the continuous covariate and plotting survival curves for each category, can result in misleading depictions of the main effects. Instead, we propose a new graphic, the survival area plot, to directly depict the survival probability over time and as a function of a continuous covariate simultaneously. This plot utilizes g-computation based on a suitable time-to-event model to obtain the relevant estimates. Through the use of g-computation, those estimates can be adjusted for confounding without additional effort, allowing a causal interpretation under the standard causal identifiability assumptions. If those assumptions are not met, the proposed plot may still be used to depict noncausal associations. We illustrate and compare the proposed graphics to simpler alternatives using data from a large German observational study investigating the effect of the Ankle-Brachial Index on survival. To facilitate the usage of these plots, we additionally developed the contsurvplot R-package, which includes all methods discussed in this paper.


Generation of Mouse for Conditional Expression of Forkhead Box A2.
Forkhead box A2 (FOXA2) is a pioneer transcription factor involved in organ development, function, and cancer. In the uterus, FOXA2 is essential for pregnancy and expressed specifically in the glands of the endometrium. Loss of FOXA2 function occurs during development of endometrial cancer in humans. The current study describes the development of a mouse model for conditional expression of mouse FOXA2. Using a system consisting of a minigene located at the Rosa26 locus, we generated a CAG-S-mFOXA2 allele in embryonic stem cells and subsequently in mice; before activation, the minigene is silent because of a floxed stop cassette inserted between the promoter and the transgene. To validate functionality, mice with the CAG-S-mFOXA2 allele were crossed with progesterone receptor (Pgr)-Cre mice and lactotransferrin (Ltf)-iCre mice that express Cre in the immature and adult uterus, respectively. In immature Pgr-Cre-CAG-S-mFoxa2 mice, FOXA2 protein was expressed in the luminal epithelium (LE), glandular epithelium (GE), stroma, and inner layer of the myometrium. Interestingly, FOXA2 protein was not observed in most of the LE of uteri from adult Pgr-Cre-CAG-S-mFoxa2 mice, although FOXA2 was maintained in the stroma, GE, and myometrium. The adult Pgr-Cre-CAG-S-mFoxa2 females were completely infertile. In contrast, Ltf-iCre-CAG-S-mFoxa2 mice were fertile with no detectable histological differences in the uterus. The adult uterus of Pgr-Cre-CAG-S-mFoxa2 mice was smaller, contained few endometrial glands, and displayed areas of partially stratified LE and GE. This transgenic mouse line is a valuable resource to elucidating and exploring FOXA2 function.


The Impact of Paralympic School Day on Student Attitudes Toward Inclusion in Physical Education.
The purpose of this study was to determine if Paralympic School Day (PSD), a published disability awareness program, would have a positive impact on the attitudes of students without disabilities toward the inclusion of students with disabilities in physical education classes. Participants were 143 sixth-grade students who were divided into 2 groups (experimental n = 71, control n = 72), with the experimental group receiving the PSD treatment. Participants responded 2 times to Siperstein's Adjective Checklist and Block's Children's Attitudes Toward Integrated Physical Education-Revised (CAIPE-R) questionnaire. Four ANCOVA tests were conducted. Results indicated a significant PSD treatment effect across all 4 measures: Adjective Checklist (p = .046, η² = .03), CAIPE-R (p = .002, η² = .04), inclusion subscale (p = .001, η² = .05), and sport-modification subscale (p = .027, η² = .02).


Using Morpholinos to Probe Gene Networks in Sea Urchin.
The control processes that underlie the progression of development can be summarized in maps of gene regulatory networks (GRNs). A critical step in their assembly is the systematic perturbation of network candidates. In sea urchins the most important method for interfering with expression in a gene-specific way is application of morpholino antisense oligonucleotides (MOs). MOs act by binding to their sequence complement in transcripts resulting in a block in translation or a change in splicing and thus result in a loss of function. Despite the tremendous success of this technology, recent comparisons to mutants generated by genome editing have led to renewed criticism and challenged its reliability. As with all methods based on sequence recognition, MOs are prone to off-target binding that may result in phenotypes that are erroneously ascribed to the loss of the intended target. However, the slow progression of development in sea urchins has enabled extremely detailed studies of gene activity in the embryo. This wealth of knowledge paired with the simplicity of the sea urchin embryo enables careful analysis of MO phenotypes through a variety of methods that do not rely on terminal phenotypes. This article summarizes the use of MOs in probing GRNs and the steps that should be taken to assure their specificity.


Method of Improved Fuzzy Contrast Combined Adaptive Threshold in NSCT for Medical Image Enhancement.
Noises and artifacts are introduced to medical images due to acquisition techniques and systems. This interference leads to low contrast and distortion in images, which not only impacts the effectiveness of the medical image but also seriously affects the clinical diagnoses. This paper proposes an algorithm for medical image enhancement based on the nonsubsampled contourlet transform (NSCT), which combines adaptive threshold and an improved fuzzy set. First, the original image is decomposed into the NSCT domain with a low-frequency subband and several high-frequency subbands. Then, a linear transformation is adopted for the coefficients of the low-frequency component. An adaptive threshold method is used for the removal of high-frequency image noise. Finally, the improved fuzzy set is used to enhance the global contrast and the Laplace operator is used to enhance the details of the medical images. Experiments and simulation results show that the proposed method is superior to existing methods of image noise removal, improves the contrast of the image significantly, and obtains a better visual effect.


Racial and Ethnic Disparities in Pregnancy-Related Acute Kidney Injury.
Pregnancy-related AKI (PR-AKI) is increasing in the United States. PR-AKI is associated with adverse maternal outcomes. Disparities in racial/ethnic differences in PR-AKI by race have not been studied. This was a retrospective cohort study using the National Inpatient Sample (NIS) from 2005 to 2015. We identified patients who were admitted for a pregnancy-related diagnosis using the Neomat variable provided by the NIS database that indicates the presence of a maternal or neonatal diagnosis code or procedure code. PR-AKI was identified using ICD codes. Survey logistic regression was used for multivariable analysis adjusting for age, medical comorbidities, socioeconomic factors, and hospital/admission factors. From 48,316,430 maternal hospitalizations, 34,001 (0.07%) were complicated by PR-AKI. Hospitalizations for PR-AKI increased from 3.5/10,000 hospitalizations in 2005 to 11.8/10,000 hospitalizations in 2015 with the largest increase seen in patients aged ≥35 and black patients. PR-AKI was associated with higher odds of miscarriage (adjusted odds ratio [aOR], 1.64; 95% CI, 1.34 to 2.07) and mortality (aOR, 1.53; 95% CI, 1.25 to 1.88). After adjustment for age, medical comorbidities, and socioeconomic factors, blacks were more likely than whites to develop PR-AKI (aOR, 1.17; 95% CI, 1.04 to 1.33). On subgroup analyses in hospitalizations of patients with PR-AKI, blacks and Hispanics were more likely to have preeclampsia/eclampsia compared with whites (aOR, 1.29; 95% CI, 1.01 to 1.65; and aOR, 1.69; 95% CI, 1.23 to 2.31, respectively). Increased odds of mortality in PR-AKI compared with whites were only seen in black patients (aOR, 1.61; 95% CI, 1.02 to 2.55). The incidence of PR-AKI has increased and the largest increase was seen in older patients and black patients. PR-AKI is associated with miscarriages, adverse discharge from hospital, and mortality. Black and Hispanic patients with PR-AKI were more likely to have adverse outcomes than white patients. Further research is needed to identify factors contributing to these discrepancies.


Hyperinsulinuria in diabetic ketoacidosis.
Urinary insulin excretion has been measured in diabetic children. In nine well controlled diabetics urinary insulin excretion (mean and 2SD) was significantly greater than that found in healthy controls (8.8; 4.4-17.5 versus 3.8; 2.3-6.4 microU/min/1.73 m2). In ten ketoacidotic diabetic children a 50 fold increase of the urinary insulin excretion has been observed (464.8; 158.2-1363 microU/min/1.73 m2). The hyperinsulinuria proved to be reversible: significantly decreased excretion rate (12.9; 9.7-12.3) could be measured 8-10 days after recovery from coma. The hyperinsulinuria during ketoacidosis indicates severe reversible tubular dysfunction. Recurrent ketoacidotic episodes might play a role in the development of diabetic nephropathy.


Tunable Mechanochemistry of Lithium Battery Electrodes.
The interplay between mechanical strains and battery electrochemistry, or the tunable mechanochemistry of batteries, remains an emerging research area with limited experimental progress. In this report, we demonstrate how elastic strains applied to vanadium pentoxide (V2O5), a widely studied cathode material for Li-ion batteries, can modulate the kinetics and energetics of lithium-ion intercalation. We utilize atomic layer deposition to coat V2O5 materials onto the surface of a shapememory superelastic NiTi alloy, which allows electrochemical assessment at a fixed and measurable level of elastic strain imposed on the V2O5, with strain state assessed through Raman spectroscopy and X-ray diffraction. Our results indicate modulation of electrochemical intercalation potentials by ∼40 mV and an increase of the diffusion coefficient of lithium ions by up to 2.5-times with elastic prestrains of <2% imposed on the V2O5. These results are supported by density functional theory calculations and demonstrate how mechanics of nanomaterials can be used as a precise tool to strain engineer the electrochemical energy storage performance of battery materials.


Impact of Left Ventricular Diastolic Property on Left Atrial Function from Simultaneous Left Atrial and Ventricular Three-Dimensional Echocardiographic Volume Measurement.
Simultaneous left atrial (LA) and left ventricular (LV) 3-dimensional (3D) echocardiographic volume measurements enable the quantifying of precise LA function, by virtue of their independence on any geometric assumption and capability of measurement for net LA conduit volume. We sought to elucidate the impact of conventional Doppler LV diastolic property on LA volume and function derived from this method. Our study subjects consisted of 381 patients who underwent 3D echocardiography. From LA time-volume curve, maximum and minimum volume index (VI) and VI before atrial contraction (LAVIpre-c) were determined; subsequently, active emptying volume was calculated as LAVIpre-c - minimum LAVI. From LA and LV volume measurement, conduit volume was calculated as LV stroke VI - (maximum LAVI - minimum LAVI). LA volume increased depending on the severity of diastolic dysfunction. Compared with patients with normal diastolic function, LA booster pump function, as the contribution of active emptying volume to LV filling, was higher in those with mild diastolic dysfunction. Additionally, it gradually decreased as diastolic dysfunction was advanced from mild to moderate and moderate to severe degree (23.2 ± 15.5%, 29.5 ± 15.1%, 25.1 ± 16.2%, 14.9 ± 14.1%, respectively; p <0.001). Contrarily, conduit contribution was significantly higher in patients with severe diastolic dysfunction than in those with mild diastolic dysfunction; furthermore, conduit function tended to increase, reciprocally to booster pump function, as diastolic dysfunction grade was advanced (39.1 ± 28.8%, 36.8 ± 26.2%, 42.7 ± 25.6%, 52.9 ± 26.2%, respectively; p = 0.034). In conclusion, simultaneous LA and LV volumetric analyses through 3D echocardiography clearly demonstrate the characteristic LA functional alterations following LA dilation caused by LV diastolic dysfunction.


Mastopexy and reduction mammoplasty pedicles and skin resection patterns.
Mastopexy and reduction mammoplasty share techniques of pedicle formation and skin excision patterns, with the main difference being the amount of breast tissue resected. Various types of excision patterns and orientation of pedicles were developed throughout the years, each with flares of popularity at different times. This article reviews the multiple techniques of pedicle orientation and skin excision patterns separately and gives the advantages and disadvantages of each.


Women with polycystic ovary syndrome have greater muscle strength irrespective of body composition.
The aim of this study was to compare metabolic parameters, body composition (BC) and muscle strength of women with and without polycystic ovary syndrome (PCOS). This was a case-control study that evaluated 40 women with PCOS and 40 controls. Androgens and insulin resistance were measured. BC was based on dual-energy X-ray absorptiometry. Isometric handgrip and maximal dynamic muscle strength (1-RM) strength tests were performed. Median total testosterone (p < 0.01), free androgen index (p < 0.01), insulin (p < 0.01) and homeostasis model assessment-insulin resistance (p = 0.02) were higher and sex hormone binding globulin (SBHG) (p = 0.04) was lower in the PCOS group. Normoweight women with PCOS had higher percentages of android body fat. However, the prevalence of android fat distribution was higher in the PCOS than in the control group (p = 0.04). The strength 1-RM in bench press (p < 0.01), muscle strength relative to lean muscle mass in the dominant lower limb (p = 0.04) and isometric handgrip strength tests (p = 0.03) was higher in the PCOS group. PCOS was a determinant of strength in the bench press exercise (p = 0.04). The hyperandrogenism was a predictor of increased strength in biceps curl exercises (p = 0.03) in the dominant lower limb (p = 0.02) and isometric handgrip strength (p = 0.03). In conclusion, women with PCOS have greater muscle strength and a higher prevalence of central obesity, but no difference in BC. Muscle strength may be related to high androgen levels in these women.


Which Transition Metal Atoms Can Be Embedded into Two-Dimensional Molybdenum Dichalcogenides and Add Magnetism?
As compared to bulk solids, large surface-to-volume ratio of two-dimensional (2D) materials may open new opportunities for postsynthesis introduction of impurities into these systems by, for example, vapor deposition. However, it does not work for graphene or h-BN, as the dopant atoms prefer clustering on the surface of the material instead of getting integrated into the atomic network. Using extensive first-principles calculations, we show that counterintuitively most transition metal (TM) atoms can be embedded into the atomic network of the pristine molybdenum dichalcogenides (MoDCs) upon atom deposition at moderate temperatures either as interstitials or substitutional impurities, especially in MoTe2, which has the largest spacing between the host atoms. We further demonstrate that many impurity configurations have localized magnetic moments. By analyzing the trends in energetics and values of the magnetic moments across the periodic table, we rationalize the results through the values of TM atomic radii and the number of (s + d) electrons available for bonding and suggest the most promising TMs for inducing magnetism in MoDCs. Our results are in line with the available experimental data and should further guide the experimental effort toward a simple postsynthesis doping of 2D MoDCs and adding new functionalities to these materials.