STMS-YOLOv5: A Lightweight Algorithm for Gear Surface Defect Detection.
Most deep-learning-based object detection algorithms exhibit low speeds and accuracy in gear surface defect detection due to their high computational costs and complex structures. To solve this problem, a lightweight model for gear surface defect detection, namely STMS-YOLOv5, is proposed in this paper. Firstly, the ShuffleNetv2 module is employed as the backbone to reduce the giga floating-point operations per second and the number of parameters. Secondly, transposed convolution upsampling is used to enhance the learning capability of the network. Thirdly, the max efficient channel attention mechanism is embedded in the neck to compensate for the accuracy loss caused by the lightweight backbone. Finally, the SIOU_Loss is adopted as the bounding box regression loss function in the prediction part to speed up the model convergence. Experiments show that STMS-YOLOv5 achieves frames per second of 130.4 and 133.5 on the gear and NEU-DET steel surface defect datasets, respectively. The number of parameters and GFLOPs are reduced by 44.4% and 50.31%, respectively, while the email@example.com reaches 98.6% and 73.5%, respectively. Extensive ablation and comparative experiments validate the effectiveness and generalization capability of the model in industrial defect detection.


Acute asthma management in children: factors identifying patients at risk for intensive care unit treatment.
The hospitalization and mortality rates incurred from childhood asthma continue to rise despite recent progress into the pathophysiology and treatment of reactive airway disease. We believe that there are specific factors that identify children at risk for death from asthma. The objective of the study was to determine those risk factors that identify children at increased risk for nonfatal, but life-threatening asthma exacerbations resulting in pediatric intensive care unit (PICU) admission. Patients aged 10 months-16 years admitted to Brenner Children's Hospital for status asthmaticus between April 1991 and December 1992 were evaluated with regard to the prevalence of eight different factors using two categories for asthma: (1) life-threatening asthma requiring PICU admission and (2) non-life-threatening asthma requiring routine hospitalization. Risk factors associated with an increased prevalence of non-fatal, but life-threatening asthma requiring PICU sensitivity state. The classification employed here seemed to provide some merits in delineating the features of adulthood asthma.


Secondary Metabolites from the Marine-Derived Fungus Dichotomomyces sp. L-8 and Their Cytotoxic Activity.
Bioassay-guided isolation of the secondary metabolites from the fungus Dichotomomyces sp. L-8 associated with the soft coral Lobophytum crassum led to the discovery of two new compounds, dichotones A and B (1 and 2), together with four known compounds including dichotocejpin C (3), bis-N-norgliovictin (4), bassiatin (5) and (3R,6R)-bassiatin (6). The structures of these compounds were determined by 1D, 2D NMR and mass spectrometry. (3R,6R)-bassiatin (6) displayed significant cytotoxic activities against the human breast cancer cell line MDA-MB-435 and the human lung cancer cell line Calu3 with IC50 values of 7.34 ± 0.20 and 14.54 ± 0.01 μM, respectively, while bassiatin (5), the diastereomer of compound 6, was not cytotoxic.


Complicated strabismus and adjustable sutures.
Clinical experience in performing over 500 adjustable strabismus operations is mentioned in this paper particularly as it relates to complicated strabismus. A maximum hang-loose recession of a rectus muscle has a limited effect, which is tabulated and the implications discussed. Aids in finding the lost medial rectus muscle are mentioned. Adjustable sutures are then exploited in managing the found "lost" medial rectus. Adjustable recession of both vertical recti in the affected eye were used in some cases of blow-out fracture to manage limitations of upward and downward gaze. Adjustable recession of both yoke medial recti are used in some unilateral superior oblique palsies where the main sequela is hypertropia in downward gaze only. A previously paralysed lateral rectus muscle, which has completely recovered function but has left the patient with a concomitant esotropia with full ductions and normal versions, responds excessively to resection. This should be taken into consideration when planning adjustable strabismus surgery in such a case.


Survey of open science practices and attitudes in the social sciences.
Open science practices such as posting data or code and pre-registering analyses are increasingly prescribed and debated in the applied sciences, but the actual popularity and lifetime usage of these practices remain unknown. This study provides an assessment of attitudes toward, use of, and perceived norms regarding open science practices from a sample of authors published in top-10 (most-cited) journals and PhD students in top-20 ranked North American departments from four major social science disciplines: economics, political science, psychology, and sociology. We observe largely favorable private attitudes toward widespread lifetime usage (meaning that a researcher has used a particular practice at least once) of open science practices. As of 2020, nearly 90% of scholars had ever used at least one such practice. Support for posting data or code online is higher (88% overall support and nearly at the ceiling in some fields) than support for pre-registration (58% overall). With respect to norms, there is evidence that the scholars in our sample appear to underestimate the use of open science practices in their field. We also document that the reported lifetime prevalence of open science practices increased from 49% in 2010 to 87% a decade later.


Factor structure and measurement invariance of the Chinese version of the COVID-19 Phobia Scale in depressive symptoms sample during COVID-19 closure: An exploratory structural equation modeling approach.
The COVID-19 Phobia Scale is an instrument for measuring the phobia of coronavirus. It has a stable four-factor structure and good reliability and validity in other countries and regions. In order to expand related research, this study aims to test the reliability and validity of the COVID-19 Phobia Scale in Chinese adolescents with depressive symptoms. The C19P-SC was translated into Chinese by the method of forward and back translation and tested in 1933 Chinese adolescents with depressive symptoms. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were used to test and compare the four-factor model of the C19P-SC. Then we tested the measurement invariance of the C19P-SC across gender and time. Finally, the reliability was measured with the McDonald's omega coefficients. Consistent with previous studies, the C19P-SC showed a stable four-factor structure. The results showed that ESEM was better than CFA and more reasonable. In addition, the results of multi-group ESEM showed that the C19P-SC met the strict invariance at male and female and partial longitudinal strict invariance. The Mcdonald's omega coefficients of the C19P-SC total scale and each subscale reached the expected acceptable level. In short, the reliability and validity index of C19P-SC has reached an acceptable level, and the measurement invariance of different genders and different time points was established, but the cross-factor phenomenon of individual items was abnormal, and a further revision and testing are still needed.


Calibration of EBT2 film using a red-channel PDD method in combination with a modified three-channel technique.
Ashland Inc. EBT2 and EBT3 films are widely used in quality assurance for radiation therapy; however, there remains a relatively high degree of uncertainty [B. Hartmann, M. Martisikova, and O. Jakel, "Homogeneity of Gafchromic EBT2 film," Med. Phys. 37, 1753-1756 (2010)]. Micke et al. (2011) recently improved the spatial homogeneity using all color channels of a flatbed scanner; however, van Hoof et al. (2012) pointed out that the corrected nonuniformity still requires further investigation for larger fields. To reduce the calibration errors and the uncertainty, the authors propose a new red-channel percentage-depth-dose method in combination with a modified three-channel technique. For the ease of comparison, the EBT2 film image used in the authors' previous study (2012) was reanalyzed using different approaches. Photon beams of 6-MV were delivered to two different films at two different beam on times, resulting in the absorption doses of ranging from approximately 30 to 300 cGy at the vertical midline of the film, which was set to be coincident with the central axis of the beam. The film was tightly sandwiched in a 30(3)-cm(3) polystyrene phantom, and the pixel values for red, green, and blue channels were extracted from 234 points on the central axis of the beam and compared with the corresponding depth doses. The film was first calibrated using the multichannel method proposed by Micke et al. (2010), accounting for nonuniformities in the scanner. After eliminating the scanner and dose-independent nonuniformities, the film was recalibrated via the dose-dependent optical density of the red channel and fitted to a power function. This calibration was verified via comparisons of the dose profiles extracted from the films, where three were exposed to a 60° physical wedge field and three were exposed to composite fields, and all of which were measured in a water phantom. A correction for optical attenuation was implemented, and treatment plans of intensity modulated radiation therapy and volumetric modulated arc therapy were evaluated. The method described here demonstrated improved accuracy with reduced uncertainty. The relative error compared with the measurements of a water phantom was less than 1%, and the overall calibration uncertainty was less than 2%. Verification tests revealed that the results were close to those of the authors' previous study, and all differences were within 3%, except those with a high-dose gradient. The gamma pass rates (2%/2 mm) of the treatment plan evaluated using the method described here were greater than 99%, and no obvious stripe patterns were observed in the dose-difference maps. Spatial homogeneity was significantly improved via the calibration method described here. This technique is both convenient and time-efficient because it does not require cutting the film, and only two exposures are necessary.


Genotyping of Methicillin Resistant Staphylococcus aureus Strains Isolated from Hospitalized Children.
Community associated methicillin resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen increasingly reported to cause skin and soft tissue infections for children. The emergence of highly virulencet CA-MRSA strains in the immunodeficiency of young children seemed to be the basic explanation of the increased incidence of CA-MRSA infections among this population. The subjects of this study were 8 patients hospitalized in the Pediatric Department at the University Hospital of Monastir. The patients were young children (aged from 12 days to 18 months) who were suffering from MRSA skin infections; two of them had the infections within 72 h of their admission. The isolates were classified as community isolates as they all carried the staphylococcal cassette chromosome mec (SCCmec) IV and pvl genes. Epidemiological techniques, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST), were applied to investigate CA-MRSA strains. Analysis of molecular data revealed that MRSA strains were related according to PFGE patterns and they belonged to a single clone ST80. Antimicrobial susceptibility tests showed that all strains were resistant to kanamycin and 2 strains were resistant to erythromycin.


Chemisorption of CO on au/TiO(x)/Pt(111) model catalysts with different stoichiometry and defectivity.
Au/TiO(x)/Pt(111) model catalysts were prepared starting from well characterized TiO(x)/Pt(111) ultrathin films, according to an established procedure consisting in a reactive evaporation of Ti, subsequent thermal treatment in O2 or in UHV, and final deposition of submonolayer quantities of Au. Temperature Programmed Desorption measurements were performed to compare the interaction of CO in the case of two reduced TiO(x)/Pt(111) substrates (indicated as w-TiO(x) and w'-TiO(x), being the former characterized by an ordered array of defects that can act as template for the deposition of a stable array of Au nanoparticles), with the case of a stoichiometric rect'-TiO2/Pt(111) substrate. It was found that in all cases CO is molecularly adsorbed and two different desorption peaks are detected: one at approximately 140 K corresponding to CO desorption from less active adsorption sites (terraces) of the Au nanoparticles and one at approximately 200 K corresponding to CO desorption from Au nanoparticles step sites. After annealing at 770 K, the high temperature CO desorption peak is still present in the case of the defective reduced w-TiO(x) phase, supporting the good templating and stabilizing effect of such phase. On the rect'-TiO2 stoichiometric phase, the CO uptake decreases after annealing but only to a minor extent.


[A case of a corneal disorder after lung cancer treatment with erlotinib].
We report a case of a severe corneal disorder after lung cancer treatment with the epidermal growth factor receptor (EGFR) inhibitor, erlotinib hydrochloride (Tarceva). A 59-year-old man, who was referred to our cornea service, presented with blurred vision and pain OD. Visual acuity was 6/20. Slit-lamp examination showed a severe corneal epithelial defect and ocular inflammation OD. Eighteen months previously, he had been diagnosed with lung cancer and had been undergoing treatment with erlotinib for 6 months. He had no history of ocular surgery, trauma or diabetes. After topical antibiotic therapy was started and the erlotinib treatment was discontinued for 1 week, the corneal findings resolved completely. The visual acuity recovered to 20/20 after 8 weeks. An EGFR inhibitor used to treat lung cancer can cause severe corneal disorders including severe corneal defects and ocular inflammation. Clinicians should consider the possibility of erlotinib in cases of corneal disorders of uncertain etiology.


Genetic alteration and expression of the phosphoinositol-3-kinase/Akt pathway genes PIK3CA and PIKE in human glioblastomas.
Glioblastomas frequently carry genetic alterations resulting in an aberrant activation of the phosphoinositol-3-kinase (Pi3k)/protein kinase B (Akt) signalling pathway, including most notably phosphatase and tensin homolog (PTEN) mutation, epidermal growth factor receptor (EGFR) amplification and rearrangement, as well as carboxyl-terminal modulator protein (CTMP) hypermethylation [Knobbe et al., (2004) Hypermethylation and transcriptional downregulation of the carboxyl-terminal modulator protein gene in glioblastomas. J Natl Cancer Institute, 96, 483-486]. Here, we investigated two further Pi3k/Akt pathway genes, namely PIK3CA (3q26.3) and phosphatidylinositol-3-kinase enhancer (PIKE) (CENTG1, 12q14), for genetic alteration and aberrant expression in a series of 97 primary glioblastomas. Single strand conformation polymorphism (SSCP) analysis of PIK3CA revealed somatic mutations in five tumours (5%). Twelve glioblastomas (12%) showed amplification of PIKE with invariable co-amplification of the adjacent CDK4 gene. All tumours with PIKE amplification as well as the vast majority of glioblastomas without amplification demonstrated increased expression of PIKE-A but not PIKE-S/L transcripts as compared with non-neoplastic brain tissue. Taken together, our data support an important role of PIK3CA and PIKE gene aberrations in the molecular pathogenesis of primary glioblastomas.


The mother's immune system is a balanced threat to the foetus, turning to protection of the neonate.
Immunological tolerance by the mother prevents rejection of the foetus, but aberrations may increase risk of abnormalities like spontaneous abortion, or foetal growth restriction. The neonate is normally colonized with mother's gut microflora, mainly composed of protective anaerobes. This least threatening form of microbial colonization of the neonate, is impaired by sectio delivery, but supported by breastfeeding. Mother's transplacental IgG, secretory IgA and other milk components help protect the neonate together with its own slowly expanding immune system. The mother's immune system tolerates her foetus via several mechanisms. Failure to do so may cause foetal growth retardation, or spontaneous abortion. The mother and the neonate cooperate in preventing infections in the offspring.


Predicting Structural Susceptibility of Proteins to Proteolytic Processing.
The importance of 3D protein structure in proteolytic processing is well known. However, despite the plethora of existing methods for predicting proteolytic sites, only a few of them utilize the structural features of potential substrates as predictors. Moreover, to our knowledge, there is currently no method available for predicting the structural susceptibility of protein regions to proteolysis. We developed such a method using data from CutDB, a database that contains experimentally verified proteolytic events. For prediction, we utilized structural features that have been shown to influence proteolysis in earlier studies, such as solvent accessibility, secondary structure, and temperature factor. Additionally, we introduced new structural features, including length of protruded loops and flexibility of protein termini. To maximize the prediction quality of the method, we carefully curated the training set, selected an appropriate machine learning method, and sampled negative examples to determine the optimal positive-to-negative class size ratio. We demonstrated that combining our method with models of protease primary specificity can outperform existing bioinformatics methods for the prediction of proteolytic sites. We also discussed the possibility of utilizing this method for bioinformatics prediction of other post-translational modifications.


In infertile women with subclinical hypothyroidism, with or without thyroid peroxidase antibodies, serum TSH during pregnancy follows preconception values and thyroid hormones remain stable.
How does subclinical hypothyroidism, defined in infertile women during preconception by thyroid-stimulating hormone (TSH) >2.5 or >4.5 mIU/l, with or without thyroid peroxidase antibodies (anti-TPO) >100 IU/ml, impact thyroid hormone levels during pregnancy and after birth? During pregnancy, TSH levels remain similar to those in preconception, even with supplementary thyroxine, whereas the serum levels of anti-TPO progressively decline. Overt hypothyroidism impacts both pregnancy and offspring but randomized clinical trials and cohort studies failed to detect the benefit of treatment with thyroxine in cases with low-threshold TSH or with anti-TPO during pregnancy. First, the prevalence and reproducibility of two candidate cut-off levels of subclinical hypothyroidism in a cohort of 177 infertile women was compared with 171 women not aiming for pregnancy. Second, the impact of distinct setpoints of TSH in preconception (with or without anti-TPO) was monitored during pregnancy in 87 previously infertile women by high-frequency monitoring of thyroid function. Both studies were carried out from 2007 to 2019. Reproducibility and prevalence of subclinical hypothyroidism were examined in infertile women presenting in the fertility care unit of an academic institution. Women not aiming for pregnancy participated as controls. In both groups, TSH and anti-TPO were measured two times on different occasions. In addition, a group of previously infertile women with known preconception setpoints of TSH (with or without anti-TPO) were followed up prospectively throughout pregnancy and after birth. During pregnancy, serum was sampled weekly until Week 12, then monthly until delivery, and once after birth. Only cases with preconception TSH >4.5 mIU/l were supplemented with thyroxine. After collection of all samples, the serum levels of anti-TPO and the major thyroid hormones were measured. Prolactin with known fluctuations during pregnancy was used as reference. Measures of both TSH and anti-TPO at two different time points were accurate and reproducible. The odds of subclinical hypothyroidism in infertile women and controls were similar. During pregnancy, TSH closely followed preconception TSH levels, whereas serum levels of the thyroid hormones predominantly remained within or above (not below) the reference. Treatment of infertile women with preconception TSH >4.5 mIU/l with thyroxine resulted in higher free thyroxine (fT4) serum levels. The serum levels of anti-TPO declined as pregnancies evolved. The numbers of participants both in the prevalence study and in pregnancy did not reach the a priori estimated numbers. For ethical reasons, the patients with preconception TSH >4.5 mIU/l were treated with thyroxine. The findings apply to infertile women only. We propose to use >4.5 mIU/l as the serum TSH threshold for supplementing women with thyroxine before pregnancy. During pregnancy, fT4 may be the better marker to monitor thyroid function. The consistent decrease of anti-TPO antibody levels during ongoing pregnancies must be considered a protective element. The prevalence part of this study was supported by Merck-Serono, Geneva (TH006/EMR200007-603). The hormone measurements of the serum samples collected during the follow-up pregnancies were made possible by financial support of Roche Diagnostica (November 1721, 2017, Rotkreuz, Switzerland). I.D.G. was supported by a grant of the Repronatal Foundation, Basel, Switzerland. All authors declare no conflict of interest. Research Database of UniBasel, project no. 576691 (2007).


[Effects of different irrigations on the water physiological characteristics of Haloxylon ammodendron in Taklimakan Desert hinterland].
By using heat-balance stem flow gauge and press chamber, the water physiological characteristics of Haloxylon ammodendron under different irrigations in Taklimakan Desert hinterland were measured and analyzed. The results indicated that the diurnal variation curve of H. ammodendron stem sap flow varied with irrigations. When irrigated 35 and 24.5 kg x plant(-1) once time, the diurnal variation of stem sap flow changed in single peak curve and the variation extent was higher; while irrigated 14 kg x plant(-1) once time, the diurnal variation changed in two-peak curve and the variation extent was small. With the decrease of irrigations, the average daily sap flow rate and the daily water consumption of H. ammodendron decreased gradually, the dawn and postmeridian water potential also had a gradual decrease, and the correlations of stem sap flow with total radiation, air temperature, relative humidity, and wind speed enhanced. Under different irrigations, the correlation between stem sap flow rate and total radiation was always the best.


The seventh nationwide surveillance of six otorhinolaryngological infectious diseases and the antimicrobial susceptibility patterns of the isolated pathogens in Japan.
The Japanese Three Academic Societies Joint Antimicrobial Susceptibility Surveillance Committee conducted a nationwide surveillance on six otorhinolaryngological diseases and investigated the antimicrobial susceptibility patterns and isolation rates of the causative pathogens. The surveillance program was conducted in the otorhinolaryngological departments of 12 universities, and 36 affiliated hospitals and clinics. Patients with acute otitis media (children under six years old), chronic otitis media, acute nasal sinusitis, chronic nasal sinusitis, acute tonsillitis, and peritonsillar abscess (over 20 years old) between December 2015 and June 2017 were investigated. The collected swab or incision samples were cultivated for microbial identification, and the antimicrobial susceptibility of the detected bacteria was measured at the Kitasato University Research Center for Infections and Antimicrobials. The surveillance focused on three gram-positive bacteria (Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus), three gram-negative bacteria (Haemophilus influenzae, Moraxella catarrhalis, and Pseudomonas aeruginosa), and three anaerobic bacteria (anaerobic gram-positive cocci, Prevotella spp., Porphyromonas spp., and Fusobacterium spp.). Bacterial susceptibility to 40 antimicrobial agents was investigated. We were unable to completely mitigate the rise in the occurrence of resistant bacteria, such as methicillin-resistant S. aureus, penicillin-resistant S. pneumoniae, penicillin-intermediate resistant S. pneumoniae, beta-lactamase non-producing ampicillin-resistant H. influenzae, and beta-lactamase producing ampicillin-resistant H. influenzae. We suggest promoting the proper usage of antimicrobial agents to prevent the spread of these bacteria. We also suggested that immunization with pneumococcal vaccines is useful for decreasing the occurrence of otorhinolaryngological infectious diseases caused by pneumococci.


Metabolic and nutritional changes after bariatric surgery.
Bariatric surgery is the most durable intervention for severe obesity. Appropriate candidates for surgery include those with a body mass index over 40 kg/m(2), or those with a BMI over 35 kg/m(2) who also have weight-related comorbidities. Bariatric procedures are categorized as restrictive, where food intake is limited by a small gastric 'pouch'; malabsorptive, where the length of intestine available for nutrient absorption is decreased; or a combination of both. Although pure malabsorptive procedures, such as the now-historical jejunoileal bypass, achieve greater weight loss than restrictive procedures, they are generally associated with more postoperative metabolic problems. The Roux-en-Y gastric bypass is currently considered the gold standard bariatric procedure for most patients. It results in excellent weight loss with minimal complications, but does require life-long vitamin supplementation. Compliance with vitamins and supplements is also mandatory after malabsorptive procedures. With these procedures, decreased oral intake, as well as altered absorption of nutrients from the GI tract, results in potentially low blood levels of a variety of micronutrients, especially iron, vitamin B12 and folate. Bariatric surgery also improves the comorbid conditions that are associated with obesity, such as diabetes, hypertension, dyslipidemia, obstructive sleep apnea, obesity hypoventilation, gastroesophageal reflux disease, asthma, venous stasis, polycystic ovary syndrome and pseudotumor cerebri. The resolution of diabetes is secondary to weight loss and may also be due to alteration of the enteroinsular axis.


Maternal parenting and children's conscience: early security as moderator.
Socialization research is shifting from direct links between parenting and children's outcomes toward models that consider parenting in the context of other factors. This study proposed that the effects of maternal responsive, gentle parenting on child conscience are moderated by the quality of their relationship, specifically, early security. A 2-process model of early conscience development was proposed and confirmed in this longitudinal study. The child's security and trust in the caregiver, assessed at 14 months in the Strange Situation, rendered him or her receptive and eager to accept the caregiver's socialization agenda. That early security then enhanced the effectiveness of parental adaptive parenting style, observed from 14 to 45 months, in terms of promoting conscience at 56 months, which encompassed moral conduct, moral cognition, and moral self.


Selective protein kinase C inhibition attenuates pulmonary artery cytokine expression without affecting hypoxic pulmonary vasoconstriction.
Hypoxic pulmonary vasoconstriction may be an adaptive response to shunt blood to well-oxygenated areas of the lung, but hypoxia-induced inflammatory cytokine production leads to acute lung injury. We have previously shown that protein kinase C (PKC) mediates both hypoxic pulmonary vasoconstriction and inflammatory cytokine expression from the pulmonary artery; however, the effect of specific PKC isoform inhibition is currently unknown. We hypothesized that inhibition of classical PKC (cPKC) isoforms would attenuate hypoxic pulmonary vasoconstriction and downregulate hypoxia-induced pulmonary artery cytokine expression. To study this, isometric force displacement was measured in isolated rat pulmonary artery rings (n = 6 per group) during hypoxia (95% N2/5% CO2) in the presence of the nonspecific PKC inhibitor bisindolylmaleimide (1 micromol/L), the cPKC inhibitor Gö 6976 (1 - 10 micromol/L), or vehicle (dimethyl sulfoxide, 0.001%). After 60 min of hypoxia, pulmonary artery rings were analyzed for tumor necrosis factor (TNF) alpha and interleukin (IL) 1beta messenger RNA via reverse transcriptase-polymerase chain reaction. Nonspecific PKC inhibition (bisindolylmaleimide) significantly attenuated hypoxic pulmonary vasoconstriction (44.59 +/- 10.52% vs. 87.06 +/- 10.91% vehicle; P < 0.001) and downregulated hypoxia-induced expression of pulmonary artery TNF-alpha. Specific cPKC inhibition (Gö 6976) attenuated pulmonary artery TNF-alpha expression but had no effect on hypoxic pulmonary vasoconstriction. These data are indicative of the following: (1) nonspecific PKC inhibition attenuates both hypoxic pulmonary vasoconstriction and pulmonary artery TNF-alpha expression, (2) cPKC inhibition downregulates hypoxia-induced pulmonary artery TNF-alpha expression but has no effect on hypoxic pulmonary vasoconstriction, and (3) hypoxic pulmonary vasoconstriction and hypoxia-induced pulmonary artery cytokine expression are independent processes.


Congenital varicella resulting from infection during second trimester of pregnancy.
An infant with left microphthalmia, enophthalmia, and cataract with scattered zosterform skin lesions from maternal varicella at 20 weeks' gestation is described. The mother's abnormal obstetric history is discussed and published reports on congenital and neonatal varicella reviewed.


Ultrasound-assisted butyl acetate synthesis catalyzed by Novozym 435: enhanced activity and operational stability.
The influence of low-frequency ultrasound (40 kHz) in the esterification reaction between acetic acid and butanol for flavor ester synthesis catalyzed by the commercial immobilized lipase B from Candida antarctica (Novozym 435) was evaluated. A central composite design and the response surface methodology were used to analyze the effects of the reaction parameters (temperature, substrate molar ratio, enzyme content and added water) and their response (yields of conversion in 2.5 h of reaction). The reaction was carried out using n-hexane as solvent. The optimal conditions for ultrasound-assisted butyl acetate synthesis were found to be: temperature of 46 °C; substrate molar ratio of 3.6:1 butanol:acetic acid; enzyme content of 7%; added water of 0.25%, conditions that are slightly different from those found using mechanical mixing. Over 94% of conversion was obtained in 2.5h under these conditions. The optimal acid concentration for the reaction was determined to be 2.0 M, compared to 0.3 M without ultrasound treatment. Enzyme productivity was significantly improved to around 7.5-fold for each batch when comparing ultrasound and standard mechanical agitation. The biocatalyst could be directly reused for 14 reactions cycles keeping around 70% of its original activity, while activity was virtually zeroed in the third cycle using the standard mixing system. Thus, compared to the traditional mechanical agitation, ultrasound technology not only improves the process productivity, but also enhances enzyme recycling and stability in the presence of acetic acid, being a powerful tool to improve biocatalyst performance in this type of reaction.


Risk Prediction in Women With Congenital Long QT Syndrome.
Background We aimed to provide personalized risk estimates for cardiac events (CEs) and life-threatening events in women with either type 1 or type 2 long QT. Methods and Results The prognostic model was derived from the Rochester Long QT Syndrome Registry, comprising 767 women with type 1 long QT (n=404) and type 2 long QT (n=363) from age 15 through 60 years. The risk prediction model included the following variables: genotype/mutation location, QTc-specific thresholds, history of syncope, and β-blocker therapy. A model was developed with the end point of CEs (syncope, aborted cardiac arrest, or long QT syndrome-related sudden cardiac death), and was applied with the end point of life-threatening events (aborted cardiac arrest, sudden cardiac death, or appropriate defibrillator shocks). External validation was performed with data from the Mayo Clinic Genetic Heart Rhythm Clinic (N=467; type 1 long QT [n=286] and type 2 long QT [n=181]). The cumulative follow-up duration among the 767 enrolled women was 22 243 patient-years, during which 323 patients (42%) experienced ≥1 CE. Based on genotype-phenotype data, we identified 3 risk groups with 10-year projected rates of CEs ranging from 15%, 29%, to 51%. The corresponding 10-year projected rates of life-threatening events were 2%, 5%, and 14%. C statistics for the prediction model for the 2 respective end points were 0.68 (95% CI 0.65-0.71) and 0.71 (95% CI 0.66-0.76). Corresponding C statistics for the model in the external validation Mayo Clinic cohort were 0.65 (95% CI 0.60-0.70) and 0.77 (95% CI 0.70-0.84). Conclusions This is the first risk prediction model that provides absolute risk estimates for CEs and life-threatening events in women with type 1 or type 2 long QT based on personalized genotype-phenotype data. The projected risk estimates can be used to guide female-specific management in long QT syndrome.


Impact of Wellness Policy Review, Wellness Council Activity, and Student Health Objectives on Overall School Wellness Climate.
The whole school, whole community, whole child (WSCC) model suggests wellness councils, ongoing review of wellness policy, and a plan for evaluating set objectives are some of the key features needed to support school wellness infrastructure. This study explored the relationship between implementation of these infrastructure features and overall school wellness environment assessment scores among a sampling of Pennsylvania schools. The Healthy Champions program provides Pennsylvania schools an opportunity to self-assess their wellness environments across several school wellness topics. Staff enrolled their school in the program by completing a self-report electronic assessment. Enrollment data from the 2020/2021 program year were analyzed using the Kruskal-Wallis test and linear fixed model to identify the impact of varied implementation levels across 3 wellness infrastructure activities. Interactions between these variables and overall assessment score were also analyzed. Of the 645 Pennsylvania schools enrolled and analyzed, we observed higher mean wellness environment assessment scores (∆ 0.74 95% CI 0.40-1.07; p < 0.001) among schools that reported some frequency of all 3 wellness infrastructure activities, compared to schools that reported no frequency for the activities. Schools with existing policies and practices related to the 3 wellness infrastructure activities should consider the degree of implementation to best support overall wellness in their school setting. Additional research to explore implementation barriers and supports is needed. Analyses indicated that overall wellness environment assessment scores are impacted by implementation thresholds for wellness council meeting frequency, revision of wellness policy, and review of student health promotion objectives.


Perioperative Strokes and Early Outcomes in Mitral Valve Surgery: A Nationwide Analysis.
To demonstrate the role of perioperative stroke as an independent risk factor for in-hospital morbidity and mortality after mitral valve surgery and review the trends in the early outcomes of mitral valve surgery over the past decade. Using data from the National Inpatient Sample database for analysis, all patients who underwent isolated mitral valve procedures were identified using International Classification of Diseases-Ninth Revision codes. Univariate and multivariate analyses of risk factors of in-hospital mortality and morbidity were performed. Multi-institutional. The study comprised patients who underwent mitral valve procedures from 1999 to 2011. Mitral valve repair or replacement. Data on 21,821 patients showed an in-hospital mortality of 5.5% and morbidity of 63.30% (p<0.05). Perioperative strokes were experienced by 3.89% of the cohort after isolated mitral valve surgery (p<0.05). Independent predictors of adverse outcomes were age, female sex, emergency surgery, arrhythmias, hypertension, renal failure, coagulopathy, neurologic disorders, weight loss, anemia, postoperative cardiac arrest, and myocardial infarction. Perioperative strokes were found to be the strongest risk factor for postoperative mortality (odds ratio 2.34, 95% confidence interval 1.83-2.98) and morbidity (odds ratio 4.53, 95% confidence interval 3.34-6.15). Age, female sex, emergency surgery, arrhythmias, hypertension, renal failure, coagulopathy, neurologic disorders, weight loss, fluid and electrolyte imbalance, anemia, postoperative cardiac arrest, and myocardial infarction were found to be significant predictors of morbidity and mortality after mitral valve surgery, with perioperative strokes posing the strongest risk. The trends in the last 10 years indicated a decrease in mortality and an increase in morbidity. Preoperative risk stratification and intraoperative identification for impending strokes appear warranted.


Mechanisms of cartilage growth: modulation of balance between proteoglycan and collagen in vitro using chondroitinase ABC.
To examine the cartilage growth-associated effects of a disruption in the balance between the swelling pressure of glycosaminoglycans (GAGs) and the restraining function of the collagen network, by diminishing GAG content prior to culture using enzymatic treatment with chondroitinase ABC. Immature bovine articular cartilage explants from the superficial and middle layers were analyzed immediately or after incubation in serum-supplemented medium for 13 days. Other explants were treated with chondroitinase ABC to deplete tissue GAG and also either analyzed immediately or after incubation in serum-supplemented medium for 13 days. Treatment- and incubation-associated variations in tissue volume, contents of proteoglycan and collagen network components, and tensile mechanical properties were assessed. Incubation in serum-supplemented medium resulted in expansive growth with a marked increase in tissue volume that was associated with a diminution of tensile integrity. In contrast, chondroitinase ABC treatment on day 0 led to a marked reduction of GAG content and enhancement of tensile integrity, and subsequent incubation led to maturational growth with minimal changes in tissue volume and maintenance of tensile integrity at the enhanced levels. The data demonstrate that a manipulation of GAG content in articular cartilage explants can distinctly alter the growth phenotype of cartilage. This may have practical utility for tissue engineering and cartilage repair. For example, the expansive growth phenotype may be useful to fill cartilage defects, while the maturational growth phenotype may be useful to induce matrix stabilization after filling defect spaces.


[Uteroplacental and fetal arterial Ultrasound Doppler Flow Velocity measurements in unselected pregnancies as a screening test at 32 to 34 gestational weeks].
We hypothesized a difference in mean values for ultrasound biometry and Doppler flow velocity measurements in uteroplacental and fetal arterial vessels between subgroups with a subsequent normal and pathological [pathological fetal heart rate tracing, operative delivery due to fetal distress, thick meconium, IUGR < 10th centile, prematurity < 37 weeks, APGAR 5' < 7, umbilical artery pH < 7.20, neonatal pediatric hospitalisation] birth result in unselected pregnancies screened at 32 to 34 gestational weeks. PATIENT CHARACTERISTICS AND METHODS: After having obtained informed consent we included 198 singleton pregnancies in an open prospective study and performed a single ultrasound assessment at 32 to 34 gestational weeks to collect biometry and Doppler flow velocity data: angle independent resistance indices (RI, PI) for uteroplacental and umbilical arteries, RI, PI and Vmean (mean blood flow velocity) after angel correction for fetal descending aorta and middle cerebral arteries, (ATL, Ultramark 9, HDI ESP, 4 - 7 MHz curved and 3 - 5 MHz phased array). After delivery, perinatal and neonatal data were collected and pregnancies were grouped accordingly (normal and pathological birth result). Of 198 pregnancies included, 58 fulfilled at least one of the established criteria for a pathological birth result and 17 were born growth restricted (< 10th centile) and/or prematurely (< 37 gestational weeks). Within subgroups (normal /pathological birth result) mean values only differed for uteroplacental RI (p=0.07) and aortic Vmean (p=0.04). Differences were highly significant for normally versus growth restricted/prematurely born fetuses: uteroplacental RI (p=0.01), fetal descending aorta PI (p=0.02) and Vmean (p=0.001), and middle cerebral artery PI (p=0.0008). Elevated uteroplacental Doppler flow velocity waveform indices and reduced aortic blood flow velocity might be associated with a pathological birth result and an impaired neonatal status after birth in cohorts of unselected pregnancies.


Experimental and quasi-experimental designs in implementation research.
Implementation science is focused on maximizing the adoption, appropriate use, and sustainability of effective clinical practices in real world clinical settings. Many implementation science questions can be feasibly answered by fully experimental designs, typically in the form of randomized controlled trials (RCTs). Implementation-focused RCTs, however, usually differ from traditional efficacy- or effectiveness-oriented RCTs on key parameters. Other implementation science questions are more suited to quasi-experimental designs, which are intended to estimate the effect of an intervention in the absence of randomization. These designs include pre-post designs with a non-equivalent control group, interrupted time series (ITS), and stepped wedges, the last of which require all participants to receive the intervention, but in a staggered fashion. In this article we review the use of experimental designs in implementation science, including recent methodological advances for implementation studies. We also review the use of quasi-experimental designs in implementation science, and discuss the strengths and weaknesses of these approaches. This article is therefore meant to be a practical guide for researchers who are interested in selecting the most appropriate study design to answer relevant implementation science questions, and thereby increase the rate at which effective clinical practices are adopted, spread, and sustained.


S-nitrosation of Ca(2+)-loaded and Ca(2+)-free recombinant calbindin D(28K) from human brain.
Calbindin D(28K) is noted for its abundance and specific distribution in mammalian brain and sensory neurons. It can bind three to five Ca(2+) ions and may act as a Ca(2+) buffer to maintain intracellular Ca(2+) homeostasis, but its exact role is still unknown. In the present study, mass spectrometric analysis reveals that the five cysteine residues in recombinant human brain calbindin D(28K) (rHCaBP) are derivatized with N-ethylmaleimide, consistent with the determination of 5.3 +/- 0.4 and 4.7 +/- 0.4 free thiols in the protein using the thiol-specific reagents 5,5'-dithiobis(2-nitrobenzoic acid) and 5-(octyldithio)-2-nitrobenzoic acid, respectively. The results of UV-vis and circular dichroism absorption, intrinsic fluorescence, and mass spectrometry measurements indicate that both Ca(2+)-loaded (holo) and Ca(2+)-free (apo) rHCaBP are S-nitrosated by S-nitrosocysteine (CysNO). The number of cysteine residues S-nitrosated in holorHCaBP and aporHCaBP are 2.6 +/- 0.05 and 3.4 +/- 0.09, respectively, as determined by the Saville assay. HolorHCaBP also undergoes S-nitrosation at one to three cysteine residues when exposed to S-nitrosoglutathione (GSNO), and Cys100 was found to be an S-nitrosation site by peptide mass mapping. Treatment of holorHCaBP with free NO resulted in a mass increase of 59 +/- 2 Da, corresponding to two NO adducts. Since up to four cysteine residues can be S-nitrosated in rHCaBP, it is proposed that the protein may act as a NO buffer or reservoir in the brain in a manner similar to serum albumin in blood. It is significant in this context that rHCaBP is found coexistent with nitric oxide synthase in cerebellum and that S-nitrosation varies with Ca(2+) binding, with S-nitrosation occurring to a greater extent in aporHCaBP than in the holoprotein. Furthermore, exposure of rHCaBP to either CysNO or GSNO also leads to rapid S-thiolation of Cys187. We demonstrate here for the first time that intrinsic protein fluorescence is a sensitive probe of protein S-nitrosation. This is due to efficient Förster energy transfer (R(0) approximately 17 A) between tryptophan donors and S-nitrosothiol acceptors.


Impact of interpreters' approach on Latinas' use of amniocentesis.
Communication difficulties in multicultural clinical settings can be exacerbated by translators, but their actual impact on medical decisions has not been systematically evaluated. This study sought to determine the influence of translators participating in clinical encounters in which English-speaking clinicians offered amniocentesis to Spanish-speaking women by conducting systematic observations of 61 prenatal genetic consultations and recording translators' training and background characteristics and patients' amniocentesis decisions. Translators' behavioral styles were classified according to 10 inductively determined criteria. Translators' approaches were classified as Distant, Authoritative, or Missionary. Whereas the first category remained emotionally detached, the others sought to build rapport and trust with the patient. Quantitative analysis revealed statistically significant associations between translation styles that sought to engender trust and likelihood the pregnant woman agreed to amniocentesis. The authors conclude that translators' affective approaches can influence whether patients accept or decline amniocentesis.


Superimposed histologic and genetic mapping of chromosome 17 alterations in human urinary bladder neoplasia.
Multistep alterations of chromosome 17 in the progression of human urinary bladder neoplasia were studied by superimposed histologic and genetic mapping. The p53 gene was included in the analysis as a model tumor suppressor gene that is frequently involved in urothelial carcinogenesis. The strategy provided a systematic approach to the study of multistep genomic alterations that occur as neoplasia progresses from precursor intraurothelial conditions to invasive cancer. This was accomplished by sampling the entire mucosa of the organ and displaying microscopically identified invasive cancer and precursor conditions in the form of a histologic map. Subsequent isolation of DNA provided a set of samples in which the search for genetic alterations was performed and superimposed on the histologic map. This approach disclosed multifocal allelic losses of chromosome 17 in the early preinvasive phases of urothelial neoplasia. The alterations were predominantly confined to the p12-13, q22-11 and q24-25 regions. Mutations and allelic losses of the p53 gene were mapped to early preinvasive phases of urothelial neoplasia. The data provide detailed analysis of chromosome 17 allelic losses that occur in the development and progression of urothelial neoplasia and represent the first step for genome-wide modeling of multistep human urothelial carcinogenesis.


Body composition from 18 to 22 years and pulmonary function at 22 years-1993 Pelotas Birth Cohort.
The objective was to verify the association between body composition from 18 to 22 years and pulmonary function at 22 years of age. This longitudinal analysis was conducted with a Brazilian birth cohort data. The outcomes were the forced expiratory volume in the first second and forced vital capacity (FVC), measured at 22 years follow-up. Main exposures: obesity (body mass index ≥ 30kg/m2), and highest tertiles of fat mass (FM) and fat mass index (air displacement plethysmography) measured at 18 and 22 years-old follow-ups. The reference category (not exposed) was defined by those individuals who were not classified in the highest adiposity categories mentioned, in both ages. Multivariable linear regressions stratified by sex were used. The sample comprised 3,511 participants. Those who belonged to the highest adiposity categories in 18 and 22 years follow-ups showed lower pulmonary function at 22 years when compared to those who were not classified in the higher adiposity categories in both ages (reference category); those in the highest tertile of FM showed a mean FVC -313mL (95%CI -421; -206) and -259mL (95%CI -336; -182) in men and women, compared to the reference category, respectively. Those who changed from the higher to the lower adiposity categories (from 18 to 22 years) showed pulmonary function similar to the reference, and those who presented the opposite body composition trajectory, showed decreased pulmonary function results at 22 years, mainly among women. We concluded that high body adiposity in two follow-ups and especially contemporary adiposity was associated with lower pulmonary function at 22 years.


Short incubation of disc diffusion for Streptococcus pneumoniae and Haemophilus influenzae to reduce time to susceptibility report.
Rapidly instituted antimicrobial therapy is important in severe infections, and reduced time to the antimicrobial susceptibility testing (AST) report is thus of importance. Disc diffusion (DD) is a cheap, rapidly adaptable, flexible and comprehensive method for phenotypic AST. Previous studies have shown that early reading of inhibition zones for non-fastidious species is possible. To evaluate zone reading after short incubation of DD in Haemophilus influenzae (n = 73) and Streptococcus pneumoniae (n = 112). The readability was evaluated and susceptibility interpretation (SIR) was performed, using the EUCAST 18 ± 2 h incubation breakpoint table (version 12.0), after 6 and 8 h of incubation. Categorical agreement (CA) and error rates were calculated using standard DD and broth microdilution as reference. The proportion of readable zones in H. influenzae was 19% (6 h) and 89% (8 h). The CA was 98% after 8 h. The corresponding readability in S. pneumoniae was 63%/98% and CA was 95%/97% after 6 and 8 h, respectively. Early reading of the screening discs (benzylpenicillin 1 unit in H. influenzae and oxacillin 1 µg in S. pneumoniae) correctly identified 18/22 of the H. influenzae isolates and all the readable S. pneumoniae isolates with reduced β-lactam susceptibility. For non-β-lactam agents, very major errors were most common for quinolones in S. pneumoniae. Introduction of areas of technical uncertainty (ATUs) reduced the error rate to ≤1.1%. We conclude that shortened incubation is feasible for H. influenzae and S. pneumoniae. To reduce the risk of false categorization a buffer zone (i.e. ATU) near the breakpoints must be used.


The yeast ILV2 gene is under general amino acid control.
The yeast ILV2 gene encodes acetolactate synthase, the first enzyme in the biosynthesis of isoleucine and valine. Its multiple regulation has precluded the clear demonstration of whether ILV2 is under general amino acid control. Nonderepressible gcn4 strains were used as recipients for transformation with a YCp plasmid carrying GCN4. Parental gcn4 cells and their isogenic GCN4 transformants were evaluated for ALS derepression following induced amino acid starvation. GCN4 cells showed 1.5- to 1.7-fold derepression but no derepression was observed in isogenic control gcn4 strains. A similar depression of ILV2 mRNA was also observed. Genetic evidence for general amino acid control was the gcn4 suppression of high level resistance to sulfometuron methyl by the SMRI-410 allele of ILV2.


Public economic gains from tax-financed investments in childhood immunization in the United States.
The emergence of COVID-19 has displayed the importance of immunization and the need for continued public investment in vaccination programs. Globally, national vaccination programs rely heavily on tax-financed expenditure, requiring upfront investments and ongoing financial commitments. To evaluate annual public investments, we conducted a fiscal analysis that quantifies the public economic consequences to government in the United States attributable to childhood vaccination. To estimate the change in net government revenue, we developed a decision-analytic model that quantifies lifetime tax revenues and transfers based on changes in morbidity and mortality arising from vaccination of the 2017 U.S. birth cohort. Reductions in deaths and comorbid conditions attributed to pediatric vaccines were used to derive gross lifetime earnings gains, tax revenue gains attributed to averted morbidity and mortality avoided, disability transfer cost savings, and averted special education costs associated with each vaccine. Our analysis indicates a fiscal dividend of $41.7 billion from vaccinating this cohort. The bulk of this gain for government reflects avoiding the loss of $30.6 billion in present-value tax revenues. All pediatric vaccines raise tax revenues by reducing vaccine-preventable morbidity and mortality in amounts ranging from $7.3 million (hepatitis A) to $20.3 billion (diphtheria) over the life course. Based on public investments in pediatric vaccines, a benefit-cost ratio of 17.8 was calculated for each dollar invested in childhood immunization. The public economic yield attributed to childhood vaccination in the U.S. is significant from a government perspective, providing fiscal justification for ongoing investment.


Cholesterol re-organisation and lipid de-packing by arginine-rich cell penetrating peptides: Role in membrane translocation.
Cell penetrating peptides (CPPs) are able to transport hydrophilic molecules inside cells. To reach the cytosol, the peptide associated with a cargo must cross the plasma or the endosomal membrane. Different molecular mechanisms for peptide internalisation into cells have been proposed and it is becoming clear that the cellular internalisation mechanisms are different depending on the peptide sequence and structure and the target membrane. Herein, the penetration of three peptides into large unilamellar vesicles were studied: the homeodomain derived 16-residues penetratin, nona-arginine (R9), and a small peptide containing 6 arginine and 3 tryptophan residues (RW9). The membrane models were composed of phospholipids from natural sources containing different molecular species. We observed that among the three peptides, only the amphipathic peptide RW9 was able to cross the membrane vesicles in the liquid disordered state. The changes in the distribution of the previously characterized cholesterol-pyrene probe show that cholesterol-pyrene molecules dissociate from clusters upon membrane interaction with the three peptides and that the cholesterol environment becomes more disordered in the presence of RW9. Finally, we studied the effect of the peptides on lipid ordering on giant plasma membrane vesicles. The amphipathic peptides RW9 and its longer homologue RW16 induced lipid de-packing in plasma membrane vesicles. Overall, the data suggest that a disordered membrane favours the translocation of RW9, that the membrane cholesterol is redistributed during peptide interaction, and that the peptide amphipathic character is important to increase membrane fluidity and peptide membrane translocation.


Differences of self-reported osteoarthritis disability and race.
Differences in self-reported disability may be found for older black and white adults with knee osteoarthritis (OA). This secondary analysis of data from a randomized single-blind clinical trial examined race differences in the relationship between self-reports and timed performance tests of walking. Study participants were 518 older adults (131 blacks, 387 whites), including 363 women and 155 men, with an average age of 68.6 years. Older black and white adults with radiographically documented knee OA reported equivalent functional ability and pain severity. However, both blacks' OA severity rating and tested performance were significantly worse than those of whites. Self-report and tested walking performance were significantly less correlated among black older adults than among white older adults. Analyses of potential confounding variables documented that the difference was not due to marital status, gender, education, income, body mass index, comorbidity, pain level, OA severity or general health. Self-reports of OA disability were less related to tested performance for walking among black older adults. Clinicians' knowledge of black patients' underestimation of their disability has compelling potential for improving clinical treatment and enhancing diagnostic approaches to care of older adults.


Architecture and Electrochemical Performance of Alkynyl-Linked Naphthyl Carbon Skeleton: Naphyne.
The synthesis of new sp-hybridized carbon allotropes is a meaningful and challenging issue. Among the alkynyl carbon family, polyaromatic alkynes is a new branch to be developed. Herein, naphyne with a frame construction of alkynyl-linked naphthyl skeleton was efficiently fabricated through targeted mechanochemical reaction of calcium carbide and perchloronaphthalene. Its unique property and structure with wide alkynyl-naphthyl conjugation, multilayered nanofilm morphology, and high structural stability were corroborated by the comprehensive characterizations combined with computational simulations. Because of these structural features, the as-prepared naphyne can be applied as high-performance binder-free supercapacitor electrode with high specific capacitance (154 F g-1), robust long-term retention (92.1% after 5000 cycles), and prominent electrical conductivity (1490 S m-1). The successful architecture of naphyne approves the feasible synthesis of polyaromatic alkynes and further may provide a prospective approach for the development of alkynyl carbon materials.


Meyer's dysplasia : delayed ossification of the femoral head as a differential diagnosis in perthes' disease.
Meyer's dysplasia strongly mimics Legg-Calve-Perthes' disease despite differing markedly in eventual outcome. This study presents the clinicoradiologi-cal features which differentiate it from Perthes' disease in a group of 178 children with a preliminary diagnosis of Perthes' disease, of whom nine were subsequently diagnosed with Meyer's dysplasia. All had a near normal development of the femoral head; mild flattening was seen in two cases. Clinical initial presentation often resembles Perthes' disease. However, the presence of a granular aspect of the femoral head, often bilateral, in a male child with a preliminary diagnosis of Perthes' disease should alert the clinician to the possibility of Meyer's dysplasia. Restitution of normal capital architecture is usual; there may however be a mild residual hypoplasia.


Human postural response to lower leg muscle vibration of different duration.
Body lean response to bilateral vibrations of soleus muscles were investigated in order to understand the influence of proprioceptive input from lower leg in human stance control. Proprioceptive stimulation was applied to 17 healthy subjects by two vibrators placed on the soleus muscles. Frequency and amplitude of vibration were 60 Hz and 1 mm, respectively. Vibration was applied after a 30 s of baseline. The vibration duration of 10, 20, 30 s respectively was used with following 30 s rest. Subjects stood on the force platform with eyes closed. Postural responses were characterized by center of pressure (CoP) displacements in the anterior-posterior (AP) direction. The CoP-AP shifts as well as their amplitudes and velocities were analyzed before, during and after vibration. Vibration of soleus muscles gradually increased backward body tilts. There was a clear dependence of the magnitude of final CoP shift on the duration of vibration. The amplitude and velocity of body sway increased during vibration and amplitude was significantly modulated by duration of vibration as well. Comparison of amplitude and velocity of body sway before and after vibration showed significant post-effects. Presented findings showed that somatosensory stimulation has a long-term, direction-specific influence on the control of postural orientation during stance. Further, the proprioceptive input altered by soleus muscles vibration showed significant changes in postural equilibrium during period of vibration with interesting post-effects also.


Emodin, aloe-emodin and rhein inhibit migration and invasion in human tongue cancer SCC-4 cells through the inhibition of gene expression of matrix metalloproteinase-9.
Emodin, aloe-emodin and rhein are major compounds in rhubarb (Rheum palmatum L.), used in Chinese herbal medicine, and found to have antitumor properties including cell cycle arrest and apoptosis in many human cancer cells. Our previous studies also showed that emodin, aloe-emodin and rhein induced apoptosis in human tongue cancer SCC-4 cells. However, the detail regarding emodin, aloe-emodin and rhein affecting migration and invasion in SCC-4 cells are not clear. In the present study, we investigated whether or not emodin, aloe-emodin and rhein inhibited migration and invasion of SCC-4 cells. Herein, we demonstrate that emodin, aloe-emodin and rhein inhibit the protein levels and activities of matrix metalloproteinase-2 (MMP-2) but did not affect gene expression of MMP-2, however, they inhibited the gene expression of MMP-9 and all also inhibited the migration and invasion of human tongue cancer SCC-4 cells. MMP-9 (gelatinase-B) plays an important role and is the most associated with tumor migration, invasion and metastasis in various human cancers. Results from zymography and Western blotting showed that emodin, aloe-emodin and rhein treatment decrease the levels of MMP-2, urokinase plasminogen activator (u-PA) in a concentration-dependent manner. The order of inhibition of associated protein levels and gene expression of migration and invasion in SCC-4 cells are emodin >aloe-emodin >rhein. Our results provide new insight into the mechanisms by which emodin, aloe-emodin and rhein inhibit tongue cancers. In conclusion, these findings suggest that molecular targeting of MMP-9 mRNA expression by emodin, aloe-emodin and rhein might be a useful strategy for chemo-prevention and/or chemo-therapeutics of tongue cancers.


Defect of platelet function associated with chronic hypoglycaemia.
Two patients are described with chronic hypoglycaemia; the first having glucose-6-phosphatase deficiency (type I glycogen storage disease), and the second fructose 1:6-diphosphatase deficiency. Both cases were associated with a bleeding diathesis, a defect of platelet aggregation, and a deficiency of platelet adenine nucleotides. The effect on the platelet abnormalities of a period of normoglycaemia was studied in both patients. Correction of the platelet abnormalities occurred rapidly after stabilization of the blood glucose within the normal range. Normal function persisted for the duration of the normoglycaemia, facilitating diagnostic liver biopsy and surgical procedures. A biochemical explanation for the nucleotide deficiency is suggested.


Newly generated neurons in the amygdala and adjoining cortex of adult primates.
The subventricular zone remains mitotically active throughout life in rodents. Studies with tritiated thymidine, which is incorporated into the DNA of mitotic cells, have revealed that the rodent subventricular zone produces neuroblasts that migrate toward the olfactory bulb along the rostral migratory stream. A similar migratory stream has been documented in monkeys by using the thymidine analogue BrdUrd. The same approach showed that neurogenesis occurred in the dentate gyrus of adult primates, including humans. In the present study, experiments combining injections of BrdUrd and the dye 1,1'-dioctadecyl-3,3,3',3'-tetramethylindo-carbocyanine, with the immunostaining for molecular markers of neurogenesis (polysialylated neural cell adhesion molecule, beta-tubulin-III, collapsin response mediator protein-4, neuronal nuclear protein) in New World (Saimiri sciureus) and Old World (Macaca fascicularis) monkeys have revealed that new neurons are produced in the amygdala, piriform cortex, and adjoining inferior temporal cortex in adult primates. These newborn neurons expressed the antiapoptotic protein Bcl-2 and formed a more-or-less continuous pathway that extended from the tip of the temporal ventricular horn to the deep portion of the temporal lobe. The production of newborn neurons in the amygdala, piriform cortex, and inferior temporal cortex seems to parallel the continuing addition of neurons in the olfactory bulb. These two concomitant phenomena may ensure structural stability and functional plasticity to the primate olfactory system and temporal lobe.


Treatment of Urinary Incontinence in Patients With Erectile Dysfunction.
Concurrent urinary incontinence (UI) and erectile dysfunction (ED) can greatly damage a patient's quality of life. Owing to the intertwined anatomy, treatment options for one most certainly have implications on the other. The aim of this review is to characterize and elucidate the treatment patients with postprostatectomy UI undergoing concurrent or subsequent treatment of ED. These principles can be extrapolated to all patients with UI and ED. The literature on postprostatectomy UI treatment in the context of concurrent ED was reviewed through a Medline search. Original research using quantitative and qualitative methodologies was considered. The epidemiology, workup, and management of postprostatectomy UI being mindful of ongoing or future ED treatments are the main outcome measures. Owing to the intertwined anatomy, treatment options for UI and ED have implications on the other. It is essential for the surgeon to obtain an understanding of the patient's degree of bother for each process, personal preference on treatment options, and management of expectations. Surgical treatment options include a combination of the artificial urinary sphincter, sling, inflatable penile prosthesis, semi-rigid penile prosthesis, and new techniques such as the Mini-Jupette. The appropriate combinations will be determined by patient factors of dexterity, preference, degree of leakage, history of radiation, and so on. The decision of staged vs dual implant will be largely driven by the surgeons' preference, payor limitations, and comfort level. This issue is particularly challenging in redo cases where we advocate for cuff downsizing or tandem cuff before the transcorporal approach is used with the goal of preserving sexual function. The concurrent treatment of ED and UI requires thoughtful workup, meticulous attention to detail, and an armamentarium of surgical skills. It is crucial for the surgeon to understand and manage patient expectations in treating these delicate and difficult pathologies. Ajay D, Mendez MH, Wang R, et al. Treatment of Urinary Incontinence in Patients With Erectile Dysfunction. Sex Med Rev 2021;9:593-604.


Transient dynamics and multistability in two electrically interacting FitzHugh-Nagumo neurons.
We analyze the existence of chaotic and regular dynamics, transient chaos phenomenon, and multistability in the parameter space of two electrically interacting FitzHugh-Nagumo (FHN) neurons. By using extensive numerical experiments to investigate the particular organization between periodic and chaotic domains in the parameter space, we obtained three important findings: (i) there are self-organized generic stable periodic structures along specific directions immersed in a chaotic portion of the parameter space; (ii) the existence of transient chaos phenomenon is responsible for long chaotic temporal evolution preceding the asymptotic (periodic) dynamics for particular parametric combinations in the parameter space; and (iii) the existence of various multistable domains in the parameter space with an arbitrary number of attractors. Additionally, we also prove through numerical simulations that chaos, transient chaos, and multistability prevail even for different coupling strengths between identical FHN neurons. It is possible to find multistable attractors in the phase and parameter spaces and to steer them apart by increasing the asymmetry in the coupling force between neurons. Such a strategy can be essential to experimental matters, as setting the right parameter ranges. As the FHN model shares the crucial properties presented by the more realistic Hodgkin-Huxley-like neurons, our results can be extended to high-dimensional coupled neuron models.


Effect of nandrolone decanonate on paraoxonase activity in hemodialysis patients.
This study was designed to determine the effect of nandrolone decanonate (ND) on HDL-C, apolipoproteins and paraoxonase (PON) activity in stable hemodialysis patients. 64 hemodialysis patients were treated with ND at a dose of 100 mg/I.M./week for 4 months. HDL-C, Apo-AI, Apo B, concentrations and PON activity were measured before and after 2 and 4 months of treatment as well as 2 months after withdrawing the treatment. After 4 months of treatment, an elevation in the serum levels of Apo B (P<0.0001) and a marked decrease in the concentration of HDL-C (P<0.0001), Apo-AI (P<0.0001) and PON activity (P<0.0001) were found. A significant correlation between PON and both Apo-AI (r=0.270, P<0.04) and HDL-C (r=0.455, P<0.0001) and also between HDL-C and Apo-AI (r=0.305, P<0.02) were found. Results revealed the adverse effects of ND on apolipoprotein levels in our study population. It is possible that ND reduces PON activity mostly by reducing both the HDL-C and Apo-AI levels.


The uptake of an early warning system in an Australian emergency department: a pilot study.
To evaluate the uptake of an emergency department early warning system (ED EWS) for recognition of, and response to, clinical deterioration. A descriptive exploratory study conducted in an urban district hospital in Melbourne, Australia. Systematic sampling was used to identify every 10th patient for whom the ED EWS was activated from May 2009 to May 2011. Patient characteristics, ED system data and ED EWS activation characteristics. ED EWS activation occurred in 1.5% of ED patients; 204 patients were included in this pilot study. The median age was 65.1 years (interquartile range [IQR], 47.8-77.5 years), 89.2% of patients were classified as triage category 2 or 3, and 82.4% of patients were seen by medical staff before ED EWS activation. Hypotension (27.7%) and tachycardia (23.7%) were the most common reasons for ED EWS activation. Median duration of clinical instability was 39 minutes (IQR, 5- 129 minutes). Nurses made 93.1% of ED EWS activations. Median time between documenting physiological abnormalities and ED EWS activation was 5 minutes (IQR, 0- 20). Most patients (57.8%) required hospital admission: 4.4% of patients required intensive care unit admission. The ED EWS resulted in at least two formal reports of clinical deterioration in ED patients per day, indicating reasonable uptake by clinicians. A greater understanding of clinical deterioration in ED patients is warranted to inform an evidence-based approach to recognition of, and response to, clinical deterioration in ED patients.


The increased rate of stimulant treatment for hyperactive/inattentive students in secondary schools.
To describe trends in medication use for hyperactive/inattentive (HA/I) secondary school students from 1975 through 1993 and to present differences in the treatment of HA/I relative to school grade. A comprehensive survey of the HA/I treatment of public elementary and secondary school students has been conducted biennially by school nurses in Baltimore County, MD since 1975. Although only 11% of all public school students on medication for HA/I were in secondary schools in 1975, the proportion gradually rose such that in the 1990s, 30% of all medicated students were attending secondary schools. Also in secondary schools, the gender ratio for students on medication for HA/I narrowed from a 1:12 female/male ratio in 1981 to a 1:6 female/male ratio in 1993. Many more elementary school students are now remaining on stimulant medication for HA/I into their teens. Compared with a decade ago, relatively more girls are on stimulant treatment for HA/I during their secondary school years.


Protective effect of tanreqing injection on axon myelin damage in the brain of mouse model for experimental autoimmune encephalomyelitis.
To evaluate the effect of Tanreqing injection on axon myelin in the mouse brain of experimental autoimmune encephalomyelitis (EAE). An EAE model was established by myelin oligodendrocyte glycoprotein (MOG)35-55 immunization in C57BL/6 mice. Mice were randomly divided into the following groups: normal, model, prednisone acetate (PA) (6 mg/kg), Tanreqing high dose (5.14 mL/kg), Tanreqing low dose (2.57 mL/kg). On the day of immunization, both Tanreqing groups were treated by intraperitoneal injection, with the PA group treated by intragastrical perfusion after T cell response, and the other groups treated with saline. Changes in body weight, neurological deficit score, incidence rate, mortality rate, and course of disease were observed for all mice. Brain tissue was isolated and stained with hematoxylin-eosin, and pathological investigations performed to evaluate axon myelin damage by transmission electron microscopy (TEM). Myelin basic protein and microtubule associated protein-2 were analyzed by immunohistochemistry. Tanreqing injection significantly prolonged EAE latency and decreased the neurological deficit score, alleviated infiltration of inflammatory cells in the focus area, up-regulated hippocampal MBP expression at the acute stage and the remission stage, and increased microtubule associated protein-2 expression in the EAE brain to varying degrees in the acute stage. TEM analysis indicated that Tanreqing injection alleviates myelin damage in the EAE mouse and maintains the integrity of circular layer structures and alleviates axon mitochondrial swelling. Tanreqing injection alleviates EAE symptoms.


Facilitation of the subclavian-introducer technique with contrast venography.
The subclavian-introducer technique is a rapid and easily performed method of obtaining venous access for implanting permanent pacemaker electrodes. Although this technique has facilitated the participation of nonsurgeons in pacemaker implantation, the potential for complications is increased over the venous cutdown approach. This is particularly true in difficult cases, such as those with prior lead implants, venous thrombosis, or anomalous venous return. This article describes the use of contrast venography for facilitating an otherwise "blind" subclavian venipuncture. This method should make use of the subclavian-introducer technique safer.


Comprehensive microRNA profiling reveals potential augmentation of the IL1 pathway in rheumatic heart valve disease.
Valvular heart disease is a leading cause of cardiovascular mortality, especially in China. More than a half of valvular heart diseases are caused by acute rheumatic fever. microRNA is involved in many physiological and pathological processes. However, the miRNA profile of the rheumatic valvular heart disease is unknown. This research is to discuss microRNAs and their target gene pathways involved in rheumatic heart valve disease. Serum miRNA from one healthy individual and four rheumatic heart disease patients were sequenced. Specific differentially expressed miRNAs were quantified by Q-PCR in 40 patients, with 20 low-to-moderate rheumatic mitral valve stenosis patients and 20 severe mitral valve stenosis patients. The target relationship between certain miRNA and predicted target genes were analysis by Luciferase reporter assay. The IL-1β and IL1R1 expression levels were analyzed by immunohistochemistry and western blot in the mitral valve from surgery of mitral valve replacement. The results showed that 13 and 91 miRNAs were commonly upregulated or downregulated in all four patients. Nine miRNAs, 1 upregulated and 8 downregulated, that had a similar fold change in all 4 patients were selected for quantitative PCR verification. The results showed similar results from miRNA sequencing. Within these 9 tested miRNAs, hsa-miR-205-3p and hsa-miR-3909 showed a low degree of dispersion between the members of each group. Hsa miR-205-3p and hsa-miR-3909 were predicted to target the 3'UTR of IL-1β and IL1R1 respectively. This was verified by luciferase reporter assays. Immunohistochemistry and Western blot results showed that the mitral valve from rheumatic valve heart disease showed higher levels of IL- 1β and IL1R1 expression compared with congenital heart valve disease. This suggested a difference between rheumatic heart valve disease and other types of heart valve diseases, with more inflammatory responses in the former. In the present study, by next generation sequencing of miRNAs, it was revealed that interleukin 1β and interleukin 1 receptor 1 was involved in rheumatic heart diseases. And this is useful for diagnosis and understanding of mechanism of rheumatic heart disease.


Dislocation of the ulnar nerve at the elbow in an elite wrestler.
Dislocation of the ulnar nerve is uncommon among the general population, but it has been reported more frequently in athletes who use their upper limbs to make forceful and resisted flexion of elbow joint. The authors report a unique case of ulnar nerve dislocation in an elite wrestler treated by partial epicondylectomy and subcutaneous transposition of the ulnar nerve. Following the surgery, a supervised and well-designed sport-specific rehabilitation program is a necessary requirement for a rapid return to sport. Such a program requires a bilateral consultation and collaboration between treating physician and trainer of the wrestler. The athlete regained his full function and returned to wrestling after a 3-month sport-specific functional rehabilitation program.


Updates in the treatment of eating disorders in 2018: A year in review in eating disorders: The Journal of Treatment & Prevention.
Current evidence suggests that the majority of patients with eating disorders will not fully recover during treatment, and little doubt can exist around the urgent need for improved treatment outcomes across the field of eating disorders. While empirical efforts are underway to optimize outcomes, this article reviews treatment-related research findings published in Eating Disorders: The Journal of Treatment & Prevention during 2018. Importantly, this review encapsulates research addressing (i) barriers to access and the uptake of empirically supported treatments, (ii) research assessing the delivery of empirically supported treatments across the full spectrum of patient care, and (iii) research aiming to isolate treatment mechanisms and optimize treatment outcomes across a transdiagnostic array of eating disorders. Ultimately, while much ground has been covered in 2018, further research is needed to enhance the accessibility and uptake existing treatments, since only a fraction of those with eating disorders are currently engaged in treatment. Further, with the expanding scope of non-outpatient eating disorder treatment settings, further research is required to adapt and assess the implementation of empirically supported treatments in higher levels of patient care. Lastly, in aiming to optimize patient outcomes, treatment outcome research must seek to identify (i) mechanisms that underlie illness eating disorder psychopathology, and (ii) the active mechanisms of existing treatments.


Pooled Systemic Efficacy and Safety Data from the Pivotal Phase II Studies (NP28673 and NP28761) of Alectinib in ALK-positive Non-Small Cell Lung Cancer.
Alectinib demonstrated clinical efficacy and an acceptable safety profile in two phase II studies (NP28761 and NP28673). Here we report the pooled efficacy and safety data after 15 and 18 months more follow-up than in the respective primary analyses. Enrolled patients had ALK receptor tyrosine kinase gene (ALK)-positive NSCLC and had progressed while taking, or could not tolerate, crizotinib. Patients received oral alectinib, 600 mg twice daily. The primary end point in both studies was objective response rate assessed by an independent review committee (IRC) using the Response Evaluation Criteria in Solid Tumors, version 1.1. Secondary end points included disease control rate, duration of response, progression-free survival, overall survival, and safety. The pooled data set included 225 patients (n = 138 in NP28673 and n = 87 in NP28761). The response-evaluable population included 189 patients (84% [n = 122 in NP28673 and n = 67 in NP28761]). In the response-evaluable population, objective response rate as assessed by the IRC was 51.3% (95% confidence interval [CI]: 44.0-58.6 [all PRs]), the disease control rate was 78.8% (95% CI: 72.3-84.4), and the median duration of response was 14.9 months (95% CI: 11.1-20.4) after 58% of events. Median progression-free survival as assessed by the IRC was 8.3 months (95% CI: 7.0-11.3) and median overall survival was 26.0 months (95% CI: 21.4-not estimable). Grade 3 or higher adverse events (AEs) occurred in 40% of patients, 6% of patients had treatment withdrawn on account of AEs, and 33% had AEs leading to dose interruptions/modification. This pooled data analysis confirmed the robust systemic efficacy of alectinib in ALK-positive NSCLC with a durable response rate. Alectinib also had an acceptable safety profile with a longer duration of follow-up.


Exciton-Induced Degradation of Carbazole-Based Host Materials and Its Role in the Electroluminescence Spectral Changes in Phosphorescent Organic Light Emitting Devices with Electrical Aging.
We investigate the origins of the long-wavelength bands that appear in the emission spectra of carbazole-based host materials and play a role in the electroluminescence (EL) spectral changes of phosphorescent organic light emitting devices (PhOLEDs) with electrical aging. 4,4'-Bis(carbazol-9-yl)biphenyl (CBP) is used as a model carbazole host material and is studied using photoluminescence, EL, and atomic force microscopy measurements under various stress scenarios in both single and bilayer devices and in combination with various electron transport layer (ETL) materials. Results show that exciton-induced morphological aggregation of CBP is behind the appearance of those long-wavelength bands and that complexation between the aggregated CBP molecules and ETL molecules plays a role in this phenomenon. Comparisons between the effects of exciton and thermal stress suggest that exciton-induced aggregation may be limited to short-range molecular ordering or pairing (e.g., dimer or trimer species formation) versus longer-range ordering (crystallization) in the case of thermal stress. The findings provide new insights into exciton-induced degradation in wide band gap host materials and its role in limiting the stability of PhOLEDs.


Characteristics of a delayed system with time-dependent delay time.
The characteristics of a time-delayed system with time-dependent delay time is investigated. We demonstrate that the nonlinearity characteristics of the time-delayed system are significantly changed depending on the properties of time-dependent delay time and especially that the reconstructed phase trajectory of the system is not collapsed into simple manifold, differently from the delayed system with fixed delay time. We discuss the possibility of a phase space reconstruction and its applications.


Au3+ Species Boost the Catalytic Performance of Au/ZnO for the Semi-hydrogenation of Acetylene.
Au nanoparticles have garnered remarkable attention in the chemoselective hydrogenation due to their extraordinary selectivity. However, the activity is far from satisfactory. Knowledge of the structure-performance relationship is a key prerequisite for rational designing of highly efficient Au-based hydrogenation catalysts. Herein, diverse Au sites were created through engineering their interactions with supports, specifically via adjusting the support morphology, that is, flower-like ZnO (ZnO-F) and disc-like ZnO (ZnO-D), and the catalyst pretreatment atmosphere, that is, 10 vol % O2/Ar and 10 vol % H2/Ar (denoted as -O and -H, respectively). The four samples of Au/ZnO were characterized by various techniques and evaluated in the semi-hydrogenation of acetylene. The transmission electron microscopy results indicated that the Au particle sizes are almost similar for our Au/ZnO catalysts. The charge states of Au species demonstrated by X-ray photoelectron spectroscopy, diffuse reflectance infrared Fourier transform spectroscopy with CO as the probe molecule, and simulation based on density functional theory, however, are greatly dependent on the ZnO shape and pretreatment atmosphere, that is, the percentage of Au3+ reduces following the order of Au/ZnO-F-O > Au/ZnO-F-H > Au/ZnO-D-O > Au/ZnO-D-H. The testing results showed that the Au/ZnO-F-O catalyst containing maximum of Au3+ possesses the optimal activity with 1.8 × 10-2 s-1 of specific activity at 200 °C, around 16.5-fold of that for Au/ZnO-D-H. More interestingly, the specific rate at 200 °C and the average conversion/selectivity in the entire operating temperature range are well correlated with the redox states of the Au species, indicating that Au3+ sites are more active for acetylene hydrogenation. A plausible explanation is that the Au3+ species not only facilitate acetylene adsorption via electrostatic interactions but also favor the heterolysis of H2 via constructing frustrated Lewis pairs with O.


A Micro-Resonant Gas Sensor with Nanometer Clearance between the Pole Plates.
In micro-resonant gas sensors, the capacitive detection is widely used because of its simple structure. However, its shortcoming is a weak signal output caused by a small capacitance change. Here, we reduced the initial clearance between the pole plates to the nanometer level, and increased the capacitance between the pole plates and its change during resonator vibration. We propose a fabricating process of the micro-resonant gas sensor by which the initial clearance between the pole plates is reduced to the nanometer level and a micro-resonant gas sensor with 200 nm initial clearance is fabricated. With this sensor, the resonant frequency shifts were measured when they were exposed to several different vapors, and high detection accuracies were obtained. The detection accuracy with respect to ethanol vapor was 0.4 ppm per Hz shift, and the detection accuracy with respect to hydrogen and ammonias vapors was 3 ppm and 0.5 ppm per Hz shift, respectively.


Effects of Mental Fatigue Induced by Social Media Use on Volleyball Decision-Making, Endurance, and Countermovement Jump Performance.
We studied the effects of repeated inducements of mental fatigue (MF) from using social media on smartphones immediately before training sessions by young male volleyball athletes, focusing specifically on their decision-making, endurance, and countermovement jump performance (CMJ). We pair-matched 24 participants according to their decision-making abilities and then, randomly assigned them to one of two 4-week block training groups: control (CON) and smartphone use (SMA). For a 30-minute period before each training session, the CON group watched TV and the SMA group used social media apps on smartphones. We found a significant group x time interaction effect for decision making (attack, p = 0.03; passing, p = 0.02) during training blocks. More specifically, only the CON group improved their decision making (attack, p = 0.03; passing, p = 0.02). Both groups significantly improved their CMJ performance (p = .01), with no significant group x time interaction effect for CMJ (p = 0.91). Neither group significantly improved their endurance (p = 0.56). We concluded that 30-minutes of repetitive social media app use on a smartphone immediately before 4-weeks of volleyball training sessions negatively affected decision-making in young male volleyball athletes.


Demonstration of shift, scale, and rotation invariant target recognition using the hybrid opto-electronic correlator.
Previously, we had proposed a hybrid opto-electronic correlator (HOC), which can achieve the same functionality as that of a holographic optical correlator but without using any holographic medium. Here, we demonstrate experimentally that the HOC is capable of detecting objects in a scale, rotation, and shift invariant manner. First, the polar Mellin transformed (PMT) versions of two images are produced, using a combination of optical and electronic signal processing. The PMT images are then used as the reference and the query inputs for the HOC. The observed correlation signal is used to infer, with high accuracy, the relative scale and angular orientation of the original images. We also discuss practical constraints in reaching a high-speed implementation of such a system. In addition, we describe how these challenges may be overcome for producing an automated version of such a correlator.


Magnet Ingestion in Children Management Guidelines and Prevention.
Purpose: Foreign body ingestion is common in children, and most foreign bodies pass spontaneously without causing serious injuries. Ingestion of multiple high-power magnet pieces is unique and increases the risk of morbidity and mortality. The longer the duration of ingestion, the increased likelihood of complications. Various management options have been reported, and there is no consensus on the ideal management which necessitates the need for a practical algorithm. The incidence of magnet ingestion has been increasing and directly related to the laws and recalls. The aim of this review is to provide an easy and practical pathway for management and to highlight the preventive rules of the legislations and recalls. Methods: PubMed/MEDLINE, the Cochrane Database of Systematic Reviews, and the list of references from all identified complete publications were searched for all publications in English-language for pediatric magnet ingestion. Conclusion: Practical and time-saving management pathways are recommended to minimize the risk of complications. Preventive rules and recalls are important for eliminating the availability of these hazardous magnets. Public awareness about the unique risks posed by these magnets if ingested is important.


Assessment of a New Silicon Carbide Tubular Honeycomb Membrane for Treatment of Olive Mill Wastewaters.
Extremely high removals of total suspended solids and oil and grease were obtained when olive mill wastewaters were filtered using new silicon carbide tubular membranes. These new membranes were used at constant permeate flux to treat real olive mill wastewaters at pilot scale. The filtration conditions were evaluated and optimized in terms of the selection of the permeate flux and flux maintenance strategies employed-backpulsing and backwashing-in order to reduce fouling formation. The results obtained reveal that the combination of backpulses and backwashes helps to maintain the permeate flux, avoids transmembrane pressure increase and decreases the cake resistance. Moreover, membrane cleaning procedures were compared and the main agents responsible for fouling formation identified. Results also show that, under total recirculation, despite an increased concentration of pollutants in the feed stream, the quality of the permeate is maintained. Membrane filtration using silicon carbide membranes is an effective alternative to dissolved air flotation and can be applied efficiently to remove total suspended solids and oil and grease from olive mill wastewaters.


SPECT imaging of joint inflammation with Nanobodies targeting the macrophage mannose receptor in a mouse model for rheumatoid arthritis.
Rheumatoid arthritis (RA) is a chronic autoimmune disease occurring in approximately 1% of the worldwide population. The disease primarily affects the joints, where inflammatory cells, such as macrophages, invade the synovium and cause cartilage and bone destruction. Currently, it is difficult to efficiently diagnose and monitor early-stage RA. In this study, we investigated whether SPECT/micro-CT imaging with (99m)Tc-labeled Nanobodies directed against the macrophage mannose receptor (MMR) is a useful tool for monitoring and quantifying joint inflammation in collagen-induced arthritis (CIA), a mouse model for RA. The expression of MMR was analyzed on macrophages and osteoclasts generated in vitro and in cells obtained from various organs from mice with CIA. CIA was induced in DBA/1 mice by injection of collagen type II in complete Freund adjuvant, and cell suspensions from the inflamed joints and other organs were obtained. Macrophages and osteoclasts were generated in vitro from bone marrow cells. Expression of MMR was quantified by quantitative polymerase chain reaction and flow cytometry with specific Nanobodies and conventional antibodies. SPECT/micro-CT imaging was performed with (99m)Tc-labeled MMR and control Nanobodies. MMR was highly expressed on macrophages and to a lesser extent on osteoclasts generated in vitro. In mice with CIA, MMR expression was detected on cells from the bone marrow, lymph nodes, and spleen. In synovial fluid of arthritic joints, MMR was expressed on CD11b(+)F4/80(+) macrophages. On in vivo SPECT/micro-CT imaging with consecutive injections of MMR and control Nanobodies, a strong MMR signal was seen in the knees, ankles, and toes of arthritic mice. Quantification of the SPECT imaging confirmed the specificity of the MMR signal in inflamed joints as compared with the control Nanobody. Dissection of the paws revealed an additional significant MMR signal in nonarthritic paws of affected mice (i.e., mice displaying symptoms of arthritis in other paws). Our data show that MMR is expressed on macrophages in vitro and in vivo in synovial fluid of inflamed paws, whereas expression is relatively low in other tissues. The use of Nanobodies against MMR in SPECT/micro-CT imaging generates the possibility to track inflammatory cells in vivo in arthritic joints.


Bacterial loads of Ureaplasma parvum contribute to the development of inflammatory responses in the male urethra.
Ureaplasma parvum, which has been recognised as a coloniser in the male urethra, is detected in some men with non-gonococcal urethritis. In this study, we quantified the 16 S rRNA genes of U. parvum by a real-time polymerase chain reaction-based assay in first-voided urine from 15 symptomatic and 38 asymptomatic men who were positive only for U. parvum. We also determined the leukocyte counts by automated quantitative urine particle analysis in their first-voided urine. Positive correlations were observed between copies of the 16 S rRNA genes of U. parvum/ml and the leukocyte counts/µl in first-voided urine (p = 0.0019). The loads of ≥10(4) copies of the 16 S rRNA gene/ml, corresponding to ≥5 × 10(3) cells of U. parvum/ml, were significantly associated with the presence of ≥12.5 leukocytes/µl in first-voided urine that might document the presence of inflammatory responses in the urethra. However, a large portion of the subjects (83.0%) had bacterial loads of <5 × 10(3) cells of U. parvum/ml, and 79.5% of them showed <12.5 leukocytes/µl. The ambiguity of the pathogenic role of U. parvum in non-gonococcal urethritis could, in part, be due to its low bacterial loads, which might not give rise to inflammatory responses in the male urethra.


Optimization of the MGH repair using an algorithm for tenorrhaphy evaluation.
Previous investigations have demonstrated the superior strength and toughness of the MGH four-strand tendon repair technique and shown that it neither weakens during maximum tendon softening nor interferes with healing in an in vivo rabbit model. In the current study, the biomechanical performance of the modified Becker (MGH) and the modified Kessler repairs were compared in situ using a dynamic human cadaveric model to evaluate strength, toughness, glide efficiency, and operator variability. Three different surgeons performed a total of 42 zone II flexor digitorum profundus repairs in 14 fresh human cadaver hands. The modified Becker (MGH) repairs were stronger (79 +/- 3 versus 64 +/- 4 N; p < 0.01) and tougher (0.092 +/- 0.002 versus 0.078 +/- 0.003 J; p < 0.01) than the Kessler repairs while allowing equally efficient glide (32 +/- 6 versus 33 +/- 4 percent; p > 0.9). Strength was operator-dependent only for the modified Kessler repair (p < 0.005). We then established the optimal configuration of the MGH tenorrhaphy (number of preloaded crosses on either side of the tendon transection) by examining gap resistance ex vivo. Fifty-one MGH flexor tendon repairs were performed on explanted fresh human cadaver tendons. The experimental groups were randomly assigned to receive 0, 1, 2, 3, or 4 crosses on each side of the tenorrhaphy. Strength and toughness to gap formation and to ultimate failure were assessed tensiometrically. The MGH two-cross configuration was most resistant to gap formation (peak load 39 +/- 3 N; p < 0.05), establishing this configuration as the optimal design of this four-strand crisscrossing repair technique. The augmented Becker (MGH) repair is significantly stronger and tougher than the modified Kessler repair and demonstrates no operator dependence. It is a superior technique for zone II tenorrhaphy in the human hand. An algorithm is presented as a systematic approach that includes the important elements necessary for the rigorous biomechanical evaluation of any tendon repair technique.


Nonlinear quantum regime of the x-ray Compton laser.
In this work a scheme of x-ray coherent radiation generation in the nonlinear quantum regime by means of mildly relativistic high density electron beams and a strong pump laser field is investigated. The consideration is based on a self-consistent set of Maxwell and relativistic quantum kinetic equations. The coupled equations are solved in the slowly varying envelope approximation.