Incidence and risk factors of blastocystis infection in orphans at the Babies' Home, Nonthaburi Province, Thailand.
Blastocystis infection is one of the most common intestinal protozoan infections reported in Thai population of all age groups for which epidemiological information is important to understand patterns of transmission for developing methods ofprevention and control for each specific group. The authors aimed to study prevalence, incidence and riskfactors associated with Blastocystis infection in orphans and childcare workers. Additionally, subtypes ofBlastocystis were identified A retrospective cohort study of Blastocystis sp. was conducted in orphans aged less than 5 years and their childcare workers at Babies' Home, Nonthaburi Province, Thailand. A base line survey was conducted in December 2009 and afollow-up survey was conducted in April 2010. A total of 336 and 331 stool samples were collected. Blastocystis infection was examined using short-term in vitro cultivation in Jones's medium supplemented with 10% fetal calf serum. To analyze subtypes ofBlastocystis sp., PCR-RFLP of the small subunit ribosomal RNA gene was performed. Theprevalence ofBlastocystis infection in December 2009 and April 2010 were 8.1% and 13.3%, respectively The inlcidence rate ofBlastocystis infection was 1.6/100 person-months. Subtype analysis ofBlastocystis sp. in December 2009 and in April 2010 showed that subtype 3 was the most predominant (76% and 76%), followed by subtype 1 (16% and 20%), and unidentified subtype (8% and 4%), respectively. Subtype 3 is of human origin, thus person-to-person transmission is considered a major route ofBlastocystis infection in this population. Person-to-person transmission of Blastocystis infection in orphans living in the same house had been proposed, thus the prevalence and incidence of Blastocystis infection could be used to reflect the hygienic condition in the orphanage. Infection prevention and control practice can be effectively implemented.


Use of a pulse oximeter in an adult emergency department: impact on the number of arterial blood gas analyses ordered.
To assess the impact of pulse oximetry (SpO2) on the indications and the number of arterial blood gas (ABG) levels ordered in an adult emergency department (ED). A prospective study during a 2-month period in 1993 with a pulse oximeter available and a comparison with the same period in 1992 without the oximeter. An adult medical ED of a university hospital in France. All patients who underwent ABG or SpO2 measurements. During the prospective study, residents ordered ABG or SpO2 measurements at their discretion. The reasons for their ordering were reviewed by two independent experts who determined whether their choice was justified. The data were compared with those for 184 consecutive patients who had ABG measurements in 1992. The study included 152 patients. SpO2 alone was used in 33 patients; ABG levels were measured in 119 patients. The use of SpO2 did not result in the ordering of fewer useful ABG determinations. One hundred and five (88%) ABG measurements were justified. There were fewer unjustified ABG determinations in 1993 when the pulse oximeter was available than in 1992 when it was not (14 of 119 vs 54 of 184; p<0.001) mainly because fewer ABG determinations were ordered for miscellaneous nonrespiratory indications (13 of 119 vs 43 of 184; p<0.01). The availability of a pulse oximeter did not affect the ordering of useful ABG measurements but allowed a significant reduction of unjustified ABG measurements. Substantial cost savings could be achieved by using SpO2 in an ED.


Thymol-Functionalized Hyaluronic Acid as Promising Preservative Biomaterial for the Inhibition of Candida albicans Biofilm Formation.
Hyaluronic acid (HA) is a naturally occurring biopolymer that has been employed for a plethora of medicinal applications. Nevertheless, as HA is a natural polysaccharide, it can be a substrate able to promote microbial growth and proliferation. Biopolymer-drug conjugates have gained attention over the years to overcome drawbacks of each single component. Within this context, thymol (Thy), a phenolic compound occurring in essential oils (EOs) extracted from Thymus and Origanum, has been largely studied for its antimycotic applications. However, it is characterized by a low water solubility and moderate cytotoxicity. Herein, we report an innovative HA-thymol conjugate (HA-Thy) biomaterial to circumvent the drawbacks of free thymol use by providing the polymer conjugate with the beneficial properties of both components. Preliminary biological tests evidenced the decrease of thymol cytotoxicity for the HA-Thy conjugate, paired with a promising antibiofilm formation activity against Candida albicans, similar to pure thymol, highlighting its potential application as a preservative biomaterial in formulations.


Sheep - and sun - in Scotland.
Sue Tongue reports from the Sheep Veterinary Society's autumn meeting, held on the Island of Mull from September 28 to 30.


[Use of data: legal and ethical aspects].
Health care professionals and organizations, in carrying out their activities, consistently handle information related to identified or identifiable (even indirectly) natural persons, therefore "personal data". The application of Legislative Decree 30 June 2003 n. 196--the Code concerning the protection of personal data--as integrated by the pronunciations of the authority tasked with the application of such a complex legislation, the Authority for the Protection of Personal Data, consequently follows. The aforementioned legislation is seldom fully applied even 12 years after its publication, and even so not properly or with the adequate level of care. As a consequence, the data processed is often not adequately safeguarded, and compliance is hindered at an organisational level: this is particularly true with reference to the state of the art in medical technology, which is characterized by the utilization of ICT technologies such as the ones used with clinical registries and the Electronic Health Record. This chapter shows that, even when processing personal data that is of a sensitive nature, and at the same time of great importance, it is possible to reconcile the need to access and manage information with the protection of the individuals to whom such information refers to. This possibility is however closely linked to the awareness of the issues involved, awareness that in turn comes from an indispensable knowledge of the different aspects of that complex legislation.


Glycosylation influences intracellular transit time and secretion rate of human prorenin in transfected cells.
The mouse pituitary tumour (AtT-20) cell transfected with the human renin gene has been shown to be a useful model system to study human renin biosynthesis. To investigate the influence of glycosylation on secretion of human renin from these cells, we performed pulse labelling experiments on transfected cells in the presence or absence of tunicamycin, a potent inhibitor of n-linked glycosylation. Intracellular and secreted renins were characterized by immunoprecipitation, sodium dodecyl sulphate (SDS) gel electrophoresis and fluorography. Our data showed that blockade of n-linked glycosylation reduced the intracellular transit time and increased the rate of prorenin secretion from transfected cells. We conclude that the carbohydrate moiety influences the kinetics of human renin secretion. This result provides one possible explanation for the observation that the secretion of glycosylated human renin is considerably slower than that of the unglycosylated mouse renin-2.


Increased CD4 and CCR5 expression and human immunodeficiency virus type 1 entry in CD40 ligand-stimulated macrophages.
The effects of a soluble trimeric CD40 ligand (CD40L) agonist on the expression of CD4 and CCR5 and on human immunodeficiency virus (HIV) type 1 entry into and replication in human macrophages were investigated. CD40L increased the number of CD4 and CCR5 antibody-binding sites and the percentage of CD4- and CCR5-expressing cells. Infection of CD40L-stimulated macrophages with HIV-1 resulted in a marked increase of viral DNA with respect to controls, as demonstrated by polymerase chain reaction assay. HIV-1 p24 antigen analysis showed that peak viral production did not differ between CD40L-stimulated macrophages and controls. However, because of a prolonged life span, overall viral output was increased in CD40L-stimulated cultures. In addition, CD40L down-regulated the antiviral efficacy of compounds that inhibit HIV-1 reverse transcriptase. In conclusion, CD40L stimulation of macrophages can contribute to plasma virus load and favor the establishment of a pool of latently infected macrophages that can be reactivated to release virus.


Cerebral blood flow autoregulation in early experimental S. pneumoniae meningitis.
We studied cerebral blood flow (CBF) autoregulation and intracranial pressure (ICP) during normo- and hyperventilation in a rat model of Streptococcus pneumoniae meningitis. Meningitis was induced by intracisternal injection of S. pneumoniae. Mean arterial blood pressure (MAP), ICP, cerebral perfusion pressure (CPP, defined as MAP - ICP), and laser-Doppler CBF were measured in anesthetized infected rats (n = 30) and saline-inoculated controls (n = 30). CPP was either incrementally reduced by controlled hemorrhage or increased by intravenous norepinephrine infusion. Twelve hours postinoculation, rats were studied solely during normocapnia, whereas rats studied after 24 h were exposed to either normocapnia or to acute hypocapnia. In infected rats compared with control rats, ICP was unchanged at 12 h but increased at 24 h postinoculation (not significant and P < 0.01, respectively); hypocapnia did not lower ICP compared with normocapnia. Twelve hours postinoculation, CBF autoregulation was lost in all infected rats but preserved in all control rats (P < 0.01). Twenty-four hours after inoculation, 10% of infected rats had preserved CBF autoregulation during normocapnia compared with 80% of control rats (P < 0.01). In contrast, 60% of the infected rats and 100% of the control rats showed an intact CBF autoregulation during hypocapnia (P < 0.05 for the comparison of infected rats at normocapnia vs. hypocapnia). In conclusion, CBF autoregulation is lost both at 12 and at 24 h after intracisternal inoculation of S. pneumoniae in rats. Impairment of CBF autoregulation precedes the increase in ICP, and acute hypocapnia may restore autoregulation without changing the ICP.


Influence of Mineral Oil-Based Nanofluids on the Temperature Distribution and Generated Heat Energy Inside Minimum Oil Circuit Breaker in Making Process.
The enhancement of the thermal properties of insulating oils has positively reflected on the performance of the electrical equipment that contains these oils. Nanomaterial science plays an influential role in enhancing the different properties of liquids, especially insulating oils. Although a minimum oil circuit breaker (MOCB) is one of the oldest circuit breakers in the electrical network, improving the insulating oil properties develops its performance to overcome some of its troubles. In this paper, 66 kV MOCB is modeled by COMSOL Multiphysics software. The internal temperature and the internally generated heat energy inside the MOCB during the making process of its contacts are simulated at different positions of the movable contact. This simulation is introduced for different modified insulating oils (mineral oil and synthetic ester oil) with different types of nanoparticles at different concentrations (0.0, 0.0025, 0.005, and 0.01 wt%). From the obtained results, it is noticed that the thermal stress on the MOCB can be reduced by the use of high thermal conductivity insulating oils. Nano/insulating oils decrease internal temperature and generate heat energy inside the MOCB by about 17.5%. The corresponding physical mechanisms are clarified considering the thermophoresis effect.


Pathology of early- vs late-onset TTR Met30 familial amyloid polyneuropathy.
Late-onset type I familial amyloid polyneuropathy (FAP TTR Met30) cases unrelated to endemic foci in Japan show clinical features setting them apart from early-onset cases in endemic foci. To compare pathologic features between the early- and late-onset types. Pathologic findings in FAP TTR Met30 with onset before age 50 in relation to endemic foci (11 cases) were compared with those in 11 later-onset cases unrelated to endemic foci. Sural nerve biopsy specimens showed predominantly small-fiber loss in early-onset cases; variable fiber size distribution, axonal sprouting, and relatively preserved unmyelinated fibers characterized late-onset cases. Autopsy cases representing both groups showed amyloid deposition throughout the length of nerves and in sympathetic and sensory ganglia, but amounts were greater in early-onset cases. Amyloid deposition and neuronal cell loss were greater in sympathetic than dorsal root ganglia in early-onset cases; the opposite was true in late-onset cases. Size assessment of remaining neurons in these ganglia suggested predominant loss of small neurons in early-onset cases but loss of neurons of all sizes in late-onset cases. Transthyretin-positive, Congo red-negative amorphous material was more conspicuous in nerves from late- than early-onset cases. In extraneural sites, amyloid was more conspicuous in thyroid and kidney from early-onset cases and in heart and hypophysis from late-onset cases. In early-onset cases, cardiac amyloid deposition was prominent in the atrium and subendocardium but was conspicuous throughout the myocardium in late-onset cases. The pathology of early- and late-onset FAP TTR Met30 correlated well with differences in clinical findings.


[Adenomatoid malformation as peripheral round shadow in lung].
The authors present a case report of a 17 years old female patient who had a peripheral round shadow on the chest X-ray. After the operation the histological examination verified cystic adenomatoid malformation. The cystic adenomatoid malformation is an abnormal growth of the terminal bronchiolar structures. It is a rare disease, but often associates with other developmental abnormalities. It is important in the differential diagnosis to separate this disease from other cystic pulmonary lesions or sequestration. It is usually recognized in antenatal period or early childhood, but rarely in adulthood. It is possible that there is a connection between the adenoid malformation and lung cancer.


Toward a new future for healthcare and nursing practice.
The healthcare trends described in this article will eventually lead to transformation of healthcare delivery and nursing practice. The nursing profession needs to be proactive in creating new models of care delivery and in redefining the work of nursing. The authors describe 2 examples of emerging models and principles for the creation of future models, related leadership challenges for nurse executives, and strategies for leading change. Ensuring that changes in care delivery models lead toward a desired future that fulfills nursing's social contract is a mandate for nursing leaders.


Activities of Daily Living Assessment among Nursing Home Residents with Advanced Dementia: Psychometric Reevaluation of the Bristol Activities of Daily Living Scale.
The purpose of this study was to conduct psychometric reevaluation of the Bristol Activities of Daily Living Scale (BADL) among a population logistically difficult to observe beyond cross-sectional analysis: nursing home residents with advanced dementia (AD). Data from observation-based measures were collected by nursing home staff at two intervals within a three-month time frame among 43 residents identified with AD via medical records and nursing home staff. Three broad properties of BADL were examined: factor structure, reliability, and validity. Principal components analysis determined underlying components. BADL internal consistency was assessed by Cronbach's and Guttman coefficients; test-retest reliability was also observed. Convergent validity was assessed by correlating BADL with theoretically linked measures of quality of life (QOL) and social engagement. Compared with the original evaluation, BADL showed inconsistent factor structure at interval 1 but comparable at interval 2. Reliability coefficients at both intervals were robust and comparable to the original evaluation. BADL demonstrated significant convergence with QOL and social engagement. Psychometric potency of BADL was confirmed, suggesting practice applicability with this AD population. Future research calls for further examination of tools to guide effective interventions with this vulnerable population.


Anti-alpha8 integrin immunoliposomes in glomeruli of lupus-susceptible mice: a novel system for delivery of therapeutic agents to the renal glomerulus in systemic lupus erythematosus.
Glomerular mesangial cells are active participants in the pathogenesis of lupus glomerulonephritis (GN). Thus, targeted delivery of therapeutic agents to mesangial cells would be an attractive approach to treatment. However, lack of known unique mesangial cell surface markers has hampered this process. This study was undertaken in a mouse model of lupus GN to identify mesangial markers and to develop a system for targeted drug delivery to the glomerulus. Based on previous observations, alpha8 integrin expressed on the surface of glomerular mesangial cells was selected as a target molecule for delivery. Two mouse strains susceptible to lupus GN, NZM2328 and (NZM2328 x NOD)F1, were studied. Glomerular expression of alpha8 integrin in normal and nephritic mice was confirmed by immunofluorescence and quantitative polymerase chain reaction analysis. Liposomes were formulated and conjugated with an anti-alpha8 integrin antibody. These immunoliposomes were loaded with DiI, a red fluorescent dye, to allow tracking in vivo, and injected into the tail vein of female mice at different ages. Specificity of targeting was studied by fluorescence microscopy and flow cytometry. Expression of alpha8 integrin was observed in the glomeruli of normal and nephritic mice. Anti-alpha8 integrin immunoliposomes were detected in the glomerulus and glomerular mesangial cells after tail vein injection in normal and nephritic mice. Delivery of DiI by anti-alpha8 integrin immunoliposomes was tissue specific, being observed predominantly in the glomeruli, with some nonspecific uptake by CD11b cells. These findings are the first demonstration of specific delivery of anti-alpha8 integrin immunoliposomes to the mesangium following tail vein injection in mice. Anti-alpha8 integrin immunoliposomes thus offer a novel approach for targeted drug therapy in lupus and other glomerular diseases.


Improvement of image-type very-low-energy-electron-diffraction spin polarimeter.
Spin- and angle-resolved photoemission spectroscopy (SARPES) with high efficiency and resolution plays a crucial role in exploring the fine spin-resolved band structures of quantum materials. Here, we report the performance of the SARPES instrument with a second-generation home-made multichannel very-low-energy-electron-diffraction spin polarimeter. Its energy and angular resolutions achieve 7.2 meV and 0.52°, respectively. We present the results of SARPES measurements of Bi(111) film to demonstrate its performance. Combined with the density functional theory calculations, the spin polarization of the bulk states was confirmed by the spin-layer locking caused by the local inversion asymmetry. The surface states at a binding energy of 0.77 eV are found with 1.0 ± 0.11 spin polarization. Better resolutions and stability compared with the first-generation one provide a good platform to investigate the spin-polarized electronic states in materials.


[Pulmonary rehabilitation].
Pulmonary rehabilitation commenced in Japan in 1957. However, the development of pulmonary rehabilitation took a long time due to the lack of the necessary health and medical services. Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors. The benefits of pulmonary rehabilitation include a decrease in breathlessness and an improvement in exercise tolerance. It is important that the gains in exercise tolerance lead to an increase in daily physical activity.


An indirect transmission measurement-based spectrum estimation method for computed tomography.
The characteristics of an x-ray spectrum can greatly influence imaging and related tasks. In practice, due to the pile-up effect of the detector, it's difficult to directly measure the spectrum of a CT scanner using an energy resolved detector. An alternative solution is to estimate the spectrum using transmission measurements with a step phantom or another CT phantom. In this work, we present a new spectrum estimation method based on indirect transmission measurement and a model spectra mixture approach. The estimated x-ray spectrum was expressed as a weighted summation of a set of model spectra, which can significantly reduce the degrees of freedom of the spectrum estimation problem. Next, an estimated projection was calculated with the assumed spectrum. By iteratively updating the unknown weights, we minimized the difference between the estimated projection data and the raw projection data. The final spectrum was calculated with these calibrated weights and the model spectra. Both simulation and experimental data were used to evaluate the proposed method. In the simulation study, the estimated spectra were compared to the raw spectra which were used to generate the raw projection data. For the experimental study, the ground truth measurement of the raw x-ray spectrum was not available. Therefore, the estimated spectrum was compared against the spectra generated using the SpekCalc software with tube configurations provided by the scanner manufacturer. The results show the proposed method has the potential to accurately estimate x-ray spectra using the raw projection data. The difference between the mean energy of the raw spectra and the mean energy of the estimated spectra was less than 0.5 keV for both the simulation and experimental data. Further tests show the method was robust with respect to the model spectra generator.


[The clinical outcomes of idiopathic optic neuritis with no light perception in 21 eyes].
To evaluate the treatment outcomes of idiopathic optic neuritis with no light perception in 21 eyes. This is a retrospective study. The hospital data of 17 patients (21 eyes) with idiopathic optic neuritis whose visual acuity were no light perception from August 2003 to April 2011 were retrospectively analyzed. These patients were treated with steroid pulse and other drugs. The clinical features, the time of appearance light perception, the best corrected visual acuity and VEP were measured. The follow-up was at least three months. Before the treatment, the average time of occurring no light perception were 1.0 ∼ 90.0 days, except 1 eye was 90.0 days while the other 20 eyes was (12.5 ± 10.6) days. After the treatment, vision improved in 14 eyes (66.7%) from Hand Move/30 cm to 20/20, the average time of appearance light perception was (9.9 ± 7.9) days. The best corrected vision acuity were 1 eye Hand Move, 2 eyes Finger Count, 1 eye 20/2000, 3 eyes 20/1000, 2 eyes 20/800, 1 eye 20/500, 1 eye 20/320, 1 eye 20/125, 1 eye 20/32, 1 eye 20/20. 5 eyes with no VEP wave pattern emerge P(100) after therapy, the other 2 eyes which had P(100) was flatten after therapy. The follow-up found that except 1 eye vision improve outside, the rest eye vision remained stable. The patients with optic neuritis who initially were no light perception should be treated promptly. The prognostic of vision can not be evaluated only by the duration time of no light perception, the appearing-time of light perception and the pattern of VEP.


Zoledronic acid inhibits osteoclastogenesis in vitro and in a mouse model of inflammatory osteolysis.
This study assessed effects of the bisphosphonate zoledronic acid (ZLNA) on osteoclastogenesis. To assess the effect of ZLNA on osteoclast formation in vitro, we cultured mouse bone marrow cells under conditions that promote osteoclastogenesis. Administered at concentrations from 10(-6) to 10(-9) mol/L, ZLNA led to a dose-dependent inhibition of osteoclastogenesis. Combined TUNEL staining and histochemical staining for tartrate-resistant acid phosphatase showed that ZLNA induced apoptosis in osteoclasts and monocytic precursor cells. To study the effects of ZLNA in vivo, we placed keratin particles onto the surface of the parietal bone of mice to induce localized inflammatory bone resorption. Three experimental groups received daily subcutaneous injections of ZLNA (1, 3, or 10 microg/kg body weight) from 4 days before surgery until 5 days after keratin implantation. The ZLNA significantly reduced osteoclast recruitment in a dose-dependent manner, but did not affect the degree of inflammation or the mineral apposition rate.


MicroRNA-340-mediated degradation of microphthalmia-associated transcription factor (MITF) mRNA is inhibited by coding region determinant-binding protein (CRD-BP).
Alternative cleavage and polyadenylation generates multiple transcript variants producing mRNA isoforms with different length 3'-UTRs. Alternative cleavage and polyadenylation enables differential post-transcriptional regulation via the availability of different cis-acting elements in 3'-UTRs. Microphthalmia-associated transcription factor (MITF) is a master regulator of melanocyte development and melanogenesis. This central transcription factor is also implicated in melanoma development. Here, we show that melanoma cells favor the expression of MITF mRNA with a shorter 3'-UTR. We also establish that this isoform is regulated by a micro RNA (miRNA/miR), miR-340. miR-340 interacts with two of its target sites on the MITF 3'-UTR, causing mRNA degradation as well as decreased expression and activity of MITF. Conversely, the RNA-binding protein, coding region determinant-binding protein, was shown to be highly expressed in melanoma, directly binds to the 3'-UTR of MITF mRNA, and prevents the binding of miR-340 to its target sites, resulting in the stabilization of MITF transcripts, elevated expression, and transcriptional activity of MITF. This regulatory interplay between RNA-binding protein and miRNA highlights an important mechanism for the regulation of MITF in melanocytes and malignant melanomas.


A cognitive deficit subscale of the SCL-90-R.
Evaluated at two neuropsychology laboratories (N = 50) an 8-item Cognitive Deficit (CD) subscale of the SCL-90-R using both empirical and a priori criteria. After adjusting for symptom response rates, significant correlations are observed between the subscale and both the Impairment Index and Category Test of the Halstead-Reitan Battery. The issue of "organicity" subscales and the use of self-reporting with cognitively impaired patients are addressed.


Increased expression of the relaxin receptor (LGR7) in human endometrium during the secretory phase of the menstrual cycle.
Relaxin (RLX) is a structural homolog of insulin that is the ligand for the LGR7 receptor. Although the 6k peptide is produced by the ovaries to cause connective tissue remodeling of the rodent and pig reproductive tracts to facilitate parturition, in human reproduction, the role of RLX is less well understood. Binding of human gene 2 (H2) [(33)P]-RLX, expression of RLX peptides and the LGR7 receptor was examined in the human uterus at different stages of the menstrual cycle. A significant increase in RLX receptor binding in endometrium was identified by quantitative autoradiography in the secretory compared with the proliferative phase. H2RLX competed with [(33)P]-H2RLX binding with higher affinity than porcine RLX during both the proliferative and secretory phases. Increased LGR7 receptor gene expression during the secretory phase paralleled the changes in [(33)P]-H2RLX binding. Human gene 1 RLX transcripts were not detected in the uterus, and H2RLX gene expression was low and not influenced by the stage of the menstrual cycle. The studies show that binding to and gene expression of the LGR7 RLX receptor changes markedly with the phases of the menstrual cycle, suggesting a specific role for the hormone in the physiology of the human uterus.


The Prevalence of Allergic Rhinitis toAmbrosia Elatior in OlteniaArea and the Association with Allergic Conjunctivitis or Asthma.
Introduction-Ambrosia elatior pollen sensitivity can lead to respiratory diseases such as rhinitis, asthma and allergic conjunctivitis. Ambrosia is quite an important source of pollen and it is thought to be an invasive plant. Sensitivity prevalence to Ambrosia pollen varies from one country to another. The aim of the present study was to assess the prevalence of pollen allergic rhinitis caused by Ambrosia elatior in the Oltenia area located in the south west part of Romania. Material and method - The study was carried on 1004 patients with allergic rhinitis. All the patients experienced symptoms of allergic rhinitis, associated with /without conjunctivitis or asthma, and positive skin tests to aeroallergens. Results - In the group under study, 48,80% of the cases are sensitized to Ambrosia elatior pollen. The number of patients with allergic rhinitis and pollen sensitivity to Ambrosia is higher in 2014-2015 compared to 2012, i.e. 282 cases and the symptoms are moderate-severe. Conclusions - Ambrosia elatior pollen has become a major source of aeroallergen in Oltenia area.


Risk factors for chronic respiratory disorders in a sample of farmers in middle Italy.
To evaluate the prevalence of respiratory symptoms in agricultural workers in a rural area of Tuscany and to relate them to some occupational risk factors. A cross sectional study was performed on a sample of 461 agricultural workers from two rural area of Tuscany. All subjects underwent to respiratory questionnaire, pulmonary function test and skin prick tests. Occupational risk factors were evaluated as response to questions related to 11 specific jobs, most of them related to cow-shed works. Subjects had high mean age and a long work duration. Smoking habit was significantly associated with symptoms of chronic bronchitis, while atopy was significantly associated with chronic cough, phlegm and dyspnea. In comparison with a control group of workers which did not report any occupational risk factors (reference group), logistic analysis showed that most symptoms were significantly associated with some specific jobs related to animal breeding, taking into account differences due to age, smoking habit, atopy and district. Mean pulmonary function tests were in the normal range, without any significant relationship with different risk factors, except smoking habit. Increased work duration was associated with significant decrease of pulmonary function. Symptoms of chronic bronchitis were frequent in this population of farmers of Middle Italy. The analysis of risk factors confirms a relevant role for some specific occupational risk factors, related to jobs in the cow-shed, in the development of respiratory disorders.


Using the DAS-ELISA Test to Establish an Effective Distance Between Bait Stations for Control of Linepithema humile (Hymenoptera: Formicidae) in Natural Areas.
Linepithema humile (Mayr), the Argentine ant, is an invasive pest that has spread throughout the United States and is a problem in natural and managed habitats in South Carolina. Foraging patterns and the effectiveness of liquid baits for control of this pest have been studied in urban areas. However, similar studies have not been conducted in natural areas such as parks, picnic grounds, or campsites. L. humile populations can be large and widespread, making them a major nuisance pest for visitors to these natural areas. The primary objective of this study was to determine an effective distance between bait stations for control of L. humile in a natural area. A double antibody-sandwich enzyme-linked immunosorbent assay (DAS-ELISA) procedure was used to detect individual ants that consumed rabbit immunoglobin (IgG) protein for marking and tracking. In both lab and field conditions, there was a significant difference in the detection of IgG in ants fed protein marker mixed with sugar water compared with ants only fed sugar water. Additional field studies revealed that an individual ant could retain detectable levels of protein marker for 3 d and that an ant feeding on IgG containing bait could be detected over 15 m from the original bait source. Overall, we found that using liquid ant baits, with a placement of 20 m between stations, was effective in reducing L. humile numbers between April to October, 2012 in a natural park area of Lake Greenwood State Park, SC.


THE DIAGNOSIS AND TREATMENT OF TUBERCULOSIS OF THE BREAST.
Tuberculosis of the breast is a rare disease. It may be primary-confined to the breast, or secondary to tuberculosis elsewhere. Five cases are reported of which three were primary.The clinician confuses the disease with pyogenic breast abscess and cancer. The pathologist may confuse the disease with comedomastitis. Definite diagnosis must rest on bacteriological proof, that is, positive tuberculous culture and guinea-pig inoculation.Treatment of the disease may be either medical or surgical. Medical treatment in our hands has been long and expensive, and the disease tends to reappear in further pregnancies. Surgical treatment, which usually consists of simple mastectomy, is preferable.


Subacute thyroiditis in a patient with juvenile idiopathic arthritis undergoing etanercept treatment: a case report and review of the literature.
We report on a 24-year-old woman with juvenile idiopathic arthritis (JIA) who developed subacute thyroiditis (SAT) while being treated with etanercept. She had suffered from JIA for 12 years, and her arthritis proved refractory to treatment with ibuprofen, prednisolone, and methotrexate. For the past 5 years, the patient had been treated successfully with etanercept at 25 mg/week. The patient more recently complained of high fever and lassitude, and presented with anterior neck swelling and tenderness. Palpation of the thyroid gland revealed it to be warm, erythematous, tender, and diffusely swollen. Laboratory tests revealed an increased erythrocyte sedimentation rate and C-reactive protein level. Thyroid function tests revealed decreased levels of thyrotropin-stimulating hormone, increased levels of free triiodothyronine, free thyroxine, and thyroglobulin, and an absence of thyroid autoantibodies. Sonography showed a diffusely reduced predominantly hypoechoic thyroid gland. Unenhanced computed tomography of the neck showed a homogeneously and mildly reduced thyroid gland. Serum titers of several viruses were not significant and so were considered unlikely to be the pathogens. On the basis of these presented findings, we diagnosed SAT, and etanercept therapy was withdrawn. The patient was treated with antibiotics and an increased prednisolone dose was initiated. She became symptom free and showed improved laboratory test results within 2 weeks, and was euthyroid by 3 months. Three months later, the patient developed hypothyroidism, although 6 months further on, the patient was asymptomatic on prednisolone, methotrexate, and levothyroxine therapy. In conclusion, whether SAT is a specific adverse event in this case in response to etanercept remains unclear. Nevertheless, the possibility of SAT should be considered in such patients on etanercept treatment.


Head size at birth in neonates with transposition of great arteries and hypoplastic left heart syndrome.
Appropriate fetal brain growth depends upon the cerebral blood flow (CBF). Different congenital heart defects (CHDs), due to the difference in anatomy and physiology, alter the intrauterine CBF. Thus, variable brain growth is expected in different CHDs that is reflected by variability in the head circumference (HC) at birth. The present study was carried out to compare the HC of babies born with transposition of great arteries (TGA) and hypoplastic left heart syndrome (HLHS) in comparison to normal control. The data on the HC of neonates with TGA and HLHS were extracted from the computer database then compared with the control group. During the period from January 1996 to December 2003, a total of 7396 neonates were admitted, out of which 639 (8.6%) were admitted with the diagnosis of the CHD. After correcting for gestational age and non-availability of HC measurements, 236 infants were excluded. Out of the remaining 403 term appropriate for gestational age (AGA) infants, 46 had TGA while 28 had HLHS. The control group comprised of a total of 74 term AGA infants. The mean HC for the control group was noted to be 34.4 +/- 1.7 centimeters (cms), 33.7 +/- 1.5 cms for TGA while it was 32.9 +/- 1.3 cms for HLHS. The head size at birth for newborn with HLHS was significantly smaller than the TGA (p=0.03) and control group (p=0.001). Similarly, HC of TGA group was significantly smaller than the control group (p=0.02). The newborns with TGA and HLHS are found to have significantly small head size at birth. The clinical significance of this finding with respect to the neurodevelopmental outcome and value of early antenatal intervention to repair these defects remains to be evaluated in further studies.


Elevated expression of H19 and Igf2 in the female mouse eye.
The catalogue of genes expressed at different levels in the two sexes is growing, and the mechanisms underlying sex differences in regulation of the mammalian transcriptomes are being explored. Here we report that the expression of the imprinted non-protein-coding maternally expressed gene H19 was female-biased specifically in the female mouse eye (1.9-fold, p = 3.0E-6) while not being sex-biased in other somatic tissues. The female-to-male expression fold-change of H19 fell in the range expected from an effect of biallelic versus monoallelic expression. Recently, the possibility of sex-specific parent-of-origin allelic expression has been debated. This led us to hypothesize that H19 might express biallelically in the female mouse eye, thus escape its silencing imprint on the paternal allele specifically in this tissue. We therefore performed a sex-specific imprinting assay of H19 in female and male eye derived from a cross between Mus musculus and Mus spretus. However, this analysis demonstrated that H19 was exclusively expressed from the maternal gene copy, disproving the escape hypothesis. Instead, this supports that the female-biased expression of H19 is the result of upregulation of the single maternal. Furthermore, if H19 would have been expressed from both gene copies in the female eye, an associated downregulation of Insulin-like growth factor 2 (Igf2) was expected, since H19 and Igf2 compete for a common enhancer element located in the H19/Igf2 imprinted domain. On the contrary we found that also Igf2 was significantly upregulated in its expression in the female eye (1.2-fold, p = 6.1E-3), in further agreement with the conclusion that H19 is monoallelically elevated in females. The female-biased expression of H19 and Igf2 specifically in the eye may contribute to our understanding of sex differences in normal as well as abnormal eye physiology and processes.


Application of the Mannich reaction in the structural modification of natural products.
The Mannich reaction is commonly used to introduce N atoms into compound molecules and is thus widely applied in drug synthesis. The Mannich reaction accounts for a certain proportion of structural modifications of natural products. The introduction of Mannich bases can significantly improve the activity, hydrophilicity, and medicinal properties of compounds; therefore, the Mannich reaction is widely used for the structural modification of natural products. In this paper, the application of the Mannich reaction to the structural modification of natural products is reviewed, providing a method for the structural modification of natural products.


Arterial switch for double-outlet left ventricle - Diagnostic and surgical considerations.
Double-outlet left ventricle (DOLV) is a rare congenital cardiac anomaly in which both the aorta and pulmonary artery arise completely or predominantly from the left ventricle. DOLV is a spectrum and can be classified depending on the position of the ventricular septal defect (VSD) relative to the great vessels, the relationship of the great vessels, and the presence or absence of pulmonary or aortic outflow obstruction. In the absence of tricuspid atresia or hypoplastic right ventricle, two ventricle repair is the preferred surgical treatment. We report a 31-day-old, 2.1 kg neonate with DOLV, subaortic VSD who underwent a successful arterial switch with VSD closure.


Treatment Outcome in Patients with Primary Central Nervous System Germ Cell Tumour: Clinical Experience from a Regional Cancer Centre in North India.
Primary intracranial germ cell tumour is a rare entity and constitutes 2-3% of all paediatric brain tumours in Western countries. We herein intend to report the clinical features and treatment outcome of patients with primary central nervous system germ cell tumour treated at our institute. Clinical data were collected by retrospective chart review from 2006 to 2012. Histopathology slides were reviewed and relevant immunohistochemistry stains were done. Overall survival (OS) and progression-free survival (PFS) were analysed by the Kaplan-Meier product-limit method. Twenty patients met the study criterion (male:female = 7:3). Median age at presentation was 13 years. Tumour location was pineal in 10 patients, suprasellar in 6, thalamic in 2, basal ganglion in 1, and spinal in 1. Leptomeningeal spread was noted in 1 patient at presentation. Surgical resection was gross-total in 7 patients (35%), near-total in 2 (10%), subtotal in 4 (20%), and limited to biopsy in 6 (30%). The tumours were germinomatous, non-germinomatous, and of mixed germ cell subtype in 17 patients (85%), 2 patients (10%), and 1 patient (5%), respectively. Systemic chemotherapy (median of 4 cycles) was given to 19 patients (95%). The common regimens used were a combination of bleomycin, etoposide and cisplatin (BEP) in 14 patients (70%) and etoposide and cisplatin (EP) in 5 patients (25%). Radiation therapy (40-50 Gy in conventional fractionation; median of 42 Gy) was delivered to 17 patients (85%): local radiation in 6 and whole ventricular, whole brain, and craniospinal irradiation followed by a boost in 5, 3, and 3 patients, respectively. After a median follow-up of 44.52 months, 17 patients (85%) were in complete response and 3 (15%) had progressive disease. Death and disease recurrence were noted in 6 patients (30%) and 1 patient, respectively. Median OS and PFS were not reached. The actuarial rates of OS at 3 and 5 years were 75.8 and 68.9%, respectively. The actuarial rates of PFS at both 3 and 5 years were 81.6%. Multimodality treatment consisting of limited resection followed by platinum-based systemic chemotherapy and radiotherapy (40-50 Gy) is a reasonable treatment strategy in patients of primary central nervous system germ cell tumour in a developing nation.


Ureaplasma urealyticum and male infertility: an animal model. I. Artificial infection, breeding experiments and histological preparation of organs.
Male Wistar rats were infected with Ureaplasma urealyticum, serotype 3 or 7, by injecting broth containing organisms into the urinary bladder following laparatomy. Animals were sacrificed 3, 7 and 21 days after infection. Ureaplasmas were detected in the organs of the genital tract by culture in 43% (serotype 3) and in 60% (serotype 7) of the animals. Type-specific ureaplasma antigen was detected in the genital organs in 44% (serotype 3) and 45% (serotype 7) of the animals. Control animals injected with sterile bouillon were negative for organisms and antigen. Male Wistar rats artificially infected with Ureaplasma urealyticum, serotype 3, were mated 3 and 6 months after infection with ureaplasma free female rats. The mating experiment revealed a smaller mean litter size and a lower birth weight in the offspring of infected males compared with the control animals, but no general influence on the fertility of infected animals.


Text Message Intervention for Teens with Type 1 Diabetes Preserves HbA1c: Results of a Randomized Controlled Trial.
Aims: Teens with type 1 diabetes (T1D) often struggle with diabetes self-management, which may lead to suboptimal self-care and worsening hemoglobin A1c (HbA1c). Innovative strategies are needed to improve self-care and protect against glycemic decline, especially during adolescence. We aimed to assess the impact on HbA1c of two interventions, problem-solving and text messaging, in teens with T1D. Methods: In a two-site randomized controlled trial, teens (N = 301) 13-17 years of age with T1D were randomized to one of the four groups using a 2 × 2 factorial design: Teenwork (TW), Text Messaging (Text), TW+Text, or Usual Care. TW intervention included problem-solving aimed at improving T1D self-care for blood glucose (BG) monitoring and insulin bolus dosing. Text intervention involved text reminders to check BG. The primary outcome was change in HbA1c from baseline to 12 months. Results: At baseline, teens (51% female, 78% white, 59% pump-treated) were (mean ± SD) 15.0 ± 1.3 years, had diabetes duration of 6.5 ± 3.7 years, and HbA1c 8.5% ± 1.1%. There was no significant difference in HbA1c over time by study group. Responsiveness to text reminders by teens in the TEXT and TW+TEXT predicted glycemic benefit; TW did not. Conclusions: Despite no HbA1c difference by study group, greater response to text message reminders to check BG led to better glycemic control and no deterioration in HbA1c; the problem-solving intervention did not. Given the high penetration of mobile phones and the wide acceptance of text messaging among teens in general, it is encouraging that a text messaging intervention can preserve HbA1c, thus preventing the expected deterioration in glycemic control often seen in teens with T1D.


Cyclophilin anaCyp40 regulates photosystem assembly and phycobilisome association in a cyanobacterium.
Cyclophilins, or immunophilins, are proteins found in many organisms including bacteria, plants and humans. Most of them display peptidyl-prolyl cis-trans isomerase activity, and play roles as chaperones or in signal transduction. Here, we show that cyclophilin anaCyp40 from the cyanobacterium Anabaena sp. PCC 7120 is enzymatically active, and seems to be involved in general stress responses and in assembly of photosynthetic complexes. The protein is associated with the thylakoid membrane and interacts with phycobilisome and photosystem components. Knockdown of anacyp40 leads to growth defects under high-salt and high-light conditions, and reduced energy transfer from phycobilisomes to photosystems. Elucidation of the anaCyp40 crystal structure at 1.2-Å resolution reveals an N-terminal helical domain with similarity to PsbQ components of plant photosystem II, and a C-terminal cyclophilin domain with a substrate-binding site. The anaCyp40 structure is distinct from that of other multi-domain cyclophilins (such as Arabidopsis thaliana Cyp38), and presents features that are absent in single-domain cyclophilins.


Electrophoretic Deposition of Carbon Nanotubes on 3-Amino-Propyl-Triethoxysilane (APTES) Surface Functionalized Silicon Substrates.
Fabrication of uniform thin coatings of multi-walled carbon nanotubes (MWCNTs) by electrophoretic deposition (EPD) on semiconductor (silicon) substrates with 3-aminopropyl-triethoxysilane (APTES) surface functionalization has been studied extensively in this report. The gradual deposition and eventual film formation of the carbon nanotubes (CNTs) is greatly assisted by the Coulombic force of attraction existing between the positively charged -NH₂ surface groups of APTES and the acid treated, negatively charged nanotubes migrating towards the deposition surfaces. The remarkable deposition characteristics of the CNT coatings by EPD in comparison to the dip coating method and the influence of isopropyl (IPA)-based CNT suspension in the fabricated film quality has also been revealed in this study. The effect of varying APTES concentration (5%-100%) on the Raman spectroscopy and thickness of the deposited CNT film has been discussed in details, as well. The deposition approach has eliminated the need of metal deposition in the electrophoretic deposition approach and, therefore, establishes a cost-effective, fast and entirely room temperature-based fabrication strategy of CNT thin films for a wide range of next generation electronic applications.


Immunoglobulin E antibodies enhance pulmonary inflammation induced by inhalation of a chemical hapten.
Occupational exposure to chemicals is an important cause of asthma. Recent studies indicate that IgE antibodies enhance sensitization to chemicals in the skin. We investigated whether IgE might similarly promote the development of airway inflammation following inhalation of a contact sensitizer. A model of chemical-induced asthma is described in which introduction of the low-molecular-weight compound, trinitrobenzene sulphonic acid (TNBS), via the respiratory tract was used for both sensitization and challenge. The role of IgE antibodies in the immune response to inhaled TNBS in this model was assessed by comparing the responses of wild-type (WT) and IgE-deficient (IgE(-/-)) mice on the BALB/c background. Reconstitution of circulating IgE levels by intravenous injection of IgE antibodies into IgE(-/-) mice before sensitization was performed to confirm the role of IgE in any differences observed between the responses of WT and IgE(-/-) mice. Intranasal challenge of TNBS-sensitized (but not sham-sensitized control mice) induced intense pulmonary inflammation. Macrophages, eosinophils and lymphocytes, including T, B, natural killer and natural killer T cells, were recruited to the airway and the animals displayed bronchial hyperresponsiveness (BHR) to methacholine. Serum levels of murine mast cell protease-1 (mMCP-1) were elevated suggesting mast cell activation. In contrast, the development of airway inflammation, recruitment of lymphocytes, induction of BHR and production of mMCP-1 were all significantly attenuated in IgE-deficient mice. Reconstitution of IgE(-/-) mice with IgE (of unrelated antigen specificity) before sensitization partially restored these features of asthma. Our data indicate that IgE antibodies non-specifically enhance the development of airway inflammation induced by exposure to chemical antigens.


National Lipid Association Annual Summary of Clinical Lipidology 2015.
The National Lipid Association (NLA) Annual Summary of Clinical Lipidology 2015 is a summary of principles important to the patient-centered evaluation, management, and care of patients with dyslipidemia. This summary is intended to be a "living document," with future annual updates based on emerging science, clinical considerations, and new NLA Position and Consensus Statements. The goal is to provide clinicians an ongoing resource that translates the latest advances in medical science toward the evaluation and treatment of patients with dyslipidemia. The 2015 NLA Annual Summary of Clinical Lipidology was founded on the principles of evidence-based medicine and is generally consistent with established national and international lipid guidelines. Topics include a general discussion of the 2014 NLA Recommendations for Patient-Centered Management of Dyslipidemia, genetics, secondary causes of dyslipidemia, biomarkers and "advanced lipid testing," medical nutrition, physical activity, obesity, pharmacotherapy, statin safety, lipid-altering drug interactions, lipoprotein apheresis, dyslipidemia in children and adolescence, dyslipidemia in older individuals, race/ethnicity, and women, health information technology and electronic medical records, as well as investigational lipid-altering drugs in development.


Molecular polymorphism of native gonadotropin-releasing hormone (GnRH) is restricted to mammalian GnRH and [hydroxyproline9] GnRH in the developing rat brain.
Although chicken gonadotropin-releasing hormone (GnRH)-II is thought to occur in most animal species, its presence and that of two other variants (lamprey GnRH-III, salmon GnRH) is questionable in rodents. Here we report on the GnRH peptides present in the hypothalamus and the remaining brain of rat of both sexes during development. No immunoreactivity was detected in the elution zone of either native or hydroxylated forms of the above three variants in any of brain extracts chromatographed. The main peptides detected were mammalian GnRH (mGnRH) and m[hydroxyproline9]GnRH (mHypGnRH). In the hypothalamus, these peptides were associated with their free acid and precursor forms. N-terminal fragments from both native decapeptides (GnRH) and mGnRH (GnRH) were observed only in the hypothalamus. C-terminal fragments were detected in both tissues. The relative proportions of mGnRH and mHypGnRH showed no developmental changes in the remaining brain. The hypothalamic proportions of mHypGnRH were high on day 5, and decreased from day 15 onwards. The [Gly11]-precursor to mHypGnRH molar ratio was twofold lower than with the non-hydroxylated peptides. The mGnRH to GnRH molar ratio increased in males but decreased in females during development. No sex-related differences were observed in the native decapeptide to GnRH molar ratio. It was concluded that (1) chicken GnRH-II is not present in all mammals, (2) mGnRH and mHypGnRH are the main GnRH isoforms present in the rat brain, (3) the processing of [Gly11]-precursor into mHypGnRH occurs at a higher rate than that of mGnRH, and (4) the catabolism does not interfere with the developmental changes undergone by the mGnRH and mHypGnRH brain contents.


Racial differences in prostate-specific antigen-based prostate cancer screening: State-by-state and region-by-region analyses.
Black men are more prone to harbor prostate cancer. They are more likely to succumb to this tumor than their White counterparts and may benefit from early detection and treatment. In this study, we assess the nationwide and regional disparity in prostate-specific antigen (PSA) screening for prostate cancer between Black men and non-Hispanic Whites (NHWs). A total of 247,079 (weighted 55,185,102) men, aged 40 to 99 years, who responded to the 2012 and 2014 behavioral risk factor surveillance system surveys were used for our analysis. End points consisted of self-reported PSA screening and self-reported nonrecommended PSA screening within 12 months of the interview. The latter was defined as screening in men with <10-year life expectancy. Available sociodemographic variables were used to predict these end points. The independent predictors from multivariate models were used to calculate the adjusted prevalence of PSA screening and nonrecommended PSA screening on a nationwide and regional level. These numbers were calculated for Blacks and NHWs separately and were compared between the 2 groups. Prevalence of PSA screening was 30.7% in NHWs vs. 28.1% in Blacks (P<0.001). On a region-based analysis, New England, Middle Atlantic, South Atlantic, East North Central, East South Central, West South Central, and Mountain showed a significantly higher rate of PSA screening in NHWs as compared to Blacks (all P<0.001). Middle Atlantic had a significantly higher prevalence of nonrecommended screening in NHWs as compared to Blacks, whereas South Atlantic, West South Central, and Pacific had a significantly higher prevalence of nonrecommended screening in Blacks as compared to NHWs (all P<0.001). Overall, 43 states performed screening more frequently to NHWs, whereas only 8 states performed it more frequently to Black men. The nonrecommended screening was performed more frequently to NHWs in 19 states, whereas 24 states performed it more frequently to Black men. Our study demonstrates that on a regional-level (and state-level), there are significant racial differences in overall and nonrecommended PSA screening across the United States. Further research is necessary to identify the reasons for the differences and help overcoming it.


Artificial soil studies reveal domain-specific preferences of microorganisms for the colonisation of different soil minerals and particle size fractions.
Artificial soils were used in this study to analyse the importance of different mineral compositions for the diversity of soil microorganisms. Variants containing montmorillonite (MT), illite (IL) and illite + ferrihydrite (IL+FH) were compared to each other. Bulk material and their particle size fractions, as obtained by ultracentrifugation and wet-sieving, were characterised for abundance and diversity of Bacteria, Archaea and Fungi. Samples were analysed 6 and 18 months after inoculation with sterilised manure and a soil-extracted microbial community. Generally, IL, and even more pronouncedly IL+FH, supported the growth of more Bacteria, Archaea and Fungi, than MT. This trend was most pronounced in the finest fraction (< 20 μm). The structural diversity of Fungi responded more strongly to the different mineral compositions than the Bacteria, for which particle size fractions were more important. Archaea established a specific community in the finest fraction and showed no response to the different mineral compositions. Overall, this study demonstrates that the mineral composition and the particle size fractions have specific and different selective effects on the three domains and, thus, suggests that these factors strongly contribute to niche separation and the high diversity of microbial communities in natural soils with complex mineral compositions.


PI3K/AKT/Nrf2 signalling pathway is involved in the ameliorative effects of xanthohumol on amyloid β-induced oxidative damage and bone loss.
Xanthohumol (XAN), a natural isoflavone from Humulus lupulus L., possesses biological activities on relieving oxidative stress and osteoporosis (OP). This study aimed to evaluate the antioxidative and osteoprotective effect of XAN on Aβ-injured osteoblasts, and explore its underlying mechanism. Osteoblasts were pretreated with XAN followed by stimulation with Aβ1-42. Cell proliferation, ALP activity, bone mineralization and bone formation index were measured. Apoptosis and reactive oxygen species (ROS) were analysed with flow cytometer. PI3K inhibitor LY294002 or siRNA-Nrf2 was added and transfected in osteoblasts, to further confirm whether the pathway participated in the regulation of XAN-induced cytoprotection. XAN markedly improved the proliferation, differentiation and mineralization of Aβ-injured osteoblasts. Additionally, XAN reduced cell apoptosis rate and ROS level, and increased the expression of p-AKT, Nrf2, NQO1, HO-1 and SOD-2. More importantly, LY294002 or siNrf2 abolished the beneficial effect of XAN on osteoblasts activity and decreased the PI3K expression and inhibited its downstream proteins, indicating XAN activated PI3K/AKT/Nrf2 pathway in Aβ-injured osteoblasts. It was the first time to reveal the antioxidative and osteoprotective effect of XAN through regulating PI3K/AKT/Nrf2 pathway in Aβ-injured osteoblasts, which provides reference for the clinical application of XAN in the prevention and treatment of OP.


Declining growth rate of West Nile virus in North America.
To determine the demographic history of West Nile virus (WNV) in North America, we employed a coalescent method to envelope coding region data sets for the NY99 and WN02 genotypes. Although the observed genetic diversities in both genotypes were of approximately the same age, the mean rate of epidemiological growth of the WN02 population was approximately three times that of the NY99 population, a finding compatible with the recent dominance of the former genotype. However, there has also been a marked decrease in the recent growth rate of WN02, suggesting that WNV has reached its peak prevalence in North America.


Solid-Contact Potentiometric Sensors Based on Stimulus-Responsive Imprinted Polymers for Reversible Detection of Neutral Dopamine.
Herein, we present for the first time a novel potentiometric sensor based on the stimulus-responsive molecularly imprinted polymer (MIP) as a selective receptor for neutral dopamine determination. This smart receptor can change its capabilities to recognize according to external environmental stimuli. Therefore, MIP-binding sites can be regenerated in the polymeric membrane by stimulating with stimulus after each measurement. Based on this effect, reversible detection of the analyte via potentiometric transduction can be achieved. MIPs based on 4-vinylphenylboronic acid as the functional monomer were prepared as the selective receptor. This monomer can successfully bind to dopamine via covalent binding and forming a five- or six-membered cyclic ester in a weakly alkaline aqueous solution. In acidic medium, the produced ester dissociates and regenerates new binding sites in the polymeric membrane. The proposed smart sensor exhibited fast response and good sensitivity towards dopamine with a limit of detection 0.15 µM over the linear range 0.2-10 µM. The selectivity pattern of the proposed ISEs was also evaluated and revealed an enhanced selectivity towards dopamine over several phenolic compounds. Constant-current chronopotentiometry is used for evaluating the short-term potential stability of the proposed ISEs. The obtained results confirm that the stimulus-responsive MIPs provide an attractive way towards reversible MIP-based electrochemical sensors designation.


Ultrafast MAS solid-state NMR permits extensive 13C and 1H detection in paramagnetic metalloproteins.
We show here that by combining tailored approaches based on ultrafast (60 kHz) MAS on the Co(II)-replaced catalytic domain of matrix metalloproteinase 12 (CoMMP-12) we can observe and assign, in a highly paramagnetic protein in the solid state, (13)C and even (1)H resonances from the residues coordinating the metal center. In addition, by exploiting the enhanced relaxation caused by the paramagnetic center, and the low power irradiation enabled by the fast MAS, this can be achieved in remarkably short times and at very high field (21.2 T), with only less than 1 mg of sample. Furthermore, using the known crystal structure of the compound, we are able to distinguish and measure pseudocontact (PCS) contributions to the shifts up to the coordinating ligands and to unveil structural information.


Do different parasite species interact in their effects on host fitness? A case study on parasites of the amphipod Paracalliope fluviatilis.
There is a gap in our understanding of the relative and interactive effects of different parasite species on the same host population. Here we examine the effects of the acanthocephalan Acanthocephalus galaxii, an unidentified cyclophyllidean cestode, and the trematodes Coitocaecum parvum and Microphallus sp. on several fitness components of the amphipod Paracalliope fluviatilis, using a combination of infection surveys and both survival and behavioural trials. In addition to significant relationships between specific parasites and measures of amphipod survival, maturity, mating success and behaviour, interactions between parasite species with respect to amphipod photophilia were also significant. While infection by either A. galaxii or C. parvum was associated with increased photophilia, such increases were negated by co-infection with Microphallus sp. We hypothesize that this is due to the more subtle manipulative effect of A. galaxii and C. parvum being impaired by Microphallus sp. We conclude that the low frequency at which such double infections occur in our sampled population means that such interactions are unlikely to be important beyond the scale of the host individual. Whether or not this is generally true, implying that parasitological models and theory based on single parasite species studies do generally hold, requires cross-species meta-analytical studies.


Airway hyperresponsiveness in patients with normal spirometry results and symptoms compatible with asthma: Primary care retrospective chart review.
To evaluate the proportion of patients with symptoms suggestive of asthma and normal lung function who exhibit airway hyperreactivity with methacholine challenge testing (MCT) in primary care. Retrospective chart review. Primary care lung clinic in Toronto, Ont. A total of 69 patients presenting to the lung clinic who had symptoms compatible with asthma, normal spirometry test results, and were referred for MCT. Descriptive statistics, frequency counts, independent t tests, and 2 tests were used to examine differences in the proportion of clinical and demographic variables identified in patients with or without a positive MCT result. Effect size was determined between MCT-positive and MCT-negative patients for both categorical ( coefficient) and continuous (Hedges g) data. Twenty-one patients (30.4%) had positive MCT results, and 48 patients (69.6%) had negative MCT results. Family history of asthma and reduced baseline and postbronchodilator forced expiratory volume in 1 second were associated with a positive MCT result. The findings of this study provide insight into the utility of simple spirometry for asthma diagnosis and the need to further clarify the role of MCT in the primary care setting.


In vitro activity of ampicillin alone and in combination with different concentrations of 6 beta-bromopenicillanic acid, clavulanic acid and mecillinam.
The antibacterial activity of ampicillin against Enterobacteriaceae strongly increased when combined with 6 beta-bromopenicillanic acid (BPA) or clavulanic acid (CA). In vitro, the combination ampicillin: BPA in the ratio 1:1 proved to be the most effective one. The antibacterial activity of mecillinam against Enterobacteriaceae was strongly potentiated by the addition of ampicillin. The combination mecillinam:ampicillin in the ratio 4:5 showed an antibacterial activity comparable to that of new beta-lactam compounds such as cefotaxime and ceftazidime.


Gastrojejunal anastomosis stricture after laparoscopic gastric bypass. Our experience with 62 patients.
Gastrojejunal stricture (GYS), not only is a common complication after laparoscopic gastric bypass (LGBP), but its frequency is about 15% according to bibliography. Our aim is to present our experience after 62 LGBP. From January 2004 to September-2006, we performed 62 consecutive laparoscopic gastric bypass (Wittgrove's technique). The gastrojejunal anastomosis is performed with auto suture material type CEAA No 21 termino-lateral (ILS, Ethicon). In 4 cases (6.45%) was converted to laparotomy, perform the anastomosis in the same way. Monitoring has a range of 3-35 months, conducted in 61 patients because one patient died of pulmonary thromboembolism in the immediate postoperative period after reoperation, after two weeks of gastric bypass, by necrosis of a small fragment of the remnant gastric. In all patients with persistent feeding intolerance were performed barium transit and/or gastroscopy. When gastrojejunal stricture showed proceeded to endoscopic pneumatic dilation (recommending dilate the anastomosis to a maximum 1.5 cm). Five cases (8.1%) developed a gastrojejunal stricture, in 4 of these cases the initial diagnosis was made by barium transit and in 1 case by endoscopy. Two patients had a history of digestive bleeding that required endoscopic sclerosis of the bleeding lesion (circumferentially sclerosis within 48 hours of surgery and sclerosis of bleeding points). All cases were resolved by endoscopic dilatation. At follow-up has not been detected re-stricture. Clinically, gastrojejunal stricture results in a progressive oral intolerance, revealing stenosis between 1 and 3 months postoperatively. The situations of sclerosis of the bleeding lesions favor, especially in cases of extensive sclerosis. In cases of suspected barium transit offers us a high diagnostic yield. Endoscopic dilatation resolved, so far, all cases.


[New medications; erlotinib].
Erlotinib inhibits the phosphorylation of the epidermal growth-factor receptor (EGFR/HERI), a tyrosinekinase protein. This results in an inhibition of signal transduction and therefore decreased cell division and increased cell death. The agent is indicated for the treatment of patients with advanced local or metastasised non-small-cell pulmonary carcinoma after other cytostatic therapy has failed.


Neural mechanisms of auditory sensory processing in children with high intelligence.
To investigate the differences in event-related potential parameters related to children's intelligence, 18 intellectually gifted children and 18 average children participated in this study. The electroencephalograms were recorded the auditory sensory memory that elicited the mismatch negativity (MMN) and late discriminative negativity (LDN), as well as involuntary attention switch that elicited the P3a and early MMN were analyzed. The results indicated that children with high intelligence had comparatively larger MMN, LDN, early MMN, P3a amplitudes, and earlier peak latency in LDN than average children. The enhanced neural function of the intellectually gifted children might be due to more spatially and temporally coordinated neural network, faster neural processing speed and more efficient neural activation functions.


Independent of Birth Mode or Gestational Age, Very-Low-Birth-Weight Infants Fed Their Mothers' Milk Rapidly Develop Personalized Microbiotas Low in Bifidobacterium.
Very-low-birth-weight (VLBW; born weighing <1500 g) infant feeding with mother's own milk (mother's milk) is associated with numerous beneficial health outcomes. Several interventions, including the prophylactic use of probiotics, are being adopted to promote a gastrointestinal microbiota favorable to the gut health of VLBW infants. An improved understanding of the microbiota that results from mother's milk feeding would therefore facilitate progress in this field. A preplanned primary objective of this research was to characterize the development of the gut microbiota in exclusively mother's milk-fed VLBW infants and describe the reference taxonomic profile that results from mother's milk feeding. In this prospective longitudinal cohort study, we collected weekly stool samples from exclusively mother's milk-fed VLBW infants admitted to Mount Sinai Hospital and profiled their gastrointestinal microbiota development from birth (primary outcome of stool collection). In total, we profiled 231 stools from 54 exclusively mother's milk-fed VLBW infants with the use of V6-16S ribosomal RNA gene sequencing. Bacterial evenness, but not bacterial richness, increased over time in VLBW infants (P < 0.001). Bifidobacterium relative abundances were consistently low in all microbiotas at all time points (<0.5% in 97% of samples). VLBW infant microbiotas did not cluster by birth mode, gestational age, or weeks after birth and instead clustered as a function of patient identity (R2 = 0.51, P < 0.001). Exclusively mother's milk-fed VLBW infants rapidly develop personalized gut microbiotas that show increasing evenness and are seemingly unaffected by birth mode or gestational age at birth. The benefits from mother's milk feeding are likely modulated through microbes or pathways that are not dependent on Bifidobacterium because these microbes are present at low levels in VLBW infants. These results help define a reference VLBW infant microbiota profile derived from mother's milk, the optimal source of nutrition for these infants. This trial was registered at ISRCTN (http://www.isrctn.com/) as ISRCTN35317141.


Age-related change in ketone body metabolism: diminished glucagon effect on ketogenesis in adult rats.
The age-related changes in plasma ketone body levels and related substances such as carnitine and FFA of normal and streptozotocin diabetic rats, as well as its effects on glucagon-induced ketogenesis in isolated perfused rat livers, were examined in this study. The degree of increase of acetoacetate (AcAc) in adult rats (50-week-old) after a 36-h fasting period in both normal and diabetic rats was significantly smaller than that of young rats (8-week-old). Plasma total carnitine tended to decrease with aging. On the other hand, the plasma levels of FFA and glucagon in fasted adult rats were significantly higher than those in young rats. In parallel with the in vivo observation, the basal output of AcAc, but not 3-hydroxybutyrate, from adult rat livers was significantly smaller than that of the young normal and diabetic rats. The level of glucagon-stimulated AcAc output from the young rat liver was significantly higher than that from the adult rat liver in both the normal and diabetic rats. This study demonstrates that the hepatic unresponsiveness to glucagon in terms of its ketone body production by aging may be one of the major causes of hyperosmolar nonketotic coma in elderly people.


Telehealth in response to the COVID-19 pandemic: Implications for rural health disparities.
Telehealth programs have long held promise for addressing rural health disparities perpetuated by inadequate healthcare access. The COVID-19 (coronavirus disease 2019) pandemic and accompanying social distancing measures have hastened the implementation of telehealth programs in hospital systems around the globe. Here, we provide specific examples of telehealth efforts that have been implemented in a large rural healthcare system in response to the pandemic, and further describe how the massive shift to telehealth and reliance on virtual connections in these times of social isolation may impact rural health disparities for those without access to necessary broadband to deploy digital technologies. Finally, we provide recommendations for researchers and policymakers to ensure that telehealth initiatives do not amplify existing health disparities experienced by those living in rural communities.


Stereoselective metabolism of carvedilol by the beta-naphthoflavone-inducible enzyme in human intestinal epithelial Caco-2 cells.
Treatment of Caco-2 cells with beta-naphthoflavone (beta-NF) and 1alpha,25-dihydroxyvitamin D(3) (VD(3)) induces UDP-glucuronosyltransferases (UGTs) and cytochrome P450 (CYP) 3A4, respectively. In the present study, we evaluated the metabolism of carvedilol in beta-NF- and VD(3)-treated Caco-2 cells. The metabolism of R-carvedilol was not significant in non-treated Caco-2 cells, whereas S-carvedilol was significantly metabolized in the cells. The metabolism of R- and S-carvedilol was significantly increased by the treatment of Caco-2 cells with 50 microM beta-NF for 3 d. In contrast, the treatment of Caco-2 cells with 250 nM VD(3) for 2 weeks did not induce a significant change in the metabolism of R- and S-carvedilol. The metabolism of carvedilol in beta-NF-treated Caco-2 cells was markedly inhibited by a substrate of UGTs, baicalein. In addition, the expression of UGT1A1, 1A6, and 1A9 mRNA was increased in beta-NF-treated Caco-2 cells as compared with non-treated cells. These findings indicated that carvedilol was metabolized stereoselectively by the beta-NF-inducible enzyme in Caco-2 cells. The UGT1A subfamily in intestinal epithelial cells may be partly responsible for first-pass (presystemic) metabolism of the drug.


[Long-term results in the treatment of foot injuries in polytraumatized patients].
The aim of this study was to evaluate the long-term outcome of multiple injured patients with foot injuries. While severity and frequency of multiple injuries could be decreased in the last years, it was not possible to decrease the severity of injuries of the foot and ankle region. These injuries are often not detected and their severity is underestimated in primarily diagnostics what might lead to complaints in the longterm course. The multiple trauma database of the Department of Traumatology of the University of Vienna includes 386 patients from September 1992 to April 2001. 40 (10.4 %) of these patients suffered a fracture or dislocation of foot or ankle. 33 (82.5 %) multiple injured patients with injuries of foot or ankle could be reexamined between April and September 2002 and the longterm outcome of the foot and ankle region could be evaluated objectively and subjectively. 22 (66.7 %) patients were male, 11 (33.3 %) female. The mean age was 34.5 years. 27 (81.8 %) patients still suffered from complaints related to their injured foot and ankle region. After calculation of the AOFAS these complaints were predominantly located in the ankle-hindfoot region. 22 (66.7 %) patients had to limit their sports activity. In our study period an increasing number and severity of injuries of foot or ankle can be shown. Furthermore multiple injured patients with concomitant injuries of foot or ankle show a lower ISS what suggests that these patients might have a higher survival rate and consecutively enter rehabilitation process.


Risk assessment models in acute coronary syndromes and their applicability in Singapore.
Risk prediction models are critical in managing patients with acute coronary syndromes (ACS) as they identify high-risk patients who benefit the most from targeted care. We discuss the process of developing and validating a risk prediction model as well as highlight the more commonly used models in clinical practice currently. Finally we conclude by outlining the importance of creating a risk prediction model based on a Singapore population of ACS patients so as to further improve patient, hospital and research outcomes.


Evaluation of a commercial PCR test for the diagnosis of dermatophyte nail infections.
Tinea unguium, known as onychomycosis, is a dermatophyte infection of nails with worldwide distribution. Conventional methods for detecting fungi in nail specimens are either non-specific (microscopy) or insensitive (culture). PCR has been used to improve sensitivity in detecting the causative fungi in nail specimens from patients with suspected onychomycosis. Results of a commercial multiplex PCR for the detection of dermatophytes, especially Trichophyton rubrum (the main dermatophyte implicated), as compared to conventional methods are presented. A total of 418 nail scrapings obtained from dermatological outpatients were handled in the Laboratory of Microbiology between May 2010 and May 2013. Among them, multiplex PCR detected 126 (30.1 %) dermatophyte-positive samples, whereas culture revealed 44 (10.5 %). Direct microscopy revealed 63 (15.1 %) positive specimens. T. rubrum was identified in 116 out of 126 (92 %) positive PCR samples and 40 out of 44 (91 %) dermatophyte-positive cultures. Implementation of PCR increased species-specific detection of dermatophytes by 21.1 %, leading to a threefold increase as compared to culture alone. Multiplex PCR offers a time-saving diagnostic tool for tinea unguium and augments laboratory assistance to clinical evaluation for proper treatment.


Future role of proprotein convertase subtilisin/kexin type 9 inhibitors in preventive cardiology.
The use of therapeutic monoclonal antibodies to target proprotein convertase subtilisin/kexin type 9 (PCSK9) represents a novel approach to the management of hypercholesteremia and prevention of atherosclerotic cardiovascular disease. We review the most recent literature relevant to PCSK9 inhibition with emphasis on how recent results and ongoing trials have and will continue to shape the use of this new therapeutic class in preventive cardiology. PCSK9 inhibitors reduce plasma lipoprotein(a) concentrations but a mechanistic understanding remains elusive. Evaluation of evolocumab for use in patients without prior myocardial infarction or stroke is underway (NCT03872401). Concerns regarding the cost-effectiveness of PCSK9 inhibitors have continued to thwart access to these drugs, though innovative models of care delivery and price reductions have improved this situation. Inclisiran, a small interfering ribonucleic acid (siRNA), reduces translation of PCSK9 and demonstrates more durable reductions in low-density lipoprotein-cholesterol (LDL-C). It is currently evaluated in the context of a phase III cardiovascular outcome trial in patients with established vascular disease (NCT03705234). The current scope of PCSK9 inhibitor therapy in preventive cardiology is limited to patients with familial hypercholesterolemia and/or established atherosclerotic cardiovascular disease. Future cardiovascular outcome trial results with PCSK9 blocking antibodies in primary prevention and with siRNA to PCSK9 in secondary prevention, improved understanding of the drivers of lipoprotein(a) reduction with PCSK9 inhibition, and cost-effectiveness will determine the future role of this therapeutic class.


Selective effects of aniracetam across receptor types and forms of synaptic facilitation in hippocampus.
Aniracetam reversibly increased synaptic responses mediated by the AMPA but not the NMDA subclass of glutamate receptors in hippocampus and was considerably more potent than structurally similar nootropics. The drug had greater effects on field excitatory postsynaptic potentials (EPSPs) in the dentate gyrus and CA1 region than it did in the CA3 region, suggesting that it differentiates between variants of the AMPA receptor. Ligand binding to glutamate receptors in synaptosomal membrane fractions was minimally changed by aniracetam. Finally, the percent facilitation produced by aniracetam in the CA1 region was not reduced by any of three treatments (4-aminopyridine, changes in extracellular calcium concentrations, paired-pulse stimulation) that affect release but, in accord with a previous report, was substantially decreased by long-term potentiation. These results support the conclusion that aniracetam selectively increases the conductance of a subgroup of synaptic AMPA receptors in hippocampus and suggest that receptor changes underlie the expression of long-term potentiation.


From puppy to service dog: raising service dogs for the rehabilitation team.
Service dogs, also known as assistance dogs, are seen increasingly in public places, including healthcare settings. Whereas an earlier article reviewed literature relevant to the human-animal bond in general, this article recounts my personal and professional experiences as a volunteer for Canine Companions for Independence (CCI). Rehabilitation professionals are advocates for their clients, and this article provides important information about the issues, benefits, and challenges in obtaining, training, and living with a service dog. For additional information, sources available through the Internet and a bibliography are provided.


Structural properties and fragile to strong transition in confined water.
We derive by computer simulation the radial distribution functions of water confined in a silica pore modeled to reproduce MCM-41. We perform the calculations in a range of temperatures from ambient to deep supercooling for the subset of water molecules that reside in the inner shell (free water) by applying the excluded volume corrections. By comparing with bulk water we find that the first shell of the oxygen-oxygen and hydrogen-hydrogen radial distribution functions is less sharp and the first minimum fills in while the oxygen-hydrogen structure does not significantly change, indicating that the free water keeps the hydrogen bond short range order. The two body excess entropy of supercooled water is calculated from the radial distribution functions. We connect the behavior of this function to the relaxation time of the same system already studied in previous simulations. We show that the two body entropy changes its behavior in coincidence with the crossover of the relaxation time from the mode coupling fragile to the strong Arrhenius regime. As for bulk water also in confinement, the two body entropy has a strict connection with the dynamical relaxation.


What mothers don't know and doctors don't say: Detecting early developmental delays.
The present study examined the detection of early developmental delays of high-risk infants by first-time mothers in a community sample of families (N = 451). About half of the mothers were adolescents at time of childbirth, and two thirds reported household incomes below $20,000 annually. Children were assessed at 12 and 24 months of age on standardized measures of cognitive, language, adaptive, and socioemotional development. According to the Individuals with Disabilities Education Act (PL101-476) guidelines, about 1 in 4 children was eligible for intervention services at 12 months, and about 1 in 3 children was eligible at 24 months. Despite receiving regular medical services, mothers reported that very few eligible children (2% at 12 months and 9% at 24 months) were identified by medical professionals as having any problems that could interfere with development. Much like medical professionals, few mothers were appropriately worried about development, and the likelihood of expressing concerns was related to mothers' knowledge about infant development. These findings highlight the need for medical providers to frequently screen high-risk children and for parents to become more knowledgeable about infant development.


Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement.
Because the structure of the spine is inherently unstable, muscle activation is essential for the maintenance of trunk posture and intervertebral control when the limbs are moved. To investigate how the central nervous system deals with this situation the temporal components of the response of the muscles of the trunk were evaluated during rapid limb movement performed in response to a visual stimulus. Fine-wire electromyography (EMG) electrodes were inserted into transversus abdominis (TrA), obliquus internus abdominis (OI) and obliquus externus abdominis (OE) of 15 subjects under the guidance of real-time ultrasound imaging. Surface electrodes were placed over rectus abdominis (RA), lumbar multifidus (MF) and the three parts of deltoid. In a standing position, ten repetitions of shoulder flexion, abduction and extension were performed by the subjects as fast as possible in response to a visual stimulus. The onset of TrA EMG occurred in advance of deltoid irrespective of the movement direction. The time to onset of EMG activity of OI, OE, RA and MF varied with the movement direction, being activated earliest when the prime action of the muscle opposed the reactive forces associated with the specific limb movement. It is postulated that the non-direction-specific contraction of TrA may be related to the control of trunk stability independent of the requirement for direction-specific control of the centre of gravity in relation to the base of support.


Totally minimally invasive esophagectomy versus hybrid minimally invasive esophagectomy: systematic review and meta-analysis.
Minimally invasive esophagectomy is increasingly performed for the treatment of esophageal cancer, but it is unclear whether hybrid minimally invasive esophagectomy (HMIE) or totally minimally invasive esophagectomy (TMIE) should be preferred. The objective of this study was to perform a meta-analysis of studies comparing HMIE with TMIE. A systematic literature search was performed in MEDLINE, Embase, and the Cochrane Library. Articles comparing HMIE and TMIE were included. The Newcastle-Ottawa scale was used for critical appraisal of methodological quality. The primary outcome was pneumonia. Sensitivity analysis was performed by analyzing outcome for open chest hybrid MIE versus total TMIE and open abdomen MIE versus TMIE separately. Therefore, subgroup analysis was performed for laparoscopy-assisted HMIE versus TMIE, thoracoscopy-assisted HMIE versus TMIE, Ivor Lewis HMIE versus Ivor Lewis TMIE, and McKeown HMIE versus McKeown TMIE. There were no randomized controlled trials. Twenty-nine studies with a total of 3732 patients were included. Studies had a low to moderate risk of bias. In the main analysis, the pooled incidence of pneumonia was 19.0% after HMIE and 9.8% after TMIE which was not significantly different between the groups (RR: 1.46, 95% CI: 0.97-2.20). TMIE was associated with a lower incidence of wound infections (RR: 1.81, 95% CI: 1.13-2.90) and less blood loss (SMD: 0.78, 95% CI: 0.34-1.22) but with longer operative time (SMD:-0.33, 95% CI: -0.59--0.08). In subgroup analysis, laparoscopy-assisted HMIE was associated with a higher lymph node count than TMIE, and Ivor Lewis HMIE was associated with a lower anastomotic leakage rate than Ivor Lewis TMIE. In general, TMIE was associated with moderately lower morbidity compared to HMIE, but randomized controlled evidence is lacking. The higher leakage rate and lower lymph node count that was found after TMIE in sensitivity analysis indicate that TMIE can also have disadvantages. The findings of this meta-analysis should be considered carefully by surgeons when moving from HMIE to TMIE.


Possible involvement of endogenous nociceptin/orphanin FQ in the pain-related behavioral responses induced by its own metabolite, nociceptin/orphanin FQ(14-17).
Nociceptin/orphanin FQ(14-17) (N/OFQ(14-17)) is one of the major fragments that are released from N/OFQ, an endogenous ligand for the opioid receptor like-1 (ORL-1) receptor by endopeptidase 24.11. In the present study, we determined the pharmacological profiles of N/OFQ(14-17) on pain-related behavioral responses in the mouse. Intrathecal (i.t.) administration of N/OFQ(14-17) (5-160 pmol) evoked pain-related behaviors, and these behavioral responses were reduced by i.t. co-administration of an ORL-1 receptor antagonist, [Nphe(1)]N/OFQ(1-13)NH2 (4 pmol). However, in the ligand-binding receptor assay, N/OFQ(14-17) had no affinity for the ORL-1 receptor. Furthermore, i.t. pretreatment with an antiserum against N/OFQ (1:50) diminished the N/OFQ(14-17)-induced pain-related behaviors, suggesting that endogenous N/OFQ is involved in their expression. Therefore, N/OFQ(14-17)-induced pain-related behaviors may be mediated through the release of endogenous N/OFQ in the mouse spinal cord.


Timbre Brownfield Prioritization Tool to support effective brownfield regeneration.
In the last decade, the regeneration of derelict or underused sites, fully or partly located in urban areas (or so called "brownfields"), has become more common, since free developable land (or so called "greenfields") has more and more become a scare and, hence, more expensive resource, especially in densely populated areas. Although the regeneration of brownfield sites can offer development potentials, the complexity of these sites requires considerable efforts to successfully complete their revitalization projects and the proper selection of promising sites is a pre-requisite to efficiently allocate the limited financial resources. The identification and analysis of success factors for brownfield sites regeneration can support investors and decision makers in selecting those sites which are the most advantageous for successful regeneration. The objective of this paper is to present the Timbre Brownfield Prioritization Tool (TBPT), developed as a web-based solution to assist stakeholders responsible for wider territories or clusters of brownfield sites (portfolios) to identify which brownfield sites should be preferably considered for redevelopment or further investigation. The prioritization approach is based on a set of success factors properly identified through a systematic stakeholder engagement procedure. Within the TBPT these success factors are integrated by means of a Multi Criteria Decision Analysis (MCDA) methodology, which includes stakeholders' requalification objectives and perspectives related to the brownfield regeneration process and takes into account the three pillars of sustainability (economic, social and environmental dimensions). The tool has been applied to the South Moravia case study (Czech Republic), considering two different requalification objectives identified by local stakeholders, namely the selection of suitable locations for the development of a shopping centre and a solar power plant, respectively. The application of the TBPT to the case study showed that it is flexible and easy to adapt to different local contexts, allowing the assessors to introduce locally relevant parameters identified according to their expertise and considering the availability of local data.


Sex-dependent impact of perinatal 5G electromagnetic field exposure in the adolescent rat behavior.
The fifth generation (5G) network is currently being worldwide spread out, raising questions about the potential impact of this new technology, particularly on immature organisms. The current study aimed to investigate the effects of daily 5G electromagnetic field (EMF) perinatal exposure on the neurodevelopment of rats. The exposure level was set to the limit of whole-body public exposure defined by the International Commission on Non-Ionizing Radiation Protection. The mother rat specific absorption rate (SAR) was 0.07 W/kg for 22 h/day at 3500 MHz continuous wave from gestational day (GD) 8 to post-natal day (PND) 21. Clinical observations were performed on weight, length, sex ratio, number of pups per litter, and number of stillborn in sham and EMF-exposed groups (n = 7). The age of pinna ear detachment, incisor eruption, and eye opening were recorded. Behavior was assessed on righting, gripping, and negative geotaxis reflexes at PND 3 or 7 and on stereotyped and horizontal movements in the open field at PND 43. Our results indicated that both male and female pups showed delayed incisor eruption in the EMF-exposed group compared to the sham group (+ 1 day). Regarding activity in the open field, adolescent females showed less stereotyped movements (- 70%), while adolescent males showed more stereotyped movements (+ 50%) compared to the sham-exposed adolescent rats. Thus, the present study suggested that perinatal exposure to 5G at SAR level below reglementary threshold led to perturbations in the descendants seen in juveniles and adolescents.


Comparison of Rotterdam and Barcelona Magnetic Resonance Imaging Risk Calculators for Predicting Clinically Significant Prostate Cancer.
Magnetic resonance imaging (MRI)-based risk calculators (MRI-RCs) individualise the likelihood of clinically significant prostate cancer (csPCa) and improve candidate selection for prostate biopsy beyond the Prostate Imaging Reporting and Data System (PI-RADS). To compare the Barcelona (BCN) and Rotterdam (ROT) MRI-RCs in an entire population and according to the PI-RADS categories. A prospective comparison of BCN- and ROT-RC in 946 men with suspected prostate cancer in whom systematic biopsy was performed, as well as target biopsies of PI-RADS ≥3 lesions. Saved biopsies and undetected csPCa (grade group ≥2) were determined. The csPCa detection was 40.8%. The median risks of csPCa from BCN- and ROT-RC were, respectively, 67.1% and 25% in men with csPCa, whereas 10.5% and 3% in those without csPCa (p < 0.001). The areas under the curve were 0.856 and 0.844, respectively (p = 0.116). BCN-RC showed a higher net benefit and clinical utility over ROT-RC. Using appropriate thresholds, respectively, 75% and 80% of biopsies were needed to identify 50% of csPCa detected in men with PI-RADS <3, whereas 35% and 21% of biopsies were saved, missing 10% of csPCa detected in men with PI-RADS 3. BCN-RC saved 15% of biopsies, missing 2% of csPCa in men with PI-RADS 4, whereas ROT-RC saved 10%, missing 6%. No RC saved biopsies without missing csPCa in men with PI-RADS 5. ROT-RC provided a lower and narrower range of csPCa probabilities than BCN-RC. BCN-RC showed a net benefit over ROT-RC in the entire population. However, BCN-RC was useful in men with PI-RADS 3 and 4, whereas ROT-RC was useful only in those with PI-RADS 3. No RC seemed to be helpful in men with negative MRI and PI-RADS 5. Barcelona risk calculator was more helpful than Rotterdam risk calculator to select candidates for prostate biopsy.


Identification, characterization, and control of potential human carcinogens: a framework for Federal decision-making.
A two-stage process is proposed for a uniform framework for Federal agency decisions regarding the identification, characterization, and control of potential human carcinogens. Stage I would include the identification, through epidemiologic and/or laboratory studies, of chemicals that represent a potential carcinogenic risk and the characterization of that risk. Stage II would encompass the actual regulatory decision-making process regarding control of potential carcinogens. Stage I relies predominantly on scientific activity and judgment. Centralized management could enhance the efficiency and effectiveness of this process. The new National Toxicology Program may be able to perform this function. Stage II judgments are social and political. Centralization of stage II decision-making is not possible under current law.