Intraoperative Versus Postoperative Vault Measurement After Implantable Collamer Lens Implantation in a Large Cohort of Patients.
To compare intraoperative and postoperative central vault measurement after implantable Collamer lens (ICL; STAAR Surgical) implantation using optical coherence tomography (OCT). A total of 574 eyes of 338 consecutive patients undergoing myopic ICL implantation were evaluated (mean age of 30.8 ± 5.7 years, 117 men and 221 women). Central ICL vault was measured both intraoperatively using the microscope-integrated iOCT (Optomedical Technologies GmbH) mounted on a standard surgical microscope (HS Hi-R NEO 900A; Haag-Streit Surgical GmbH), and postoperatively using the CASIA2 swept-source OCT (Tomey GmbH) at 4 and 24 hours. Mean differences between intraoperative and postoperative vault values were 11.5 ± 29.0% of the mean value 4 hours postoperatively (P < .001) and 2.7 ± 33.5% of the mean value 24 hours postoperatively (P < .001). Correlation analysis shows significant agreement between vault values obtained intraoperatively and at the two postoperative times, 4 hours (Spearman Rho = 0.850, P < .001) and 24 hours (Spearman Rho = 0.745, P < .001). In 73% of cases, postoperative vault values 4 hours after the surgery could be predicted from intraoperative vault values, and so were 56% of vault values 1 day after surgery. Significant differences in vault were found at the different times, grouping cases by ICL size (Kruskal-Wallis, P = .028 for intraoperative vault, and P < .001 for both postoperative vault times), with smaller vault values for the smaller ICL size. Intraoperative determination of ICL vault using iOCT is an effective method for predicting postoperative ICL vault and minimizing postoperative vault surprises that could require surgical retouching. [J Refract Surg. 2021;37(7):477-483.].


Analyzing breath samples of hypoglycemic events in type 1 diabetes patients: towards developing an alternative to diabetes alert dogs.
Diabetes is a disease that involves dysregulation of metabolic processes. Patients with type 1 diabetes (T1D) require insulin injections and measured food intake to maintain clinical stability, manually tracking their results by measuring blood glucose levels. Low blood glucose levels, hypoglycemia, can be extremely dangerous and can result in seizures, coma, or even death. Canines trained as diabetes alert dogs (DADs) have demonstrated the ability to detect hypoglycemia from breath, which led us to hypothesize that hypoglycemia, a metabolic dysregulation leading to low blood glucose levels, could be identified through analyzing volatile organic compounds (VOCs) contained within breath. We hoped to replicate the canines' detection ability and success by analytically using gas chromatography/mass spectrometry of VOCs in 128 breath samples collected from 52 youths with T1D at two different diabetes camps. We used different tests for significance including Ranksum, Student's T-test, and difference between means, and found a subset of 56 traces of potential metabolites. Principle component and linear discriminant analysis (LDA) confirmed a hypoglycemic signature likely resides within this group. Supervised machine learning combined with LDA narrowed the list of likely components to seven. The technique of leave one out cross validation demonstrated the model thus developed has a sensitivity of 91% (95% confidence interval (CI) [57.1, 94.7]) and a specificity of 84% (95% CI [73.0, 92.7]) at identifying hypoglycemia. Confidence intervals were obtained by bootstrapping. These results demonstrate that it is possible to differentiate breath samples obtained during hypoglycemic events from all other breath samples by analytical means and could lead to developing a simple analytical monitoring device as an alternative to using DADs.


Morphological analysis of in vivo velocity field in the alteration of the vasomotor tone.
Vessel wall remodeling is involved in atherogenesis and in several important vascular diseases affecting mainly aged and prosthetic implanted patients. This adaptive response to pathological states in arterial hemodynamics strongly suggests that flow-derived stresses act as mechanical stimuli to the release of endothelium-derived vasoactive factors, leading to vascular alterations. As the correlation of intimal hyperplasia (IH) with blood flow alterations in arteries has been shown to be significant, and as it is well-known that clinical procedures carry a substantial risk of development of vascular disease, the relevance of local hemodynamics must be investigated to describe changes in compliance matching in prosthetic applications. The aim of our research is to investigate the use of principal components analysis, together with varimax rotation, in the individuation process of morphological characteristics of real time ultrasound in in vivo recordings of blood flow velocities, as provided by two different carotid perivascular manipulations. This would be of use in the clinical assessment of atherogenesis, hypertension, prosthetic replacement or more in general in all applications in which vascular tone may be impaired. Data recordings refer to previous animal experiments where the Moncada model was investigated by means of an ultrasound profilometer. The present study confirms the feasibility of the proposed analysis to follow vascular pathology evolution, distiguishing between an in progress and a static situation.


The SMART model: Soft Membranes Adapt and Respond, also Transiently, in the presence of antimicrobial peptides.
Biophysical and structural studies of peptide-lipid interactions, peptide topology and dynamics have changed our view on how antimicrobial peptides insert and interact with membranes. Clearly, both the peptides and the lipids are highly dynamic, change and mutually adapt their conformation, membrane penetration and detailed morphology on a local and a global level. As a consequence, the peptides and lipids can form a wide variety of supramolecular assemblies in which the more hydrophobic sequences preferentially, but not exclusively, adopt transmembrane alignments and have the potential to form oligomeric structures similar to those suggested by the transmembrane helical bundle model. In contrast, charged amphipathic sequences tend to stay intercalated at the membrane interface where they cause pronounced disruptions of the phospholipid fatty acyl packing. At increasing local or global concentrations, the peptides result in transient membrane openings, rupture and ultimately lysis. Depending on peptide-to-lipid ratio, lipid composition and environmental factors (temperature, buffer composition, ionic strength, etc.), the same peptide sequence can result in a variety of those responses. Therefore, the SMART model has been introduced to cover the full range of possibilities. With such a view in mind, novel antimicrobial compounds have been designed from amphipathic polymers, peptide mimetics, combinations of ultra-short polypeptides with hydrophobic anchors or small designer molecules.


Combined serous microcystic adenoma and well-differentiated endocrine pancreatic neoplasm: a case report and review of the literature.
We report a case of combined microcystic adenoma and pancreatic endocrine neoplasm of the pancreas in a 53-year-old male patient. The pancreatic tumor was an incidental computed tomography scan finding and was not accompanied by gastrointestinal symptoms. The tumor was located in the head of the pancreas and was composed of numerous small cysts lined by uniform clear cells with a centrally located solid endocrine component. Four cases of similar neoplasm have recently been reported, exclusively in women. Literature review and case analysis indicate that combined microcystic adenoma and pancreatic endocrine neoplasm is characterized by the presence of pancreatic endocrine neoplasm within microcystic adenoma in the head of the pancreas, affects women more often than men, and presents at a younger age when compared to microcystic adenoma.


Gas-phase ion thermochemistry in organometallic systems.
This review represents a general overview on the determination of bond energies in gas-phase organometallic systems. The paper focuses on articles published in the last 7 years, whose main scope was to experimentally measure metal ion-ligand binding energies. Therefore, studies of reactivity and characterization of ion complexes are not included, even if some of them display bond energies among the data measured. Bond energies are presented according to the metal ion complexed, in increasing order of atomic number. Periodic trends of binding energies and correlations among the various ligand are discussed. A brief summary of the most used techniques specifically devoted to gather bond energies is also provided.


Once-weekly alendronate 70 mg and raloxifene 60 mg daily in the treatment of postmenopausal osteoporosis.
To compare the efficacy and tolerability of once-weekly (OW) alendronate (ALN) 70 mg and raloxifene (RLX) 60 mg daily in the treatment of postmenopausal osteoporosis. This 12-month, randomized, double-blind study enrolled 456 postmenopausal women with osteoporosis (223 ALN, 233 RLX) at 52 sites in the United States. Efficacy measurements included lumbar spine (LS), total hip, and trochanter bone mineral density (BMD) at 6 and 12 months, biochemical markers of bone turnover, and percent of women who maintained or gained BMD in response to treatment. The primary endpoint was percent change from baseline in LS BMD at 12 months. Adverse experiences were recorded to assess treatment safety and tolerability. Over 12 months, OW ALN produced a significantly greater increase in LS BMD (4.4%, P < 0.001) than RLX (1.9%). The percentage of women with > or = 0% increase in LS BMD (ALN, 94%; RLX, 75%; P < 0.001) and > or =3% increase in LS BMD (ALN, 66%; RLX, 38%; P < 0.001) were significantly greater with ALN than RLX. Total hip and trochanter BMD increases were also significantly greater (P < or =0.001) with ALN. Greater (P < 0.001) reductions in N-telopeptide of type I collagen and bone-specific alkaline phosphatase were achieved with ALN compared with RLX at 6 and 12 months. No significant differences in the incidence of upper gastrointestinal or vasomotor adverse experiences were seen. ALN 70 mg OW produced significantly greater increases in spine and hip BMD and greater reductions in markers of bone turnover than RLX over 12 months. A greater percentage of women maintained or gained BMD on ALN than RLX. Both medications had similar safety and tolerability profiles.


Outcomes of biliopancreatic EUS in patients with surgically altered upper gastrointestinal anatomy: a multicenter study.
Background and study aims Little is known about outcomes of biliopancreatic endosonography (EUS) in patients with surgically altered upper gastrointestinal (gastrointestinal) anatomy. We aimed to assess the rate of procedural success and EUS-related adverse events (AEs), according to post-surgical anatomies. Patients and methods Retrospective study including patients with post-surgical altered upper gastrointestinal anatomy who underwent EUS for evaluation of the biliopancreatic region between January 2008 and June 2018 at eight European centers. Results Of 242 patients (162 males, mean age 66.4 ± 12.5), 86 had (35.5 %) Billroth II, 77 (31.8 %) pancreaticoduodenectomy, 23 (9.5 %) Billroth I, 19 (7.9 %) distal esophagectomy, 15 (6.2 %) total gastrectomy, 14 (5.8 %) sleeve gastrectomy, and eight (3.3 %) Roux-en-Y. Sleeve gastrectomy, Billroth I, and pancreaticoduodenectomy were associated with high rates of success (100 %, 95.7 %, and 92.2 %, respectively). Visualization of the head of the pancreas was significantly impacted by total gastrectomy, Billroth II, and Roux-en-Y (success rates 6.7 %, 53.7 %, and 57.1 %, respectively). Examination of the pancreatic body and tail was impaired in esophagectomy and total gastrectomy (82.4 % and 71.4 %, respectively). Technical success and diagnostic accuracy of EUS-guided tissue acquisition (EUS-TA) was 78.2 % and 71.3 % (95 % CI, 60.6-80.5), respectively. Four (1.6 %) AEs were observed: one mucosal tearing in a Billroth II patient, one cardiac arrest in a distal esophagectomy patient, one bleed after EUS-TA in a Billroth I patient, and one acute pancreatitis after EUS-TA in a sleeve gastrectomy patient. Conclusions The yield of bilio-pancreatic EUS is dependent on lesion location and surgery type. Before considering EUS in these patients, one must carefully consider whether the lesion may be approachable by EUS.


Actin turnover-dependent fast dissociation of capping protein in the dendritic nucleation actin network: evidence of frequent filament severing.
Actin forms the dendritic nucleation network and undergoes rapid polymerization-depolymerization cycles in lamellipodia. To elucidate the mechanism of actin disassembly, we characterized molecular kinetics of the major filament end-binding proteins Arp2/3 complex and capping protein (CP) using single-molecule speckle microscopy. We have determined the dissociation rates of Arp2/3 and CP as 0.048 and 0.58 s(-1), respectively, in lamellipodia of live XTC fibroblasts. This CP dissociation rate is three orders of magnitude faster than in vitro. CP dissociates slower from actin stress fibers than from the lamellipodial actin network, suggesting that CP dissociation correlates with actin filament dynamics. We found that jasplakinolide, an actin depolymerization inhibitor, rapidly blocked the fast CP dissociation in cells. Consistently, the coexpression of LIM kinase prolonged CP speckle lifetime in lamellipodia. These results suggest that cofilin-mediated actin disassembly triggers CP dissociation from actin filaments. We predict that filament severing and end-to-end annealing might take place fairly frequently in the dendritic nucleation actin arrays.


The peculiar extra-acrosomal structure of the Collembola (Hexapoda) spermatozoa.
The springtail Collembola are characterized by having rolled spermatozoa, with a long cylindrical extracellular structure adhering to the acrosome. This structure is produced by the secretory activity of the testes epithelial cells at almost the end of spermiogenesis. At the beginning of its formation, it is a thin extension with a helical wall and a dense axial region. Later the cylindrical structure shows an inner organization which is different in the several species examined: species of Entomobryidae contain material with a paracrystalline structure, whilst some of Symphypleona contain ovoid structures. The outer envelope of the extracellular structure consists of two overlapped layers orthogonally arranged, clearly identified by cryo-preparations. Immunoblot analysis and lectin stainings have indicated that the cylindrical structure has a glycoproteic composition. As the structure is no longer visible after the sperm transfer into the female spermatheca, it is suggested that it could contain enzymes able to activate the sperm unwinding process and possibly allowing the reacquisition of sperm motility.


The m-BACOD combination chemotherapy regimen in large-cell lymphoma: analysis of the completed trial and comparison with the M-BACOD regimen.
One hundred thirty-four assessable patients with stage II-IV large-cell lymphoma (LCL) were treated with the combination chemotherapy regimen methotrexate with leucovorin, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone (m-BACOD) between July 1981 and May 1986. The m-BACOD regimen substituted moderate-dose methotrexate (200 mg/m2 x 2) for the high-dose methotrexate used in the preceding M-BACOD regimen; all other drugs were administered as with m-BACOD. Eighty-two patients (61%) in the completed m-BACOD trial achieved a complete response (CR). With a median follow-up of 3.6 years, 62 patients (76%) continue in CR. Predicted survivals of 1, 3, and 5 years for the entire m-BACOD group are 80%, 63%, and 60%, respectively, with a 5-year disease-free survival (DFS) of 74% for the patients who achieve CR. The results obtained with m-BACOD are comparable with those obtained in the preceding M-BACOD trial, which now has a median follow-up of 8.0 years. The reduction in methotrexate dosage in m-BACOD patients was not associated with an increased incidence of CNS relapse. Long-term follow-up of the 215 M/m-BACOD patients indicates that the regimens are not associated with an increased incidence of secondary malignancy. Prolonged follow-up also indicates that advanced-stage patients have a persistent rate of late relapse of about 7.0% per year for years 2 to 5 of their follow-up and that stage II patients have an approximate 2.1% per year rate of late relapse. Application of the previously described prognostic factor model to the 215 M/m-BACOD patients from the completed trials identifies a high-risk group of patients with a CR rate and predicted 5-year survival (38% and 24%, respectively) that are significantly worse than those of the group as a whole (65% and 57%, respectively).


Characterization of Temperature and Humidity Dependence in Soft Elastomer Behavior.
Soft robots are predicted to operate well in unstructured environments due to their resilience to impacts, embodied intelligence, and potential ability to adapt to uncertain circumstances. Soft robots are of further interest for space and extraterrestrial missions, owing to their lightweight and compressible construction. Most soft robots in the literature to-date are made of elastomer bodies. However, limited data are available on the material characteristics of commonly used elastomers in extreme environments. In this study, we characterize four commonly used elastomers in the soft robotics literature-EcoFlex 00-30, Dragon Skin 10, Smooth-Sil 950, and Sylgard 184-in a temperature range of -40°C to 80°C and humidity range of 5-95% RH. We perform pull-to-failure, stiffness, and stress-relaxation tests. Furthermore, we perform a case study on soft elastomers used in stretchable capacitive sensors to evaluate the implications of the constituent material behavior on component performance. We find that all elastomers show temperature-dependent behavior, with typical stiffening of the material and a lower strain at failure with increasing temperature. The stress-relaxation response to temperature depends on the type of elastomer. Limited material effects are observed in response to different humidity conditions. The mechanical properties of the capacitive sensors are only dependent on temperature, but the measured capacitance shows changes related to both humidity and temperature changes, indicating that component-specific properties need to be considered in tandem with the mechanical design. This study provides essential insights into elastomer behavior for the design and successful operation of soft robots in varied environmental conditions.


Effect of postoperative use of nasal oxygen catheter supplementation in wound healing following total knee arthroplasty.
Healing is an event that is fundamental to the success of total knee arthroplasty. The aims of the present study were to compare the rates of complications related to wound healing between two groups of volunteers submitted to total knee arthroplasty and to evaluate the effects of postoperative oxygen supplementation by means of a nasal catheter. A total of 109 patients who underwent total knee arthroplasty were randomized into two groups, namely, groups that did and did not receive postoperative oxygen supplementation via a nasal catheter. The surgical wound was monitored every day during the hospital stay and on the 7th, 14th, 21st, 30th and 42nd postoperative days. Characteristics related to healing were observed, including hyperemia, dehiscence, necrosis, phlyctenules and deep and superficial infection. There were no cases of deep infection. Hyperemia was statistically correlated with the total number of complications in the groups, with oxygen demonstrated to be a protective factor against hyperemia. Approximately 30% of the patients who exhibited hyperemia had other complications, independent of oxygen supplementation. Oxygen supplementation following total knee arthroplasty was shown to be effective in diminishing hyperemia around the operative wound. The development of hyperemia was a precursor to other complications, irrespective of whether oxygen supplementation was used.


Fibroblast growth factors (FGFs) in cancer: FGF traps as a new therapeutic approach.
Originally characterized as angiogenic factors, fibroblast growth factors (FGFs) are pleiotropic factors that exert autocrine and paracrine functions on tumor and stromal cells. Thus, they may represent key players in the complex crosstalk among angiogenesis, inflammation, tumor growth, and drug resistance, all contributing to tumor progression. Given the multiple activities of FGFs, inhibitors of the FGF/FGFR system may act as "two compartment" targeting drugs able to exert a deep impact on the growth of FGF/FGFR-driven tumors. To date, the discovery of drugs targeting the FGF/FGFR system has focused mainly on the development of selective and non-selective tyrosine kinase FGFR inhibitors. Recently, a different approach has been emerging, aimed at the development of extracellular "FGF ligand traps" able to bind and sequester FGFs, thus preventing their interaction with cognate signaling receptors. This approach is based on the identification of natural FGF ligands followed by the development of small molecule mimetics endowed with a significant FGF binding/neutralizing capacity. Aim of this review is to provide an overview of the role of the FGF/FGFR system in cancer and a comprehensive analysis of the process, based on the study of the FGF interactome, which has led to the identification and characterization of FGF ligand traps. This approach has allowed the development of promising FGF-targeting molecules with potential implications for the therapy of FGF-driven tumors.


[Inhibition of oxidation of human blood low density lipoproteins by carotenoids from paprika].
beta-Carotene (C1), acyl derivatives of capsanthin (C2), and acyl derivatives of capsorubin (C3) were isolated from red paprika (Capsicum annuum) oleoresin. Incorporation of carotenoids C1, C2, and C3 into human plasma LDLs changed the LDL flotation coefficient distribution for LDL fraction 1.019 < d < 1.050 g/ml. The comparative studies of Cu(2+)-catalyzed oxidation for LDL, LDL-C1, LDL-C2, and LDL-C3 revealed that carotenoids C1, C2, and C3 efficiently suppressed the oxidation of LDL, inhibited the formation of conjugated dienes from polyunsaturated fatty acid residues, lowered the content of small dense LDL subfraction, and inhibited the transformation of cholesterol to auto oxidized products (in particular to 5,6-epoxycholesterol, 7-ketocholesterol and 7 beta-hydroxycholesterol). This suggests that the main carotenoids may effectively inhibit LDL oxidation in vitro with probable lowering the "atherogenic" LDL subfraction production in vivo.


Hepatobiliary scintigraphy to evaluate liver function in associating liver partition and portal vein ligation for staged hepatectomy: Liver volume overestimates liver function.
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) induces a rapid and extensive increase in liver volume. The functional quality of this hypertrophic response has been called into question because ALPPS is associated with a substantial incidence of liver failure and high perioperative mortality. This multicenter study aimed to evaluate functional liver regeneration in contrast to volumetric liver regeneration in ALPPS, using technetium-99m hepatobiliary scintigraphy and computed tomography volumetry, respectively. Patients who underwent ALPPS and hepatobiliary scintigraphy in 6 centers were included. Hepatobiliary scintigraphy data were analyzed centrally at the Academic Medical Center in Amsterdam according to established protocols. Increase in liver function as measured by hepatobiliary scintigraphy after stage 1 of ALPPS was compared with the increase in liver volume. In addition, we analyzed the impact of liver function and volume on postoperative outcomes including liver failure, morbidity, and mortality. In 60 patients, future liver remnant volume increased by a median 78% (interquartile range 48-110) during a median 8 (interquartile range 6-14) days after stage 1, while function as measured by hepatobiliary scintigraphy increased by a median 29% (interquartile range 1-55) throughout 7 days (interquartile range 6-10) in the 27 patients with paired measurements. After stage 2 of ALPPS, liver failure occurred in 5/60 (8%) patients, severe complications in 24/60 (40%), and mortality occurred in 4/60 (7%). In ALPPS, volumetry overestimates liver function as measured by hepatobiliary scintigraphy and may be responsible for the high rate of liver failure. Quantitative liver function tests are highly recommended to avoid post hepatectomy liver failure.


[Safety engineered devices prevent needle stick injuries].
Needle stick injuries are common among health-care personnel. There is a potential risk of transmitted infection, which is why directives and guidelines have formulated advices and law suggestions to prevent the accidents. Among these advices is implementation of safety engineered devices that have been suggested to reduce the risk significantly, which is proved by several clinical trials. The health-care workers' influence on choosing the instrument type is important, as is training in the use of the instruments and information about the risk procedures.


Different susceptibility of elastase inhibitors to inactivation by proteinases from Staphylococcus aureus and Pseudomonas aeruginosa.
Neutrophil elastase is thought to contribute to the lung pathology in patients with cystic fibrosis (CF). Therefore, intrapulmonary application of elastase inhibitors might be beneficial for these patients. Inactivation of such inhibitors by bacterial proteinases, however, is an important consideration in this therapy. We studied the effects of Staphylococcus aureus proteinase (STAP) and Pseudomonas aeruginosa elastase (PsE) on native (alpha 1-AT) and recombinant (rAAT) alpha 1-antitrypsin, recombinant secretory leukocyte proteinase inhibitor (rSLPI) and the leech inhibitor eglin C. All inhibitors were inactivated by these bacterial proteinases showing pronounced differences in their susceptibilities to proteolytic cleavage. Comparing the turnover rate (mol of inhibitor inactivated by one mol bacterial proteinase/min), rAAT and alpha 1-AT were approximately 20,000-fold more susceptible to STAP than rSLPI and 50,000-fold more susceptible than eglin C. Pseudomonas aeruginosa elastase inactivated all inhibitors more rapidly than STAP. rAAT and alpha 1-AT were 13-fold and 17,000-fold more susceptible than rSLPI and eglin C, respectively. Incubation of the rAAT-elastase complex with equimolar amounts of STAP did not result in release of elastase activity. Upon simultaneous addition of STAP and leukocyte elastase to rAAT, there was undisturbed elastase inhibition indicating that complex formation with elastase proceeded at a faster rate than inactivation of rAAT by the bacterial proteinase. From these results of inactivation in vitro and considering the immunogenic potential of the inhibitors studied here, we conclude that rSLPI may be the appropriate choice for anti-elastase therapy in CF.


Odontomas and supernumerary teeth: is there a common origin?
The aim of the present work is to analyze all scientific evidence to verify whether similarities supporting a unified explanation for odontomas and supernumerary teeth exist. A literature search was first conducted for epidemiologic studies indexed by PubMed, to verify their worldwide incidence. The analysis of the literature data shows some interesting similarities between odontomas and supernumerary teeth concerning their topographic distribution and pathologic manifestations. There is also some indication of common genetic and immuno-histochemical factors. Although from a nosological point of view, odontomas and supernumeraries are classified as distinct entities, they seem to be the expression of the same pathologic process, either malformative or hamartomatous.


Opinion strength influences the spatial dynamics of opinion formation.
Opinions are rarely binary; they can be held with different degrees of conviction, and this expanded attitude spectrum can affect the influence one opinion has on others. Our goal is to understand how different aspects of influence lead to recognizable spatio-temporal patterns of opinions and their strengths. To do this, we introduce a stochastic spatial agent-based model of opinion dynamics that includes a spectrum of opinion strengths and various possible rules for how the opinion strength of one individual affects the influence that this individual has on others. Through simulations, we find that even a small amount of amplification of opinion strength through interaction with like-minded neighbors can tip the scales in favor of polarization and deadlock.


Mid-Term Results of the SL-PLUS Femoral Prosthesis The Influence of Femoral Bone Type.
Cementless fixation of the femoral stem has been shown to be durable and predictable in total hip arthroplasty (THA), primarily as a result ofrecent improvements in prosthesis geometry and porous surface. Although patients with osteoporotic bone have been considered poor candidates for the use of a cementless femoral component, some recent studies have indicated satisfactory results. However, the indications and selection criteria of cementless stems based on the morphology of the femoral canal have not been established. We aimed to assess and compare the mid-term results of cementless THA with an SL-PLUS® femoral component in patients classified as Dorr types A, B, and C. We evaluated the clinical and radiographic results of primary THA with the cementless SL-PLUS® stem for 34 hips (25 patients). The preoperative femoral bones were classified as Dorr types A, B, and C in 12, 15, and 7 hips, respectively. Implant survival rates were calculated, hip function was evaluated using the Japanese Orthopaedic Association hip score, and radiographic signs were determined from anteroposterior radiographs. The mean follow-up period was 9.4 years (range: 7 to 13 years), and the mean Japanese Orthopaedic Association hip score improved from 43.8 points preoperatively to 85.3 points at the latest follow-up. The overall implant survival rate was 100% at 10 years; radiographic loosening or revision for any reason was used as the endpoint. Third and fourth degrees of stress shielding were observed in 29.4% of cases and were found to be significantly associated with a low cortical index, a Dorr type C femur, and a larger stem size. The use of the SL-PLUS® stem provided satisfactory mid-term clinical and radiographic results in patients with any type of femoral canal morphology.


Attraction modulated by spacing of pheromone components and anti-attractants in a bark beetle and a moth.
Orientation for insects in olfactory landscapes with high semiochemical diversity may be a challenging task. The partitioning of odor plumes into filaments that are interspersed with pockets of 'clean air' may help filament discrimination and upwind flight to attractive sources in the face of inhibitory signals. We studied the effect of distance between odor sources on trap catches of the beetle, Ips typographus, and the moth, Spodoptera littoralis. Insects were tested both to spatially separated pheromone components [cis-verbenol and 2-methyl-3-buten-2-ol for Ips; (Z,E)-9,11-tetradecadienyl acetate and (Z,E)-9,12-tetradecadienyl acetate for Spodoptera], and to separated pheromone and anti-attractant sources [non-host volatile (NHV) blend for Ips; (Z)-9-tetradecenyl acetate for Spodoptera]. Trap catch data were complemented with simulations of plume structure and plume overlap from two separated sources using a photo ionization detector and soap bubble generators. Trap catches of the beetle and the moth were both affected when odor sources in the respective traps were increasingly separated. However, this effect on trap catch occurred at smaller (roughly by an order of magnitude) odor source separation distances for the moth than for the beetle. This may reflect differences between the respective olfactory systems and central processing. For both species, the changes in trap catches in response to separation of pheromone components occurred at similar spacing distances as for separation of pheromone and anti-attractant sources. Overlap between two simulated plumes depended on distance between the two sources. In addition, the number of detected filaments and their concentration decreased with downwind distance. This implies that the response to separated odor sources in the two species might take place under different olfactory conditions. Deploying multiple sources of anti-attractant around a pheromone trap indicated long-distance (meter scale) effects of NHV on the beetle and a potential use for NHV in forest protection.


Excitation spectrum of a supersolid.
Conclusive experimental evidence of a supersolid phase in any known condensed matter system is presently lacking. On the other hand, a supersolid phase has been recently predicted for a system of spinless bosons in continuous space, interacting via a broad class of soft-core, repulsive potentials. Such an interaction can be engineered in assemblies of ultracold atoms, providing a well-defined pathway to the unambiguous observation of this fascinating phase of matter. In this Letter, we study by first principles computer simulations the elementary excitation spectrum of the supersolid, and show that it features two distinct modes, namely, a solidlike phonon and a softer collective excitation, related to broken translation and gauge symmetry, respectively.


Factors associated with birth preparedness and complication readiness among pregnant women attending government health facilities in the Bamenda Health District, Cameroon.
birth preparedness and complication readiness (BPCR) intervention should greatly have an impact on the reduction of maternal mortality if implemented properly at all levels. Responsibility for BPCR must be shared among all safe motherhood stakeholders-because a coordinated effort is needed to reduce the delays that contribute to maternal and newborn deaths. This study aimed to assess the factors associated with birth preparedness and complication readiness among pregnant women attending government health facilities in the Bamenda Health District. this was a cross-sectional analytic study. The study period was 30th October - 30th November, 2016. A total of 345 pregnant women of ≥ 32 weeks gestational age seen at the antenatal consultation (ANC) units were recruited. The dependent variable was birth preparedness and complication readiness while the independent variables were the socio-demographic and reproductive health characteristics. Frequency distributions were used to determine the awareness and practice and logistic regression at 95% confidence interval (CI) and p<0.05 to identify the factors that favour birth preparedness and complication readiness. the most likely factors that favour birth preparedness and complication readiness were monthly income (Odds Ratio (OR) = 2.94, (1.39, 6.25), p = 0.005) and the number of antenatal care visits (OR = 2.16, (1.18, 3.90), p = 0.013). majority of the women in this study were not prepared for birth/complications. The factors most associated with birth preparedness and complication readiness were monthly income and number of antenatal care visits.


Malpractice arising from negligent psychotherapy: ethical, legal, and clinical implications of Osheroff v. Chestnut Lodge.
Traditionally, there have been few legal actions brought against psychotherapists that allege negligent psychotherapy and negligent treatment of psychiatric disorders. However, in the case of Osheroff v. Chestnut Lodge, a patient-physician (Dr. Osheroff) sued Chestnut Lodge, a private psychiatric facility, for negligence based on the staff's decision to apply a psychodynamic model of treatment (through psychotherapy) and not a biological model. The case sparked a heated debate between adherents of the psychodynamic model and those of the biological model. This article explores the implications of the Osheroff litigation for mental health professionals. It is proposed that an interactive informed consent process be used to protect psychotherapists against Osheroff-type litigation.


Glucose Response during the Night Is Suppressed by Wheat Albumin in Healthy Participants: A Randomized Controlled Trial.
Postprandial blood glucose excursions are important for achieving optimal glycemic control. In normal-weight individuals, glucose tolerance is diminished in the evening compared to glucose tolerance in the morning. Wheat albumin (WA) has the potential to suppress the postprandial glucose response with a relatively small dose, compared to the dose required when using dietary fiber. In the present study, the effect of WA on glycemic control during the night was investigated after a late evening meal. A randomly assigned crossover trial involving a single oral ingestion in healthy male participants was performed in a double-blind placebo-controlled manner. The participants ingested the placebo (PL) tablets or the WA (1.5 g)-containing tablets 3 min before an evening meal at 22:00 hour, and blood samples were drawn during the night until 07:00 hour using an intravenous cannula. The participants slept from 00:30 hour to 06:30 hour. Glucose response, as a primary outcome during the night, was suppressed significantly by the WA treatment compared to the PL treatment, but the insulin response was not. Plasma glucose-dependent insulinotropic polypeptide concentration during the night was lowered significantly by the WA treatment compared to the PL treatment. In conclusion, WA may be a useful food constituent for glycemic control during the night.


High Salt Intake Is Associated with Atrophic Gastritis with Intestinal Metaplasia.
Background: Although several studies have investigated excessive salt intake as a risk factor for gastric precancerous lesions, such as atrophic gastritis and intestinal metaplasia, the evidence is insufficient to make a conclusion. We evaluated the association between gastric precancerous lesions and salt intake.Methods: From 2008 to 2015, the medical records of 728 subjects who underwent upper gastrointestinal endoscopy and sodium excretion in 24-hour urine tests were retrospectively reviewed. Sixty-six subjects were excluded due to diuretics use (n = 55), diagnosis with a gastric neoplasm (n = 4), or the cases of intestinal metaplasia in the absence of atrophy (n = 7), so 662 subjects were included. Atrophic gastritis and intestinal metaplasia were diagnosed by endoscopic findings. The subjects were grouped into three levels by tertiles of 24-hour urine sodium excretion.Results: A total of 192 (29.0%) had atrophic gastritis without intestinal metaplasia and 112 (16.9%) had atrophic gastritis with intestinal metaplasia. A total of 276 subjects (61.5%) were infected with Helicobacter pylori (H. pylori). In multivariate analyses, H. pylori infection [OR = 14.17; 95% confidence interval (CI), 7.12-28.22) was associated with atrophic gastritis without intestinal metaplasia. Highest levels of sodium excretion (OR = 2.870; 95% CI, 1.34-6.14), heavy smoking (≥20 pack-years) (OR = 2.75; 95% CI, 1.02-7.39), and H. pylori infection (OR = 3.96; 95% CI, 2.02-7.76) were associated with atrophic gastritis with intestinal metaplasia.Conclusions: Our endoscopy-based study suggested that high salt intake could be associated with an increased risk of atrophic gastritis with intestinal metaplasia.Impact: Low salt diet might be helpful to prevent gastric carcinogenesis. Cancer Epidemiol Biomarkers Prev; 26(7); 1133-8. ©2017 AACR.


Uncoupling the Vicious Cycle of Mechanical Stress and Inflammation in Calcific Aortic Valve Disease.
Calcific aortic valve disease (CAVD) is a common acquired valvulopathy, which carries a high burden of mortality. Chronic inflammation has been postulated as the predominant pathophysiological process underlying CAVD. So far, no effective medical therapies exist to halt the progression of CAVD. This review aims to outline the known pathways of inflammation and calcification in CAVD, focussing on the critical roles of mechanical stress and mechanosensing in the perpetuation of valvular inflammation. Following initiation of valvular inflammation, dysregulation of proinflammatory and osteoregulatory signalling pathways stimulates endothelial-mesenchymal transition of valvular endothelial cells (VECs) and differentiation of valvular interstitial cells (VICs) into active myofibroblastic and osteoblastic phenotypes, which in turn mediate valvular extracellular matrix remodelling and calcification. Mechanosensitive signalling pathways convert mechanical forces experienced by valve leaflets and circulating cells into biochemical signals and may provide the positive feedback loop that promotes acceleration of disease progression in the advanced stages of CAVD. Mechanosensing is implicated in multiple aspects of CAVD pathophysiology. The mechanosensitive RhoA/ROCK and YAP/TAZ systems are implicated in aortic valve leaflet mineralisation in response to increased substrate stiffness. Exposure of aortic valve leaflets, endothelial cells and platelets to high shear stress results in increased expression of mediators of VIC differentiation. Upregulation of the Piezo1 mechanoreceptor has been demonstrated to promote inflammation in CAVD, which normalises following transcatheter valve replacement. Genetic variants and inhibition of Notch signalling accentuate VIC responses to altered mechanical stresses. The study of mechanosensing pathways has revealed promising insights into the mechanisms that perpetuate inflammation and calcification in CAVD. Mechanotransduction of altered mechanical stresses may provide the sought-after coupling link that drives a vicious cycle of chronic inflammation in CAVD. Mechanosensing pathways may yield promising targets for therapeutic interventions and prognostic biomarkers with the potential to improve the management of CAVD.


[Echinococcosis: the threat of the urban fox].
The incidence of alveolar echinococcosis in Switzerland is on the rise, probably due to the proliferation of foxes observed between 1980 and 1995 in both urban and rural areas. This is nevertheless a rare disease as humans are not a natural host for the parasite. Hepatic tumor-like lesions discovered during a workup for jaundice or abdominal pain is the most frequent mode of presentation. In the presence of typical radiological features (echography, CT-Scan, MRI), diagnostic confirmation can be made by serology. If diagnosis remains doubtful, a biopsy of the lesion with histopathological examination and PCR is indicated. Curative radical surgery is possible in only 25 to 35% of cases. In non-operable cases, long standing antiparasitic therapy allows to stop the progression of lesions.


[Fractures of the orbito-zygomatico-malar complex].
Reference is made to the increasing number and severity of orbito-zygomatico-malar fractures brought about by the greater number of vehicles on the orads and their higher speeds. Fracture lines in such cases very considerably. An account is given of the therapeutical approaches usually followed at the Parma University Odontostomatological Clinic, based on experience acquired in 275 cases.


Food as a social determinant of mental health among household heads in the Upper West Region of Ghana.
According to the World Health Organization, mental distress and related illnesses are becoming leading causes of morbidity and mortality in developing countries. Despite the influence of food insecurity on mental health, empirical understanding of this relationship in sub-Saharan Africa, where incidence of food insecurity is relatively high, is almost non-existent. This study contributes to the literature by examining the association between food insecurity and mental health in the Upper West Region of Ghana. We used Ordinary Least Square (OLS) to analyze cross-sectional data collected on household heads (n = 1438) in 2014 using the Household Food Insecurity Access Scale and the DUKE Health Profile. The results show that heads of severely food insecure (β = 0.934, p ≤ 0.001) and moderately food secure households (β = 0.759, p ≤ 0.001) were more likely to report elevated mental distress compared to those from food secure households. We also found that female household heads were more likely to report elevated mental distress (β = 0.164, p ≤ 0.05) compared to their male counterparts. Our findings suggest the need to improve food security as a strategy targeted at improving overall mental health in the Ghanaian context.


Time series extrinsic regression: Predicting numeric values from time series data.
This paper studies time series extrinsic regression (TSER): a regression task of which the aim is to learn the relationship between a time series and a continuous scalar variable; a task closely related to time series classification (TSC), which aims to learn the relationship between a time series and a categorical class label. This task generalizes time series forecasting, relaxing the requirement that the value predicted be a future value of the input series or primarily depend on more recent values. In this paper, we motivate and study this task, and benchmark existing solutions and adaptations of TSC algorithms on a novel archive of 19 TSER datasets which we have assembled. Our results show that the state-of-the-art TSC algorithm Rocket, when adapted for regression, achieves the highest overall accuracy compared to adaptations of other TSC algorithms and state-of-the-art machine learning (ML) algorithms such as XGBoost, Random Forest and Support Vector Regression. More importantly, we show that much research is needed in this field to improve the accuracy of ML models. We also find evidence that further research has excellent prospects of improving upon these straightforward baselines.


Prostaglandin E2 regulates renal function in C57/BL6 mouse with 5/6 nephrectomy.
To investigate the roles of cyclooxygenases (COX) and their metabolites in C57/BL6 mice with 5/6 nephrectomy, an animal model of chronic renal failure. C57/BL6 mice were grouped into sham-operated (2K), one kidney removal (1K) and 5/6 nephrectomy groups (5/6Nx). Renal resistive index was measured by ultrasonography. Blood, aortae, renal arteries and renal cortex were collected for measurement of kidney function, assessment of vascular responsiveness, Western blotting, immuohistochemistry and enzyme-linked immunosorbent assays. After four weeks, acetylcholine-induced relaxations were blunted in renal arteries of 1K and 5/6Nx mice; indomethacin, a non-selective COX inhibitor, improved the response in 5/6Nx, but not in 1K renal arteries. In 5/6Nx renal arteries, but not in 1K preparations, the protein presence of endothelial nitric oxide synthase (eNOS) was decreased, while that of COX-2 and its products [prostacyclin and thromboxane A2] were increased. The renal resistive index was lower in 5/6Nx mice, suggesting a lower resistance in the renal microvasculature. In the renal cortex of 5/6Nx mice, eNOS protein presence was increased; while the presence of COX-2 was not detectable. The prostaglandin E2 level was lower in the 5/6Nx cortex than in the other two groups. The early stage of renal mass removal is associated with increased renal arterial constriction and reduced microvascular resistance. The former is due to downregulation of eNOS and upregulation of COX-2, leading to an increased production of prostacyclin and thromboxane A2. A reduced production of PGE2 in the renal cortex is important for maintaining normal renal function.


A public school-based referral system for psychiatric mental health nursing experiences.
Numerous advantages are anticipated with the implementation of the school-based referral system as a method of providing outpatient clinical experiences for a group of Psychiatric/Mental Health Nursing students. The school setting, when used as a clinical site, can provide valuable learning experiences where the student can apply the nursing process with individuals, families and groups. This multi-dimensional involvement reinforces family systems theory as well as group concepts. The nature of the students' experiences through the school-based referral system gives them the opportunity to increase their knowledge and understanding of the three levels of prevention: primary, secondary, and tertiary. The referrals generally constitute secondary intervention, with early recognition/intervention being the focus. Students are also encouraged to assess for factors that would place a child at risk for the development of other problems. With the identification of such factors, primary intervention strategies can be structured and implemented to reduce the child's risk. In some cases, students are involved in tertiary prevention, with a rehabilitative approach employed to assist individuals/families cope with a long-term problem situation. This expanded clinical experience facilitates the application of leadership concepts and reinforces the collaborative role of the nurse in the multidisciplinary provision of client services. Since the Psychiatric/Mental Health component of the curriculum is in the senior year, involvement in such a clinical experience also provides the students with a positive stimulus for the assumption of their professional roles and an opportunity to synthesize all previous learning.


[Predictors of Heart Failure With Preserved Ejection Fraction in Patients With Metabolic Syndrome and Preclinical Diastolic Dysfunction].
to evaluate differences in echocardiographic parameters between patients with preclinical diastolic dysfunction (PDD) and heart failure with preserved ejection fraction (HFpEF) and to identify predictors of transition from PDD to HFpEF. Echocardiographic parameters were recorded in 325 patients with PDD and 50 healthy subjects. PDD and HFpEF were diagnosed by tissue Doppler imaging of the left ventricle (LV) during exercise stress test and detection of symptoms of heart failure. There were significant differences between both groups of patients and control group as well as between groups of patients with PDD and HFpEF in LV mass index, maximal left atrial (LA) volume index, systolic blood pressure, LV and LA parameters of longitudinal strain and strain rate. Patients with PDD and subsequent development of HFpEF had high values of LA stiffness and interatrial mechanical dyssynchrony. These parameters were independent predictors of HFpEF development in patients with PDD. Predictors of HFpEF identified in this study provide an opportunity for early detection of patients with PDD with high risk of HFpEF development.


Recent Advances in Antiretroviral Agents: Potent Integrase Inhibitors.
Integrase strand transfer inhibitors (INSTIs) belong to a novel class of antiretroviral agents that have emerged as the new first-line treatments. Three such compounds are currently available, raltegravir, elvitegravir, dolutegravir and two more under development, bictegravir and cabotegravir. These compounds share the same mode of action but exhibit different pharmacokinetic/ pharmacodynamic properties, and drug-drug interactions. A series of studies in the past decade have established their efficacy compared to previous regimens, both in treatment- naïve and experienced patients. INSTIs have demonstrated a favorable safety profile with fewer adverse events and low rates of virological failure. Emergence of resistance to these agents, however, is a worrying concern, particularly for elvitegravir and raltegravir that display a lower genetic barrier than dolutegravir. On-going trials aim at establishing INSTIs as part of dual-drug HIV treatments or even monotherapy. New long-acting, injectable formulations are under investigation for treatment or prevention.


[Chemotherapy for the patients with esophageal cancer].
The combination of cisplatin and continuous-infusion 5-fluorouracil is the standard regimen for the treatment of both squamous cell carcinoma and adenocarcinoma. Paclitaxel has shown favorable results as a single agent or in combination with cisplatin. The efficacy of neoadjuvant chemotherapy in terms of survival benefit remains controversial despite large-scale, randomized, controlled trials comparing it with surgery alone. The disease-free survival benefit of postoperative adjuvant chemotherapy was recognized in a Japan Clinical Oncology Group randomized controlled trial in comparison with surgery alone.


Diffusion and thermal diffusion of semidilute to concentrated solutions of polystyrene in toluene in the vicinity of the glass transition.
The approaching glass transition in polystyrene/toluene solutions leads to a sharp decay of both the collective diffusion coefficient D and the thermal diffusion coefficient D(T) at concentrations above 0.2 g/cm(3). The Soret coefficient S(T) = D(T)/D follows power-law scaling from semidilute to concentrated and is not influenced by the slowing down of the dynamics associated with the glass transition. Both D and D(T) are governed by the same friction coefficient. The scaling behavior of S(T) with concentration on approach of the glass transition is compared to the divergence of S(T) near a consolute critical point.


Word Sense Disambiguation in biomedical ontologies with term co-occurrence analysis and document clustering.
With more and more genomes being sequenced, a lot of effort is devoted to their annotation with terms from controlled vocabularies such as the GeneOntology. Manual annotation based on relevant literature is tedious, but automation of this process is difficult. One particularly challenging problem is word sense disambiguation. Terms such as 'development' can refer to developmental biology or to the more general sense. Here, we present two approaches to address this problem by using term co-occurrences and document clustering. To evaluate our method we defined a corpus of 331 documents on development and developmental biology. Term co-occurrence analysis achieves an F-measure of 77%. Additionally, applying document clustering improves precision to 82%. We applied the same approach to disambiguate 'nucleus', 'transport', and 'spindle', and we achieved consistent results. Thus, our method is a viable approach towards the automation of literature-based genome annotation.


The role of attenuated redox and heat shock protein responses in the age-related decline in skeletal muscle mass and function.
The loss of muscle mass and weakness that accompanies ageing is a major contributor to physical frailty and loss of independence in older people. A failure of muscle to adapt to physiological stresses such as exercise is seen with ageing and disruption of redox regulated processes and stress responses are recognized to play important roles in theses deficits. The role of redox regulation in control of specific stress responses, including the generation of heat shock proteins (HSPs) by muscle appears to be particularly important and affected by ageing. Transgenic and knockout studies in experimental models in which redox and HSP responses were modified have demonstrated the importance of these processes in maintenance of muscle mass and function during ageing. New data also indicate the potential of these processes to interact with and influence ageing in other tissues. In particular the roles of redox signalling and HSPs in regulation of inflammatory pathways appears important in their impact on organismal ageing. This review will briefly indicate the importance of this area and demonstrate how an understanding of the manner in which redox and stress responses interact and how they may be controlled offers considerable promise as an approach to ameliorate the major functional consequences of ageing of skeletal muscle (and potentially other tissues) in man.


Effect of ketanserin on sodium nitroprusside requirements, arterial pressure control and heart rate following coronary artery bypass surgery.
In a double-blind, placebo controlled study ketanserin, a serotonin S2 antagonist, was administered to hypertensive patients who had undergone coronary artery bypass surgery. Patients were allocated randomly to receive placebo or ketanserin at an infusion rate of 0.05, 1 or 2 mg kg-1 h-1. Sodium nitroprusside was used as escape medication. Ketanserin reduced the nitroprusside requirements and improved the quality of arterial pressure control in all groups, and this was significant in the low- and high-dose groups. There was a significant decrease in heart rate in the low- and high-dose groups compared with placebo, and no effect in patients who received the medium dose of ketanserin. Ketanserin may be a useful treatment for hypertension following coronary artery surgery as it reduced arterial pressure without reflex tachycardia.


Ki67 Immunohistochemistry Quantification in Breast Carcinoma: A Comparison of Visual Estimation, Counting, and ImmunoRatio.
Molecular analysis has shown that breast carcinomas can be classified into several intrinsic subtypes, with implications for management and prognosis. In the majority of pathology laboratories molecular analysis of each case is not possible and immunohistochemistry is used for subtyping. This includes analysis of hormone receptors as well as HER2-neu and Ki67. The methodology for the interpretation of the proliferation index using Ki67 remains an area of uncertainty. We investigated the degree of agreement between different methods of Ki67 interpretation. We analyzed 204 breast core biopsies diagnostic of breast carcinoma using visual estimation/eyeballing (EB), ImmunoRatio, and counting by 2 pathologists (CP1 and CP2). The correlation between the different methods and the interobserver agreement between the 2 pathologists was assessed. Specific analysis was also done with respect to classification of cases into low Ki67 groups (using Ki67 values<14% and <20%) since this is critical in classifying tumors into luminal A and luminal B subtypes. Correlation between the different methods was best achieved comparing ImmunoRatio and CP1, and worst comparing CP1 and EB. Correlation was better when considering interobserver variability (CP1 vs. CP2). Comparing the number of cases classified as low Ki67 (<14% and <20%) the Cohen κ statistic varied from κ=0.267 to 0.814 with different methods. When limiting the analysis to cases with a Ki67 of 10% to 25% according to any method, there was greater disagreement. At the higher and lower Ki67 levels, the correlation between the methods of assessment was acceptable, however, at levels close to the cut-off values for lumial A versus luminal B, several patients would be differently classified by the different methods and therefore potentially receive suboptimal management.


Case report: mitochondrial diabetes mellitus in a Chinese family due to m.3243A>G.
Mitochondrial diabetes mellitus is caused by dysfunctional mitochondria and is often misdiagnosed because of its various clinical manifestations. It's even rarer in children, and without a clear family history of diabetes with hearing loss, it's often difficult to diagnose. This is a case study of a family with maternally inherited diabetes mellitus and deafness (MIDD). The proband was an adolescent girl with diabetes with a family history of type 2 diabetes (T2DM) for three generations. Family members have undetected hearing impaired. The proband could not be diagnosed with type 1 diabetes (T1DM) or T2DM. Therefore, whole exome and mitochondrial gene sequencing was performed, which identified an m.3243A>G mutation in the mitochondrial DNA. This suggests that we should be alert to the possibility of hereditary diabetes, especially mitochondrial diabetes in patients with atypical diabetes. A thorough physical examination is very important. What is new: (1) Mitochondrial diabetes in childhood may not be accompanied by deafness even with highly heteroplasmy levels. (2) In MIDD patients, sometimes hearing loss cannot be perceived, which requires us to conduct detailed physical examinations and related examinations. (3) The use of metformin in MIDD patients did not have adverse consequences.


Sensitization by heat treatment of Escherichia coli K-12 cells to hydrophobic antibacterial compounds.
The sensitivities of intact and heat-injured cells of Escherichia coli K-12 to several antibacterial compounds were measured by the prolongation of growth delay. Cells exposed to sublethal heat became more sensitive to various hydrophobic compounds, such as medium-chain fatty acids, alkyl esters of p-hydroxybenzoic acid, and some kinds of antibiotics or dyes, than unheated cells; but there was a smaller or no increase in sensitivity to short-chain fatty acids, chloramphenicol, and vancomycin. The destruction by heat of a permeability barrier of the outer membrane may have sensitized the cells to hydrophobic compounds. The sensitization was much lower for a strain defective in lipopolysaccharide, which is important as a barrier against hydrophobic compounds.


Propofol Ameliorates Exaggerated Human Neutrophil Activation in a LPS Sepsis Model.
Sepsis is a leading cause of morbidity and mortality worldwide. Many patients suffering from sepsis are treated on intensive care units and many of them require mechanical ventilation under sedation or general anesthesia. Propofol, a drug used for these purposes, is known to interact with polymorphonuclear granulocytes (PMNs). Therefore, the aim of this study was to investigate the influence of propofol on PMN functions after experimental Gram-negative induced sepsis using lipopolysaccharide (LPS) stimulation. A total of 34 granulocyte-enriched samples were collected from healthy subjects. PMNs were isolated by density gradient centrifugation and incubated simultaneously with either 6 µg/mL or 60 µg/mL propofol, or none (control). Additionally, the experimental sepsis samples were incubated with either 40 pg/mL or 400 pg/mL LPS. Live cell imaging was conducted in order to observe granulocyte chemotactic migration, ROS production, and NETosis. Flow cytometry was used to analyze viability and antigen expression. Propofol led to significantly reduced PMN track length (p < 0.001) and track speed (p < 0.014) after LPS-induced sepsis in a dose-dependent manner. NETosis (p = 0.018) and ROS production (p = 0.039) were accelerated by propofol without LPS incubation, indicating improved immune function. Propofol also ameliorated LPS-induced increased NETosis and ROS-production. Antigen expression for CD11b, CD62l and CD66b was unaffected by propofol. Propofol improves LPS-induced exaggerated PMN activation in an ex vivo model. Beneficial effects due to restored immune function in septic patients might be possible, but needs further investigation.


Human CD6 Down-Modulation following T-Cell Activation Compromises Lymphocyte Survival and Proliferative Responses.
Available evidence indicates that the CD6 lymphocyte surface receptor is involved in T-cell developmental and activation processes, by facilitating cell-to-cell adhesive contacts with antigen-presenting cells and likely modulating T-cell receptor (TCR) signaling. Here, we show that in vitro activation of human T cells under different TCR-ligation conditions leads to surface downregulation of CD6 expression. This phenomenon was (i) concomitant to increased levels of soluble CD6 (sCD6) in culture supernatants, (ii) partially reverted by protease inhibitors, (iii) not associated to CD6 mRNA down-regulation, and (iv) reversible by stimulus removal. CD6 down-modulation inversely correlated with the upregulation of CD25 in both FoxP3- (Tact) and FoxP3+ (Treg) T-cell subsets. Furthermore, ex vivo analysis of peripheral CD4+ and CD8+ T cells with activated (CD25+) or effector memory (effector memory T cell, CD45RA-CCR7-) phenotype present lower CD6 levels than their naïve or central memory (central memory T cell, CD45RA-CCR7+) counterparts. CD6lo/- T cells resulting from in vitro T-cell activation show higher apoptosis and lower proliferation levels than CD6hi T cells, supporting the relevance of CD6 in the induction of proper T-cell proliferative responses and resistance to apoptosis. Accordingly, CD6 transfectants also showed higher viability when exposed to TCR-independent apoptosis-inducing conditions in comparison with untransfected cells. Taken together, these results provide insight into the origin of sCD6 and the previously reported circulating CD6-negative T-cell subset in humans, as well as into the functional consequences of CD6 down-modulation on ongoing T-cell responses, which includes sensitization to apoptotic events and attenuation of T-cell proliferative responses.


Understanding colors in nature.
There are two ways in which white light is transformed into colored light by interaction with matter: absorption and scattering. Absorption transforms light into other forms of energy, whereas scattering redirects it. Reflection, refraction, and diffraction are not distinct from scattering but rather are manifestations of it. There is a hierarchy of theories for describing any color phenomenon. For example, many features of rainbows--but not all--can be described satisfactorily by geometrical optics. More accurate descriptions require more exact theories. What one observes when matter is illuminated depends on its disposition. A microscope slide scatters light mostly in two directions. When smashed to bits, it scatters in all directions. Yet its chemical composition has not changed. Glass particles, unlike those in smoke, are usually too large to give colors upon scattering. The colors one sees when smoke is illuminated depend on whether one observes light that has or has not been scattered. Moreover, particle size is crucial in determining what colors are observed. As with scattering, there is a hierarchy of theories of absorption. One can content oneself with an empirical description of absorption or seek a fuller understanding by appealing to microscopic theories. Yet it is sometimes difficult to associate a definite microscopic mechanism with a given absorption feature. Ice is intrinsically blue, yet this cannot be attributed readily to a specific mechanism. Beer has no yellow absorption feature; absorption by it is least in the red and rises steadily toward the blue. Over short paths, beer is yellow; over long paths, it is reddish. Selective scattering by molecules causes the blue of the sky.(ABSTRACT TRUNCATED AT 250 WORDS)


Idiopathic Chronic Pancreatitis Presenting as Hemorrhagic Ascites: A Case Report.
This report presents a perplexing case involving a 16-year-old adolescent presenting with persistent upper abdominal pain and distention. The patient had no history of substance abuse or animal-related encounters. Clinical examination revealed abdominal tension, distention, and localized tenderness. Laboratory analysis indicated elevated white blood cell count, mildly reduced hemoglobin and platelet levels, and notably heightened amylase and lipase levels. Serum albumin displayed a minor decrease. Despite repeated consultations and ultrasound evaluations, the underlying cause remained elusive. Advanced imaging unveiled substantial abdominopelvic ascites, a shrunken pancreas with an expanded main duct, and thickening at the ileocecal junction. Ascitic fluid analysis unveiled hemorrhagic fluid with elevated cell and neutrophil counts. Notably, the fluid accumulation extended into the omental apron covering the intestines. Biopsy results ruled out malignancy and chronic infections. We diagnosed him as a case of idiopathic chronic pancreatitis presenting as hemorrhagic ascites. This case underscores the intricacies of diagnosing complex abdominal disorders. A comprehensive approach, involving multidisciplinary collaboration, rigorous diagnostic assessments, and meticulous patient evaluation, is essential for elucidating such challenging clinical scenarios.


N-tert-Butyl-3-mesitylpropanamide.
In the title compound, C(16)H(25)NO, the N-tert-butyl-propanamide fragment is essentially planar, with the exception of two C atoms of the tert-butyl group (r.m.s. deviation = 0.005 Å), forming a dihedral angle of 84.09 (10)° with the plane of the mesityl fragment (r.m.s. deviation = 0.002 Å). The crystal packing is stabilized by an inter-molecular N-H⋯O hydrogen bond, which links the mol-ecules into chains with graph-set notation C(4) running parallel to the c axis.


Modulation of Ins(2,4,5)P3-stimulated Ca2+ mobilization by ins(1,3,4, 5)P4: enhancement by activated G-proteins, and evidence for the involvement of a GAP1 protein, a putative Ins(1,3,4,5)P4 receptor.
We have previously shown that addition of Ins(1,3,4,5)P4 to permeabilized L1210 cells increases the amount of Ca2+ mobilized by a submaximal concentration of Ins(2,4,5)P3, and we suggested that, in doing this, Ins(1,3,4,5)P4 is not working via an InsP3 receptor but indirectly via an InsP4 receptor [Loomis-Husselbee, Cullen, Dreikhausen, Irvine and Dawson (1996) Biochem. J. 314, 811-816]. Here we have investigated whether this effect might be mediated by GAP1(IP4BP), recently identified as a putative receptor for Ins(1,3, 4,5)P4. GAP1(IP4BP) is a protein that interacts with one or more monomeric G-proteins, so we sought evidence for involvement of monomeric G-proteins in the effects of Ins(1,3,4,5)P4 in permeabilized L1210 cells. Guanosine 5'-[gamma-thio]triphosphate (GTP[S]) enhanced the effect of Ins(1,3,4,5)P4 on Ins(2,4, 5)P3-stimulated Ca2+ mobilization, but had no effect on the action of Ins(2,4,5)P3 alone. A specific enhancement of only the action of Ins(1,3,4,5)P4 was also seen with GTP[S]-loaded R-Ras or Rap1a (two G-proteins known to interact with GAP1(IP4BP)), whereas H-Ras was inactive at similar concentrations. Guanosine 5'-[beta-thio]diphosphate (GDP[S]) did not alter the action of either Ins(2,4,5)P3 or Ins(1,3,4,5)P4. Finally, the addition of exogenous GAP1(IP4BP), purified from platelets, markedly enhanced the effect of Ins(1,3,4,5)P4, and again, the amount of Ca2+ mobilized by Ins(2,4,5)P3 alone was unaltered. We conclude that the increase in Ins(2,4,5)P3-stimulated Ca2+ mobilization by Ins(1,3,4, 5)P4 may be mediated by GAP1(IP4BP) or a closely related protein (such as GAP1(m)), and if so, the action of the GAP1 is not solely to regulate GTP loading of a G-protein, but rather it acts with a G-protein to cause its effect.


Conformationally organized lysine isosteres in Streptococcus pyogenes M protein mediate direct high-affinity binding to human plasminogen.
The binding of human plasminogen (hPg) to the surface of the human pathogen group A Streptococcus pyogenes (GAS) and subsequent hPg activation to the protease plasmin generate a proteolytic surface that GAS employs to circumvent host innate immunity. Direct high-affinity binding of hPg/plasmin to pattern D GAS is fully recapitulated by the hPg kringle 2 domain (K2hPg) and a short internal peptide region (a1a2) of a specific subtype of bacterial surface M protein, present in all GAS pattern D strains. To better understand the nature of this binding, critical to the virulence of many GAS skin-tropic strains, we used high-resolution NMR to define the interaction of recombinant K2hPg with recombinant a1a2 (VKK38) of the M protein from GAS isolate NS455. We found a 2:1 (m/m) binding stoichiometry of K2hPg/VKK38, with the lysine-binding sites of two K2hPg domains anchored to two regions of monomeric VKK38. The K2hPg/VKK38 binding altered the VKK38 secondary structure from a helical apo-peptide with a flexible center to an end-to-end K2hPg-bound α-helix. The K2hPg residues occupied opposite faces of this helix, an arrangement that minimized steric clashing of K2hPg We conclude that VKK38 provides two conformational lysine isosteres that each interact with the lysine-binding sites in K2hPg Further, the adoption of an α-helix by VKK38 upon binding to K2hPg sterically optimizes the side chains of VKK38 for maximal binding to K2hPg and minimizes steric overlap between the K2hPg domains. The mechanism for hPg/M protein binding uncovered here may facilitate targeting of GAS virulence factors for disease management.


Stability and structure of clathrin.
The effects of urea on the dissociation and structural transitions of clathrin (8 S) have been evaluated by various techniques. The dissociation of the light chains in 3 M urea has been shown by light scattering, ultracentrifugation, and column chromatography. The dissociated components still retain the capacity to form the characteristic polygonal structure of the coat after removal of the urea. At higher concentrations of urea, the secondary and tertiary structures are eliminated, as documented by various spectroscopic techniques, i.e., tryptophan polarization and emission maxima, circular dichroism, and difference spectra. Two distinct transitions are observed by all techniques, one between 3 and 6 M urea and a second one which starts at 7 M but is still incomplete by 9.6 M urea. A concentration-dependent aggregation of clathrin chains occurs in 4 and 5 M urea solutions, as observed by light scattering and sedimentation. The results indicate that there are two large, independent domains in clathrin heavy chains and that each domain may have a single, highly cooperative transition.


The intestinal mucosa as a reservoir of HIV-1 infection after successful HAART.
The presence of HIV-1 RNA in distal duodenal mucosa was evaluated in 44 HIV-1-positive patients. HIV-1 RNA was detected in gut tissue in antiretroviral-naive patients with high plasma viral loads, as well as in patients on HAART with plasma viral loads below the limit of detection and in patients on HAART with virological failure. The intestinal mucosa seems to serve as a reservoir poorly influenced by levels of plasma viral load or HAART.


Diagnosis, management, and pathogenesis of TTP/HUS in an HIV positive patient.
An atypical presentation of HUS/TTP in an HIV positive adult with a prodrome of bloody diarrhea and lack of neurological deficits makes atypical HUS the likely etiology. This case demonstrates the differing treatment modalities for HUS and TTP given the atypical presentation and a discussion of the pathogenesis.


Fabrication of magnetically separable mesostructured silica with an open pore system.
Magnetically separable mesostructured silica with an unobstructed pore system was fabricated through the deposition of cobalt nanoparticles on the outer surface of the submicron-sized silica particles. These cobalt nanoparticles were further protected by a nanometer-thick carbon shell against acid erosion. Due to the fact that the magnetic particles are grafted on the outer surface of the porous silica, the pores are still accessible for further modification, which could widen the application range of porous silica.


Cryptorchidism (Undescended Testicle).
Cryptorchidism refers to an undescended testicle, the most common genitourinary malformation in male children. It is diagnosed with history and physical examination findings, and primary care physicians play a key role in the early identification of the condition. Early surgical intervention reduces the risk of testicular cancer and preserves fertility. Patients should be referred for surgical intervention at six months of age or at the time of diagnosis if the child is older. After surgery, patients require lifelong surveillance and counseling regarding fertility implications and increased risk of testicular conditions. Patients with bilateral undescended testicles that are nonpalpable should undergo endocrinologic evaluation for sexual development disorders. Retractile testicles are a variant of cryptorchidism and should be monitored annually until puberty, when acquired ascent becomes unlikely due to greater testicular volume. Based on expert opinion, all patients with a history of cryptorchidism should undergo annual clinical examination and be taught self-examination techniques for early detection of testicular cancer.


Evaluation of the epistemic state of the speaker/author.
Language users are sensitive to their language's grammatical requirements, the plausibility of the situation described and the information shared by speaker and listener. We propose that they are also sensitive to whether an author is likely to be in a state of knowledge that actually supports the assertion being made. Failure to be in such a state reduces the naturalness of the assertion. Consistent with this proposal, sentences with a disjoined noun phrase are judged to be less natural than their conjunctive counterparts, presumably because the author of a disjunctive sentence must know that an event took place but not know which of the two individuals was the agent. This unlikely state of knowledge reduces the naturalness of the sentence. The results of three experiments indicate that providing evidence that the speaker could be in an unlikely epistemic state reduces the disjunction penalty; a fourth extends the demonstration of the penalty from coordinated noun phrases to coordinated verb phrases. We also present one experiment that explores the possibility that disjunction penalty is due to the unexpectedness of a disjunction. These findings demonstrate that language users evaluate linguistic input in light of the epistemic state of its author.


Cell suspension culture of Eriobotrya japonica regulates the diabetic and hyperlipidemic signs of high-fat-fed mice.
The present study investigates the anti-hyperlipidemic and antihyperglycemic effects and mechanism in high-fat (HF)-fed mice of cell suspension culture of Eriobotrya japonica (TA), which contains a great number of pentacyclic terpenoids. Firstly, C57BL/6J mice were randomly divided into two groups: the control (CON) group was fed with a low-fat diet (n = 9), whereas the experimental group was fed a 45% HF diet for 8 weeks. Afterwards, the CON group was treated with vehicle, whereas the HF group was subdivided into five groups and was orally given TA or rosiglitazone or not for 4 weeks. Blood and visceral adipose tissue, liver tissue and skeletal muscle were examined. Treatment with TA reduced body weight gain, weights of white adipose tissue (WAT) (including epididymal, perirenal, mesenteric WAT and visceral fat), and hepatic triacylglycerol content significantly without affecting food intake in diet-induced diabetic mice. TA effectively prevented HF diet-induced increases in the levels of blood glucose, insulin, leptin and HOMA-IR index (p < 0.001, p < 0.05, p < 0.05, p < 0.01, respectively) and attenuated insulin resistance. Treatment with TA, adipocytes in the visceral depots showed a reduction in size. TA effectively significantly increased the protein contents of phosphorylation of AMPK-α (Thr172) both in liver and adipose tissue. It is shown that TA exhibits hypolipidemic effect in HF-fed mice by decreasing gene expressions of fatty acid synthesis, including acyl-coenzyme A: diacylglycerol acyltransferase (DGAT) 2, which catalyzes the final step in the synthesis of triglycerides, and antidiabetic properties occurred as a result of decreased hepatic glucose production via phosphenolpyruvate carboxykinase (PEPCK) down- regulation, improved insulin sensitization and TA (at 1.0 g/kg dose) decreased expression of hepatic and adipose 11-β-hydroxysteroid dehydroxygenase (11β-HSD1) gene, which contributed in attenuating diabetic state. Futhermore, TA at doses of 0.5 and 1.0 g/kg had serum lipid-lowering action characterized by the inhibition of DGAT 1 expression. Thus, amelioration of diabetic and dyslipidemic state by TA in HF-fed mice occurred by regulation of PEPCK, DGAT2 and AMPK phosphorylation.


Pyopneumothorax Caused by Trichomonas tenax and Porphyromonas endodontalis Coinfection in a Patient with Previous Cerebral Infarction: A Case Report and Literature Review.
Even with the advent of NGS and PCR diagnostic tools, cases of chest infections caused by Trichomonas are still very rare. Such pathogens are less likely to be considered by clinicians. These cases frequently involve the pleura and lead to pneumothorax, hydropneumothorax, or pyopneumothorax, making the disease severe. A 69-year-old man diagnosed with cerebral infarction a year ago sought medical attention for right-sided pyopneumothorax and respiratory failure. The pathogen found in the pleural fluid was highly suspected to be Trichomonas tenax (T. tenax). Pleural fluid mNGS confirmed T. tenax and Porphyromonas endodontalis coinfection. Metronidazole combined with piperacillin tazobactam was administered to counteract infection. Simultaneously, closed chest drainage and thoracoscopic release of pleural adhesions were performed. The patient was cured, discharged from the hospital, and was in good condition after six months of follow-up. When chest infections occur in patients with poor oral hygiene and underlying diseases that may lead to aspiration, the identification of Trichomonas infection should be noted. Early confirmation of the diagnosis often requires mNGS and PCR. Metronidazole is essentially effective against Trichomonas, and medical thoracoscopy can be used to manage pleural conditions if necessary.


The control of Glossina morsitans morsitans (Diptera: Glossinidae) in a settled area in Petauke District (Eastern Province, Zambia) using odour-baited targets.
A trial to control G. m. morsitans with the use of 980 odour-baited, insecticide-impregnated targets was conducted in a 300 km2 area in the Eastern Province of Zambia between 1989 and 1991. The area is highly cultivated and cattle density is high (about 8 cattle/km2). Targets were deployed along roads and tracks. Deployment was restricted to suitable tsetse habitat. The effect of the targets on the tsetse population and on the transmission of tsetse-transmitted trypanosomosis was monitored by means of man-walked fly rounds and sentinel herds, respectively. The apparent density of tsetse in the trial area and in adjacent areas, declined rapidly after targets had been deployed. Trypanosomosis incidence in the trial area decreased significantly but did not completely disappear. Results from the trial show that odour-baited targets are effective in controlling Glossina m. morsitans in highly cultivated areas even when deployment is restricted to suitable tsetse habitat. It is concluded that tsetse control operations should be chosen such that either the invasion pressure is low from adjacent areas, or the size of the area is big enough, so that a central challenge-free area can be created.


First Report of Anthracnose Caused by Colletotrichum ciggaro on Lonicera macranthoides Hand.-Mazz. in China.
Lonicera macranthoides Hand.-Mazz. is a traditional medicinal plant that is cultivated in Hunan, Yunnan, and Guizhou Provinces in China. In June 2020, a new leaf spot disease was observed on this plant in Longhui County, Shaoyang City, Hunan Province, China, where 14,000 hm2 of L. macranthoides had been planted. About 20% of the total cultivated area exhibited symptoms. Brown spots appeared on the leaves during the early stage and gradually expanded into irregular lesions, which became necrotic and dry. The whole plant withered and died in severe cases. To isolate the pathogen, the infected leaves were collected from different fields and washed with flowing sterile water. The small lesions were then cut and surface sterilized with 75% alcohol for 45 s followed by a 3 min treatment in 3% sodium hypochlorite. The lesions were rinsed five times in sterile water, incubated on potato dextrose agar (PDA) plates and cultured for 3-5 d at 28℃. In total, eleven isolates were obtained, and eight of them were Colletotrichum (isolation frequency 73%). Three representative isolates (JYH1, JYH2, and JYH5) were selected for further study. The fungus grew as circular white colonies, which then became grey. The older colonies looked like cotton and had dense aerial hyphae. The conidia were aseptate, transparent, cylindric, and thin walled, which measured 11.54 to 22.64 × 3.55 to 4.75 μm (n=100). Six genetic regions were amplified and sequenced to further confirm the identity of fungus. They included β-tubulin (TUB2), the internal transcribed spacer (ITS), actin (ACT), chitin synthase (CHS), calmodulin (CAL) and glyceraldehyde 3-phosphate dehydrogenase (GAPDH). The sequences were submitted to GenBank (ITS: OQ746331; ON954583; OQ746334; TUB2: OQ772278; ON960155; OQ772279; CHS: OQ772280; ON960156; OQ772281; ACT: OQ772282; ON960157; OQ772283; CAL: OQ772284; ON960158; OQ772285; GAPDH: OQ772286; ON960159; OQ772287). The construction of a 6-gene joint phylogenetic tree analysis showed that the three isolates unambiguously clustered with Colletotrichum kahawae subsp. ciggaro strains C022-1 (GenBank: KJ001120.1, KJ001124.1, KJ001109.1, KJ001102.1, KJ001106.1, KJ001113.1) and R019 (GenBank: JN715847.1, KC860023.1, KC859980.1, KC859954.1, KC859972.1, KC859997.1), which was recently reclassified as C. cigarro (Cabral et al. 2020). Three representative isolates were used for the pathogenicity test on the young leaves of the whole plant. A sterile pin was used to prick the leaf epidermis, and 6 × 6 mm mycelial blocks that had been cultured on PDA for 7 d were placed on the leaf wounds. The controls were treated in the same manner except that sterile blocks of PDA were used. There were three replicates per treatment. All the plants used in the experiment were maintained at 28°C in a climate chamber. There was a 12 h photoperiod, and the chamber was kept at 80% relative humidity. Dark brown spots appeared at the sites of inoculation on the plants after 5 days. All the strains that were re-isolated from the lesions shared the same morphological characteristics and had the same type of colonies as the pathogen Colletotrichum ciggaro. Thus, Koch's postulates were fulfilled. C. ciggaro had been shown to cause anthracnose on Olea europaea L. (Weir et al. 2012), Mangifera indica L. (Ismail et al. 2015), Citrus reticulata L. (Perrone et al. 2016) and Areca catechu L. (Zhang et al. 2020). To our knowledge, this is the first report of C. ciggaro causing anthracnose on L. macranthoides in China and worldwide. This research provides a basis for further research to control epidemics of this disease.


Multiple Factors Including Infections and Antibiotics Affecting New-Onset Epilepsy in Hemodialysis Patients.
This study investigates some clinical characteristics of maintenance hemodialysis patients with new-onset epilepsy. Thirty-five patients with new-onset epilepsy who underwent maintenance hemodialysis were selected for study. Sixty patients undergoing routine hemodialysis were selected as the control group. We evaluated and compared the general characteristics, clinical features, and prognosis of patients in both groups. Investigation of the etiology of the 35 cases of new-onset epilepsy identified 17 cases of metabolic encephalopathy, six cases of viral encephalitis, five cases of cerebral infarction, five cases of cerebral hemorrhage, and two cases of purulent meningitis. Among the 35 patients, 19 experienced improvement in their condition and 16 patients died. The overall mortality rate was 45.71%. There were statistically significant differences between the epilepsy group and control group in gender, incidence of fever, application of antibiotic treatment, levels of serum albumin, and the clinical course of hypertension (P < 0.05). Maintenance hemodialysis patients who experience new-onset epilepsy are often critically ill with rapid progression of disease and a high mortality rate. Female dialysis patients complicated with infections, antibiotics use and hypoalbuminemia are more likely to develop epilepsy.


Cosmetic surgery: medicolegal considerations.
Cosmetic surgery is one of the two branches of plastic surgery. The characteristic of non-necessity of this surgical speciality implies an increased severity in the evaluation of the risk-benefit balance. Therefore, great care must be taken in providing all the information necessary in order to obtain valid consent to the intervention. We analyzed judgments concerning cosmetic surgery found in national legal databases. A document of National Bioethics Committee (CNB) was also analyzed. The receipt of valid, informed consent is of absolute importance not only to legitimise the medical-surgical act, but it also represents the key element in the question concerning the existence of an obligation to achieve certain results/use of certain methods in the cosmetic surgery.


Tetrahedral DNA nanostructure-corbelled click chemistry-based large-scale assembly of nanozymes for ratiometric fluorescence assay of DNA methyltransferase activity.
Ligation efficiency in a surface-based DNA click chemistry (CuAAC) reaction is extremely restricted by the orientation and density of probes arranged on a heterogeneous surface. Herein, we engineer DNA tetrahedral nanostructure (DTN)-corbelled click chemistry to trigger a hybridization chain reaction (HCR) assembling a large-scale of nanozymes for ratiometric fluorescence detection of DNA adenine methyltransferase (Dam). In this study, a DNA tetrahedron structure with an alkynyl modifying pendant DNA probe (Alk-DTN) is designed and assembled on a magnetic bead (MB) as a scaffold for click chemistry. When a CuO NP-encoded magnetic nanoparticle (CuO-MNP) substrate was methylated by Dam, CuO NPs were released and turned into a mass of Cu+. The Cu+ droves azido modifying lDNA (azide-lDNA) to connect with the Alk-DTN probe on the MB through the click reaction, forming an intact primer to initiate the HCR. The HCR product, a rigid structure double-stranded DNA, periodically assembles glucose oxidase mimicking gold nanoparticles (GNPs) into a large-scale of nanozymes for catalyzing the oxidation of glucose to H2O2. NH2-MIL-101 MOFs, a fluorescent indicator and a biomimetic catalyst, activated the product H2O2 to oxidize o-phenylenediamine (oPD) into visually detectable 2,3-diaminophenazine (DAP). The change of the signal ratio between DAP and NH2-MIL-101 is proportional to the methylation event corresponding to the MTase activity. In this study, the DTN enhances the efficiency of the surface-based DNA click reaction and maintains the catalytic activities of gold nanoparticle nanozymes due to the intrinsic nature of mechanical rigidity and well-controlled orientation and well-adjusted size. Large-scale assembly of nanozymes circumvents the loss of natural enzyme activity caused by chemical modification and greatly improves the amplification efficiency. The proposed biosensor displayed a low detection limit of 0.001 U mL-1 for Dam MTase due to multiple amplification and was effective in real samples and methylation inhibitor screening, providing a promising modular platform for bioanalysis.


Interaction of integrin alpha 7 beta 1 in C2C12 myotubes and in solution with laminin.
The dimer of integrin alpha 7 and beta 1 is a major laminin-binding receptor in skeletal muscle. We studied interactions of integrin alpha 7 beta 1 with the extracellular matrix protein laminin in solution and in intact cells. Integrin alpha 7 beta 1 bound to EHS laminin (laminin-1, composed of alpha 1, beta 1, and gamma 1 chains), but not to endogenous laminin expressed in C2C12 myotubes. Northern blot analysis demonstrated that C2C12 myotubes synthesized laminin-1 alpha, beta, and gamma subunits mRNAs. C2C12 laminin was, however, immunologically distinct from EHS laminin; it was not recognized by 5D3 anti-laminin-1 monoclonal antibody, whereas 5A2 and LT3 antibodies reacted equally well with C2C12 and EHS laminins. Following deglycosylation of EHS laminin, separation of the subunits by SDS-PAGE, Western blotting, and partial amino acid sequencing of the protein bands, the epitope recognized by 5D3 antibody was localized to the gamma 1 laminin chain. Following binding in vitro, the complex of EHS laminin and integrin alpha 7 beta 1 was subject to chemical cross-linking. The two proteins did not undergo cross-linking at the cell surface, consistent with the fact that in intact, resting myotubes integrin alpha 7 beta 1 interacted poorly with EHS laminin, which may reflect a limited accessibility of integrin alpha 7 beta 1 in the membrane to laminin or an inactive state of the integrin.


Impact of Ramadan on clinical and microbiologic parameters of patients seen at a diarrheal hospital in urban Dhaka, Bangladesh, 1996-2012.
Ramadan is a month in the Islamic calendar when Muslims fast during daylight hours. We used data from the surveillance system of the International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka Hospital in Dhaka, Bangladesh, a predominantly Muslim country, to compare the etiology and clinical presentation of patients who presented with diarrhea during Ramadan to that of control periods, defined as the 30 days immediately before Ramadan. The proportion of infecting pathogens was largely the same, although Shigella spp. were less likely to be identified during Ramadan. Clinical presentations during Ramadan among adult Muslim diarrheal patients were also comparable to those admitted during control periods. A subgroup of cholera patients who presented after sunset during Ramadan had a shorter duration of diarrhea and higher prevalence of severe thirst, drowsiness, and severe dehydration. Our findings suggest that Ramadan has few effects on the profile of enteric pathogens and clinical features of adults seeking medical care for diarrhea.


Anti-fungal potential of ozone against some dermatophytes.
Dermatophytes are classified in three genera, Epidermophyton, Microsporum and Trichophyton. They have the capacity to invade keratinized tissue to produce a cutaneous infection known as dermatophytoses. This investigation was performed to study the effect of gaseous ozone and ozonized oil on three specific properties of six different dermatophytes. These properties included sporulation, mycelia leakage of sugar and nutrients and the activity of their hydrolytic enzymes. Generally, ozonized oil was found to be more efficacious than gaseous ozone. Microsporum gypseum and Microsporum canis were the most susceptible, while Trichophyton interdigitale and T. mentagrophytes were relatively resistant. The study revealed a steady decline in spore production of M. gypseum and M. canis on application of ozonated oil. An increase in leakage of electrolytes and sugar was noticed after treatment with ozonized oil in the case of M. gypseum, M. canis, T. interdigitale, T. mentagrophytes and T. rubrum. The results also revealed loss in urease, amylase, alkaline phosphatase, lipase and keratinase enzyme producing capacity of the investigated fungi.


Cloning of a cDNA encoding phospholipase D from Pimpinella brachycarpa.
Phospholipase D (PLD, EC 18.104.22.168) has been known to be related to various cellular processes in plants. To gain an understanding of the property of the enzyme in Pimpinella brachycarpa, the cDNA of the enzyme was isolated by PCR with degenerate primers, cDNA library screening, and 5' RACE. The full-length PLD cDNA is 2859 bp long and contains an open reading frame of 2424 bp coding for a polypeptide of 808 amino acids. The deduced enzyme has a calculated molecular mass of 91.7 kDa and pI of 5.86. The percent identity and similarity values of P. brachycarpa PLD with those of other PLDs in plants are 70 approximately 78 and 84 approximately 95, respectively. It was identified that PLD from P. brachycarpa has HQKIVVVD and HAKMMIVD sequences which were homologous with a duplicated HXKXXXXD motif that has been conserved in PLDs from plants, animals, and yeast. Based on the analysis of amino acid similarity, it is believed that PLD from P. brachycarpa is an alpha form which is distinct from PLD beta reported recently. The N-terminus is homologous to the C2 domain which is present in a number of different proteins involved in signal transduction and membrane trafficking in animals. Southern and northern blot analyses indicated that PLD was expressed from one copy of PLD gene in the genome of P. brachycarpa.


Impact of zinc oxide nanoparticles on an in vitro model of the human air-blood barrier.
The inhalation of zinc oxide nanoparticles (nZnO) may induce systemic diseases, damages to the alveolar epithelium and inflammatory response to endothelial cells. In this work the use of an in vitro air-blood barrier (ABB) model provided a tool to elucidate the biological mechanisms underlying the potential effects of inhaled nanoparticles (NPs). The ABB model used is composed of a Transwell co-culture of a lung epithelial cell line (NCI-H441) and an immortalized pulmonary microvascular endothelial cell line (HPMEC-ST1.6R). In addition, a tri-culture model was developed by adding monocytes (THP-1) on the basal compartment of the inserts. These models have been set up to analyse the importance of the interplay among the different cell types on various responses after nZnO exposure: inflammation, endothelial damage and modulation of the immune system. The barrier integrity was assessed by measuring the transepithelial electrical resistance (TEER); the pro-inflammatory and immune cells responses were analysed by ELISA. The results have evidenced that nZnO do not affect the barrier integrity, since no TEER reduction was measured after 24h of exposure, but an activation of endothelial cells, which released pro-inflammatory mediators (IL-6, IL-8), and endothelial dysfunction markers (sICAM-1 and sVCAM-1) were induced. These results confirm that apical exposure to NPs promote endothelium activation. The in vitro-ABB model here used is thus a useful tool able to evidence the interaction between lung epithelium and endothelium in inducing biological response, and the role of endothelium dysfunction following NPs inhalation.