Transcriptome profiling reveals infection strategy of an insect maculavirus.
Bombyx mori macula-like virus (BmMLV) is a positive, single-stranded insect RNA virus that is closely related to plant maculaviruses. BmMLV is currently characterized as an unclassified maculavirus. BmMLV accumulates at extremely high levels in cell lines derived from the silkworm, Bombyx mori, but it does not lead to lethality and establishes persistent infections. It is unknown how this insect maculavirus replicates and establishes persistent infections in insect cells. Here, we showed that BmMLV p15, which is located on a subgenomic fragment and is not found in plant maculaviruses, is highly expressed in BmMLV-infected silkworm cells and that p15 protein is required to establish BmMLV infections in silkworm cells. We also showed that two distinct small RNA-mediated pathways maintain BmMLV levels in BmMLV-infected silkworm cells, thereby allowing the virus to establish persistent infection. Virus-derived siRNAs and piRNAs were both produced as the infection progressed. Knockdown experiments demonstrated that the exogenous RNAi pathway alone or RNAi and piRNA pathways function cooperatively to silence BmMLV RNA and that both pathways are important for normal growth of BmMLV-infected silkworm cells. On the basis of our study, we propose a mechanism of how a plant virus-like insect virus can establish persistent infections in insect cells.


Anti-thymocyte serum as part of an immunosuppressive regimen in treating haematological immune-mediated diseases in dogs.
To report the outcomes associated with the use of rabbit anti-dog thymocyte serum in dogs with haematological immune-mediated diseases. Medical records from 2000 to 2016 of patients diagnosed with immune-mediated haemolytic anaemia, immune-mediated thrombocytopenia, pancytopenia and myelofibrosis were reviewed. All dogs had a severe or refractory disease and received rabbit anti-dog thymocyte serum. Lymphocyte counts were used to monitor the immediate anti-thymocyte effect of therapy; long-term patient outcome was recorded. A total of 10 dogs were included. All dogs except one had a notable decrease in their lymphocyte count after rabbit anti-dog thymocyte serum; four of nine had a decrease to less than 10% of the initial lymphocyte count and one dog reached 10·8%. All dogs were discharged from the hospital following their treatment. The dog with no alteration of lymphocyte count following therapy with rabbit anti-dog thymocyte serum had refractory immune mediated haemolytic anemia and was euthanised within two weeks. All other cases achieved clinical remission with immunosuppressive therapy eventually being tapered (3 of 10) or discontinued (6 of 10). Rabbit anti-dog thymocyte serum therapy might be of interest as an adjunctive therapy in refractory immune-mediated diseases and suppressed lymphocyte counts in most dogs.


BERGMANN'S RULE, SEASONALITY, AND GEOGRAPHIC VARIATION IN BODY SIZE OF HOUSE SPARROWS.
Body size of House Sparrows is positively correlated with seasonality (annual temperature range) in both North America and Europe. Previously used climatic variables gave inconsistent or contrasting results for the two continental samples. The physiological advantage of large size in seasonal environments appears to be increased fasting ability, but this may be offset somewhat, particularly for females, by other factors, e.g., competitive interactions that influence rates of energy intake or ability to initiate breeding in the spring. It is proposed that minimization of maintenance energy costs on a per individual basis, and thus small size, is advantageous in equable (and predictable) environments.


Investigation on the effect of static magnetic field up to 30 mT on viability percent, proliferation rate and IC50 of HeLa and fibroblast cells.
We have investigated the effects of static magnetic field (SMF) on the viability of the human cervical cancer (HeLa) cell line and fibroblast cells. The cells were cultured in DMEM medium and treated several times (24, 48,72 and 96 h) and at several intensities (5, 10, 20 and 30 mT) of magnetic field (MF). The cytotoxicity and cell viability percent in treated cells were performed using MTT assay by evaluating mitochondrial dehydrogenase activity. The MF ability on inducing cell death or inhibiting biochemical function was reported as cell death percent. The results showed that the increase of MF intensity and the time that cells were exposed to this treatment increased sharply cell death percent and proliferation rate in HeLa cell compare to fibroblast cells. Our data suggest that SMF biological effects on cell death were different in our selected targets. Cell type and time of exposure have been therefore found to be significant factors. These findings could be used to improve new effective method using SMF in conjunction with the common therapeutic approaches.


Co-delivery of siRNA and hypericin into cancer cells by hyaluronic acid modified PLGA-PEI nanoparticles.
Malignant tumors cause more death because of the resistance of the hypoxic cancer cell toward radiotherapy. Targeting for hypoxic cancer area and gene silencing to overcome the hypoxia are two kinds of important therapeutic strategies for treating tumors. In order to explore the combined effects of gene therapy and hypericin (Hy) on tumor cells, hypoxia-inducible factor 1 alpha (HIF-1α) small interfering ribonucleic acid (siRNA) was transfected into the hypoxic human nasopharyngeal carcinoma (CNE2) cells using Hy-encapsulated nanocomplexes (Hy-HPP NPs) as a carrier which would achieve dual targeting to the tumor necrosis area. NPs were prepared by emulsion-diffusion-evaporation method. Formulations were evaluated by conducting in vitro physicochemical studies, electrophoresis, in vivo study, and biochemical studies. Hy-loaded nanoparticles with a mean size of around 160 nm was able to enhance the accumulation in the tumors by enhanced permeability and retention effect. The electrophoresis confirmed the good stability of siRNA/Hy-HPP NPs in the presence of phosphate-buffered saline (pH 7.4), competitive heparin, and RNase. The results of transfection showed that the uptake of siRNA was significantly increased up to 50% in CNE2 cells. The level of the HIF-1α with Hy-encapsulated nanocomplexes was significantly reduced to 30% in the transfected CNE2 cells. In vivo studies, the carrier exhibited higher intensity at the tumor tissue cells and higher affinity toward the necrotic tumor tissue. Results demonstrated that Hy-HPP NPs could significantly enhance the tranfection efficiency of siRNA, suggesting Hy-encapsulated nanoparticle as an efficient gene carrier. The co-delivery of HIF-1α siRNA (siHIF-1α) and Hy could efficiently decrease the level of HIF-1α and increase the affinity toward necrotic tissues. Hence, this is a promising strategy for further application in radiotherapy.


A study of autopsies upon 116 patients with acute pancreatitis.
A series of 116 nonselected and consecutive patients with acute pancreatitis with a fatal outcome underwent necropsy and have been analyzed with special attention paid to hepatic findings and the cause of death. This series includes the total fatalities caused by the disease during a 15 year period from 1956 to 1970. All but two patients died in the first attack of acute pancreatitis. The patients were divided into four etiologic groups: gallstone disease, 43 per cent; alcoholism, 25 per cent; idiopathic origin, 18 per cent, and postoperative origin, following abdominal operations, 14 per cent. Over the three five-year periods, the frequency of alcohol abuse as a predisposing factor increased, while gallstone disease showed a corresponding decrease. About 75 per cent of the patients had hyperbilirubinemia. Half of these showed signs of cholestasis. Macroscopic steatosis of the liver was recorded in 62 per cent of the alcohol addicts and in about 25 per cent of the patients in the other etiologic groups. Shock and late sequelae of shock were the dominating immediate causes of death in 72 per cent. About 50 per cent of the fatalities occurred within the first week. Most of these early deaths were caused by intractable circulatory failure. Early death was most commonly caused by alcoholism, followed in frequency by gallstone disease. It is possible that impaired hepatic function contributes to the fatal outcome in both early and late phases of the disease.


The prevalence of hepatitis-B antigen (HB S Ag) and its antibody (Anti-HB S) among London hemophiliacs and blood donors from London and two tropical areas.
The prevalence of hepatitis-B antigen (HB s AG) and its antibody (anti-HBs) among 49 London hemophiliacs was compared with that among women attending an antenatal clinic and healthy blood donors from London and from two parts of the tropics (Mauritius and Zambia). The prevalence of HBsAG and anti-HBs was low in antenatal patients, London blood donors and blood donors from Mauritius. However, a high proportion of hemophiliacs (59%) were anti-HBs positive, this being comparable with Zambian blood donors (53%), although anti-HBs titers in hemophiliacs were much higher (GMT 1:342) than in Zambian blood donors (GMT 1:36). In contrast, HBsAG was detected in 29 of 250 (12%) Zambian donors but in only 3 of 49 (6%) hemophiliacs. Clinically overt hepatitis occurred in only two hemophiliacs. However, the presence of HBsAG-specific IgM in 7 of 29 (24%) anti-HBs-positive hemophiliacs suggests that a proportion of these patients recently experienced subclinical infection by hepatitis-B virus, Anti-HBs-positive hemophiliacs received a significantly higher number of- cryoprecipitate units than did those without anti-HBs(P less than 0.01). Five of seven hemophiliacs with high titers of anti-HBs (greater than 1:4,096) showed a decline in titer after 1972 which may have been associated with the introduction of screening of cryoprecipitate for HBsAG.


Biomagnification of polybrominated diphenyl ether and hexabromocyclododecane flame retardants in the polar bear food chain in Svalbard, Norway.
Concentrations of brominated flame retardants (BFRs), including polybrominated diphenylethers (PBDEs) and hexabromocyclododecane (HBCD), were investigated in an arctic marine food chain consisting of four invertebrate species: polar cod (Boreogadus saida), ringed seals (Pusa hispida), and polar bears (Ursus maritimus). The most abundant BFR, brominated diphenyl ether (BDE)-47, was found in detectable concentrations even in zooplankton, the lowest trophic level examined in this study. Most of the investigated BFRs biomagnified as function of tropic level in the food chain. A noticeable exception occurred at the highest trophic level, the polar bear, in which only BDE-153 was found to increase from its main prey, the ringed seal, indicating that polar bears appear to be able to metabolize and biodegrade most BFRs. In contrast, lower-brominated PBDEs, particularly BDE-47, showed clear signs of bioaccumulation in zooplankton, polar cod, and ringed seals. We suggest that this discrepancy in the fate of BFRs among the different species may be related to greater induction of oxidative detoxification activities in the polar bear. Absorption and debromination rates may be more important for bioaccumulation rates of BFRs in zooplankton, polar cod, and ringed seals. Lipid weight-based concentrations (LWCs) and whole body-based concentrations (WBCs) of BFRs were used to assess biomagnification factors (BMFs). Whole-body concentrations gave the most realistic BMFs, as BMFs derived from LWCs seem to be confounded by the large variability in lipid content of tissues from the investigated species. This study demonstrates that PBDEs and HBCD have reached measurable concentrations even in the lower trophic levels (invertebrates and fish) in the Arctic and biomagnifies in the polar bear food chain.


Aligning Single-Layer Cylinders of Block Copolymer Nanodomains using Soft Molding.
By a novel "soft molding" method, a single layer of cylindrical nanodomains in a copolymer thin film is aligned on the macroscopic scale. The domains orient parallel to the surface and perpendicular to the grating pattern of the mold with a density of 3 × 105 lines cm-2 . The arrow in the Figure shows the direction of the grating (parallel to the contour line) of the mold. The fast Fourier transform in the inset indicates the well-oriented cylinders obtained.


A mathematical model of receptor-mediated apoptosis: dying to know why fasl is a trimer.
The scientific importance of understanding programmed cell death is undeniable; however, the complexity of death signal propagation and the formerly incomplete knowledge of apoptotic pathways has left this topic virtually untouched by mathematical modeling. In this paper, we use a mechanistic approach to frame the current understanding of receptor-mediated apoptosis with an immediate goal of isolating the role receptor trimerization plays in this process. Analysis and simulation suggest that if the death signal is to be successful at low-receptor, high-ligand concentration, Fas trimerization is unlikely to be the driving force in the signal propagation. However at high-receptor and low-ligand concentrations, the mathematical model illustrates how the ability of FasL to cluster three Fas receptors can be crucially important for downstream events that propagate the apoptotic signal.


Adsorption of methyl orange on low-cost adsorbent natural materials and modified natural materials: a review.
Recently a large number of extensive studies have amassed that describe the removal of dyes from water and wastewater using natural adsorbents and modified materials. Methyl orange dye is found in wastewater streams from various industries that include textiles, plastics, printing and paper among other sources. This article reviews methyl orange adsorption onto natural and modified materials. Despite many techniques available, adsorption stands out for efficient water and wastewater treatment for its ease of operation, flexibility and large-scale removal of colorants. It also has a significant potential for regeneration recovery and recycling of adsorbents in comparison to other water treatment methods. The adsorbents described herein were classified into five categories based on their chemical composition: bio-sorbents, activated carbon, biochar, clays and minerals, and composites. In this review article, we want to demonstrate the capacity of natural and modified materials for dye adsorption which can yield significant improvements to the adsorption capacity of dyes such as methyl orange. In addition, the effect of critical variables including contact time, initial methyl orange concentration, dosage of adsorbent, pH, temperature and mechanism on the adsorption efficiency will be covered as part of this literature review.


[Effects of yinian jiangya decoction contained serum on endothelial cell proliferation and PPAR gamma mRNA expression in spontaneously hypertensive rat].
To observe the effects of Yinian Jiangya (YNJY) Decoction contained serum on cell proliferation of primary cultured endothelial cells of spontaneously hypertensive rat (SHR) and the peroxisome proliferator-activated receptor-gamma (PPAR-gamma) mRNA expression in the cells. SD rats were fed with high-lipid diet and different doses (high, medium and low, containing crude drug of 5.2 g/mL, 2.6 g/mL, 1.3 g/mL respectively) of YNJY respectively and the serum contained different doses of YNJY (S-YNJY) was prepared by collecting the rats' serum after 20 days of feeding. The serum obtained from SD rats fed with normal diet, i.e. drug free serum (S-free) was taken for control. Primary cultured endothelial cells of SHR were treated respectively with S-YNJY in different doses (treated groups) and S-free (control group), the cell activity and the mRNA expression of PPAR-gamma in cells of all groups were detected by MTT and RT-PCR respectively at different time points: 2, 4, 8, 16 and 24 h after treatment. MTT test showed that at time points of 4 and 8 h, the OD value raised in the treated groups with insignificant difference among them (P>0.05), but was higher than that in the control group (P<0.05); at 16 h, it increased but showed a smaller increment in the medium-dose treated group (P<0.05); at 24 h, it decreased in all groups, but the decrement in the high- and medium-dose treated groups was more remarkable (P<0.05); at 48 h, it decreased continuously, with the decrement more significant in the high-dose group than in the control group (P<0.05). RT-PCR detection showed that at 4 h, the expression of PPAR-gamma mRNA was not changed significantly in all groups (P>0.05); at 8 h, it was remarkably lower in high-dose group than in others (P<0.05); at 16 h, it was higher in the three treated groups than in the control group (P<0.05), with a highest level shown in the high-dose treated group (P<0.01); at 24 h, the expression decreased in all groups, but the level in the low-dose treated group was still higher than that in the control group (P<0.05). YNJY Decoction shows a two-way regulation on endothelial cells proliferation, and which is negatively dose-dependent in the late stage. The regulation is perhaps relevant to the regulating of the PPAR-gamma mRNA expressions. The PPAR-gamma mRNA expression up-regulating and maintaining effects of YNJY Decoction may be one of the mechanisms for its vascular endothelial cell protection and blood pressure suppressing.


Depressive Symptoms and Associated Factors among People Living with HIV/AIDS.
The purpose of this study was to evaluate the prevalence of depressive symptoms and associated variables among people living with HIV/AIDS (PLWHA) in a specialized treatment center in a city located in southern Brazil. A cross-sectional study was conducted using the Beck Depression Inventory to assess the presence of depressive symptoms. The prevalence of depressive symptoms was 53.5% among the surveyed population, which supports the idea that depressive symptoms are more common among PLWHA, mainly if compared with the general population. It was observed that 57.7% of the study participants were with depressive symptoms and did not take any psychiatric medication and 100% did not undergo psychotherapy, which indicates undertreatment. There was no statistically significant difference in the mean CD4 count between patients with depressive symptoms (484.1 ± 353) and patients without depressive symptoms (528.4 ± 263). Further actions should be taken to improve the care for PLWHA. The interface between psychology, psychiatry, and internal medicine is of utmost importance to provide a more humanized care, in which the psychosocial, psychological, and psychiatric aspects are not neglected.


[Congenital obstruction of lacrimal ducts in 578 children].
Congenital obstruction of the nasa lacrimal ducts is a frequent problem in infancy. Its management is still controversial. 578 children aged 6 weeks to 3 years were treated in our department between 1980 and 1987. Congenital obstruction of the nasa lacrimal ducts was bilateral in 172 of them, so that a total of 750 ducts were obstructed. All the infants were treated with antibiotics until they are 2 months old. Permeability was obtained in 97% of the 750 obstructed ducts: this was spontaneous in 38.7%, after a single wash in 3%, and by probing under general anesthesia in 55.3%. The percentage of cases requiring surgery increased with age at time of diagnosis. The best results are obtained in infants 2 to 4 months old.


International Nosocomial Infection Control Consortium (INICC) national report on device-associated infection rates in 19 cities of Turkey, data summary for 2003-2012.
Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U.S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report.


[Construction of EF-G knockdown strain of Mycobacterium smegmatis and drug resistance analysis].
As the only translational factor that plays a critical role in two translational processes (elongation and ribosome regeneration), GTPase elongation factor G (EF-G) is a potential target for antimicrobial agents. Both Mycobacterium smegmatis and Mycobacterium tuberculosis have two EF-G homologous coding genes, MsmEFG1 (MSMEG_1400) and MsmEFG2 (MSMEG_6535), fusA1 (Rv0684) and fusA2 (Rv0120c), respectively. MsmEFG1 (MSMEG_1400) and fusA1 (Rv0684) were identified as essential genes for bacterial growth by gene mutation library and bioinformatic analysis. To investigate the biological function and characteristics of EF-G in mycobacterium, two induced EF-G knockdown strains (Msm-ΔEFG1(KD) and Msm-ΔEFG2(KD)) from Mycobacterium smegmatis were constructed by clustered regularly interspaced short palindromic repeats interference (CRISPRi) technique. EF-G2 knockdown had no effect on bacterial growth, while EF-G1 knockdown significantly retarded the growth of mycobacterium, weakened the film-forming ability, changed the colony morphology, and increased the length of mycobacterium. It was speculated that EF-G might be involved in the division of bacteria. Minimal inhibitory concentration assay showed that inhibition of EF-G1 expression enhanced the sensitivity of mycobacterium to rifampicin, isoniazid, erythromycin, fucidic acid, capreomycin and other antibacterial agents, suggesting that EF-G1 might be a potential target for screening anti-tuberculosis drugs in the future.


Errors in determination of total body protein by in vivo neutron activation of nitrogen due to non-uniform neutron fluence inside the patient.
Total body protein can be estimated by in vivo neutron activation of nitrogen. The method is based on capture of thermal neutrons in a 14N(n,g )15N reaction. Sources of error associated with this method, such as background subtraction, variations in detection efficiency, etc, are analysed. Different neutron reactions (absorption, elastic and inelastic scattering) cause the neutron fluence to decrease inside the body. The activation profile through the body is non-uniform which causes errors in the calculation of total body nitrogen. A reduction of nitrogen by 5% in a 3 cm thick volume near the body surface would result in an error in the determination of total body nitrogen of approximately 0.3%. The error induced by changes in thickness of the subcutaneous fat has also been estimated and the results show that a 5 mm change in subcutaneous fat thickness changes the count rate from nitrogen by 5%.


Virus-dependent phosphorylation of the IRF-3 transcription factor regulates nuclear translocation, transactivation potential, and proteasome-mediated degradation.
The interferon regulatory factors (IRF) consist of a growing family of related transcription proteins first identified as regulators of the alpha beta interferon (IFN-alpha/beta) gene promoters, as well as the interferon-stimulated response element (ISRE) of some IFN-stimulated genes. IRF-3 was originally identified as a member of the IRF family based on homology with other IRF family members and on binding to the ISRE of the ISG15 promoter. IRF-3 is expressed constitutively in a variety of tissues, and the relative levels of IRF-3 mRNA do not change in virus-infected or IFN-treated cells. In the present study, we demonstrate that following Sendai virus infection, IRF-3 is posttranslationally modified by protein phosphorylation at multiple serine and threonine residues, which are located in the carboxy terminus of IRF-3. A combination of IRF-3 deletion and point mutations localized the inducible phosphorylation sites to the region -ISNSHPLSLTSDQ- between amino acids 395 and 407; point mutation of residues Ser-396 and Ser-398 eliminated virus-induced phosphorylation of IRF-3 protein, although residues Ser-402, Thr-404, and Ser-405 were also targets. Phosphorylation results in the cytoplasm-to-nucleus translocation of IRF-3, DNA binding, and increased transcriptional activation. Substitution of the Ser-Thr sites with the phosphomimetic Asp generated a constitutively active form of IRF-3 that functioned as a very strong activator of promoters containing PRDI-PRDIII or ISRE regulatory elements. Phosphorylation also appears to represent a signal for virus-mediated degradation, since the virus-induced turnover of IRF-3 was prevented by mutation of the IRF-3 Ser-Thr cluster or by proteasome inhibitors. Interestingly, virus infection resulted in the association of IRF-3 with the CREB binding protein (CBP) coactivator, as detected by coimmunoprecipitation with anti-CBP antibody, an interaction mediated by the C-terminal domains of both proteins. Mutation of residues Ser-396 and Ser-398 in IRF-3 abrogated its binding to CBP. These results are discussed in terms of a model in which virus-inducible, C-terminal phosphorylation of IRF-3 alters protein conformation to permit nuclear translocation, association with transcriptional partners, and primary activation of IFN- and IFN-responsive genes.


Fetal urine and amniotic fluid in monochorionic twins with twin-twin transfusion syndrome: simulations of therapy.
Therapy for twin-twin transfusion syndrome includes amnioreduction, septostomy, and laser ablation, but there is no accepted standard of care. Mechanisms for the reported improvement in survival are incompletely understood. We sought to model the mechanisms and predict the response of varying severities of twin-twin transfusion syndrome and placental angioarchitectures to current therapies to determine optimal clinical interventions. We used our mathematic model of twin-twin transfusion syndrome that predicts fetal and amniotic fluid abnormalities that are related to the placental angioarchitecture. Amnioreduction was modeled as reduction in amniotic fluid volume; septostomy was modeled as the merging of donor and recipient amniotic fluid, and laser ablation was modeled as the cessation of all placental anastomotic blood flows. Amnioreduction reduces amniotic fluid pressure, which improves transplacental fluid flow from mother to fetus and increases both donor and recipient blood volume. However, net arteriovenous transfusion increases, because of increased donor arterial pressure, which negates, in part, the benefit of amnioreduction. Septostomy allows amniotic fluid to be swallowed by the donor, with minimal effects on donor growth and blood volume. Laser ablation eliminates anastomotic exchange of blood and reduces discordant fetal growth. Amnioreduction may be effective in milder twin-twin transfusion syndrome pregnancies but ineffective in severe cases. Septostomy is unlikely to offer significant therapeutic efficacy. Laser ablation is equally effective in mild and severe twin-twin transfusion syndrome but has a higher spontaneous abortion rate than amnioreduction. The model indicates improved outcomes with the use of amnioreduction in mild twin-twin transfusion syndrome cases and with laser ablation in severe cases.


[Determination of amphetamines in human urine using microwave extraction-gas chromatography].
A method has been developed for the determination of methamphetamine (MA), 3,4-methylenedioxyamphetamine (MDA) and 3,4-methylenedioxymethamphetamine (MDMA) in human urine using microwave extraction-gas chromatography(GC). To improve the extraction efficiency, experimental parameters of the extraction, including extraction solvent and its amount, pH value of the urine sample, extraction time and temperature were investigated. The optimal conditions were as follows: the pH value of urine sample at pH 12, cyclohexane as extraction solvent, extraction at 40 degrees C for 10 min. The average recoveries of MA, MDA and MDMA with this extraction method were 92.25%, 85.94% and 91.50%, the relative standard deviations were 5.5%, 5.5% and 6.1%(n = 5), and the limits of detection were 10, 20 and 20 ng/mL, respectively. Using this method, MA, MDA and MDMA need not be derivatized and can be separated from the matrix. The results indicate that the developed method is rapid, accurate and sensitive, and can be used for the simultaneous determination of MA, MDA and MDMA in urine samples.


Total IgE plasma levels vary according to gender and age in Brazilian patients with allergic rhinitis.
Allergic rhinitis is a disease that affects the upper airways and causes inflammation of the nasal mucosa and it is mediated by IgE antibodies produced after sensitization to environmental allergens. Previous reports have indicated that this disease affects males more often than females. The objective of this study was to verify whether total IgE plasma levels vary between genders in patients suffering from allergic rhinitis. A total of 171 adult patients suffering from allergic rhinitis (55 males and 116 females) were enrolled. Total IgE plasma levels were determined using commercial kits, with 140 IU/mL considered as a reference value. The mean total IgE plasma levels were compared according to gender and age. The mean age of the overall patient group with allergic rhinitis was 38.4 ± 19.0 years and a significant difference in age was observed between genders (males: 32.2 ± 17.8 years; females: 41.4 ± 18.9 years; p=0.0027). Additionally, the mean total IgE plasma levels were higher in males (413.0 ± 143.0 IU/mL) than in females (147.9 ± 98.0 IU/mL) (p<0.0001). These differences persisted even when males and females were stratified by age (up to or older than 20 years of age). In conclusion, total IgE plasma levels are higher in young adult males than in females suffering from allergic rhinitis. Evaluating total IgE plasma levels can be useful to identify patients at risk of allergic rhinitis in areas with low industrial pollution.


Evolution from superatomic Au24Ag20 monomers into molecular-like Au43Ag38 dimeric nanoclusters.
Hierarchical assembly of nanoparticles has been attracting wide interest, as advanced functionalities can be achieved. However, the ability to manipulate structural evolution of artificial nanoparticles into assemblies with atomic precision has been largely unsuccessful. Here we report the evolution from monomeric Au24Au20 into dimeric Au43Ag38 nanoclusters: Au43Ag38 inherits the kernel frameworks from parent Au24Ag20 but exhibits distinct surface motifs; Au24Ag20 is racemic, while Au43Ag38 is mesomeric. Importantly, the evolution from monomers to dimers opens up exciting opportunities exploring currently unknown properties of monomeric and dimeric alloy nanoclusters. The Au24Ag20 clusters show superatomic electronic configurations, while Au43Ag38 clusters have molecular-like characteristics. Furthermore, monomeric Au24Ag20 catalysts readily outperform dimeric Au43Ag38 catalysts in the catalytic reduction of CO2.


Reprogramming Cell Identity: Past Lessons, Challenges, and Future Directions.
Reprogramming is traditionally defined as the fate conversion of a cell to a stage of increased developmental potential. In its broader meaning, the reprogramming term is also applied to all forms of cell fate conversion that do not follow a developmental trajectory. Reprogramming is now a well-established field of research that gained rapid progress upon the advent of induced pluripotency. In this perspective, I reflect on the reprogramming lessons of the past, in the contributions to other fields of research and on the potential transformative future use of reprogrammed cells and of its cell derivatives.


PHENOTYPIC SELECTION BY PARASITOIDS ON THE TIMING OF LIFE HISTORY IN A LEAFMINING MOTH.
Direct measurements of phenotypic selection by parasitoids on quantitative traits in herbivorous insects have been rare. I analysed episodes of phenotypic selection on the timing of life-history events in a multivoltine leafmining moth, Phyllonorycter mespilella, and assessed the importance of hymenopterous parasitoids as selective influences. Phyllonorycter mespilella has two consecutive stages of larval development, the sap-feeding (SF) and tissue-feeding (TF) stages. Adult parasitoids host feed predominantly on SF larvae, and oviposit predominantly on TF larvae. Oviposition attack on TF larvae caused positive directional selection on the date of transition to the the TF stage (TF date) in the third generation of P. mespilella in one population in 1991. Overwinter mortality caused negative directional selection on TF date in the third generation in a second population in 1993. No directional or variance selection on TF date was detected in the second population in the second generation of 1993. Parasitoid females accepted SF larvae for oviposition more often in the fall generation than in summer generations in both populations. The relative frequencies of SF and TF larvae may alter the pattern of oviposition attack by parasitoids, and thus the form of phenotypic selection on TF date.


The effects of microwave-irradiated fixation for postmortem changes of the kidney.
In the present study, we evaluated the advantages of microwave-irradiated fixation for postmortem autolysis of the kidney. Mouse kidneys, sampled at 0, 1, 3, 5, 10, 15, 20 and 25 hr after death, were fixed with 10% neutral formalin by microwave irradiation (MWI; 20 sec/500 W) and by conventional immersion. They were then examined with light and electron microscopy, morphometrics and immunohistochemicals. Light microscopic and morphometric observations showed that structural preservation effect of MWI was limited to the proximal convoluted tubules at 25 hr. Contrary, mild ultrastructural damage by MWI was found in the glomeruli at 0 and 15 hr. Immunohistochemistry for renin and alpha-smooth muscle actin showed no apparent differences between MWI and the immersion.


Imaging findings in recurrent extramedullary leukaemias.
Acute leukaemias are relatively common malignancies. Treatment has advanced significantly in the recent past and there has been improved patient survival. This improved initial response is leading to an increasing number of cases of relapse. Extramedullary relapse occurs in a wide variety of locations with varying presentations, imaging findings and differentials. The pathophysiology and clinical course of recurrent extramedullary myeloid and lymphocytic leukaemias are reviewed in this article. The wide variety of imaging findings associated with many important sites of recurrence and the associated differential diagnosis are discussed and illustrated.


Handedness in opposite and same-sex dizygotic twins: testing the testosterone hypothesis.
Prenatal exposure to testosterone is proposed to promote development of the right hemisphere and increase the incidence of sinistrality. This proposition was tested by comparing the hand preference of 59 opposite-sex and 61 same-sex dizygotic twins. Because testosterone is thought to pass between twins in utero, it was predicted that females with a male twin would show a high incidence of sinistrality compared to females with a female twin. Similarly, it was predicted that males with a male twin would be more likely to be sinistral than males with a female twin. Measures of the strength of hand preference and the incidence of sinistrality revealed no difference between the opposite and same-sex twins for either sex. The data also failed to confirm reports that first-born twins are more likely to be sinistral than second-born twins. These data add to a growing body of research which is critical of the testosterone hypothesis.


[Transuterine migration of intrauterine contraceptive devices. 12 cases].
Transuterine migration of an IUCD is a rare complication, more spectacular than serious. In general asymptomatic or associated with only minor symptoms, such a perforation usually passes unnoticed. The diagnosis is made when the absence of the string at the cervix is noted at routine examination, and may be proved by radiological examination of the uterine cavity. Treatment consists of removal of the migratory foreign body either by coelioscopy or by laparotomy. Although the no single mechanism for the occurrence of such perforations exists, this study confirmed the high incidence of this complication when the device is inserted in the immediate post-partum period.


Receipt of assistance and extended family residence among elderly men in Mexico.
This article focuses on help received by a nationally-representative sample of 2,376 Mexican men age 60+ in 1994. In the month before the interview, about one-half of the men received in-kind or domestic assistance, two-fifths received financial assistance, and about one-fourth received physical assistance. This was so even as almost half the men still worked, and over half (57%) had no discernable functional limitation. Using logistic regression, the study found support for the common assumption that living arrangements are an important predictor of assistance. Other factors are important too however. In fact, many elders received help from non-coresiding relatives. Beside financial remittances, help from non-coresiding relatives included in-kind, domestic, and physical assistance. Research on Mexico suggests that we need to revisit notions of a modified extended family in which non-coresidential ties can be important. Surveys need questions about frequency of contact and geographic distance between elderly people and their kin.


Fewer Wrong-Site Peripheral Nerve Blocks Following Updates to Anesthesia Time-Out Policy.
Background: Peripheral nerve block (PNB) has been shown to be safe and effective, and its use has continued to increase, but it is not without risks. One potentially preventable risk is wrong-site blocks (WSBs). Our institution mandated a time-out process before PNB in 2003, and then in 2007 made two more changes to our policy to mitigate risk: (1) the circulating/block nurse was the only person permitted to access the block needles; after a time-out period was complete, the nurse gave the needles to the anesthesiologist; and (2) the nurse remained at the patient's bedside until the PNB was initiated. Purpose: We sought to compare the incidence of WSBs before and after this time-out process was implemented in 2003 and the enhanced form of it was implemented in 2007. We hypothesized that the enhanced process would decrease the incidence of WSBs. Methods: We retrospectively analyzed data, from January 2003 to December 2016, taken from the quality assurance and performance improvement (QA/PI) division of the anesthesiology department at our institution, which maintained daily statistics on anesthetic types using quality audits from paper or electronic anesthesia records. All WSBs from this period were reported to the QA/PI division and root cause analyses performed. The incidence of WSB was compared pre- and post-implementation of the enhanced time-out policy for upper extremity, lower extremity, and all blocks by calculating relative risks with 95% score confidence intervals and performing Fisher's exact tests. Results: The incidence of WSBs decreased from 1.10/10,000 before changes to the policy were initiated to 0.24/10,000 afterward. Conclusion: We observed an association between the implementation of a dynamic, team-focused time-out process and a reduction in the incidence of WSBs at our institution. A causal effect of the enhanced time-out cannot be determined given the risk of bias associated with before-after study designs and our lack of adjustment for potential confounders. Further research is therefore warranted.


On the relationship between inhibition and receptor occupancy by nondepolarizing neuromuscular blocking drugs.
Nondepolarizing neuromuscular blocking drugs (NDNBs) are clinically used to produce muscle relaxation during general anesthesia. To better understand clinical properties of NDNBs, comparative in vitro pharmacologic studies have been performed. In these studies, a receptor binding model, which relies on the assumption that the inhibition, i.e., the effect of an NDNB, is proportional to the receptor occupancy by the drug, has been effectively used to describe obtained experimental data. However, it has not been studied in literature under which conditions the above assumption can be justified nor the assumption still holds in vivo. The purpose of this study is to explore the in vivo relationship between the inhibition and the receptor occupancy by an NDNB and to draw implications on how in vitro experimental results can be used to discuss the in vivo properties of NDNBs. An ordinary differential equation model is employed to simulate physiologic processes of the activation of receptors by acetylcholine (ACh) as well as inhibition by an NDNB. With this model, the degree of inhibition is quantified by the fractional amount of receptors that are not activated by ACh due to the presence of an NDNB. The results are visualized by plotting the fractional amounts of the activated receptors as a function of the receptor occupancy. Numerical investigations reflecting in vivo conditions show that the degree of inhibition is not proportional to the receptor occupancy, i.e., there is a nonlinear relationship between the inhibition and the receptor occupancy. However, under a setting of high concentration of ACh reflecting a typical situation of in vitro experiments, the relationship between the inhibition and the receptor occupancy becomes linear, suggesting the validity of the receptor binding model. Also, it is found that the extent of nonlinearity depends on the selectivity of NDNBs for the two binding sites of the receptors. While the receptor binding model may be effective for estimating affinity of an NDNB through in vitro experiments, these models do not directly describe in vivo properties of NDNBs, because the nonlinearity between the inhibition and the receptor occupancy causes the modulation of the resultant concentration-effect relationships of NDNBs.


Impact of Medicaid Restrictions on Availability of Buprenorphine in Addiction Treatment Programs.
To examine how utilization restrictions on state Medicaid benefits for buprenorphine are related to addiction treatment programs' decision to offer the drug. We used data from 2 waves of the National Drug Abuse Treatment System Survey conducted in 2014 and 2017 in the United States to assess the relationship of utilization restrictions to buprenorphine availability. The proportion of programs offering buprenorphine was 43.2% in states that did not impose any utilization restrictions, 25.5% in states that imposed only annual limits, 17.3% in states that imposed only prior authorization, and 12.8% in states that imposed both. Programs in states requiring prior authorization from Medicaid had substantially lower odds of offering buprenorphine (odds ratio = 0.50; 95% confidence interval = 0.29, 0.87). Medicaid prior authorization was linked to lower odds of buprenorphine provision among addiction treatment programs. Public Health Implications. State Medicaid prior authorization requirements are linked to reduced odds of buprenorphine provision among addiction treatment programs and may discourage prescribing.


Evidence for a labile intermediate in the butyrate induced reduction of the level of c-myc RNA in SW837 rectal carcinoma cells.
We have found that the differentiation inducer butyric acid causes the synthesis of a cellular protein(s) that mediates a rapid decline in the level of myc RNA in SW837, a cell line derived from a human adenocarcinoma of the rectum. This effect was dose-dependent and was maximal at 1 mM. Among the short chain fatty acids tested, butyric acid was found to be the most potent. Valeric acid was less effective, and acetic, propionic, isobutyric, and caproic acids did not cause a significant change in myc RNA level. Dimethylsulfoxide, another inducer of differentiation, also caused a marked diminution of myc RNA level, but was only tested at a relatively high dose (282 mM). The reduction in myc RNA level caused by butyrate was blocked by inhibitors of protein synthesis, and was rapidly reversed by removing the inducer. This suggests that butyrate causes the induction of a labile activity that has a negative effect on myc RNA abundance.


Genetic Toxicity of Complex Mixtures of Polycyclic Aromatic Hydrocarbons: Evaluating Dose-Additivity in a Transgenic Mouse Model.
This study evaluates the risk assessment approach currently employed for polycyclic aromatic hydrocarbon (PAH)-contaminated media, wherein carcinogenic hazards are evaluated using a dose-addition model that employs potency equivalency factors (PEFs) for targeted carcinogenic PAHs. Here, MutaMouse mice were subchronically exposed to PAH mixtures (p.o.), and mutagenic potency (MP) values were determined for five tissues. Predicted dose-additive mixture MPs were generated by summing the products of the concentrations and MPs of the individual targeted PAHs; values were compared to the experimental MPs of the mixtures to evaluate dose-additivity. Additionally, the PEF-determined BaP-equivalent concentrations were compared to those determined using a bioassay-derived method (BDM) (i.e., an additivity-independent approach). In bone marrow, mixture mutagenicity was less than dose-additive and the PEF-method provided higher estimates of BaP-equivalents than the BDM. Conversely, mixture mutagenicity in site-of-contact tissues (e.g., small intestine) was generally more than dose-additive and the PEF-method provided lower estimates of BaP-equivalents than the BDM. Overall, this study demonstrates that dose-additive predictions of mixture mutagenic potency based on the concentrations and potencies of a small number of targeted PAHs results in values that are surprisingly close to those determined experimentally, providing support for the dose-additive assumption employed for human health risk assessment of PAH mixtures.


Volatolomics in Bacterial Ecotoxicology, A Novel Method for Detecting Signatures of Pesticide Exposure?
Volatile organic compounds (VOC) produced by microorganisms in response to chemical stressor showed recently increasing attention, because of possible environmental applications. In this work, we aimed to bring the first proof of concept that volatolomic (i.e., VOCs analysis) can be used to determine candidate VOC markers of two soil bacteria strains (Pseudomonas fluorescens SG-1 and Bacillus megaterium Mes11) exposure to pesticides. VOC determination was based on solid-phase microextraction (SPME) coupled with gas chromatography-mass spectrometry (GC-MS). Accordingly, we highlighted a set of bacterial VOCs modulated in each strains according to the nature of the pesticide used. Three out these VOCs were specifically modulated in P. fluorescens SG-1 when exposed with two pyrethroid pesticides (deltamethrine and cypermethrine): 2-hexanone; 1,3-ditertbutylbenzene and malonic acid, hexyl 3-methylbutyl ester. Our results thus suggest the possible existence of generic VOC markers of pyrethroids in this strain. Of particular interest, two out of these three VOCs, the 1,3-ditertbutylbenzene and the malonic acid, hexyl 3-methylbutyl ester were found also in B. megaterium Mes11 when exposed with cypermethrine. This result highlighted the possible existence of interspecific VOC markers of pyrethroid in these two bacteria. Altogether, our work underlined the relevance of volatolomic to detect signatures of pesticides exposure in microorganisms and more generally to microbial ecotoxicology. Based on these first results, considerations of volatolomics for the chemical risk assessment in environment such as soils can be indirectly explored in longer terms.


Trends in the Diversification of the Detergentome.
Detergents are amphiphilic molecules that serve as enabling steps for today's world applications. The increasing diversity of the detergentome is key to applications enabled by detergent science. Regardless of the application, the optimal design of detergents is determined empirically, which leads to failed preparations, and raising costs. To facilitate project planning, here we review synthesis strategies that drive the diversification of the detergentome. Synthesis strategies relevant for industrial and academic applications include linear, modular, combinatorial, bio-based, and metric-assisted detergent synthesis. Scopes and limitations of individual synthesis strategies in context with industrial product development and academic research are discussed. Furthermore, when designing detergents, the selection of molecular building blocks, i. e., head, linker, tail, is as important as the employed synthesis strategy. To facilitate the design of safe-to-use and tailor-made detergents, we provide an overview of established head, linker, and tail groups and highlight selected scopes and limitations for applications. It becomes apparent that most recent contributions to the increasing chemical diversity of detergent building blocks originate from the development of detergents for membrane protein studies. The overview of synthesis strategies and molecular blocks will bring us closer to the ability to predictably design and synthesize optimal detergents for challenging future applications.


Adrenomedullin in mammalian and human skin glands including the mammary gland.
Adrenomedullin is a peptide that has been ascribed numerous functions. In the present paper, adrenomedullin has been localized immunhistochemically in a variety of skin glands of humans, elephants and impalas: apocrine scent glands, eccrine sweat glands, holocrine glands and mammary glands. In the apocrine glands expression of adrenomedullin varied with respect to staining intensity and intracellular localization. In general, glands which appeared to be actively secreting were more strongly stained than quiescent glands. However, within a single glandular tubule, individual cells differed considerably in the staining intensity of adrenomedullin. Adrenomedullin was present in both non-lactating and lactating mammary secretory epithelia, both ducts and alveoli reacted positively. In human mammary glands displaying apocrine metaplasia, the apical protrusions were strongly positive. Furthermore, positive immunostaining was found in endothelium and often in smooth muscle cells of small arteries and veins and in mast cells as well. Many of the adrenomedullin-positive epithelial cells were most strongly stained in the area of the Golgi apparatus, the cellular apex and particularly close to the basal side of the cell membrane. This pattern suggests packaging of adrenomedullin into secretory granules and secretion both at the apex of cells and at their basis. The first form of secretion suggests exocrine secretion, the latter form endocrine secretion of adrenomedullin. A possible hormonal function is in line with basally located electron dense small secretory granules, which have been found by electron microscopy in the glandular epithelia studied.


The influence of ligand valency on aggregation mechanisms for inhibiting bacterial toxins.
Divalent and tetravalent analogues of ganglioside GM1 are potent inhibitors of cholera toxin and Escherichia coli heat-labile toxin. However, they show little increase in inherent affinity when compared to the corresponding monovalent carbohydrate ligand. Analytical ultracentrifugation and dynamic light scattering have been used to demonstrate that the multivalent inhibitors induce protein aggregation and the formation of space-filling networks. This aggregation process appears to arise when using ligands that do not match the valency of the protein receptor. While it is generally accepted that multivalency is an effective strategy for increasing the activity of inhibitors, here we show that the valency of the inhibitor also has a dramatic effect on the kinetics of aggregation and the stability of intermediate protein complexes. Structural studies employing atomic force microscopy have revealed that a divalent inhibitor induces head-to-head dimerization of the protein toxin en route to higher aggregates.


Self-assembled pillar-like structures in nanodiamond layers by pulsed spray technique.
Pillar-like structures of nanodiamonds on a silicon substrate are self-assembled for the first time by a pulsed spray technique. This technique allows us to deposit nanodiamond layers by using high quality nanocrystals of 250 nm dispersed in 1,2-dichloroethane (DCE) solvent. The analysis of 2D/3D confocal and atomic force microscopy images evidences the presence of self-assembled pillar-like structures distributed in an irregular way. The proposed method is simple, easy and cheap, and does not require complex growth processes or structured materials, ideal for upscaling toward industrial biochip implementation and photonic applications. The suggested formation mechanisms of self-assembly are based on the so-called coffee stain effect, i.e., on the time evolution of DCE evaporation.


[Clinical significance of high expression with UTX in renal cell carcinoma].
To investigate the expression and significance of ubiquitously transcribed TPR gene on the X chromosome (UTX) in renal cell carcinoma (RCC) tissues, then to explore the relationship between UTX expression and renal cancer pathologic characteristics. In the study, 45 patients with dignosed renal cell carcinoma clinical samples were collected in Peking University Shenzhen Hospital. Total RNA and protein were extracted from the cancer tissues and adjacent normal tissues. UTX expression of cancer tissues and adjacent normal tissues was detected on both mRNA and protein levels using real time-PCR and IHC, respectively. And the relationship between UTX expression and the 45 patients' clinical characteristics was analyzed. The mRNA level of UTX in cancer tissues(C) was 4.4 folds, higher than that of the adjacent normal tissues(N) [ 0.883 2±0.703 8 vs. 0.199 7±0.140 0, P<0.05]. The protein expression of UTX in cancer tissues was up-regulated, and the protein score of cancer tissues was 4 folds, change compared with adjacent normal tissues[12±4 vs. 3±3, P<0.05].The expression of UTX was associated with pathological grade(P=0.004)but without gender, age, tumor size and TNM stage. UTX is up-regulated in RCC tissues and the expression of UTX is associated with pathological grade, illustrating that UTX may play an important role in renal cancer progression.


Enema infusion technique inappropriate for evaluating viral competence of ticks.
To determine whether anal infusion of virus simulates the natural route of infection rather than intracoelomic injection, we compared the course of Venezuelan equine encephalitis (VEE) virus infection in Amblyomma cajennense (F.) ticks that had been exposed to virus by enema infusion with that in ticks fed on a viremic host or exposed by intracoelomic inoculation. Although virus was detected in virtually all ticks 14 d after exposure, orally exposed ticks contained significantly less virus (10(1.9) plaque-forming units [PFU] per tick) than did ticks infected by enema (10(4.1) PFU per tick) or intracoelomically (10(4.2) PFU per tick). At 42 d after virus exposure, only 1% of 512 orally exposed ticks contained virus, but most enema (77%, n = 43) or intracoelomically (79%, n = 29) exposed ticks were infected. Replication of VEE virus in A. cajennense ticks exposed to virus by enema infusion, therefore, appeared more similar to that of ticks inoculated intracoelomically than to those exposed orally. Thus, because enema infusion may bypass potential midgut infection and escape barriers, this procedure may not be appropriate for determining vector competence in ixodid ticks.


Single Daily Icodextrin Exchange as Initial and Solitary Therapy.
Incremental dialysis utilizes gradually increasing dialysis doses in response to declines in residual kidney function, and it is the preferred renal replacement therapy for patients who have just transitioned to end-stage renal disease (ESRD). Incremental peritoneal dialysis (PD) may impose fewer restrictions on patients' lifestyle, help attenuate lifetime peritoneal and systemic exposure to glucose and its degradation products, and minimize connections that could compromise the sterile fluid path. In this study, we utilized a 3-pore kinetic model to assess fluid and solute removal during single daily icodextrin treatments for patients with varying glomerular filtration rates (GFR). Single icodextrin exchanges of 8 to 16 hours using 2- and 2.5-L bag volumes were simulated for different patient transport types (i.e., high to low) to predict daily peritoneal ultrafiltration (UF), daily peritoneal sodium removal, and weekly total (peritoneal + residual kidney) Kt/V (Kt/VTotal) for patients with residual renal GFRs ranging from 0 to 15 mL/min/1.73 m2. Daily peritoneal UF varied from 359 to 607 mL, and daily peritoneal Na removal varied from 52 to 87 mEq depending on length of icodextrin exchange and bag volume. Both were effectively independent of patient transport type. All but very large patients (total body water [TBW] > 60 L) were predicted to achieve adequate dialysis (Kt/VTotal ≥ 1.7) with a GFR of 10 mL/min/1.73 m2, and small patients (TBW: 30 L) were predicted to achieve adequate dialysis with a GFR of 6 mL/min/1.73 m2. A single daily icodextrin exchange can be tailored to augment urea, UF, and Na removal in patients with sufficient residual kidney function (RKF). A solitary icodextrin exchange may therefore be reasonable initial therapy for some incident ESRD patients.


[Clinical aspect of paroxysmal disorders of heart rhythm].
The clinical analysis of 265 patients with paroxysmal disorders of cardiac rhythm established that 39,6 per cent were with chronic heart diseases, 23,4 per cent--with rheumatic valvular defects, 12,1 per cent--with arterial hypertension, 10,6 per cent--with myocardiopathy with undistinguished etiology, 8,2 per cent--with other diseases, 6,1 per cent--clinically healthy. Supraventricular paroxysmal tachycardia was established in 35,8 per cent, paroxysmal auricular fibrillation--in 37,3 per cent, paroxysmal tachycardia with AV block--15,6 per cent, ventricular tachycardia--11,3 per cent. The duration of the paroxysms in supraventricular tachycardia has lasted for 6,7 years, in auricular fibrillation--3,2 years, in AT with AV block--1,2 years and in ventricular tachycardia--3,4 years. Apart from the basic disease the duration of the paroxysm and heart rate are of importance for the origination of the hemodynamic disorders.


Nonmuscle myosin light-chain kinase mediates neutrophil transmigration in sepsis-induced lung inflammation by activating beta2 integrins.
Nonmuscle myosin light-chain kinase (MYLK) mediates increased lung vascular endothelial permeability in lipopolysaccharide-induced lung inflammatory injury, the chief cause of the acute respiratory distress syndrome. In a lung injury model, we demonstrate here that MYLK was also essential for neutrophil transmigration, but that this function was mostly independent of myosin II regulatory light chain, the only known substrate of MYLK. Instead, MYLK in neutrophils was required for the recruitment and activation of the tyrosine kinase Pyk2, which mediated full activation of beta(2) integrins. Our results demonstrate that MYLK-mediated activation of beta(2) integrins through Pyk2 links beta(2) integrin signaling to the actin motile machinery of neutrophils.


Ring1a protects against colitis through regulating mucosal immune system and colonic microbial ecology.
Inflammatory bowel disease (IBD) represents a prominent chronic immune-mediated inflammatory disorder, yet its etiology remains poorly comprehended, encompassing intricate interactions between genetics, immunity, and the gut microbiome. This study uncovers a novel colitis-associated risk gene, namely Ring1a, which regulates the mucosal immune response and intestinal microbiota. Ring1a deficiency exacerbates colitis by impairing the immune system. Concomitantly, Ring1a deficiency led to a Prevotella genus-dominated pathogenic microenvironment, which can be horizontally transmitted to co-housed wild type (WT) mice, consequently intensifying dextran sodium sulfate (DSS)-induced colitis. Furthermore, we identified a potential mechanism linking the altered microbiota in Ring1aKO mice to decreased levels of IgA, and we demonstrated that metronidazole administration could ameliorate colitis progression in Ring1aKO mice, likely by reducing the abundance of the Prevotella genus. We also elucidated the immune landscape of DSS colitis and revealed the disruption of intestinal immune homeostasis associated with Ring1a deficiency. Collectively, these findings highlight Ring1a as a prospective candidate risk gene for colitis and suggest metronidazole as a potential therapeutic option for clinically managing Prevotella genus-dominated colitis.


Monozygotic twinning associated with assisted reproductive technologies: a review.
Twin birth rates have increased markedly in developed countries since the 1970s for two primary reasons: increasing maternal age and the advent and increasing use of fertility treatments. In addition, monozygotic (MZ) twin pregnancies have been reported to occur at a significantly higher rate following assisted reproductive technologies (ART) procedures compared with the natural incidence. Twin pregnancies are of concern due to a dramatically increased risk of associated complications. Monozygotic twin pregnancies carry a 10-20% risk of twin-twin transfusion syndrome, and monoamniotic monochorionic twins are additionally at risk for cord entanglement. While the mechanisms and contributory factors for dizygotic twinning are well established, very little is known about the mechanisms involved in MZ twinning or the factors that contribute to its occurrence. In this review, we will discuss a number of potential mechanisms involved in MZ twinning and explore factors that may be contributing to the increased incidence of ART-associated MZ twins. An improved understanding of the factors that contribute to increased MZ twinning associated with ART will help to elucidate the poorly understood mechanisms involved in the process and will further aid in reducing the overall incidence of multiple pregnancies with their associated risks following ART procedures.


Early acute effects of mercuric chloride on synthesis and release of kallikrein and on distal tubular morphology of rat renal cortical slices.
The effect of mercuric chloride on kallikrein content and secretion of renal cortical slices was studied. Mercuric chloride showed dose-dependent inhibition of the secretion of immunoreactive and active kallikrein in the medium associated with a relative increase in the kallikrein tissue content of slices. However the net de novo biosynthesis was also reduced. Active and inactive kallikrein exhibited the same percentage of inhibition indicating that the activation mechanism of prokallikrein was not affected. These results suggest that mercuric chloride exerts an inhibition on tubular secretion but also on the tissular biosynthesis of kallikrein in these in vitro conditions. Morphological study of slices incubated in the presence of mercury also revealed significant tissular lesions which were located on the proximal tubule, but distal tubular changes were also observed. Distal nephrons were identified by the presence of immunoreactive kallikrein with the peroxidase-antiperoxidase method. These ultrastructural alterations included an increase in number and size of lysozomes, vacuoles and lipid droplets. These lesions were associated with an increased release of the lysozomal enzyme N-acetyl-beta-D-glucosaminidase. Since these distal tubular lesions are associated with inhibition of kallikrein secretion which is specifically located in the distal tubule, these results suggest that acute exposure of kidney cortical slices to mercuric chloride causes rapid and marked ultrastructural changes not only on the proximal tubule but also induced structural and biochemical effects at the distal tubule level. As incubation of mercuric chloride did not induce any direct alterations of immunoreactive and active kallikrein, it is likely that the observed inhibition of kallikrein synthesis and secretion are secondary to the morphological lesions.


Concentration-Gradient-Method for sulphur and strontium isotope ratio determination by quadrupole-based inductively coupled plasma mass spectrometry in gypsum.
The concentration-gradient-method (CGM) was previously introduced as a precise and accurate method for isotope ratio determination by quadrupole-based inductively coupled plasma mass spectrometry (ICP-QMS). The investigation of its potential and advantages in the analysis of analytes with a poor signal-noise ratio (S/N) is important to establish routine isotope ratio analysis industrial applications on these widely used instruments. The CGM was applied on isotope measurements of Sr near its limit of quantification (LOQ) and of sulphur where there was a massively interfered 32 S isotope signal in gypsum samples of different origin, in order to demonstrate the advantages of the CGM over the commonly used measurement and evaluation approach. The comparison between the CGM and the classical measurement and evaluation approach was performed with high and low concentration Sr standard solutions, to prove the robustness of the isotope ratio determination. In both cases the CGM reached a recovery rate of approximately 103 %, whereas the classical approach became increasingly inaccurate at lower S/N (recovery of 123 %). In the case of sulphur isotope ratio determination only the CGM enabled a differentiation between geogenic and flue gas desulphurisation plant-originated gypsum samples. The robustness of the CGM approach was illustrated for gypsum samples with trace strontium concentration and its general applicability to the determination of sulphur isotope ratios by means of quadrupole-based ICP-MS was demonstrated using the example of sulphur in gypsum.


Production of alpha-amylase by microscopic fungi.
The amylolytic activity and especially the production of alpha-amylase (EC 126.96.36.199) and alpha-glucosidase (EC 22.214.171.124) was screened in imperfect fungi, mucoral fungi and some ascomycetes. The character of the polysaccharide system, which is responsible for the utilization of alpha (1 to 4) glucan, was specified with a concomitant screening of growth on soluble starch. The amylolytic activity was found in 29 strains out of the 49 tested.


Causes of dental fractures in the early permanent dentition: a retrospective study.
Two hundred eight patients, who applied to the Department of Pedodontics, Dental School, Dicle University between 1995 and 1998, were evaluated in terms of permanent teeth fracture. The aim of this retrospective study was to investigate the probable causes of the trauma, the effects of age and gender on dental trauma, prevalence of fracture types, and distribution of fracture type according to arch. It was observed that the falls or collisions were the main causes. It was also determined that the age group most frequently suffering fractures was ages 9 to 11 years. The majority of the patients were male. The enamel-dentin-pulp-type fracture and those causing the tooth to become nonvital were the most prevalent, and the majority of the fractures were observed in maxillary central teeth.


Validation of a first-generation long-oligonucleotide microarray for transcriptional profiling in the pig.
A first-generation porcine oligonucleotide set, representing 13,297 cDNAs and ESTs, has been designed by Qiagen-Operon for transcriptional profiling. To validate this set, microarrays containing each 70-mer oligonucleotide, referred to as the Qiagen-NRSP8 array, were hybridized with targets from porcine adult liver, lung, muscle, or small intestine. Transcriptome analyses showed that 11,328 of the oligonucleotides demonstrated expression in at least one tissue. Statistical analyses revealed that 1810 genes showed differential expression among tissues (Bonferroni adjusted p < 0.05). Biological pathways identified by DAVID/EASE analysis using a list of 423 tissue-selective genes matched archetypal pathways in the corresponding human or mouse tissue. Real-time quantitative PCR confirmed expression patterns for 9 of 11 genes tested. Our results demonstrate that this first-generation porcine oligonucleotide array is informative and the specificity is high. This is essential validation for investigators using the Qiagen-NRSP8 array for porcine functional genomics and for using the pig in modeling important physiological problems.


Premature ovarian failure.
Premature ovarian failure (POF) is the term usually used to describe women aged younger than 40 years, who present with amenorrhoea, hypergonadotropic hypogonadism, and infertility. POF is a devastating diagnosis for reproductive-aged women. The clinical presentation is diverse, and several different disorders can lead to premature ovarian failure. POF has serious health consequences, including psychological distress, infertility, osteoporosis, autoimmune disorders, ischaemic heart disease, and increased risk of mortality. Hashimoto's disease is the most frequent autoimmune disorder associated with premature ovarian failure. Management should be initiated immediately to prevent long-term consequences. Oestrogen therapy is the mainstay of management. Hormone therapy should be provided to eliminate symptoms of oestrogen deficiency.


Molecular Identification and Sequencing of <I>Mycoplasma gallisepticum</I> Recovered from Broilers in Egypt.
Avian mycoplasmosis, particularly Mycoplasma gallisepticum (MG) is one of the infectious diseases associated with economic losses in Egyptian poultry industry. Thus, this study was aimed to determine the prevalence, serological identification, molecular characterization, sequencing and minimum inhibitory concentration of M. gallisepticum isolated from diseased broilers in Egypt. A total of 351 samples (227 tissue samples "tracheas and air sacs" and 124 tracheal swabs) and 71 sera were collected from diseased broilers. The conventional (isolation and biochemical) and molecular methods (PCR) were performed for detection of M. gallisepticum and virulence-associated gene (mgc2). The serum plate agglutination (SPA) test and enzyme-linked immunosorbent assay (ELISA) were applied on sera for determination of the presence of antibodies against M. gallisepticum. The minimal inhibitory concentration test (MIC) was used to determine the sensitivity of two sequenced M. gallisepticum strains to anti-mycoplasma agents. The total recovery rate of Mycoplasma from 351 samples from broilers was 45.29% (159) in which M. gallisepticum showed a prevalence of 62.89% (100/159). Serological identification of M. gallisepticum in 71 collected sera using SPA and ELISA were 54.9 and 40.8% with the highest geometric mean titer of ELISA for M. gallisepticum (699.08 and 495.92). Molecular characterization of Mycoplasma using PCR showed that 50% (3/6) of tested isolates were identified as M. gallisepticum based on 16SrRNA. Also, the mgc2 gene was detected in 50% (3/6) M. gallisepticum isolates. Two positive PCR mgc2 specific genes of M. gallisepticum isolates were subjected to gene target sequencing (GTS) to verify that these two isolates were M. gallisepticum. The minimal inhibitory concentration test (MIC) was applied to determine the sensitivity of these two sequenced M. gallisepticum strains to anti-mycoplasma agents. The first M. gallisepticum isolate was sensitive to tilmicosin, tiamulin and spiramycin. The second M. gallisepticum isolate showed sensitivity to tiamulin, spiramycin and tilmicosin. These results summarized the necessity of monitoring the Egyptian poultry farms for avian mycoplasmosis. Also, further studies are required for controlling of mycoplasma in all stages of the poultry industry production chain to avoid different losses in Egypt.


[Diabetes mellitus: current classification based on cause and sharpened blood glucose limits for diagnosis].
Recently new definitions were agreed for the glucose tolerance test (GTT), for impaired glucose tolerance and for the classification of diabetes mellitus. The World Health Organization and the American Diabetes Association have been active on this point. The fasting glucose value has been lowered and been brought into line with the two hour value of the GTT. Fasting glucose values can now be used for the diagnosis of diabetes mellitus and of impaired glucose tolerance. The new classification is based on differences in cause of the diabetes. The classification includes diabetes mellitus types 1 and 2, pregnancy diabetes and 'other forms of diabetes'.


Ultrasonography, computed tomography and arteriography in the evaluation of the local spreading of malignant renal neoplasm.
In a series of 32 operated renal carcinoma patients, the ability of ultrasonography (US), computed tomography (CT) and arteriography to demonstrate the local spreading of renal carcinoma was investigated. Operation showed that 23 of the renal carcinomas were local. Nine carcinomas had spread locally. CT was the most sensitive indicator of local spreading (particularly perirenal extension). CT examinations, however, also gave most of the false positive findings. The number of false negative findings was highest in the US group.


Recent Advances in Biosensor Development for the Detection of Viral Particles in Foods: A Comprehensive Review.
Viral foodborne diseases cause serious harm to human health and the economy. Rapid, accurate, and convenient approaches for detecting foodborne viruses are crucial for preventing diseases. Biosensors integrating electrochemical and optical properties of nanomaterials have emerged as effective tools for the detection of viruses in foods. However, they still face several challenges, including substantial sample preparation and relatively poor sensitivity due to complex food matrices, which limit their field applications. Hence, the purpose of this review is to provide an overview of recent advances in biosensing techniques, including electrochemical, SERS-based, and colorimetric biosensors, for detecting viral particles in food samples, with emerging techniques for extraction/concentration of virus particles from food samples. Moreover, the principle, design, and advantages/disadvantages of each biosensing method are comprehensively described. This review covers the recent development of rapid and sensitive biosensors that can be used as new standards for monitoring food safety and food quality in the food industry.


[Insulin application techniques in adult patients with diabetes].
Treatment of diabetes mellitus with insulin is associated with a large number of subcutaneous injections. Incorrect insulin application technique can lead to complications both local (lipohypertrophy, scars) and systemic (high variability of insulin absorption and action, unexpected hypoglycemia or hyperglycemia, suboptimal overall glucose control). Regarding insulin application, we need to pay particular attention to the risk of intramuscular application and consequent less expectable insulin effect. The risk of accidental intramuscular administration of insulin is reduced when shorter 4 mm insulin pen needles are used. Repeated application of insulin in the same locations may cause changes in the subcutaneous tissue (lipohypertrophy, inflammation). Application sites should be examined during routine checks at diabetes clinics. Patients should also be repeatedly advised to rotate the injection sites as a prevention of lipohypertrophy formation and not to inject any more injections into pathologically changed subcutaneous tissue. At the same time, patients should be advised that their total insulin dose may be decreased, and that they are temporarily at higher risk of hypoglycemia, if they switch injecting from lipohypertrophy changed tissue into healthy tissue. glucose variability - insulin application - lipohypertrophy - needles.


Endoscopic Treatment for Persistent Hematospermia: A Novel Technique Using a Holmium Laser.
We present our endoscopic technique for treating ejaculatory duct and seminal vesicle diseases with a holmium laser. Fifteen patients with persistent hematospermia were enrolled in this study from June 2007 to April 2014. All patients had failed medical treatments. All patients were evaluated with transrectal ultrasound and pelvic computed tomography or magnetic resonance imaging. We performed endoscopic treatment with a semi-rigid ureteroscope after dilation using a guidewire and ureteral serial dilator. A holmium laser was used to incise the obstructed ejaculatory duct, coagulate hemorrhagic mucosa, and fragment stones in the ejaculatory duct or seminal vesicles. Stones were removed using a basket and forceps. The mean duration of hematospermia was 30.6 months. Mean patient age was 45.3 years. The mean serum levels of prostate-specific antigen and testosterone were 1.36 and 4.95 ng/mL, respectively. No operative complications were encountered. Mean operative time was 35.4 min. Seven patients had ejaculatory duct or seminal vesicle stones, which were subsequently determined to be carbonate apatite, mucin, struvite, and calcium oxalate dehydrate stones. Mean duration of follow-up was 32.1 months. Although two patients showed recurrent hematospermia 11 and 12 months after the operation, hematospermia resolved in 13 patients (86.7%). The infertile patient showed an improved semen finding and had a successful pregnancy. Endoscopic treatment using a holmium laser is minimally invasive and was effective for treating ejaculatory duct and seminal vesicle diseases, which are the main cause of hematospermia.


Sub-Lethal Peak Exposure to Insecticides Triggers Olfaction-Mediated Avoidance in Zebrafish Larvae.
In agricultural areas, insecticides inevitably reach water bodies via leaching or run-off. While designed to be neurotoxic to insects, insecticides have adverse effects on a multitude of organisms due to the high conservation of the nervous system among phyla. To estimate the ecological effects of insecticides, it is important to investigate their impact on non-target organisms such as fish. Using zebrafish as the model, we investigated how different classes of insecticides influence fish behavior and uncovered neuronal underpinnings of the associated behavioral changes, providing an unprecedented insight into the perception of these chemicals by fish. We observed that zebrafish larvae avoid diazinon and imidacloprid while showing no response to other insecticides with the same mode of action. Moreover, ablation of olfaction abolished the aversive responses, indicating that fish smelled the insecticides. Assessment of neuronal activity in 289 brain regions showed that hypothalamic areas involved in stress response were among the regions with the largest changes, indicating that the observed behavioral response resembles reactions to stimuli that threaten homeostasis, such as changes in water chemistry. Our results contribute to the understanding of the environmental impact of insecticide exposure and can help refine acute toxicity assessment.


Toluene oxidation removal from air over CoxOy/AC catalyst.
The CoxOy/AC catalysts were prepared by wet impregnation method for toluene oxidation removal from air. The thermal stability of cobalt nitrate and Co oxide on the activated carbon (AC) support surface was analysed by thermal analysis. The physicochemical properties of the prepared catalysts were characterised by XRD, SEM, H2-TPR, and XPS. AC support with high specific surface area and developed pore structure can promote the dispersion of Co species on its surface to form highly dispersed Co oxide species. The participation of AC supports can promote the partial reduction of Co3O4 species to CoO species to coexist in the prepared CoxOy/AC catalyst. The Co2+/Co3+ ratio was significantly affected by the calcination temperature, and the appropriate Co2+/Co3+ ion pairs in the studied CoxOy/AC catalyst is helpful to the activity of O2 molecules to form reactive oxygen species. The oxygen species composition on the catalyst surface is obviously affected by the calcination temperature, which plays an important role in toluene oxidation reaction. The studied CoxOy/AC catalysts exhibited excellent toluene oxidation removal performances. The conversion of toluene exceeded 97% and 99% at 240°C and 250°C, respectively, and maintained good stability within 700 min. That is to say, the concentration of toluene in the air can be reduced from 10,000 ppm to less than 40 ppm by using the CoxOy/AC catalyst.


Multiple kernel learning for integrative consensus clustering of omic datasets.
Diverse applications-particularly in tumour subtyping-have demonstrated the importance of integrative clustering techniques for combining information from multiple data sources. Cluster Of Clusters Analysis (COCA) is one such approach that has been widely applied in the context of tumour subtyping. However, the properties of COCA have never been systematically explored, and its robustness to the inclusion of noisy datasets is unclear. We rigorously benchmark COCA, and present Kernel Learning Integrative Clustering (KLIC) as an alternative strategy. KLIC frames the challenge of combining clustering structures as a multiple kernel learning problem, in which different datasets each provide a weighted contribution to the final clustering. This allows the contribution of noisy datasets to be down-weighted relative to more informative datasets. We compare the performances of KLIC and COCA in a variety of situations through simulation studies. We also present the output of KLIC and COCA in real data applications to cancer subtyping and transcriptional module discovery. R packages klic and coca are available on the Comprehensive R Archive Network. Supplementary data are available at Bioinformatics online.


Robust fault reconstruction using sliding mode observers with nonlinear nominal systems.
This paper is concerned with fault reconstruction based on sliding mode observers; its contribution is twofold: on the one hand, it develops a novel sliding mode observer whose nominal system is nonlinear, thus relaxing former limitations on the subject, namely, rank restrictions, linear outputs, and conservative bounds; on the other hand, based on the referred sliding mode observer, a novel robust fault reconstruction scheme is constructed which can solve a variety of problems that former methodologies cannot treat. Nonlinearities are cast as convex expressions, which enables obtaining design conditions in the form of linear matrix inequalities. Examples are provided to compare the proposal with former methodologies, thus highlighting the contributions.


Grouped fuzzy SVM with EM-based partition of sample space for clustered microcalcification detection.
Detection of clustered microcalcification (MC) from mammograms plays essential roles in computer-aided diagnosis for early stage breast cancer. To tackle problems associated with the diversity of data structures of MC lesions and the variability of normal breast tissues, multi-pattern sample space learning is required. In this paper, a novel grouped fuzzy Support Vector Machine (SVM) algorithm with sample space partition based on Expectation-Maximization (EM) (called G-FSVM) is proposed for clustered MC detection. The diversified pattern of training data is partitioned into several groups based on EM algorithm. Then a series of fuzzy SVM are integrated for classification with each group of samples from the MC lesions and normal breast tissues. From DDSM database, a total of 1,064 suspicious regions are selected from 239 mammography, and the measurement of Accuracy, True Positive Rate (TPR), False Positive Rate (FPR) and EVL = TPR* 1-FPR are 0.82, 0.78, 0.14 and 0.72, respectively. The proposed method incorporates the merits of fuzzy SVM and multi-pattern sample space learning, decomposing the MC detection problem into serial simple two-class classification. Experimental results from synthetic data and DDSM database demonstrate that our integrated classification framework reduces the false positive rate significantly while maintaining the true positive rate.


Tissue-Specific Hormone Signalling and Defence Gene Induction in an In Vitro Assembly of the Rapeseed Verticillium Pathosystem.
Priming plants with beneficial microbes can establish rapid and robust resistance against numerous pathogens. Here, compelling evidence is provided that the treatment of rapeseed plants with Trichoderma harzianum OMG16 and Bacillus velezensis FZB42 induces defence activation against Verticillium longisporum infection. The relative expressions of the JA biosynthesis genes LOX2 and OPR3, the ET biosynthesis genes ACS2 and ACO4 and the SA biosynthesis and signalling genes ICS1 and PR1 were analysed separately in leaf, stem and root tissues using qRT-PCR. To successfully colonize rapeseed roots, the V. longisporum strain 43 pathogen suppressed the biosynthesis of JA, ET and SA hormones in non-primed plants. Priming led to fast and strong systemic responses of JA, ET and SA biosynthesis and signalling gene expression in each leaf, stem and root tissue. Moreover, the quantification of plant hormones via UHPLC-MS analysis revealed a 1.7- and 2.6-fold increase in endogenous JA and SA in shoots of primed plants, respectively. In roots, endogenous JA and SA levels increased up to 3.9- and 2.3-fold in Vl43-infected primed plants compared to non-primed plants, respectively. Taken together, these data indicate that microbial priming stimulates rapeseed defence responses against Verticillium infection and presumably transduces defence signals from the root to the upper parts of the plant via phytohormone signalling.


Anatomical Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autografts: A Comparative Study of Three Different Techniques.
The ideal procedure for anterior cruciate ligament (ACL) reconstruction is one that can achieve anatomical restoration for a better ACL function. This retrospective comparative study was conducted to evaluate the objective and subjective clinical results of the conventional single-bundle femoral round (SBR) tunnel technique, the single-bundle femoral oval (SBO) tunnel technique, and the double-bundle (DB) surgical technique for anatomical ACL reconstruction with hamstring tendon autografts. Patients who underwent the SBO, SBR, and DB ACL reconstructions from January 2016 to August 2017 were included in this study. A total of 163 patients underwent different surgical techniques; 41 patients underwent the SBO procedure, 78 patients received SBR, and the remaining 44 patients underwent the DB procedure. The Lachman's test, pivot-shift test, Lysholm's score, International Knee Documentation Committee (IKDC) score, and Tegner's score were compared among groups postoperatively. KT-1000 was used to measure the anterior laxity of the knee. Magnetic resonance imaging was used to compare the ACL graft maturity. Second-look arthroscopy was conducted to compare the graft status and synovial coverage. Significant differences among groups were found with respect to the Lysholm's score, Tegner's score, and IKDC score. Patients in the SBO and DB groups acquired higher functional scores than the SBR group. More patients with positive pivot-shift test were observed in the SBR group than other groups at 12- and 24-month postoperative follow-ups. The postoperative KT-1000 was better in the SBO and DB groups than in the SBR group. The mean signal/noise quotient (SNQ) of the SBO group was 2.70 ± 0.92, significantly lower than 3.58 ± 1.21 of the SBR group. Despite a higher proportion of patients with grade B or C synovial coverage and partial graft injury found in the SBR group, there were no significant differences among the groups. The SBO and DB technique achieved better clinical results than the SBR technique. The SBO technique was indeed an ideal surgical procedure for ACL reconstruction provided that the shortcoming of DB technique must be taken into account. This is a Level III, retrospective comparative study.


Successful surgery of massive thoracic injury in a girl following chest trauma.
Patients with penetrating thoracic injuries should be managed appropriately and rapidly under the supervision of multi-disciplinary team. We present a case of a 9-year-old female student who survived a major road traffic accident (RTA), a leading contributor to accidental deaths in Pakistan. The girl was hit by a public transport bus impaled by a metallic rod through the right axilla, and subsequently dragged for a distance, resulting in avulsion of a broad front of the mid-anterior and left precordial part of the chest wall. Although both the lungs and heart were exposed, she did not suffer any myocardial injury. Despite massive hypovolaemic shock with bilateral open pneumothoraces, the girl made an uneventful recovery. She was discharged on the 7th post-operative day. The report highlights the value of proper management of hypovolaemic shock and optimally timed and executed surgical intervention.


Tuberculin skin test and interferon-gamma release assay use among privately insured persons in the United States.
To describe tuberculin skin test (TST) and interferon-gamma release assay (IGRA) (i.e., QuantiFERON®-TB [QFT] and T-SPOT®.TB [T-SPOT]) use among privately insured persons in the United States over a 15-year period. We used current procedural terminology (CPT) codes for the TST and IGRAs to extract out-patient claims (2000-2014) and determined usage (claims/100 000). The χ2 test for trend in proportions was used to describe usage trends for select periods. The TST was the dominant (>80%) test in each year. Publication of guidelines preceded the assignment of QFT and T-SPOT CPT codes by 1 year (2006 for QFT; 2011 for T-SPOT). QFT usage was higher (P < 0.01) than T-SPOT in each year. The average annual increase in the use of QFT was higher than that of T-SPOT (35 vs. 3.8/100 000), and more so when the analytic period was 2011-2014 (65 vs. 38/100 000). However, during that 4-year period (2011-2014), TST use trended downward, with an average annual decrease of 28/100 000. The annual proportion of enrollees tested ranged from 1.1% to 1.5%. These results suggest a gradual shift from the use of the TST to the newer IGRAs. Future studies can assess the extent, if any, to which the shift from the use of the TST to IGRAs evolved over time.


CXCR4(+)CD45(-) BMMNC subpopulation is superior to unfractionated BMMNCs for protection after ischemic stroke in mice.
Cell-based therapy is considered to be a promising therapeutic strategy for stroke treatment. Although unfractionated bone marrow mononuclear cells (BMMNCs) have been tried in both preclinical and clinical trials, the effective subpopulations need to be identified. In this study, we used fluorescence-activated cell sorting to harvest the CXCR4(+)CD45(+) and CXCR4(+)CD45(-) BMMNC subpopulations from transgenic mice that express enhanced green fluorescent protein. We then allogeneically grafted unfractionated BMMNCs or a subpopulation into mice subjected to transient middle cerebral artery occlusion (tMCAO) and compared the effects on stroke outcomes. We found that CXCR4(+)CD45(-) BMMNCs, but not CXCR4(+)CD45(+) BMMNCs, more effectively reduced infarction volume and neurologic deficits than did unfractionated BMMNCs. Brain tissue from the ischemic hemisphere of mice treated with CXCR4(+)CD45(-) BMMNCs had higher levels of vascular endothelial growth factor and lower levels of TNF-α than did tissue from mice treated with unfractionated BMMNCs. In contrast, CXCR4(+)CD45(+) BMMNCs showed an increase in TNF-α. Additionally, CXCR4(+)CD45(+) and CXCR4(+)CD45(-) populations exhibited more robust migration into the lesion areas and were better able to express cell-specific markers of different linages than were the unfractionated BMMNCs. Endothelial and astrocyte cell markers did not colocalize with eGFP(+) cells in the brains of tMCAO mice that received CXCR4(+)CD45(+) BMMNCs. In vitro, the CXCR4(+)CD45(-) BMMNCs expressed significantly more Oct-4 and Nanog mRNA than did the unfractionated BMMNCs. However, we did not detect gene expression of these two pluripotent markers in CXCR4(+)CD45(+) BMMNCs. Taken together, our study shows for the first time that the CXCR4(+)CD45(-) BMMNC subpopulation is superior to unfractionated BMMNCs in ameliorating cerebral damage in a mouse model of tMCAO and could represent a new therapeutic approach for stroke treatment.


[Importance of in vivo and in vitro studies of leukotrienes. Application to the particular instance of aspirin].
The major role played by leukotrienes in the inflammatory reaction is today clearly demonstrated. These newly-formed mediators show powerful pro-inflammatory activities and their release from various cell types may be induced by agonists including the allergens. Therefore, leukotriene levels in biological fluids may represent a reliable image of the local or systemic inflammatory reaction and their release in vitro after incubation of the blood leukocytes in the presence of a specific allergen is today widely used for allergy diagnosis. Leukotrienes metabolism is deeply involved in aspirin intolerance or so-called pseudo allergy and, in spite of that the exact mechanism involved is still unknown, leukotriene release in vitro by ASA in the presence C5a represent the first reliable test for this diagnosis. The results of the recent clinical trials concerning the activity of anti-leukotrienes in vivo have led to a real therapeutic hope.


Comprehensive public health action for our aging world: the quintessence of public health policy.
The number of elderly people is increasing rapidly because of decreasing mortality rates and increasing lifespans throughout the world. Policies and programs for elderly people are limited, and existing programs/policies are not implemented effectively towards the goal of healthier aging. Unlike other public health issues and actions, there is an urgent need to build an evidence-based comprehensive public health action policy for healthy aging.


[Era of enhanced recovery after surgery and robotic gastric cancer surgery].
Enhanced recovery after surgery (ERAS) has been rapidly developing by combining several techniques with evidence-based adjustments, including preoperative education, preoperative carbohydrate loading, epidural or regional anesthesia, early initiation of enteral nutrition, ambulation and multi-modal pain management. The core part of ERAS is to reduce and reverse surgical stress and therefore greatly improve clinical outcome. Under the guidance of ERAS, perioperative management of robotic gastric cancer operation should follow the basic principles of ERAS and clinical pathway to maximize the advantages of the robotic surgery. ERAS protocol is safe and feasible for patients undergoing robotic radical gastrectomy and it can reduce surgical stress, shorten hospital stay, improve quality of life and does not increase complications, whose mechanism may be associated with the reduction of inflammation and insulin resistance, the decrease of resting energy exposure, and the protection of mitochondria function. It is worth emphasizing that it is very important to fully understand the changes of pathophysiology during perioperative period, to strictly implement the ERAS pathway based on optimized evidence-based medicine, to cooperate closely with the multidisciplinary team, to observe and manage the postoperative complications dynamically by systemic classification. The improvement of ERAS program on the outcome of patients should be summarized regularly and the new interventional strategies should be evaluated further according to the international standard.