Drosophila Embryos as a Model for Wound-Induced Transcriptional Dynamics: Genetic Strategies to Achieve a Localized Wound Response.
While many studies have established a paradigm for tissue repair at the level of cellular remodeling, it is not clear how an organism restricts a response only to the injured region of a damaged tissue. Skin, the largest organ in the human body, is prone to injury, and repair of epidermal tissue represents a medically relevant system to investigate. Significance: Studies in Drosophila melanogaster provide a robust genetic system to identify molecular components that will positively impact repair and healing. The Drosophila skin consists of a single-cell epidermal layer and relies on well-conserved cellular mechanisms to coordinate gene expression during development. Many studies have established that key developmental genes promote a response to epidermal injury, but the balance between activator and inhibitor signals to coordinate a localized response remains unknown. Recent Advances: Discovery of a genetic pathway that promotes the restriction of transcriptional response to damage only in effected regions. Interestingly, genome-wide microarray studies have identified an intersection between gene expression after aseptic injury and activation of the innate immune response. Critical Issues: The use of a transcriptional activation reporter provides an innovative approach to uncover well-conserved components that promote the localization of a response during epidermal injury and may influence other pathological conditions of tissue damage. Future Directions: The work reviewed in this critical review may lead to development of molecular strategies of repair and improved healing after injury or infection. The outcomes on the fundamental contribution of a transcriptional response to injury will be translatable to mammalian systems.


Two Novel MicroRNA Biomarkers Related to β-Cell Damage and Their Potential Values for Early Diagnosis of Type 1 Diabetes.
New strategies and biomarkers are needed in the early detection of β-cell damage in the progress of type 1 diabetes mellitus (T1DM). To explore whether serum microRNAs (miRNA) should be served as biomarkers for T1DM. The miRNA profile was established with miRNA microarray in discovery phase (six T1DM, six controls). A miRNA-based model for T1DM diagnosis was developed using logistic regression analysis in the training dataset (40 T1DM, 56 controls) and then validated with leave-one-out cross validation and another independent validation dataset (33 T1DM, 29 controls). Quantitative reverse transcription polymerase chain reaction was applied to confirm the differences of candidate miRNAs between T1DM and controls. Area under the receiver-operating characteristic (ROC) curve (AUC) was used to evaluate diagnostic accuracy. INS-1 cells, streptozotocin-treated mice (n = 4), and nonobese diabetic (NOD) mice (n = 12) were used to evaluate the association of miRNAs with β-cell damage. A miRNA -based model was established in the training dataset with high diagnostic accuracy for T1DM (AUC = 0.817) based on six candidate differential expressed miRNAs identified in discovery phase. The validation dataset showed the model's satisfactory diagnostic performance (AUC = 0.804). Secretions of miR-1225-5p and miR-320c were significantly increased in streptozotocin-treated mice and INS-1 cells. Noteworthy, the elevation of these two miRNAs was observed before glucose elevation in the progress of diabetes in NOD mice. Two miRNA biomarkers (miR-1225-5p and miR-320c) related to β-cell damage were identified in patients with recent-onset T1DM. The miRNA-based model established in this study exhibited a good performance in diagnosis of T1DM.


Acute spinal cord injuries in the Lebanon War, 1982.
Our experience with 17 patients with spinal cord injuries (SCI) acquired in the Lebanon War, 1982, is described. The SCI were due to gunshot wounds in 12 patients and to other causes in 5. Two laparotomies and one thoracotomy were performed. Corticosteroids were not seen to influence recovery, nor was laminectomy, which was performed in three cases. Complications such as pressure sores, hydronephrosis, ileus and deep vein thrombosis were rare or did not occur. Three high quadriplegics died. Based on our experience, we recommend conservative treatment and rehabilitation in acute SCI.


Prognostic disclosures over time: Parental preferences and physician practices.
Although the majority of parents of children with cancer say they want prognostic information, to the authors' knowledge little is known regarding how their desire for and experiences with prognosis communication change over time. A longitudinal, prospective questionnaire-based cohort study of 156 parents of children with cancer treated at 2 academic pediatric hospitals was performed. Previously published scales were administered at the time of diagnosis and at 4 months and 12 months later. The majority of parents preferred to hear about prognosis in as much detail as possible throughout the first year after a diagnosis of cancer (87%, 85%, and 84%, respectively, at the time of diagnosis, 4 months, and 12 months). Although nearly no parents reported wanting less information (<5% at any time point), a significant percentage reported wanting more information at each time point (25%, 28%, and 24%, respectively, at the time of diagnosis, 4 months, and 12 months). The majority of parents reported having had new prognostic discussions with the physician at each time point (93%, 74%, and 81%, respectively, at the time of diagnosis, 4 months, and 12 months). Irrespective of prognosis, parents were more likely to be satisfied with prognostic communication when physicians provided more extensive disclosure at the time of diagnosis (odds ratio, 1.85 per element of disclosure; 95% confidence interval, 1.25-2.74 [P = .002]) and when physicians discussed prognosis again before 4 months (odds ratio, 8.71; 95% confidence interval, 2.64-28.72 [P = .0004]). The majority of parents wanted detailed, longitudinal prognostic conversations; nearly none of the parents preferred less prognostic information. A return to these conversations over time can help rather than hurt parents. Future studies should assess the ideal contents of these longitudinal discussions, and the communication preferences of pediatric patients. Cancer 2017;123:4031-8. © 2017 American Cancer Society.


Biotin deficiency in Arthrobactger globiformis: comparative cell ultrastructure and nonreplacement of the vitamin by structurally unrelated compounds.
The development of aberrant cell forms of Arthrobacter globiformis 425 due to biotin deficiency was followed by electron microscopy of ultrathin sections. Upon comparison with normal cell growth, aberrant cells developed in the early logarithmic growth phase. Several membrane-bound bodies were embedded in a thick matrix, showing that cell division was impaired. Mesosomes and cytoplasmic membranes were still present in the abnormal cell although the normal cell wall was absent. This condition persisted throughout the growth cycle. This pattern of morphological development was correlated with changes in macromolecular composition of the cells. Various structurally unrelated compounds were tested for their ability to replace biotin. These included aspartic acid, oxalacetic acid, coenzyme A, oleic acid, linoleic acid, linolenic acid, and Tween 80. Only Tween 80 was able to spare biotin to a limited degree. However, this sparing action was eliminated in the presence of avidin.


Big battles for small gains: a cautionary note for teaching reflective processes in nursing and midwifery practice.
Since 1988, Australian university nursing courses have adopted the processes of educationalists in embracing reflective practitioner concepts and strategies. The assumption underlying reflective practice appears uniformly to be that if practitioners reflect on and in their practice worlds they can develop ways of changing them. This paper will outline some cautionary points in teaching reflective processes for use in nursing practice, given that they have been processes intent on mobilizing change in densely impacted hegemonic structures in healthcare organizations. To demonstrate that the limits of reflective practice may constitute big battles for small gains, a research project undertaken with practising midwives will be used as a case in point.


Intestinal protozoa and intestinal helminthic infections in displacement camps in Sierra Leone.
Displacement and refugee camps provide ideal grounds for the transmission of parasites and increase the risk of acute respiratory infections, diarhoea diseases, and intestinal parasitic infection. Cryptosporidium parvum, Giardia lamblia, Entomoeba histolytica, Ascaris lumbricoides, hookworm infection, Schistosoma haematobium, S. mansoni and Strongyloides stercoralis are important cosmopolitan intestinal parasites that are common among children, the immunocompromised and displaced populations. Five hundred and eighty one residents from 5 Internally Displaced Persons (IDPs) Camps voluntarily participated in the study by providing stool and urine samples for analysis. The stool specimens were used for the detection of Cryptosporidium specific and Giardia specific antigens by the DMSO modified Acid-Fast and Trichrome-PLUS stain for C. parvum and G. lamblia and E. histoyltica respectively. Stool specimens for the demonstration of helminth eggs and larvae were prepared by the modified Kato technique. One hundred and seventy eight (31%) of the 581 camp residents that submited samples were children below 10 years of age and were selected because they were screened for various forms of malnutrition. However, the data on C. parvum and G. lamblia were included in the analysis for all parasites. More children were positive for G. lamblia (29%) than for C. parvum (10%) and 5% had double infection with both parasites. The antigen positive rate decreased with age for C. parvum and G. lamblia infections. Adult samples were also examined for the C. parvum, G. lamblia, E. histolytica, A. lumbricoides, hookworms, S. haematobium, S. mansoni and S. stercoralis. The prevalence of hookworm was highest at Parade Ground Camp (50%) and hookworm had the highest pevalence rate of 18% among the 581 IDP residents followed by S. mansoni (16.7%) and A. lumbricoides (15%). The overall prevalence of E. histolytica among the study population was 9.0%. The results of this study indicate that intestinal protozoan and helminth parasites are highly prevalent among camp residents in Sierra Leone with five (5) different helminth parasites demonstrated in the stool specimens of residents in the five IDP camps.


Genetic selection and the status of the embryo.
In this paper I want to try to clarify the nature of the two different problems indicated in the title: there is a lively debate on whether or not genetic selection is a morally licit practice, and there are strong disagreements on whether or not the embryo is a person. I think that most of such controversies depend on confusions and/or unclearness about specific problems involved in each issue, I have no precise normative proposal on the morality of genetic selection, but I hope that my analysis will be helpful in avoiding some current confusions.


Imaging normal and cancerous human gastric muscular layer in transverse and longitudinal sections by multiphoton microscopy.
Multiphoton microscopy (MPM) based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG) has been widely used for imaging microstructure of biological tissues. In this article, we used MPM to investigate the microstructure changes of normal and cancerous human gastric muscular layer in transverse and longitudinal sections. The results displayed different patterns of microstructure changes of smooth muscular tissue, cell morphology and interstitial fibers in transverse and longitudinal sections, being similar to standard histopathological images but without the need for tissue processing. Our study demonstrated that MPM can bring more detailed complementary information on tissue architecture through observing transverse and longitudinal sections of tissues, which are the important pathological information when the pathologists diagnose the gastrointestinal lesions. These observations indicate that MPM could be an important potential tool to provide real-time pathological diagnosis for gastric cancer in the future. SCANNING 38:357-364, 2016. © 2015 Wiley Periodicals, Inc.


Transient nonketotic hyperglycinemia and defective serotonin metabolism in a child with neonatal seizures.
Neonatal nonketotic hyperglycinemia is usually fatal or, less commonly, severely developmentally disabling, whereas transient nonketotic hyperglycinemia has usually been followed by normal development. We report a boy who had transient neonatal nonketotic hyperglycinemia but a coexistent disorder of serotonin metabolism manifested by initially low cerebrospinal fluid 5-hydroxyindoleacetic acid (which later normalized), low whole blood serotonin, and decreased platelet serotonin uptake. He survived the neonatal period but was neurodevelopmentally delayed and developed an autistic-like disorder. Later, his positron emission tomographic (PET) scans with alpha[(11)C] methyl-l-tryptophan revealed a pattern characteristic of autistic children. Although we know of no link between glycine and serotonin metabolism, and our patient had low, rather than high, central and peripheral serotonin, this case might represent a novel infantile disorder that affects both the glycine and serotonin neurotransmitter systems.


Objective assessment of listening effort: effects of an increased task demand.
In demanding listening situations the individual has to exert an increased listening effort to process interesting auditory signals correctly. Especially people with hearing loss are particularly affected and require more effort to identify sounds compared to those with normal hearing. So far, a suitable objective estimate of listening effort is still not available. In previous studies, we presented an objective estimate of listening effort (OLEosc), which is based on the instantaneous phase distribution of the ongoing EEG activity. In the current study, the proposed measure was analyzed in detail. The task performance was taken into account, which indicates if the participants can solve the auditory task and exert effort or if they ceased solving the task. The EEG data was acquired from people with moderate hearing loss solving a listening task. During the experiment, hearing aid settings with different microphone configurations were tested. The results indicate that the OLEosc reflects the real exerted effort of the participants. Besides the reflection of different task demands related to the hearing aid settings, it was possible to show a decline of focused attention to the auditory stimuli related to an excessive task demand. Furthermore, the data indicate that the OLEosc is not directly correlated to the speech intelligibility presented in the word score data and is not subjectively biased like the results of the presented rating scale.


Early gamma oscillations.
Gamma oscillations have long been considered to emerge late in development. However, recent studies have revealed that gamma oscillations are transiently expressed in the rat barrel cortex during the first postnatal week, a "critical" period of sensory-dependent barrel map formation. The mechanisms underlying the generation and physiological roles of early gamma oscillations (EGOs) in the development of thalamocortical circuits will be discussed in this review. In contrast to adult gamma oscillations, synchronized through gamma-rhythmic perisomatic inhibition, EGOs are primarily driven through feedforward gamma-rhythmic excitatory input from the thalamus. The recruitment of cortical interneurons to EGOs and the emergence of feedforward inhibition are observed by the end of the first postnatal week. EGOs facilitate the precise synchronization of topographically aligned thalamic and cortical neurons. The multiple replay of sensory input during EGOs supports long-term potentiation at thalamocortical synapses. We suggest that this early form of gamma oscillations, which is mechanistically different from adult gamma oscillations, guides barrel map formation during the critical developmental period.


Stabilities of neutral and basic esters of bendamustine in plasma compared to the parent compound: kinetic investigations by HPLC.
Esters of the cytostatic bendamustine (1), previously demonstrated to be much more potent than the parent compound as antiproliferative agents in vitro, were investigated for stability in buffer and plasma, as well as against porcine liver esterase in the presence of different amounts of albumin using a validated RP-HPLC method with fluorescence detection. The hydrolysis of the nitrogen mustard moiety was retarded (for 1: approximately 130 vs. 11 min) in the presence of plasma proteins. For the derivatives, both cleavage of ester and nitrogen mustard moieties were analyzed. Enzymatic hydrolysis was very fast in the case of 2-pyrrolidino-, 2-piperidino- and 2-(4-methylpiperazino)-ethyl esters, whereas methyl, ethyl, morpholinoethyl and branched 2-pyrrolidinoethyl esters were considerably more stable (half-lives between 41 and 116 min, compared to <5 min). Inhibition by physostigmine indicated unspecific cholinesterases to be involved in the rapid ester cleavage. Due to lower protein content and higher enzymatic activity in murine compared to human plasma, reduced stability of all investigated esters in mouse plasma (t½<2 min) has to be taken into account with respect to the design of animal studies.


The "Managed" or Damaged Heart? Emotional Labor, Gender, and Posttraumatic Stressors Predict Workplace Event-Related Acute Changes in Cortisol, Oxytocin, and Heart Rate Variability.
Vital to the everyday operation of police services, police communicators (911 call-takers and dispatchers) are persistently subject to imminent challenges in the workplace; they must always be prepared to engage and deal with a wide variety of circumstances that provoke various intense emotions and physiological stress responses. Acute changes in cortisol, oxytocin, and heart rate variability are central to adaptive responses in stressful complex social interactions, but they might also be indicative of physiological dysregulation due to long-term psychosocial stress exposures. Thus, we examine acute stress-induced release of peripheral oxytocin and cortisol along with changes in heart rate variability, and how each relates to persistent workplace stressors and symptoms of posttraumatic stress. Findings indicate chronic forms of gendered workplace stress such as emotional labor, gender role stress and, posttraumatic stress each have differential associations with, and predict physiological responses to, acutely stressful events in the workplace. These associations suggest potential mechanisms through which communicators become more vulnerable to developing stress-related disorders such as posttraumatic stress injuries, especially after cumulative traumatic exposures in this context. The results also suggest potential pathways for the biological embedding of stressful gendered workplace experiences.


Bipolar and multipolar radiofrequency.
The increased demand for anti-aging treatments over the past decade has fueled the development of multimodality devices. This allows for more efficacious treatment of dermal defects, excess adiposity, and skin laxity. Radiofrequency (RF) devices are constantly evolving and consequently adding multiple indications for their use. In this article, the authors focus on bipolar and multipolar RF modalities. The objective was to review, summarize, and evaluate the key studies of procedural therapies using bipolar and multipolar RF technologies. Studies selected for evaluation had clear statements of purpose, patient selection, follow-up evaluations, previous and concurrent medications, treatment parameters, methods for evaluating results, and adverse effects. All studies were complete and published in peer-reviewed journals. With their unique mechanism of action, bipolar and multipolar RF devices remain versatile treatment options associated with minimal downtime and pain compared with monopolar RF and other nonablative modalities. Proper patient selection and education along with an experienced treating physician is crucial in achieving patient satisfaction and results. It is important that larger studies are conducted to provide data on upcoming devices. Review of the literature provides a starting point for physicians seeking to treat patients safely and effectively with newer devices.


Nerve entrapments of the lower leg, ankle and foot in sport.
Exercise-related leg pain is a common and yet difficult management problem in sports medicine. There are many common causes of such symptoms including stress fractures and muscle compartment syndromes. There are also a number of less common but important conditions including popliteal artery entrapment and nerve entrapment syndromes. Even for an astute clinician, distinction between the different medical causes may be difficult given that many of their presenting features overlap. This review highlights the common clinical presentations and raises a regional approach to the diagnosis of the neurogenic symptoms. In part, this overlapping presentation of different pathological conditions may be due to a common aetiological basis of many of these conditions namely, fascial dysfunction. The same fascial restriction that predisposes to muscle compartment syndromes may also envelop the neurovascular structures within the leg resulting in either ischaemic or neurogenic symptoms. For many athletes with chronic exercise-related leg pain, combinations of such problems often coexist suggesting a more widespread fascial pathology. In our clinical experience, we often label such patients as 'fasciopaths'; however, the precise pathophysiological basis of this fascial problem remains to be elucidated. This review discusses the various nerve entrapment syndromes in the lower limb that may result in exercise-related leg pain in the sporting context. The anatomy, clinical presentation, investigation, medical management and surgical treatment are discussed at length for each of the syndromes. It is clear from clinical experience that the outcome of surgical management of such syndromes fares much better where a clear dermatomal pain distribution is present or where focal weakness and/or sensory symptoms appropriate for the nerve are present. In many situations, however, nonspecific leg pain or vague nonlocalising sensory symptoms are present and in such situations, alternative diagnoses must be considered and investigated appropriately. As mentioned above, many different pathologies may coexist in the lower limb and may be a source of confusion for the clinician or alternatively may be the reason for poor treatment outcomes.


[Combined use of propafenon and lidoflazine in chronic atrial fibrillation and flutter (author's transl)].
Forty-seven patients with chronic atrial fibrillation and (or) flutter in whom the clinical picture and the length of arrhythmia indicated that drug-mediated cardioversion should be tried were treated with a combination of lidoflazine and propafenon. The average daily dosage was 600 mg for propafenon and 180 mg for lidoflazine. Duration of treatment was limited to 8 days. Return to sinus rhythm was achieved in 34 patients. In comparison with monotherapy combined use of the drugs thus led to a clear-cut increase of the conversion rate. Dosage reduction of these differently acting substances decreases the risk of toxic side effects, particularly as both substances have different side effects which in part cancel each other out. It can be assumed that ventricular extrasystoles seen during treatment with lidoflazine as precursor of malignant tachycardia can be suppressed or eliminated by propafenon.


Comparative Thermodynamic and Structural Analysis of Polyfluorinated Dodecylphosphonic Acid Adsorption to Distilled and River Water Interfaces.
As concerns rise about the health risks posed by per- and polyfluoroalkyl substances (PFAS) in the environment, there is a need to understand how these pollutants accumulate at environmental interfaces. Untangling the details of molecular adsorption, particularly when there are potential interactions with other molecules in environmental systems, can obscure the ability to focus on a particular contaminant with molecular specificity. Often adsorption studies of environmental interfaces require a reductionist approach, where laboratory experiments may not be fully tractable to environmental systems. In this work, we study polyfluorinated dodecylphosphonic acid (F21-DDPA) at the aqueous surfaces of distilled water (the most reduced "environmental" surface) and river water to explore the use of vibrational sum-frequency (VSF) spectroscopy as an experimental probe of fluorinated contaminants at natural environmental surfaces. We demonstrate how VSF spectroscopy offers advantages over nonspecific surface tension measurements when measuring PFAS adsorption isotherms at river water surfaces. VSF spectra of the C-F stretching region selectively probe the presence of F21-DDPA and can be used to extract meaningful structural insights and calculate surface concentrations, even at the complex river water surface. This study highlights the potential for VSF spectroscopy to be developed as a probe of fluorinated contaminants at natural environmental interfaces.


Gonadotropin-releasing hormone antagonist administration enhances gonadotrope responsiveness at doses inadequate to suppress immunoassayable gonadotropin levels.
Chronic GnRH antagonist therapy produces enhanced gonadotrope responsiveness to supraphysiologic stimuli despite the lack of any measurable suppression of gonadotropin levels. This indicates that GnRH antagonists fundamentally alter gonadotrope response mechanisms without inhibiting gonadotropin release. Beyond the physiologic implications, these data may eventually impact the development of clinical protocols. Benefits could include enhancements in the endogenous gonadotropin flare during controlled ovarian hyperstimulation cycles. Additionally, proposed contraceptive protocols where GnRH antagonists are used to produce the initial inhibition in gonadotropin release and are then followed by a GnRH-a (to avoid the gonadotropin flare) may in fact produce paradoxical results.


Dissociable effects of natural image structure and color on LFP and spiking activity in the lateral prefrontal cortex and extrastriate visual area V4.
Visual perception is mediated by unique contributions of the numerous brain regions that constitute the visual system. We performed simultaneous recordings of local field potentials (LFPs) and single unit activity (SUA) in areas V4 and lateral prefrontal cortex to characterize their contribution to visual processing. Here, we trained monkeys to identify natural images at different degradation levels in a visual recognition task. We parametrically varied color and structural information of natural images while the animals were performing the task. We show that the visual-evoked potential (VEP) of the LFP in V4 is highly sensitive to color, whereas the VEP in prefrontal cortex predominantly depends on image structure. When examining the relationship between VEP and SUA, we found that stimulus sensitivity for SUA was well predicted by the VEP in PF cortex but not in V4. Our results first reveal a functional specialization in both areas at the level of the LFP and further suggest that the degree to which mesoscopic signals, such as the VEP, are representative of the underlying SUA neural processing may be brain region specific within the context of visual recognition.


Endoscopic control of the sphenopalatine artery for epistaxis: long-term results.
The aim of this study was to prospectively evaluate post-operative cessation of bleeding and late recurrence of epistaxis in a cohort of patients treated by endoscopic ligation of the sphenopalatine artery. Participants comprised patients undergoing sphenopalatine artery ligation for posterior epistaxis at three east Scotland hospitals. Main outcome measures were recurrence of epistaxis in the immediate post-operative period and at long-term follow up (minimum nine months). Forty-three patients (30 men and 13 women) underwent 45 procedures; two patients underwent bilateral ligation. Two patients suffered recurrence as in-patients. Two patients experienced subsequent epistaxis requiring medical treatment. Two further patients suffered minor late epistaxis not requiring treatment. Success in preventing significant recurrence was 93 per cent. All recurrences requiring intervention occurred within one month of surgery. None of the patients in this series reported nasal complications. We found sphenopalatine artery ligation to be an effective means of achieving long-term control of posterior epistaxis.


Toward a framework for defining and resolving ethical issues in the protection of communities involved in primary prevention projects.
Ethical issues flow from and are embedded in contexts of practice. Contexts of practice refer to the diverse social settings where interventions occur. Primary prevention activities require new professional roles in these diverse social settings. These new roles engage the professional in new activities, which in turn allow new ethical issues to arise. This article takes an ecological perspective on ethical issues arising from the enactment of new preventive roles intended to affect groups or communities. Within this perspective, the concepts of context and culture take on special conceptual significance. Four ecological assumptions about preventive interventions intended to affect groups or communities are offered as a means of framing ethical issues in such interventions. Finally, several approaches to developing ecological knowledge about the contexts of practice are presented as ways of furthering our ability to conceptualize and cope with ethical issues in preventive interventions intended to affect groups or communities.


Subdiffusion equation with fractional Caputo time derivative with respect to another function in modeling transition from ordinary subdiffusion to superdiffusion.
We use a subdiffusion equation with fractional Caputo time derivative with respect to another function g (g-subdiffusion equation) to describe a smooth transition from ordinary subdiffusion to superdiffusion. Ordinary subdiffusion is described by the equation with the "ordinary" fractional Caputo time derivative, superdiffusion is described by the equation with a fractional Riesz-type spatial derivative. We find the function g for which the solution (Green's function, GF) to the g-subdiffusion equation takes the form of GF for ordinary subdiffusion in the limit of small time and GF for superdiffusion in the limit of long time. To solve the g-subdiffusion equation we use the g-Laplace transform method. It is shown that the scaling properties of the GF for g-subdiffusion and the GF for superdiffusion are the same in the long time limit. We conclude that for a sufficiently long time the g-subdiffusion equation describes superdiffusion well, despite a different stochastic interpretation of the processes. Then, paradoxically, a subdiffusion equation with a fractional time derivative describes superdiffusion. The superdiffusive effect is achieved here not by making anomalously long jumps by a diffusing particle, but by greatly increasing the particle jump frequency which is derived by means of the g-continuous-time random walk model. The g-subdiffusion equation is shown to be quite general, it can be used in modeling of processes in which a kind of diffusion change continuously over time. In addition, some methods used in modeling of ordinary subdiffusion processes, such as the derivation of local boundary conditions at a thin partially permeable membrane, can be used to model g-subdiffusion processes, even if this process is interpreted as superdiffusion.


Comparison of bacterial and tissue cell initial adhesion on hydrophilic/hydrophobic biomaterials.
In this study, interactions of widely-used polymeric biomaterials, i.e. poly(hydroxyethyl methacrylate) (PHEMA) and its copolymer with dimethylaminoethyl methacrylate (PHEMA-20% DMAEMA), polyurethane (PU), polypropylene (PP), poly(vinyl chloride) (PVC), and poly(lactide-glycolide) (PLGA), with three pathogenic bacteria and one nonpathogen were investigated comparatively with the adhesion of two tissue cells in different morphologies, i.e. fibroblast-like baby hamster kidney (BHK 21) cells and epithelial Madine Darby kidney (MDBK) cells. Biomaterials were prepared in the membrane form by bulk polymerization or solvent casting. Surface characterization studies showed that these polymers have different surface free energies in the range of 26.9-63.1 erg cm(-2) and they have smooth surfaces. The bacteria used were; Escherichia coli ATCC 25922, Staphylococcus epidermidis ATCC 12228, Staphylococcus aureus, and Lactobacillus acidophilus B-13. Initial adhesion of bacteria to the polymeric surfaces was examined under static conditions and in a laminar flow cell. The adhesion behaviour of S. aureus and S. epidermidis was found independent of the polymeric surface hydrophobicity. However, the percentage of attached E. coli decreased when increasing the surface free energy of the polymer, while L. acidophilus showed just the opposite behaviour. The comparative results indicated that the adhesion of BHK and MDBK cell was lowest on the most hydrophilic PHEMA surface and highest on the most hydrophobic PP surface. In contrast to the case of bacterial adhesion, no relationship was found between polymer hydrophobicity and mammalian cell adherence.


[Invasive endoscopy or surgery for pancreatic disorders?].
Endoscopic double papillotomy occupied the place of surgical transduodenal double sphincteroplasty for disorders of papilla of Vater or chronic pancreatitis several years ago. Endoscopic cystoenterostomy and cystogastrostomy can also replace surgery in the treatment of pseudocysts and walled-of necrosis even in cases of severe acute pancreatitis with/or without sepsis. In chronic pancreatitis endotherapy may be the treatment of choice at first, although surgical techniques give somewhat better long-term results for pain relief. Extracorporeal shock wave lithotripsy, stone resolution or extraction and multiple pancreatic stents without aggressive balloon dilatation can progressively calibrate dominant stricture of the main pancreatic duct without further damage, ischemia or obstruction of side branches. Relapse-free period becomes longer (also after stents removal) if alcohol consumption and smoking are stopped definitively. Well-controlled, randomised studies are still needed to demonstrate clinical advantage of multiple endoscopic stent placement in comparison to surgery.


Have plants evolved to self-immolate?
By definition fire prone ecosystems have highly combustible plants, leading to the hypothesis, first formally stated by Mutch in 1970, that community flammability is the product of natural selection of flammable traits. However, proving the "Mutch hypothesis" has presented an enormous challenge for fire ecologists given the difficulty in establishing cause and effect between landscape fire and flammable plant traits. Individual plant traits (such as leaf moisture content, retention of dead branches and foliage, oil rich foliage) are known to affect the flammability of plants but there is no evidence these characters evolved specifically to self-immolate, although some of these traits may have been secondarily modified to increase the propensity to burn. Demonstrating individual benefits from self-immolation is extraordinarily difficult, given the intersection of the physical environmental factors that control landscape fire (fuel production, dryness and ignitions) with community flammability properties that emerge from numerous traits of multiple species (canopy cover and litter bed bulk density). It is more parsimonious to conclude plants have evolved mechanisms to tolerate, but not promote, landscape fire.


Tweaking Mesenchymal Stem/Progenitor Cell Immunomodulatory Properties with Viral Vectors Delivering Cytokines.
Mesenchymal Stem Cells (MSCs) can be found in various body sites. Their main role is to differentiate into cartilage, bone, muscle, and fat cells to allow tissue maintenance and repair. During inflammation, MSCs exhibit important immunomodulatory properties that are not constitutive, but require activation, upon which they may exert immunosuppressive functions. MSCs are defined as "sensors of inflammation" since they modulate their ability of interfering with the immune system both in vitro and in vivo upon interaction with different factors. MSCs may influence immune responses through different mechanisms, such as direct cell-to-cell contact, release of soluble factors, and through the induction of anergy and apoptosis. Human MSCs are defined as plastic-adherent cells expressing specific surface molecules. Lack of MHC class II antigens makes them appealing as allogeneic tools for the therapy of both autoimmune diseases and cancer. MSC therapeutic potential could be highly enhanced by the expression of exogenous cytokines provided by transduction with viral vectors. In this review, we attempt to summarize the results of a great number of in vitro and in vivo studies aimed at improving the ability of MSCs as immunomodulators in the therapy of autoimmune, degenerative diseases and cancer. We will also compare results obtained with different vectors to deliver heterologous genes to these cells.


Toward fast determination of protein stability maps: experimental and theoretical analysis of mutants of a Nocardiopsis prasina serine protease.
The stability of serine proteases is of major importance for their application in industrial processes. Here we study the determinants of the stability of a Nocardiopsis prasina serine protease using fast residual activity assays, a feature classification algorithm, and structure-based energy calculation algorithms for 121 micropurified mutant enzyme clones containing multiple point mutations. Using a multivariate regression analysis, we deconvolute the data for the mutant clones and find that mutations of residues Asn47 and Pro124 are deleterious to the stability of the enzyme. Both of these residues are situated in loops that are known to be important for the stability of the highly homologous α-lytic protease. Structure-based energy calculations with PEATSA give a good general agreement with the trend of experimentally measured values but also identify a number of clones that the algorithm fails to predict correctly. We discuss the significance of the results in relation to the structure and function of closely related proteases, comment on the optimal experimental design when performing high-throughput experiments for characterizing the determinants of protein stability, and discuss the performance of structure-based energy calculations with complex data sets such as the one presented here.


Value of urine lipoarabinomannan grade and second test for optimizing clinic-based screening for HIV-associated pulmonary tuberculosis.
We assessed the role of urine lipoarabinomannan (LAM) grade and a second LAM test for HIV-associated pulmonary tuberculosis (TB) screening in outpatient clinics in South Africa. We enrolled newly diagnosed HIV-infected adults (≥18 years) at 4 clinics, excluding those on TB therapy. Participants provided sputum for acid-fast bacilli (AFB) microscopy and culture. Nurses conducted 2 rapid urine LAM tests at the point-of-care and graded positive results from low (faint) to high (5+). Culture-confirmed pulmonary TB was the gold standard. We used area under receiver operating curves (AUROC) to compare screening strategies. Among 320 HIV-infected adults, median CD4 was 248 cells per cubic millimeter (interquartile range, 107-379/mm); 54 (17%) were TB culture positive. Fifty-two (16%) of all participants were LAM positive by either test; correlation between LAM tests was high. Among 10 "faint" positive results, 2 (20%) had culture-positive TB. Using ≥1+ LAM grade as positive, 1 LAM test had sensitivity of 41% [95% confidence interval (CI): 28% to 55%] and specificity of 92% (95% CI: 88% to 95%). A 2 LAM test strategy had a sensitivity of 43% (95% CI: 29% to 57%). One LAM test ≥1+ grade (AUROC = 0.66; 95% CI: 0.60 to 0.73) was significantly better than sputum AFB alone. The optimal strategy was sequentially performing 1 LAM test followed by sputum AFB if LAM grade <1+ (AUROC = 0.70; 95% CI: 0.63 to 0.77), which had sensitivity of 48% (95% CI: 34% to 62%) and specificity of 91% (95% CI: 87% to 94%). In this clinic-based study, "faint" line was a false-positive second urine LAM test added no value, and an optimal screening strategy was 1 LAM test followed by sputum AFB microscopy for urine LAM-negative people.


Prevention of recurrences after deep venous thrombosis: role of low-molecular-weight heparins.
The management of deep venous thrombosis (DVT) requires an initial treatment with unfractionated (UF) or low-molecular-weight (LMW) heparin followed by oral anticoagulants (OA) for at least 3 months. OA therapy, however, requires laboratory monitoring and is associated with a definite bleeding risk. Therefore, alternative treatments such as UF or LMW heparin have been evaluated. In a study by Monreal et al in patients with DVT and contraindications to OA, dalteparin (5000 anti-Xa U b.i.d.) was equivalent to UF heparin (10,000 IU b.i.d.) and was associated with fewer vertebral fractures. In a study by Pini et al, Enoxaparin (4000 anti-Xa U once daily) was evaluated against OA and showed similar efficacy with fewer bleeding complications in the 3-month treatment period. A number of studies have recently shown that the risk for late thrombotic recurrences for patients developing postoperative DVT or associated with other transient risk factors is much lower than in patients with idiopathic DVT or associated with a persistent risk factor, suggesting that for the formers, 4 to 6 weeks of OA therapy may be sufficient. LMW heparins appear to be a promising alternative therapy for these patients, because in the first month of OA administration the risk for bleeding is higher and the need of laboratory monitoring more stringent. This should be evaluated in appropriate clinical trials.


Intestinal immune responses of Jian carp against Aeromonas hydrophila depressed by choline deficiency: Varied change patterns of mRNA levels of cytokines, tight junction proteins and related signaling molecules among three intestinal segments.
This study aimed to investigate the effects of choline deficiency on intestinal inflammation of fish after Aeromonas hydrophila infection and the potential molecular mechanisms. Juvenile Jian carp (Cyprinus carpio var. Jian) were fed two diets containing choline at 165 (deficient group) and 607 mg/kg diet respectively for 65 days. Choline deficiency decreased intestinal lysozyme activity, C3 and IgM contents, increased acid phosphatase activity, downregulated mRNA levels of antimicrobial peptides [liver-expressed antimicrobial peptide (LEAP) 2A, LEAP-2B, hepcidin and defensin], cytokines [interleukin (IL) 6a, tumor necrosis factor α (TNF-α), interferon γ2b (IFN-γ2b), IL-6b and transforming growth factor β2 (TGF-β2) only in proximal intestine, IL-10 in mid and distal intestine], immune-related signaling molecules [Toll-like receptor 4 (TLR4), myeloid differentiation primary response 88 (MyD88), nuclear factor kappa B (NF-κB), inhibitor of NF-κB (IκB), Janus kinase 3 (JAK3), and signal transducers and activators of transcription 5 (STAT5)], tight junction proteins (claudin 3b, claudin 3c, claudin 11 and occludin), and mitogen-activated protein kinases p38 (p38MAPK) in proximal and distal intestine of juvenile Jian carp after A. hydrophila challenge. In contrast, choline deficiency upregulated mRNA levels of antimicrobial peptides (LEAP-2A, LEAP-2B, hepcidin and defensin), cytokines (IL-6b, IFN-γ2b and TGF-β2), immune-related signaling molecules (TLR4, MyD88, NF-κB, IκB, JAK3, STAT4 in three intestinal segments, and STAT6), claudin 11, and p38MAPK in mid intestine of fish. This study provides new finding that choline deficiency-induced immune responses against A. hydrophila infection were varied among three intestinal segments in fish.


Development of a molecular marker for the adult plant leaf rust resistance gene Lr35 in wheat.
The objective of this work was to develop a marker for the adult plant leaf rust resistance gene Lr35. The Lr35 gene was originally introgressed into chromosome 2B from Triticum speltoides, a diploid relative of wheat. A segregating population of 96 F( 2 )plants derived from a cross between the resistant line ThatcherLr35 and the susceptible variety Frisal was analysed. Out of 80 RFLP probes previously mapped on wheat chromosome 2B, 51 detected a polymorphism between the parents of the cross. Three of them were completely linked with the resistance gene Lr35. The co-segregating probe BCD260 was converted into a PCR-based sequence-tagged-site (STS) marker. A set of 48 different breeding lines derived from several European breeding programs was tested with the STS marker. None of these lines has a donor for Lr35 in its pedigree and all of them reacted negatively with the STS marker. As no leaf rust races virulent on Lr35 have been found in different areas of the world, the STS marker for the Lr35 resistance gene is of great value to support the introgression of this gene in combination with other leaf rust (Lr) genes into breeding material by marker-assisted selection.


Bone marrow-derived vascular cells in response to injury.
Intimal hyperplasia is a key lesion for various vascular disorders such as atherosclerosis, postangioplasty restenosis and transplant arteriopathy. It has widely been accepted that intimal smooth muscle cells (SMC) originate from the medial layer in the same artery. However, recent studies suggest that bone marrow can also provide circulating progenitors for vascular SMC. Bone marrow-derived SMC participate in neointimal formation in animal models of allotransplantation, severe mechanical injury and hyperlipidemia-induced atherosclerosis. In human, transplantation arteriopathy also seems to involve circulating SMC, but their role in atherosclerosis and restenosis remains to be elucidated. Mobilization, differentiation and proliferation steps of SMC progenitors will provide promising targets for novel therapeutic approaches against proliferative vascular diseases.


Outer membrane of Salmonella typhimurium: chemical analysis and freeze-fracture studies with lipopolysaccharide mutants.
The outer membrane layer of the cell wall was isolated from wild-type Salmonella typhimurium LT2 as well as from its mutants producing lipopolysaccharides with shorter saccharide chains. Chemical analysis of these preparations indicated the following. (i) The number of lipopolysaccharide molecules per unit area was constant, regardless of the length of the saccharide side chain in lipopolysaccharide. (ii) In contrast, in "deep rough" (Rd or Re) mutants producing the lipopolysaccharides with very short saccharide chains, the amount of outer membrane protein per unit surface area decreased to about 60% of the value in the wild type. (iii) In the wild type, the amount of phospholipids is slightly less than what is needed to cover one side of the membrane as a monolayer. In comparison with the wild type, the outer membrane of Rd and Re mutants contains about 70% more phospholipids, which therefore must be distributed in both the outer and inner leaflets of the membrane. Freeze-fracture studies showed that the outer membrane of Re mutants were easily fractured, but fracture became increasingly difficult in strains producing lipopolysaccharides with longer side chains. The convex fracture face was always nearly smooth, but the concave fracture face or the outer half of the membrane was densely covered with particles 8 to 10 nm in diameter. The density of particles was decreased in Re mutants to the same extent as the reduction in proteins, suggesting the largely proteinaceous nature of particles. A model for the supramolecular structure of the outer membrane is presented on the basis of these and other results.


Understanding the Code: keeping accurate records.
In his continuing series looking at the legal and professional implications of the Nursing and Midwifery Council's revised Code of Conduct, Richard Griffith discusses the elements of accurate record keeping under Standard 10 of the Code. This article considers the importance of accurate record keeping for the safety of patients and protection of district nurses. The legal implications of records are explained along with how district nurses should write records to ensure these legal requirements are met.


Non-invasive identification of proteoglycans and chondrocyte differentiation state by Raman microspectroscopy.
Proteoglycans (PGs) are crucial extracellular matrix (ECM) components that are present in all tissues and organs. Pathological remodeling of these macromolecules can lead to severe diseases such as osteoarthritis or rheumatoid arthritis. To date, PG-associated ECM alterations are routinely diagnosed by invasive analytical methods. Here, we employed Raman microspectroscopy, a laser-based, marker-free and non-destructive technique that allows the generation of spectra with peaks originating from molecular vibrations within a sample, to identify specific Raman bands that can be assigned to PGs within human and porcine cartilage samples and chondrocytes. Based on the non-invasively acquired Raman spectra, we further revealed that a prolonged in vitro culture leads to phenotypic alterations of chondrocytes, resulting in a decreased PG synthesis rate and loss of lipid contents. Our results are the first to demonstrate the applicability of Raman microspectroscopy as an analytical and potential diagnostic tool for non-invasive cell and tissue state monitoring of cartilage in biomedical research.


Neighborhood effects on health: correcting bias from neighborhood effects on participation.
Studies of neighborhood effects on health that are based on cohort data are subject to bias induced by neighborhood-related selective study participation. We used data from the RECORD Cohort Study (REsidential Environment and CORonary heart Disease) carried out in the Paris metropolitan area, France (n = 7233). We performed separate and joint modeling of neighborhood determinants of study participation and type-2 diabetes. We sought to identify selective participation related to neighborhood, and account for any biasing effect on the associations with diabetes. After controlling for individual characteristics, study participation was higher for people residing close to the health centers and in neighborhoods with high income, high property values, high proportion of the population looking for work, and low built surface and low building height (contextual effects adjusted for each other). After individual-level adjustment, the prevalence of diabetes was elevated in neighborhoods with the lowest levels of educational attainment (prevalence odds ratio = 1.56 [95% credible interval = 1.06-2.31]). Neighborhood effects on participation did not bias the association between neighborhood education and diabetes. However, residual geographic variations in participation weakly biased the neighborhood education-diabetes association. Bias correction through the joint modeling of neighborhood determinants of participation and diabetes resulted in an 18% decrease in the log prevalence odds ratio for low versus high neighborhood education. Researchers should develop a comprehensive, theory-based model of neighborhood determinants of participation in their study, investigate resulting biases for the environment-health associations, and check that unexplained geographic variations in participation do not bias these environment-health relationships.


Standardized Approach for ROI-Based Measurements of Proton Density Fat Fraction and R2* in the Liver.
The purpose of this study was to evaluate the reproducibility (interreviewer agreement) and repeatability (intrareviewer agreement) of ROI sampling strategies to measure chemical shift-encoded (CSE) MRI-based liver proton density fat fraction (PDFF) and R2* (1 / T2*). A secondary purpose was to standardize ROI-based liver PDFF and R2* measurements by providing a compromise between measurement reproducibility and repeatability and time burden for image analysts. CSE data from two cohorts were retrospectively analyzed. Cohort A included 53 patients referred for abdominal MRI and healthy subjects recruited for a comparison study of CT and MRI. Cohort B included 37 patients with suspected liver iron overload. Three reviewers measured liver PDFF and R2* using previously reported ROI sampling strategies. Inter- and intrareviewer agreement of liver PDFF and R2* were evaluated using Bland-Altman analysis. Averaging largest-fit ROIs over the nine Couinaud segments resulted in the narrowest limits of agreement (LOA) for liver PDFF and R2* measurements in both cohorts. For PDFF, interreviewer agreement had mean LOA of ± 0.8% for cohort A and ± 1.7% for cohort B. Intrareviewer agreement was ± 0.5% for cohort A and ± 0.9% for cohort B. For R2* interre-viewer agreement had mean LOA of ± 3.0 s-1 for cohort A and ± 17.9 s-1 for cohort B. Intrare-viewer agreement was ± 2.6 s-1 for cohort A and ± 14.6 s-1 for cohort B. This approach was the most time-burdensome, requiring a mean ± SD of 149.7 ± 8.6 s per dataset. For improved reproducibility and repeatability of liver PDFF and R2* measurements, clinicians and researchers should sample as much area of the liver as possible using multiple large ROIs.


Intradural saccular aneurysms treated by Guglielmi detachable bare coils at a single institution between 1993 and 2005: clinical long-term follow-up for a total of 1810 patient-years in relation to morphological treatment results.
The aim of this study was to analyze the clinical results of Guglielmi detachable bare coil (GDC) embolization of intradural saccular aneurysms (AAs) at a single center and to relate the morphological results at various time points to the clinical situation. All intradural saccular AAs treated with GDCs between 1993 and April 2005 were prospectively entered into a database completed by retrospective analysis of charts and images and a long-term clinical outcome questionnaire. In 413 consecutive patients, there were 466 treated AAs, of which 68.7% were ruptured and 31.1% were unruptured. The periprocedural thromboembolic event rate, retreatment procedures included, was 5.4%, causing permanent neurologic deficits in 2.2% of patients. One patient (0.2%) bled during a mean+/-SD clinical follow-up of 64.3+/-39.9 months (93 AAs were followed up for >8 years and 45 AAs were followed up for >10 years) for a total of 1810 patient-years. The modified Rankin Scale score was 0 in 54.7%, 1 in 21.0%, 2 in 12.1%, 3 in 7.1%, 4 in 2.1%, 5 in 0.3%, and 6 (death from unrelated causes) in 2.7% of patients. If an aneurysm, with or without a remnant, was unchanged for 12 months, then the risk for future morphological loss was 4.8%, whereas if an aneurysm showed a morphological loss during the earlier 12-month interval, the risk for additional late loss was 38.3% (P<0.001, odds ratio=12.4). Embolization of saccular AAs entails a prolonged management period. A stable angiographic result during a 12-month interval predicts a low risk for morphological deterioration. This regimen, aiming for a stable angiographic result rather than complete aneurysm occlusion, gives a low rebleed rate and excellent clinical long-term results.


Effect of concurrent administration of apoptotic inhibitors and hypothermia on post hypoxic cerebral injury in the newborn.
Neonatal hypoxic-ischemic encephalopathy is known to cause long-term neurodevelopmental impairment. Experimental studies and clinical trials demonstrated that treatment with hypothermia after hypoxic-ischemic insults reduced brain injury. As a result of these data, hypothermia has emerged as the standard of care for treatment of neonatal hypoxic-ischemic encephalopathy. However up to 40% of newborns with hypoxic-ischemic encephalopathy who are treated with hypothermia have significant neurocognitive deficits on follow-up. Obviously, there remains a need to further optimize cooling strategies and to identify adjuvant therapies that could potentially augment the neuroprotective effects and accentuate neuroprotection by hypothermia. As the occurrence of hypoxia in the newborn brain can not be predicted beforehand, the only opportunity we have to improve outcomes after hypoxic-ischemic encephalopathy is to pursue neuroprotective strategies that can be used as an adjunct to therapeutic hypothermia in the post-hypoxia-ischemia period, with special emphasis on mechanism mediating the early stages of hypoxic injury. Previously, we have demonstrated in the newborn piglet that within one hour of exposure to hypoxia, there is increased activation of the enzyme Ca++/calmodulin kinase (CaM Kinase) IV localized in the nucleus, a key regulator of transcription of apoptotic genes. We have also demonstrated that the hypoxia-induced enzyme CaM kinase IV activation is mediated by activation of two protein tyrosine kinases, Src kinase and EGFR kinase and by increased Ca++ influx into the nucleus. Inhibition of Src kinase by the selective inhibitor PP2 and of EGFR kinase by the selective inhibitor PD168393 at the onset of hypoxia prevented CaM kinase IV activation and decreased subsequent hypoxia-induced neuronal death. The aim of this study was to test the hypothesis that the combined treatment with hypothermia and PP2 (4-amino-5-(4-chlorophenyl)-7-(t-butyl)pyrazolo[3,4-d]pyrimidine), a highly selective inhibitor of Src kinase, immediately after the hypoxic insult may augment the beneficial effect of hypothermia on hypoxia/ischemia- induced neuronal necrosis. To this aim we assessed the levels of CaM Kinase IV activity as well as the levels of Na+-K+-ATPase in the Cerebral Cortex of Newborn Piglets exposed experimental hypoxia that were treated with hypothermia with or without concomitant PP2 administration. 2-3 day old piglets were anesthetized and ventilated. In conclusion, our preliminary data show that concurrent administration of Src kinase inhibitor in combination with induction of whole body hypothermia results in augmented neuroprotection as indicated by further attenuation of hypoxic-ischemic induced CaM kinase IV activation and improvement in neuronal membrane integrity compared to hypothermia alone.


The Prevalence and Risk Factors of High-Altitude Pulmonary Hypertension Among Native Tibetans in Sichuan Province, China.
Gou, Qiling, Rufeng Shi, Xin Zhang, Qingtao Meng, Xinran Li, Xi Rong, Zhabu Gawa, Nage Zhuoma, and Xiaoping Chen. The prevalence and risk factors of high-altitude pulmonary hypertension among native Tibetans in Sichuan Province, China. High Alt Med Biol. 21:327-335, 2020. Background: Studies evaluating the prevalence and risk factors of high-altitude pulmonary hypertension (HAPH) are lacking. Objective: To determine the prevalence of HAPH and its correlated factors among highlanders living 3200 m above sea level in Ganzi Tibetan Autonomous Prefecture, Sichuan Province, China. Methods: This was a single-center, cross-sectional study involving 1129 subjects (mean age 46.6 ± 14 years, 39% men). In native Tibetans, HAPH was defined as a mean pulmonary artery pressure >30 mmHg as measured by transthoracic echocardiography. Results: HAPH had a crude prevalence of 6.2% and was more prevalent in men than in women (8.6% vs. 4.6%, p = 0.005). Elderly adults were more likely to develop HAPH than young adults (odds ratio [OR] = 5.308, 95% confidence interval [CI] = 2.562-10.993). Highlanders with HAPH had more severe metabolic abnormalities (including elevated blood pressure, blood glucose, blood lipids, BMI, etc., p < 0.05) and significantly increased hemoglobin and hematocrit levels (p < 0.01). In multivariate logistic regression analysis, independent risk factors for HAPH were metabolic syndrome (OR = 3.128, 95% CI = 1.110-8.818), age (>60 years vs. <40 years) (OR = 2.924, 95% CI = 1.282-6.669), and decreased SpO2 (OR = 1.072 per 1-unit decrease; 95% CI = 1.010-1.136). Conclusion: It could be concluded that HAPH was prevalent among 6.2% of native Tibetans in Sichuan Province, China. Increasing age, metabolic syndrome, and decreased SpO2 were independent predisposing factors for HAPH.


Lateral Entorhinal Cortex Lesions Impair Local Spatial Frameworks.
A prominent theory in the neurobiology of memory processing is that episodic memory is supported by contextually gated spatial representations in the hippocampus formed by combining spatial information from medial entorhinal cortex (MEC) with non-spatial information from lateral entorhinal cortex (LEC). However, there is a growing body of evidence from lesion and single-unit recording studies in rodents suggesting that LEC might have a role in encoding space, particularly the current and previous locations of objects within the local environment. Landmarks, both local and global, have been shown to control the spatial representations hypothesized to underlie cognitive maps. Consequently, it has recently been suggested that information processing within this network might be organized with reference to spatial scale with LEC and MEC providing information about local and global spatial frameworks respectively. In the present study, we trained animals to search for food using either a local or global spatial framework. Animals were re-tested on both tasks after receiving excitotoxic lesions of either the MEC or LEC. LEC lesioned animals were impaired in their ability to learn a local spatial framework task. LEC lesioned animals were also impaired on an object recognition (OR) task involving multiple local features but unimpaired at recognizing a single familiar object. Together, this suggests that LEC is involved in associating features of the local environment. However, neither LEC nor MEC lesions impaired performance on the global spatial framework task.


Outcomes after transabdominal cerclage in twin pregnancy with previous unsuccessful transvaginal cerclage.
Transabdominal cerclage (TAC) is reported to be effective for preventing preterm birth in women with unsuccessful transvaginal cerclage (TVC) history. However, TAC has rarely been performed in twin pregnancy given the lack of sufficient evidence and the technical difficulty of the operation. Thus, it is unclear whether TAC is an effective procedure for twin pregnancy in women with a history of unsuccessful TVC. The aim of this study is to compare the characteristics and pregnancy outcomes after TAC in twin pregnancy versus singleton pregnancy, to examine whether twin pregnancy is a risk factor for very preterm birth (before 32 weeks) after TAC, and to determine whether TAC is effective in preventing preterm birth in twin pregnancy. This single-center retrospective cohort study included women who underwent TAC because of unsuccessful TVC history between January 2007 and June 2018. Of 165 women who underwent TAC, 19 had twins and 146 had singletons. Our results showed that the neonatal survival rate improved dramatically when TAC was performed (15.4% (prior pregnancy) vs 94.0% (after TAC) in twins, p<0.01; 22.8% (prior pregnancy) vs 91.1% (after TAC) in singletons, p<0.01). Moreover, the risk of very preterm birth was significantly decreased after TAC in both groups (36/39 (92.3%) (prior pregnancy) vs 2/19 (10.5%) (after TAC) in twins, p<0.01; 290/337 (86.1%) (prior pregnancy) vs 17/146 (11.6%) (after TAC) in singletons, p<0.01). More advanced maternal age and history of prior preterm delivery between 26+0 and 36+6 weeks were independently associated with very preterm birth, whereas the presence of a twin pregnancy was not associated with very preterm birth on multivariate logistic regression analysis. These results suggest that TAC is associated with successful prevention of very preterm birth and improved neonatal survival rates in the absence of procedure-related major complications in women with twin pregnancy and previous unsuccessful TVC history.


A new methylene bisflavan-3-ol from the branches and leaves of Potentilla fruticosa.
Dasiphora fruticosa L. (Rosaceae), also known as Potentilla fruticosa L. (syn.), is a hardy deciduous shrub widely distributed in the north temperate regions of the world. Three methylene bisflavan-3-ols (1-3), together with a procyanidin dimer, (-)-afzelechin-(4α→8)-(-)-afzelechin (4) were isolated for the first time from the branches and leaves of the titled plant, in addition to 11 known compounds (5-15). Their structures were elucidated by means of extensive spectroscopic analysis and by comparison with data reported in the literatures. Methylene 6,8-bis(7-O-glucosyl) catechin (1) was determined to be a new dimeric flavan-3-ol glycoside through a methylene linkage between C-8 and C-8 of two units. At a concentration of 128 μg/mL, the known compounds 9 - 13 exhibited antibacterial activities on Escherichia coli, Staphylococcus aureus subsp. aureus, Salmonella enterica subsp. enterica, and Pseudomonas aeruginosa. Compound 12 also showed certain glucose uptake stimulating activity.


Artificial Intelligence and Big Data Technologies in the Construction of Surgical Risk Prediction Model for Patients with Coronary Artery Bypass Grafting.
The objective of this work was to predict the risk of mortality rate in patients with coronary artery bypass grafting (CABG) based on the risk prediction model of CABG using artificial intelligence (AI) and big data technologies. The clinical data of 2,364 patients undergoing CABG in our hospital from January 2019 to August 2021 were collected in this work. Based on AI and big data technology, business requirement analysis, system requirement analysis, complication prediction module, big data mining technology, and model building are carried out, respectively; the successful CABG risk prediction system includes case feature analysis service, risk warning service, and case retrieval service. The commonly used precision, recall, and F1-score were adopted to evaluate the quality of the gradient-boosted tree (GBT) model. The analysis proved that the GBT model was the best in terms of precision, F1-score, and area under the receiver operating characteristic curve (ROC). According to the CABG risk prediction model, 1,382 patients had a score of <0, 463 patients had a score of 0 ≤ score ≤ 2, 252 patients had a score of 2 < score ≤ 5, and 267 patients had a score of >5, which were stratified into four groups: A, B, C, and D. The actual number of in-hospital deaths was 25, and the in-hospital mortality rate was 1.05%. The mortality rate predicted by the CABG risk prediction model was 2.67 ± 1.82% (95% confidential interval (CI) (2.87-2.98)), which was higher than the actual value. The CABG risk prediction model showed the credible results only in group B with AUC = 0.763 > 0.7. In group B, 3 patients actually died, the actual mortality rate was 0.33%, and the predicted mortality rate was 0.96 ± 0.78 (95% CI (0.82-0.87)), which overestimated the mortality rate of patients in group B. It successfully constructed a CABG risk prediction model based on the AI and big data technologies, which would overestimate the mortality of patients with intermediate risk, and it is suitable for different types of heart diseases through continuous research and development and innovation, and provides clinical guidance value.


[Spatial distribution and pollution assessment of heavy metals in the tidal reach and its adjacent sea estuary of Daliaohe area, China ].
The aim of this article was to explore the pollution level of heavy metals in the tidal reach and its adjacent sea estuary of Daliaohe area. The contents and spatial distribution of As, Cd, Cr, Cu, Ph and Zn in surface water, suspended solids and surface sediments were analyzed respectively. The integrated pollution index and geoaccumulation index were used to evaluate the contamination degree of heavy metals in surface water and surface sediments respectively. The results indicated that the contents of heavy metals in surface water was in the order of Pb < Cu < Cd < Cr < As < Zn. The heavy metal contents in surface water increased from river to sea. Compared with the contents of heavy metals in surface water of the typical domestic estuary in China, the overall contents of heavy metals in surface water were at a higher level. The contents of heavy metals in suspended solids was in the order of Cd < Cu < As < Cr <Pb < Zn. Similar patterns of spatial distribution in suspended solids were observed for As, Cd, Cr,Cu and Pb, and the highest contents of Cr, Cu, Cd appeared at EM3 station. The contents of heavy metals in surface sediments was in the order of Cd <Cu < Pb < As < Cr < Zn. The highest contents of Cr, Cu, Cd and As in surface sediments also appeared at EM3 station. Temperature, pH, DO, EC and other factors affected the distribution of heavy metals in water, suspended solids and sediment. In particular, the effects of salinity and suspended solids matter were most significant. The integrated pollution index assessment showed that the water quality was good except individual stations. The geoaccumulation index assessment showed that As was the major pollution element in surface sediments.


Lentinoid and Polyporoid Fungi, Two Generic Conglomerates Containing Important Medicinal Mushrooms in Molecular Perspective.
Polyporoid and lentinoid fungi contain the important producers of substances having immunomodulatory, antitumoral, antiviral, and antihyperlipidemic effects. The discovery of several phylogenetic lines within the lentinoid-polyporoid continuum will help with target metabolomic analysis of species still not studied in pharmacological respects. The purpose of the present work was to increase a resolution in the lentinoid-polyporoid phylogenetic zone by means of selection of both the main representatives of Lentinus-related genera and poorly known/intermediate taxa such as Lentinus suavissimus, Neofavolus spp., and the resupinate part of Polyporus (genera Perenniporia and Pachykytospora) in the context of the basic structure of the Polyporales tree. The molecular phylogeny of highlighting all the polyporoid and lentinoid nodes was reconstructed using nLSU ITS rDNA and TEF datasets. The data obtained from ITS, TEF, and LSU coincide in support of core Polyporaceae of 10 clades corresponded to the generic level and 7 of these (Cerioporus, Cladomeris, Favolus, Lentinus, Neofavolus, Picipes, and Polyporus s.str.) contain generic units characterized by polyporoid or lentinoid morphotypes. The other 2 clades containing lentinoid taxa are outside the core Polyporaceae, namely Panus (Meruliaceae, Polyporales) and Neolentinus (Gloeophyllaceae, Gloeophyllales). A new genus, Picipes, is described and 25 new combinations are proposed.


Determination of total and active immobilized enzyme distribution in porous solid supports.
The total and active immobilized enzyme (IME) distributions in porous supports are studied both theoretically and experimentally. In order to determine experimentally the enzyme distribution profiles within a single particle, we construct a diffusion cell containing controlled-pore glass particles such that the cell would mimic a large pellet support. Our purpose is to study the interplay between the diffusion process within the interparticle void space and immobilization process in the controlled-pore glass particles onto the evolution of the (total and active) enzyme distributions. A mathematical model is developed to describe the interaction of various processes within the diffusion cell. The immobilized enzymes are determined for a system of trypsin and controlled-pore glass particles. The total amount of enzymes are determined by the amino acid analysis, and the active fraction is obtained by an active-site titration. The experimentally measured total IME profiles compare very well with that predicted by the model. The determined active enzyme profile is found to be nonuniform one, and it represents about 40% of the total enzyme immobilized in the support particles.


Classifying large chemical data sets: using a regularized potential function method.
In recent years classifiers generated with kernel-based methods, such as support vector machines (SVM), Gaussian processes (GP), regularization networks (RN), and binary kernel discrimination (BKD) have been very popular in chemoinformatics data analysis. Aizerman et al. were the first to introduce the notion of employing kernel-based classifiers in the area of pattern recognition. Their original scheme, which they termed the potential function method (PFM), can basically be viewed as a kernel-based perceptron procedure and arguably subsumes the modern kernel-based algorithms. PFM can be computationally much cheaper than modern kernel-based classifiers; furthermore, PFM is far simpler conceptually and easier to implement than the SVM, GP, and RN algorithms. Unfortunately, unlike, e.g., SVM, GP, and RN, PFM is not endowed with both theoretical guarantees and practical strategies to safeguard it against generating overfitting classifiers. This is, in our opinion, the reason why this simple and elegant method has not been taken up in chemoinformatics. In this paper we empirically address this drawback: while maintaining its simplicity, we demonstrate that PFM combined with a simple regularization scheme may yield binary classifiers that can be, in practice, as efficient as classifiers obtained by employing state-of-the-art kernel-based methods. Using a realistic classification example, the augmented PFM was used to generate binary classifiers. Using a large chemical data set, the generalization ability of PFM classifiers were then compared with the prediction power of Laplacian-modified naive Bayesian (LmNB), Winnow (WN), and SVM classifiers.


[Clinical study of anticoagulation with warfarin and heparin in patients after mechanical valve replacement].
To investigate the effect of different methods of anticoagulation after mechanical valve replacement. Totally 172 cases of mechanical valve replacement performed from October 2005 to June 2008 were divided into two groups and then analyzed retrospectively. Patients on warfarin and heparin were classified as the heparin group while those on warfarin alone were classified as the warfarin group. The operation, anticoagulation, anticoagulation index and associated complications were recorded to compare the effect of anticoagulation between two groups. warfarin group: the overall anticoagulation effect was satisfactory except for cerebral embolism (n=1, 1.1%) and lower gastrointestinal hemorrhage (n=1, 1.1%) during hospitalization. Heparin group: no anticoagulation-related complication was found. The time to reach stable warfarin anticoagulation was shorter than the warfarin group and difference was of significance (8 d±3 d vs 11 d±4 d, P<0.01). After adjustment of potential confounding factors such as age, gender, weight by linear regression analysis, the result showed that, the time to reach stable warfarin anticoagulation was shortened than the warfarin group by 2.11 days. Statistical significance of difference was observed between two groups (P<0.01). It is both safe and effective to anticoagulated the patients after mechanical valve replacement with warfarin and heparin.


Effective removal of Cr(VI) by attapulgite-supported nanoscale zero-valent iron from aqueous solution: Enhanced adsorption and crystallization.
The attapulgite supported nanoscale zero-valent iron composite (AT-nZVI) was synthesized and used for Cr(VI) removal. X-ray diffraction (XRD) and transmission electron microscope (TEM) indicated that nZVI particles were well distributed and immobilized on the attapulgite surface. Batch experiments of Cr(VI) removal were conducted at varying mass ratios, initial Cr(VI) concentrations and kinetics. The results indicated that the removal efficiency of Cr(VI) by AT-nZVI approaches 90.6%, being greater than that by non-supported nZVI (62.9%). The removal kinetics could be more accurately explained using pseudo second order kinetics model. The composite exhibited a synergistic interaction instead of simple mixture of AT and nZVI. Reduction was the dominant mechanism at low concentrations as opposed to adsorption at high concentrations. FeCr2O4 was the main reduction product by AT-nZVI, which was attributed to the reduction of Cr(VI) by nZVI and co-precipitation of CrFe oxides on the surface of AT. In the meantime, Fe(II) ion contributed to 64% for the Cr(VI) removal, which resulted from the dissolution of nZVI during the removal process. From the analysis of XRD and XPS results, the crystallization of FeCr2O4 is believed to be formed easily after the reaction of the AT-nZVI composite with Cr(VI) which is more stable and greatly reduce the risk of secondary pollution compared with nZVI. The introduction of AT enhanced adsorption of Cr(VI) and crystallization of the products. The above results suggested that AT-nZVI could be a promising remediation material for Cr(VI)-contaminated groundwater.


Access to heart disease and stroke care in Tennessee.
Tennessee is ranked fourth-worst in the United States for deaths caused by stroke and third-worst in the nation for cardiovascular deaths. Two recent surveys provide information about the geographic distribution of hospital-based, primary and secondary care promotion, and of emergency medical services for these disease conditions. This article is a synthesis of selected findings from these surveys to identify priority populations for interventions to reduce cardiac and stroke mortality in Tennessee. Twenty-three counties have a medical facility with a formal clinical pathway or system for implementing cardiovascular disease prevention strategies. Sixty-three of the state's 95 counties have no designated specialty center for an EMS service to transport cardiac and stroke patients. Fifty-six counties, comprising 38 percent of the state's population, lie between 20 and 50 miles from the nearest state-of-the-art stroke care. Twenty-one counties, containing nearly 10 percent of the state's population, are greater than 50 miles from advanced stroke care facility. Some health districts are faring better than the state proportion (86.8 percent) for people indicating they would call 911 for a suspected cardiac or stroke emergency, while many are performing much poorer. The Shelby district (Memphis) is much higher (p < 0.01), while Madison and South Central districts are well below the state's prevalence (p < 0.001). The fact that these "less-likely-to-call-911" areas are also in mostly rural settings poses priority challenges for public education. To combat this trend, coordinated efforts are in progress to incentivize the development of cardiac and stroke centers or, alternatively, the formation of regional collaborative networks affiliated with a specialty center.


A comparison of DNA and immunoblot fingerprinting of the SII biotype of coagulase negative staphylococci.
Thirty-eight isolates of the SII biotype of coagulase negative staphylococci were examined by phase typing, antibiograms, DNA and immunoblot fingerprinting. Multiple isolates were available from 5 patients with clinically proven infections and from 12 further patients who were epidemiologically distinct. Only 3 of the isolates were phage typable and antibiograms produced only 9 types. All isolates were typable by both DNA and immunoblot fingerprinting and reproducibility was excellent provided the conditions were standardized. Discrimination was better with immunoblot fingerprinting (17 types) than DNA fingerprinting (11 types). Both techniques were successful in assessing the significance of multiple isolates from a single patient.


Solitary neurilemmoma in postaural region.
Neurilemmoma in postaural region arising from great auricular nerve is an extremely rare tumour. An 11 years boy presented with pain and swelling behind his left ear for last 3-4 years. The clinical examination revealed the swelling appeared to be diffuse with the margin being ill defined. On radiological examination a diffuse homogeneous mass was seen in the postaural region of the left side. The tumour was completely removed by an incision through postaural route. Histopathological study revealed neurilemmoma. Postoperative period was uneventful.


Controllable transport of nanoparticles along waveguides by spin-orbit coupling of light.
Waveguide optical tweezers can capture and transport nanoparticles, and have important applications in biology, physics, and materials science. However, traditional waveguide optical tweezers need to couple incident light into one end of the waveguide, which causes problems such as difficulty in alignment and low efficiency. Here, we propose a new type of waveguide optical tweezers based on spin-orbit coupling of light. Under the effect of spin-orbit coupling between the waveguide and nearby particles illuminated by a circularly polarized light, the particles experience a lateral recoil force and a strong optical gradient force, which make particles in a large area to be trapped near the waveguide and then transmitted along the waveguide, avoiding the coupling of light into one end of the waveguide. We further demonstrate that the particles can be transmitted along a curved waveguide and even rotated along a ring-shaped waveguide, and its transmission direction can be simply switched by adjusting the spin polarization of incident light. This work has significance in the research of optical on-chip nano-tweezers.


Top-Down Atmospheric Ionization Mass Spectrometry Microscopy Combined With Proteogenomics.
Mass spectrometry-based protein analysis has become an important methodology for proteogenomic mapping by providing evidence for the existence of proteins predicted at the genomic level. However, screening and identification of proteins directly on tissue samples, where histological information is preserved, remain challenging. Here we demonstrate that the ambient ionization source, nanospray desorption electrospray ionization (nanoDESI), interfaced with light microscopy allows for protein profiling directly on animal tissues at the microscopic scale. Peptide fragments for mass spectrometry analysis were obtained directly on ganglia of the medicinal leech (Hirudo medicinalis) without in-gel digestion. We found that a hypothetical protein, which is predicted by the leech genome, is highly expressed on the specialized neural cells that are uniquely found in adult sex segmental ganglia. Via this top-down analysis, a post-translational modification (PTM) of tyrosine sulfation to this neuropeptide was resolved. This three-in-one platform, including mass spectrometry, microscopy, and genome mining, provides an effective way for mappings of proteomes under the lens of a light microscope.


The Intergenerational Transmission of Union Instability in Early Adulthood.
Research on the intergenerational transmission of divorce should be expanded to incorporate disrupted nonmarital cohabitations. The current study (1) examined the transmission of union instability from parents to offspring using Waves I and IV of Add Health, (2) replaced the binary variables (divorced versus non-divorced) typically used in this literature with count variables (number of disrupted unions), (3) relied on independent sources for data on parents' and offspring's union disruptions to minimize same-source bias, (4) assessed the mediating role of 11 theoretically derived variables (many not previously considered in this literature), and (5) incorporated information on discord in intact parental unions. Parent and offspring union disruptions were positively linked, with each parental disruption associated with a 16% increase in the number of offspring disruptions, net of controls. The mediators collectively accounted for 44% of the estimated intergenerational effect. Parent discord in intact unions also was associated with more offspring disruptions.


Ultrasound Sensors for Diaphragm Motion Tracking: An Application in Non-Invasive Respiratory Monitoring.
This paper introduces a novel respiratory detection system based on diaphragm wall motion tracking using an embedded ultrasound sensory system. We assess the utility and accuracy of this method in evaluating the function of the diaphragm and its contribution to respiratory workload. The developed system is able to monitor the diaphragm wall activity when the sensor is placed in the zone of apposition (ZOA). This system allows for direct measurements with only one ultrasound PZT5 piezo transducer. The system generates pulsed ultrasound waves at 2.2 MHz and amplifies reflected echoes. An added benefit of this system is that due to its design, the respiratory signal is less subject to motion artefacts. Promising results were obtained from six subjects performing six tests per subject with an average respiration detection sensitivity and specificity of 84% and 93%, respectively. Measurements were compared to a gold standard commercial spirometer. In this study, we also compared our measurements to other conventional methods such as inertial and photoplethysmography (PPG) sensors.


Effects of pH and added metabolites on bioconversions by immobilized non-growing Clostridium acetobutylicum.
The bioconversion activity of calcium alginate-immobilized Clostridium acetobutylicum ATCC 824 was investigated in a continuous reactor system utilizing a defined feed medium which did not support cell growth. The changes in biocatalytic activity with time were studied at different pH values as well as when different metabolites (butyric, acetic, and acetoacetic acids) were present in the feed stream. Although the nongrowing cells were metabolically active, the product distribution was shifted from solvent production to acidogenesis. Overall activity losses occurred due to cell lysis, sporulation, and the effects of nitrogen level on macromolecular turnover. These effects were minimized under some operating conditions (e.g., pH 6), resulting in significantly longer productivity lifetimes.


[Leiomyoma of the urinary bladder associated with right vesicoureteral reflux].
A 32-year-old female consulted our hospital with the complaint of recurrent urinary tract infections, especially acute pyelonephritis. Cystoscopy revealed a wide-based tumor covered with a normal epithelium at internal meatus and right slight opened orifice, the contraction of which was slightly weak. Excretory urography showed almost normal nephrogram, pyelogram and ureterogram, and voiding cystography revealed right vesicoureteral reflux with grade IIb. Under general anesthesia, tumor resection of the bladder and right ureterovesiconeostomy were carried out. Pathologically the tumor was diagnosed leiomyoma. Right vesicoureteral reflux was speculated to have occurred secondarily to leiomyoma of the urinary bladder.


Medullary Thyroid Carcinoma--Circulating Status of Vaspin and Retinol Binding Protein-4 in Iranian Patients.
Vaspin and Retinol binding protein-4 (RBP4) are new adipokines mainly produced by adipose tissue. Considering that medullary thyroid carcinoma (MTC) is a malignant neuroendocrine tumor, and to date the relationship between serum levels of vaspin and RBP4 with MTC has not been studied, in this matched case-control study we evaluated their possible significance to this tumor type. A total of 45 patients with MTC (21 males and 24 females) and 45 healthy persons as a control group (24 males and 21 females) were selected. The two groups were matched for age, sex and body mass index. Serum Vaspin and RBP4 levels were measured by enzyme-linked immunosorbent assay (ELISA) methods in both groups. Also, weight and height were measured and body mass index was calculated too. In total, patients with MTC had significantly higher serum vaspin levels compared to the controls (0.52 ng/ml vs. 0.45 ng/ml, P=0.0241). However, no significant difference was found in serum RBP4 concentrations between the patients with MTC and the controls (15.2±2.55 μg/ml versus 15.1±3.34 μg/ml, p>0.05). The results of this study demonstrated that serum RBP4 levels in MTC patients are not significantly different from those found in healthy individuals and did not correlate with MTC. On the other hand, higher levels of serum vaspin are associated with an increased risk of MTC. Thus Vaspin may be a novel and promising biomarker for diagnosis or confirmation of MTC in conjunction other specific tumor markers.


[Hemodynamic effects of positive pressure breathing].
A decrease of cardiac output during artificial ventilation with PEEP has been reported in 30-100% of patients. The drop in cardiac output is caused by (I) a decrease of transmural filling pressures of both ventricles, (II) an increase in afterload of the right ventricle, (III) a change of left ventricular geometry caused by a right to left shift of the interventricular septum in face of an enlarging right ventricle. Afterload enhancement and right to left interdependance are effective on high PEEP levels only (above 15 cm H2O). Pulmonary occlusion pressure represents left ventricular filling pressure up to PEEP 10-15 cm H2O. A rise of cardiac output during PEEP may be seen (I) in patients with severe left ventricular failure, where hemodynamics may ameliorate with PEEP (II) in patients with very stiff lungs and low FRC before ventilation. A drop in mean arterial blood pressure was observed in a certain number of patients, while arterial pressure remained constant in others. PEEP should not be delivered to patients with arterial hypotension and hypovolimia before stabilisation of circulation and volume replacement. Regional blood flow is significantly altered during PEEP. In dog experiments a redistribution of peripheral blood flow was observed favouring the flow to brain, heart, adrenal glands small intestine and sceletal muscle and ischemia of stomach, thyroideal and fatty tissue blood flow. Within the kidney, a redistribution of blood flow away from the outer cortex compromises the kidney function (decrease of glomerula filtration, urine output and sodium excretion).(ABSTRACT TRUNCATED AT 250 WORDS)


Practice of Hereditary ATTR Amyloidosis in Non-endemic Areas of Japan.
Objective Hereditary ATTR (ATTRv) amyloidosis was once an incurable disease; however, in recent years, disease-modifying therapies, such as tafamidis and patisiran, have become available. We herein report the medical care situation in an ATTRv amyloidosis non-endemic area of Japan. Methods We confirmed the information in the medical records of our department and analyzed the data retrospectively. Patients Patients with ATTRv amyloidosis who were treated in our department between 2010 and 2021 were included. Results A total of 15 ATTRv amyloidosis cases (8 men and 7 women) were treated in our department during the study period; 9 patients had a family history, and the transthyretin V30M (p.V50M) gene mutation was present in 66% of cases. The average age of the onset was 57 years old, with 73% of the initial symptoms being dysesthesia and 13% being autonomic dysfunction. Ten patients were treated with tafamidis and nine with patisiran. Although it took a long time to start treatment among our experienced cases, there were some cases in which treatment could be introduced relatively early. Conclusion ATTRv amyloidosis is treatable and should be included in the differential diagnosis of neuropathy so that it can be diagnosed early and introduced into treatment. In the near future, the presymptomatic diagnosis of ATTRv amyloidosis and genetic counseling will become more important.


Inflammation Parameters Associated with Metabolic Disorders: Relationship Between Diet and Microbiota.
The metabolic syndrome (MetS) includes numerous interrelated clinical, anthropometric, biochemical, and metabolic components and has become a public health problem due to its impact on morbimortality. Inflammation is a central mechanism underlying the etiology and clinical manifestations of MetS, contributing to its related pathological outcomes. Dietary patterns have been associated with the promotion of the diversity of microbiota in the digestive tract. Recently, research has focused on the importance of microbiota changes associated with MetS and inflammation. Other studies have been performed to understand the impact of prebiotics, probiotics, and synbiotics as allies on diet, inflammation, and MetS parameters. This review analyses the correlation between metabolic disorders, inflammation parameters, gut microbiota, and how diet has been involved as treatment of MetS and the modulation of inflammation and microbiota.


Imidazolium-based ionic liquids formed with dicyanamide anion: influence of cationic structure on ionic conductivity.
Ionic liquids composed of dicyanamide anion and various imidazolium-based cations were prepared, and the influence of structural variations such as substituting a hydrogen at 2-position and changing the sort of alkyl group at 1-position of imidazolium cations on their thermal behavior, density, solvatochromic effects, viscosity, ionic conductivity, and surface tension was characterized. The substitution of the 2-hydrogen for methyl group or N-methylimidazole decreases the fluidity and ionic conductivity, mainly caused by the increased cohesive energy associated with the increasing cation size. Chain branching at 1-position also gives rise to the pronounced depression of the fluidity and ionic conductivity, presumably as a consequence of the increased pi-pi interactions between imidazolium rings. We found that the surface tension of the present ionic liquids is in inverse proportion to the molar concentration, which can be originally rationalized on the basis of the hole theory.


Selecting treatment for high-risk, localized prostate cancer: the case for radical prostatectomy.
The most common treatment options for men with clinically localized prostate cancer include radical prostatectomy and radiation therapy. The choice between these options is often controversial, and selecting the optimal treatment poses a great challenge for patients and physicians. Factors important to the decision include age and life expectancy of the patient, the natural history of the prostate cancer, how curable the disease is, and the morbidity of treatment. Use of these criteria to select treatment for a healthy, 70-year-old man presenting with a nonpalpable tumor, stage T1c disease, serum prostate-specific antigen of 12 ng/mL, and an adenocarcinoma with a Gleason score of 8 that is present in 2 of 12 biopsy cores would lead to the choice of radical prostatectomy over radiation therapy. Data show that such a patient has a life expectancy of more than 12.3 years if the prostate cancer can be cured and a high probability of dying from the disease if it is not cured. Data further show that radical prostatectomy in such a patient would confer a survival advantage over radiation therapy without resulting in greater complications or reduction in quality of life.


Blood concentrations of some persistent organohalogens in free-ranging spotted seals (Phoca largha) from Bristol Bay, Alaska.
In recent years, the relatively high levels of organochlorine contaminants and increasing levels of brominated flame retardants found in tissues of marine mammals have raised concerns that exposure to these marine pollutants may compromise individual health. In this pilot study, levels of 11 polychlorinated biphenyls, 3 polybrominated diphenyl ethers, and the DDT metabolite p,p'-diphenyldichloroethylene were analyzed in whole blood of 7 free-ranging spotted seals (Phoca largha) from Bristol Bay, Alaska, sampled during 2000 and 2001. Blood concentrations of analytes were generally low (<1 ppb wet weight). Open-ocean foraging and feeding on a lower trophic level may contribute to the relatively lower levels of organohalogens found in this species as compared to the closely related harbor seal, Phoca vitulina, occurring in Bristol Bay.


Effectiveness of rapid rail transit system in Beijing.
The effectiveness of rapid rail transit system is analyzed using tools of complex network for the first time. We evaluated the effectiveness of the system in Beijing quantitatively from different perspectives, including descriptive statistics analysis, bridging property, centrality property, ability of connecting different part of the system and ability of disease spreading. The results showed that the public transport of Beijing does benefit from the rapid rail transit lines, and the benefit of different regions from RRTS is gradually decreased from the north to the south. The paper concluded with some policy suggestions regarding how to promote the system. This study offered significant insight that can help understand the public transportation better. The methodology can be easily applied to analyze other urban public systems, such as electricity grid, water system, to develop more livable cities.


Synchronized polymerization and fabrication of poly(acrylic acid) and nylon hybrid mats in electrospinning.
Acrylic acid monomer in a viscous supporting nylon solution was polymerized and fabricated simultaneously via an electrospinning process. This novel polymerization method defines the fiber morphology as a network of interconnected mats. This network consists of smaller poly(acrylic acid) (PAA) fibers, approximately 19 nm in diameter, and larger nylon 6 fibers, approximately 75 nm in diameter. These two different fibers are separated by extraction of PAA from the fibrous mat in water and differentiation of field-emission scanning electron microscopy (FESEM) images of the same mat using before and after extraction of PAA. The structure of the extracted PAA was confirmed by 1H NMR and Fourier transform infrared (FT-IR) analysis. The observed modification to conventional electrospun mats is due to the presence of an extra phase-separated PAA produced by the electrospinning polymerization process. Finally, fiber morphologies and hybrid property were characterized via FT-IR, FESEM, thermogravimetric analysis, and X-ray diffraction. Similarly extracted samples and synthesis PAA were characterized in FT-IR and 1H NMR spectroscopy.