Influence of pharmacy practice on community pharmacists' integration of medication and lab value information from electronic health records.
To describe how an electronic health record (EHR) was integrated into community pharmacists' patterns of patient care and to explore factors that are related to the use of medication and laboratory value information from the EHR. Descriptive, exploratory, nonexperimental study. Edmonton, Canada, between November 2008 and March 2009. 16 pharmacists, 3 pharmacy technicians, and 2 pharmacy interns from primary care networks, long-term care settings, community independent and chain pharmacies, and grocery store pharmacies. Qualitative interviews. Pharmacists' self-reported use of EHR. Pharmacists in a patient-centered care practice (involving medication therapy management activities) were more likely to adopt the EHR for medication history and laboratory values, whereas pharmacists whose practice was focused on medication dispensing primarily used the EHR for patient demographic and dispensing records. Six general factors influenced the use of EHR: patients, pharmacists, pharmacy, other health professionals (i.e., physicians), EHR, and environment. Access to the medical record versus EHR and timeliness were barriers specific to pharmacists in a patient-centered practice. Factors that affected EHR use for pharmacists with primarily a dispensing practice were role understanding, dispensing versus lab records, valid reasons for using EHR, and fear of legal and disciplinary issues. Many community pharmacists embraced the EHR as a part of practice change, particularly those in patient-centered care practices. Practice type (patient-centered care or dispensing) greatly influenced pharmacists' use of EHR, specifically laboratory values. Because these qualitative findings are exploratory in nature, they may not be generalized beyond the participating pharmacies.


Comparative genomic hybridization (CGH) in genotoxicology.
In the past two decades comparative genomic hybridization (CGH) and array CGH have become crucial and indispensable tools in clinical diagnostics. Initially developed for the genome-wide screening of chromosomal imbalances in tumor cells, CGH as well as array CGH have also been employed in genotoxicology and most recently in toxicogenomics. The latter methodology allows a multi-endpoint analysis of how genes and proteins react to toxic agents revealing molecular mechanisms of toxicology. This chapter provides a background on the use of CGH and array CGH in the context of genotoxicology as well as a protocol for conventional CGH to understand the basic principles of CGH. Array CGH is still cost intensive and requires suitable analytical algorithms but might become the dominating assay in the future when more companies provide a large variety of different commercial DNA arrays/chips leading to lower costs for array CGH equipment as well as consumables such as DNA chips. As the amount of data generated with microarrays exponentially grows, the demand for powerful adaptive algorithms for analysis, competent databases, as well as a sound regulatory framework will also increase. Nevertheless, chromosomal and array CGH are being demonstrated to be effective tools for investigating copy number changes/variations in the whole genome, DNA expression patterns, as well as loss of heterozygosity after a genotoxic impact. This will lead to new insights into affected genes and the underlying structures of regulatory and signaling pathways in genotoxicology and could conclusively identify yet unknown harmful toxicants.


Norfloxacin versus placebo for prophylaxis against travellers' diarrhoea.
In a randomized, double blind study, 127 subjects travelling to countries outside Northern Europe were given norfloxacin 200 mg or placebo bid as prophylaxis against diarrhoea. Fifty-six subjects randomized to norfloxacin and 59 to placebo fulfilled criteria for evaluation of efficacy and of those, respectively six and 20 (P = 0.0006) developed diarrhoea. The mean duration of symptoms in the placebo group was 3.6 days, while all subjects on norfloxacin had symptoms for one day only. In travellers to Mediterranean Europe or the Canary Islands, no significant differences were seen between norfloxacin and placebo. Among subjects going to Africa, Asia or Latin America, 4/32 subjects on norfloxacin and 16/30 on placebo developed diarrhoea (P = 0.0004). Adverse effects were few and mild. Faeces for aerobic cultures was obtained before travelling and three weeks and then three months post-treatment. Treatment with norfloxacin resulted in a significant reduction of samples yielding aerobic Gram-negative rods but did not affect enterococci. In the placebo group, Gram-negative organisms other than Escherichia coli were increased on return to Sweden and the subjects frequently acquired Gram-negative organisms resistant to antibiotics. In none of the groups was there a tendency towards increased norfloxacin resistance. Biotyping of E. coli showed that in both groups the subjects changed their E. coli strains frequently during and after travelling. This trial showed that norfloxacin is a safe and effective prophylactic agent with no adverse effect on bacterial flora, but that its use should be restricted to travellers to non-European countries.


Analysis of the distances covered by first division brazilian soccer players obtained with an automatic tracking method.
Methods based on visual estimation still is the most widely used analysis of the distances that is covered by soccer players during matches, and most description available in the literature were obtained using such an approach. Recently, systems based on computer vision techniques have appeared and the very first results are available for comparisons. The aim of the present study was to analyse the distances covered by Brazilian soccer players and compare the results to the European players', both data measured by automatic tracking system. Four regular Brazilian First Division Championship matches between different teams were filmed. Applying a previously developed automatic tracking system (DVideo, Campinas, Brazil), the results of 55 outline players participated in the whole game (n = 55) are presented. The results of mean distances covered, standard deviations (s) and coefficient of variation (cv) after 90 minutes were 10,012 m, s = 1,024 m and cv = 10.2%, respectively. The results of three-way ANOVA according to playing positions, showed that the distances covered by external defender (10642 ± 663 m), central midfielders (10476 ± 702 m) and external midfielders (10598 ± 890 m) were greater than forwards (9612 ± 772 m) and forwards covered greater distances than central defenders (9029 ± 860 m). The greater distances were covered in standing, walking, or jogging, 5537 ± 263 m, followed by moderate-speed running, 1731 ± 399 m; low speed running, 1615 ± 351 m; high-speed running, 691 ± 190 m and sprinting, 437 ± 171 m. Mean distance covered in the first half was 5,173 m (s = 394 m, cv = 7.6%) highly significant greater (p < 0.001) than the mean value 4,808 m (s = 375 m, cv = 7.8%) in the second half. A minute-by-minute analysis revealed that after eight minutes of the second half, player performance has already decreased and this reduction is maintained throughout the second half. Key pointsA novel automatic tracking method was presented. No previous work was found in the literature reporting data of simultaneous trajectories of all soccer players obtained by an automatic tracking method.The study reveals 7% reduction in mean distance covered in the second half and moreover after eight minutes of the second half, player performance has already decreased and this reduction is maintained throughout the second half.


Here's the latest research in pediatric pain control.
Because pediatric patients are at high risk for inadequate pain management, ED staff should be vigilant about identifying painful conditions, treating them quickly with adequate analgesics, and ensuring adequacy of outpatient pain management. Studies have shown that analgesia was given to pediatric patients less frequently than adults in the ED. Research shows that pain management is better when protocols are used to manage pain. Often, parents feel that their child's pain management is inadequate. Staff education, including regular lectures or informal inservicing, can lead to better management of pain.


Towards characteristics of photodynamic drugs specifically aimed at microvascular diseases.
Photodynamic therapy (PDT) is a versatile methodology to treat various diseases but the drugs (photosensitizers) specifically aimed at individual character of diseases are urgently needed. Among those, the perilenoquinoid photosensitizers were thought of low PDT effectiveness to solid tumors due to low absorption on the "photodynamic window" but may be specially suitable for PDT to some microvascular diseases, such as age-related macular degeneration (AMD) and port wine stains (PWS), as well as other superficial diseases. Two strategies were discussed to convert the photosensitizers into clinically acceptable drugs in consideration of the drug-delivery and biological activity.


Alcohol, aggression and the stress of subordination.
In individual resident-intruder or novel arena confrontations alcohol enhancement of aggression appears less robust than when groups of animals receive the drug. Patterns of effects in the latter situations, such as enhanced attack on familiar animals, particularly familiar females, suggest that group living engenders attack inhibitions, perhaps based on enhanced anxiety/defensiveness, that may be overcome by alcohol. Male rats living in natural, mixed-sex groups in seminatural situations develop strong dominance-subordination relationships that appear to strongly stress subordinates. Subordinate males show strongly and chronically increased defensive behaviors, increased corticosterone and reduced testosterone levels and, often, early mortality. When allowed access to both alcohol and water, they increase voluntary alcohol consumption, in comparison to dominants. Analyses of relationships between voluntary consumption and defensive behaviors support a view that the voluntary consumption increases of subordinate rats are mediated by the anxiolytic effect of alcohol in highly stressed animals.


Parental knowledge and perceptions of fever in children and fever management practices: differences between parents of children with and without a history of febrile seizures.
The aim of this study was to compare maternal knowledge and perceptions of fever, fever management practices, and information sources of mothers of children with and without a history of febrile seizures. A questionnaire was used to survey mothers of children who visited health departments for a routine 18-month-old well baby check-up. A total of 386 responses were analyzed. More mothers of children with a history of febrile seizures than mothers of children without it stated that high fever caused febrile seizures and antipyretics prevented it. Fewer mothers of children with a history of febrile seizures than mothers in the other group thought that high fever caused brain damage and antipyretics prevented the disease from worsening and warmed the child's body during fever episode. Many mothers in both groups stated that they considered physicians to be their primary information source. Spouse and own parents were named as information sources among mothers of children with a history of febrile seizures, whereas books and the Internet were named in the other group. Mothers of children with a history of febrile seizures demonstrated a higher rate of accuracy in their knowledge of fever than those in the other group. Mothers of children with a history of febrile seizures used personal communication, whereas those in the other group relied on mass communication for health information. Providing accurate information to family members is essential to provide mothers with both accurate information and emotional support.


Trial of platelet-derived growth factor antagonist, trapidil, in accelerated nephrotoxic nephritis in the rabbit.
The platelet-derived growth factor (PDGF) antagonist, trapidil, which also blocks the thromboxane and/or PG-endoperoxide receptor and is an inhibitor of thromboxane synthetase, was administered during rabbit accelerated nephrotoxic nephritis; the clinical and histological evolution was studied as well as urinary immunoreactive thromboxane (i-TXB2) and immunoreactive prostaglandin E2 (i-PGE2) excretion. Although the dose we used has been shown to be effective in vivo, and it inhibited the urinary i-TXB2 excretion on days 5 and 10, it neither inhibited the enhanced production of i-TXB2 on day 1, nor prevented the glomerular influx of monocytes on days 5 and 10. All clinical and histological data tend to be worse rather than better in trapidil-treated animals on days 5 and 10.


Injuries by marine and freshwater stingrays: history, clinical aspects of the envenomations and current status of a neglected problem in Brazil.
Stingrays are a group of rays - cartilaginous fish related to sharks - that have whiplike tails with barbed, usually venomous spines and are found around the world, especially the marine species. Despite recent reports of accidents involving these fish, they are not aggressive, reacting only when stepped on or improperly handled. Injuries by stingrays are seldom mentioned by historians, although they have always been present in riverine communities of inland waters and in South American coasts. Indeed, envenomations by stingrays are quite common in freshwater and marine fishing communities. Although having high morbidity, such injuries are neglected because they have low lethality and usually occur in remote areas, which favor the use of folk remedies. In the present review article, historical aspects of injuries caused by stingrays in Brazil and their distribution on the coast of São Paulo state and riverine communities of the North, Midwest and Southeast regions were studied. In addition, other aspects were analyzed such as clinical features, therapeutic methods, preventive measures and trends in occurrence of these accidents in the country, particularly in areas in which freshwater stingrays had not been previously registered, being introduced after breaching of natural barriers.


A case report of a cochlear implant infection - A reason to explant the device?
Case history of a paediatric patient with a cochlear implant and a surgical site infection that developed as a result of acute otitis media is presented. After conservative management including wound debridement it was decided to explant a functioning device. In a number of cases, it is necessary to remove the infected albeit functioning device, especially in the event of formation of the biofilm has occurred. It is necessary to review and evaluate the methods with which these major complications are routinely managed with the aim to increase the survival ratio for the implanted device.


[Gene mutation detection in a cleidocranial dysplasia family].
To study gene mutation in Chinese patients with cleidocranial dysplasia. A three generation family with the clinical diagnosis of cleidocranial dysplasia was investigated in present study. Genomic DNA was extracted from peripheral blood samples of each of the family members. Direct sequencing of the PCR products of the coding region of CBFA1 gene was used to identify the mutations. In each patient of the family, a heterozygous missense mutation, cDNA 674 G > A (R225Q), was detected in CBFA1 exon 3. The mutation changed the sequence in runt domain of the protein. Our findings indicate that mutation in CBFA1 is responsible for the tooth agenesis and other phenotypes of cleidocranial dysplasia in this Chinese family. The mutation detection could be applied in prenatal diagnosis for the family.


Laboratory evaluation of SARS-CoV-2 in the COVID-19 pandemic.
Laboratory evaluation of SARS-CoV-2 involves the detection of viral nucleic acid, viral protein antigens, and the antibody response. Molecular detection of SARS-CoV-2 is the only diagnostic test currently available in acutely or recently infected individuals. In contrast, serological testing is typically performed once viral RNA has been cleared and symptoms have resolved. This leads to some confusion among clinicians as to which test to order and when each is appropriate. While SARS-CoV-2 assays can suffer from poor sensitivity, all FDA authorized assays to date are intended to be qualitative. Serological tests have multiple assay formats, detect various classes of immunoglobulins, and have a distinct role in seroprevalence studies; however, the association with long-term protection remains unclear. Both molecular and serological testing for SARS-CoV-2 have complementary roles in patient management, and we highlight the challenges faced by clinicians and laboratorians alike in the evaluation and interpretation of the currently available laboratory assays.


Cytoplasmic motion induced by cytoskeleton stretching and its effect on cell mechanics.
Cytoplasmic motion assumed as a steady state laminar flow induced by cytoskeleton stretching in a cell is determined and its effect on the mechanical behavior of the cell under externally applied forces is demonstrated. Non-Newtonian fluid is assumed for the multiphase cytoplasmic fluid and the analytical velocity field around the macromolecular chain is obtained by solving the reduced nonlinear momentum equation using homotopy technique. The entropy generation by the fluid internal friction is calculated and incorporated into the entropic elasticity based 8-chain constitutive relations. Numerical examples showed strengthening behavior of cells in response to externally applied mechanical stimuli. The spatial distribution of the stresses within a cell under externally applied fluid flow forces were also studied.


Paederus dermatitis in Southeastern Anatolia, Turkey: a report of 57 cases.
Paederus dermatitis (PD), which is an irritant contact dermatitis, is common throughout the world and caused by rove beetles. To assess the clinical features of PD and the level of knowledge of patients from the city of Batman and surrounding areas who presented with the condition. We describe 57 patients who presented to our dermatology clinic in the city of Batman between May 2011 and October 2011. Sociodemographic data were collected for all the patients, and their level of knowledge about the disease was assessed with a detailed questionnaire. Fifty-seven patients, of whom 36 (63%) were men and 21 (37%) were women, were included in the study. The mean age of the patients was 24.2 years. The peak time of presentation was August. The neck and the chest were the most common sites of involvement. Clinically, the most common presentation consisted of papulo-pustules on an erythematous base. The most frequent complaints were burning and stinging sensations (66.7%). Only three patients (5%) thought that contact with insects could lead to the disease. PD is an important public health problem when it is seen epidemically. The public's awareness about the cause of the disease is very low. Knowledge about the clinical features of PD and the emergence of epidemics will prevent misdiagnosis by physicians. Increasing the level of knowledge of people about the cause of the disease and about the behavioural patterns of the insect are important in terms of disease prevention.


The response to varying concentrations of inhaled nitric oxide in patients with acute respiratory distress syndrome.
We investigated the response to varying concentrations of inhaled nitric oxide (NO) in 18 patients with acute respiratory distress syndrome (ARDS). The study was divided into two parts. In Part 1, 5-40 ppm of inhaled NO was evaluated in 10 patients with ARDS. In Part 2, 0.1-10 ppm of inhaled NO was evaluated in eight patients with ARDS. Inhaled NO significantly (P < 0.05) decreased the mean pulmonary artery pressure (MPAP) and pulmonary vascular resistance index (PVRI), and increased the arterial oxygenation (PaO2) at concentrations of 0.1 to 40 ppm. No dose response was detectable for the pulmonary artery pressure (PAP) or PVRI over this dose range. The increase in PaO2 at 10 ppm of NO was significantly greater than that at 0.1 ppm but not 1 ppm. The decrease in PVRI and the increase in PaO2 were both significantly correlated with the baseline PVRI. While the maximum hemodynamic and oxygenation responses to inhaled NO are achieved at approximately 1 ppm, it appears that the maximum hemodynamic response is observed at lower concentrations (0.1 ppm) of inhaled NO than the improvement in oxygenation (1-10 ppm). Higher concentrations of NO do not produce any further change in these variables. It appears that the baseline PVRI may be the best marker predicting a beneficial response to NO.


Molecular mechanics study of ion binding by a cyclic pentapeptide.
We have used energy minimization and harmonic analysis to study the structural and thermodynamic changes which occur upon the binding of lithium ions to the cyclic pentapeptide, cyclo-(Gly-L-Pro-Gly-D-Ala-L-Pro) (GPGAP). A number of theoretically stable vacuum configurations of uncomplexed GPGAP were found, one of which is very close to the crystal conformation determined by X-ray diffraction. Stable complexes with lithium were found where the ion binds to the carbonyl oxygen atoms of three residues. Detailed conformational information is presented for both the uncomplexed and the complexed peptide, along with an analysis of the atomic interactions which stabilize the various peptide conformations.


Boosting cancer survival in Nigeria: self-management strategies.
Cancer is a menace fast gaining momentum in Nigeria and other developing countries. It is an expensive disease requiring a major financial and human resources for prevention, diagnosis and treatment. With no national policy on cancer control in the country, incidence (111.7/100,000 population) and mortality (86.6/100,000) rates in Nigeria are spiraling beyond control. This literature search study was primarily aimed at providing recommendations on cost-effective strategies for development interventions to promote self-management for cancer survivors in Nigeria with a goal to improve quality of life and overall survival.


A Review of the Effects of Gold, Silver, Selenium, and Zinc Nanoparticles on Diabetes Mellitus in Murine Models.
Diabetes mellitus is a disease that presents great challenges for healthcare systems worldwide, and the identification of alternative therapies for the treatment of this disease is of vital importance. Metallic nanoparticles (gold, silver, and selenium) and metallic oxide (ZnO) have been studied in different areas such as medicine, biotechnology, the environment, and the food industry with promising results. In medicine, current research has revealed these nanoparticles' anti-diabetic properties thanks to the implementation of animal models. This review will address the existing antecedents and the effects of gold, silver, selenium, and zinc oxide nanoparticles in diabetes administered alone, functionalized with other molecules, or combined with drugs that have shown promising therapeutic effects. The anti-diabetic effects of these nanoparticles are related to the regulation of glucose, insulin, and lipid profiles. In addition, oxidative stress markers, liver and kidney markers, the reduction of inflammation, apoptosis of the pancreas, and the restoration of normal liver and kidney histology are also reported in the literature after using these nanoparticles. However, the therapeutic effects that these nanoparticles provide are limited due to the lack of specific protocols dictated by international organizations to evaluate the risks of using these nanoparticles.


Bilateral luxatio erecta complicated by venous thrombosis.
Inferior shoulder dislocation or luxatio erecta is an exceedingly rare form of shoulder dislocation and compromises less than 0.5% of all shoulder dislocations. Furthermore, bilateral luxatio erecta is reported only nine times in the English literature. This paper documents the tenth case of bilateral luxatio erecta. This tenth patient suffered an axial load injury to his outstretched arms and displaced both humeral heads inferiorly. After closed reduction, the patient was discharged home on hospital day two. However, he developed an axillary vein thrombosis 3 days later and required anticoagulation therapy. This report reviews the mechanisms of injury associated with inferior shoulder dislocations as well as the presentation and treatment of luxatio erecta. The complication of axillary vein thrombosis and its treatment in this patient are discussed also.


Adequacy of Using a Three-Item Questionnaire to Determine Zygosity in Chinese Young Twins.
The present study examined the adequacy of a three-item parent questionnaire in determining the zygosity of young Chinese twins and whether there was any association between parent response accuracy and some demographic variables. The sample consisted of 334 pairs of same-sex Chinese twins aged from 3 to 11 years. Three scoring methods, namely the summed score, logistic regression, and decision tree, were employed to evaluate parent response accuracy of twin zygosity based on single nucleotide polymorphism (SNP) information. The results showed that all three methods achieved high level of accuracy ranging from 91 to 93 % which was comparable to the accuracy rates in previous Chinese twin studies. Correlation results also showed that the higher the parents' education level or the family income was, the more likely parents were able to tell correctly that their twins are identical or fraternal. The present findings confirmed the validity of using a three-item parent questionnaire to determine twin zygosity in a Chinese school-aged twin sample.


Simulation of electron energy loss spectra of nanomaterials with linear-scaling density functional theory.
Experimental techniques for electron energy loss spectroscopy (EELS) combine high energy resolution with high spatial resolution. They are therefore powerful tools for investigating the local electronic structure of complex systems such as nanostructures, interfaces and even individual defects. Interpretation of experimental electron energy loss spectra is often challenging and can require theoretical modelling of candidate structures, which themselves may be large and complex, beyond the capabilities of traditional cubic-scaling density functional theory. In this work, we present functionality to compute electron energy loss spectra within the onetep linear-scaling density functional theory code. We first demonstrate that simulated spectra agree with those computed using conventional plane wave pseudopotential methods to a high degree of precision. The ability of onetep to tackle large problems is then exploited to investigate convergence of spectra with respect to supercell size. Finally, we apply the novel functionality to a study of the electron energy loss spectra of defects on the (1 0 1) surface of an anatase slab and determine concentrations of defects which might be experimentally detectable.


Transient chemokine receptor blockade does not prevent, but may accelerate type 1 diabetes in prediabetic NOD mice.
The influx of autoreactive lymphocytes into the site of an autoimmune inflammation is mediated by certain chemokines. Autoimmune insulitis in type 1 diabetes is viewed as the result of destructive Th-1-cells and their corresponding antigen-presenting cells infiltrating the pancreatic islets. Blocking the chemokine receptors that mediate a Th-1-reaction has been shown to reduce autoimmunity in other experimental autoimmune disorders. We used the NOD mouse model to investigate the potency of anti-CCR2 and anti-CCR5 antibodies to inhibit the influx of Th-1-cells into the pancreatic islets, thus preventing diabetes onset. Eleven-week-old female NOD mice were treated with 500 microg of a monoclonal anti-CCR5 or anti-CCR2 or an isotype control antibody every third day over two weeks. We did not observe any preventive effect in either treatment group, but accelerated diabetes onset in the anti-CCR5 treated group. The number of autoantigen-specific Th-1-cells detected in the two treated groups was not reduced, but increased in the anti-CCR5 group. Redundancy within the chemokine system may account for this lack of prevention, or the intervention may have come too late in the disease process. Furthermore, blocking Th-1 chemokine receptors in the late autoimmune process may also inhibit regulatory T-cells, thus accelerating rather than preventing the disease.


Dihydropyrimidine Dehydrogenase Testing prior to Treatment with 5-Fluorouracil, Capecitabine, and Tegafur: A Consensus Paper.
5-Fluorouracil (FU) is one of the most commonly used cytostatic drugs in the systemic treatment of cancer. Treatment with FU may cause severe or life-threatening side effects and the treatment-related mortality rate is 0.2-1.0%. Among other risk factors associated with increased toxicity, a genetic deficiency in dihydropyrimidine dehydrogenase (DPD), an enzyme responsible for the metabolism of FU, is well known. This is due to variants in the DPD gene (DPYD). Up to 9% of European patients carry a DPD gene variant that decreases enzyme activity, and DPD is completely lacking in approximately 0.5% of patients. Here we describe the clinical and genetic background and summarize recommendations for the genetic testing and tailoring of treatment with 5-FU derivatives. The statement was developed as a consensus statement organized by the German Society for Hematology and Medical Oncology in cooperation with 13 medical associations from Austria, Germany, and Switzerland. Key Messages: (i) Patients should be tested for the 4 most common genetic DPYD variants before treatment with drugs containing FU. (ii) Testing forms the basis for a differentiated, risk-adapted algorithm with recommendations for treatment with FU-containing drugs. (iii) Testing may optionally be supplemented by therapeutic drug monitoring.


Post-hemithyroidectomy hypothyroidism in non autoimmune thyroiditis patients: Incidence, risk factors and duration of follow up.
Hemithyroidectomy has a known but less predictable sequelae of hypothyroidism. Presence of anti-thyroid antibody is known, well studied risk factor. Other postulated risk factors include higher pre-operative TSH level and lower ratio of post-operative thyroid remnant to the patient's weight. We reviewed our data to address the above mentioned risk factors. This was a retrospective study done in National Cheng Kung University Hospital, Taiwan from 2015 to 2017. 125 patients underwent hemithyroidectomy, but 24 patients were excluded due to autoimmune thyroiditis, which was determined as the exclusion criteria. Standard panel of blood investigations were taken in each clinic visit before and after operation. A neck ultrasound was done 2 months post-operatively to assess the thyroid remnant. Chi-square test was used for categorical data analysis. Independent student t-test was used for continuous data with parametric distribution and Mann-Whitney U test for non parametric data. p < 0.05 was taken as statistically significant. The mean duration of follow up was 29.3 months. 4 out of 101 patients had clinical hypothyroidism; 23 patients developed subclinical hypothyroidism post-hemithyroidectomy. 6 patients of subclinical hypothyroidism had spontaneously recovered within 1 year. Pre-operative TSH >2.0 uIU/mL was a risk factor as Chi square test showed p < 0.001. However, thyroid remnants were found not to be a risk factor with the Mann-Whitney U test of p = 0.928. Minimum 1 year of follow up for hemithyroidectomy patients was suggested in order not to miss patients developing hypothyroidism post-operatively.


Mating-induced Fos and aromatase are not co-localized in the preoptic area.
Male sexual behavior is determined by the interaction of endocrine and environmental stimuli originating from the female, yet it is unknown how and where these stimuli are integrated within the brain. Activation of copulatory behavior by testosterone is limited by its central aromatization into an estrogen in the preoptic area. We investigated whether mating-induced neuronal activation as identified by the expression of the immediate early gene Fos occurs in aromatase-immunoreactive (ARO-ir) cells of the male quail preoptic area. Fos-immunoreactive (ir) cells were observed within and lateral to these ARO-ir cells groups but few ARO-ir cells contained Fos-ir indicating that mating-related stimuli do not directly affect estrogen-synthesizing cells.


Glucose sensing and signalling properties in Saccharomyces cerevisiae require the presence of at least two members of the glucose transporter family.
The kinetics of glucose transport in a number of different mutants of Saccharomyces cerevisiae with multiple deletions in the glucose transporter gene family were determined. The deletions led to differences in maximal rate and affinity for glucose uptake by the cells, dependent on the growth conditions. At the same time, there were changes in glucose repression, as determined by expression of invertase activity. Only in the strain with genes HXT1-4 and SNF3 deleted but carrying HXT6/7 were glucose uptake kinetics and invertase activity independent of the presence or concentration of glucose in the growth medium. Some degree of glucose sensitivity was recovered if the SNF3 or HXT2 gene was present in the multiple-deletion background. It is hypothesized that during growth on glucose, both modulation of the kinetics of glucose uptake and derepression of invertase activity require the presence of more than one active gene of the glucose transporter family.


Beyond medical insurance: delayed or forgone care among children in Chinese immigrant families.
While Asian Americans are less likely than most Americans to use health services, little is known about their barriers to pediatric care. This study seeks to describe the prevalence of delayed/forgone pediatric care and its association with parental acculturation status in recent-immigrant Chinese families. Survey data were obtained from 76 families across two community services sites. Half of the surveyed families reported delayed/forgone pediatric care in the previous 12 months. Low-income families in suburban areas reported greater financial burdens, linguistic barriers, and a higher prevalence of delayed/forgone care than low-income families living in downtown area. Middle class immigrant families reported cultural barriers as a reason for delayed/forgone care. Traditional beliefs and not medical insurance were significant predictors of delayed/forgone care. Culturally and linguistically appropriate studies on risk reduction interventions will be needed to address the linguistic and cultural barriers to health care access.


Successful Salvage Treatment of Resistant Acute Antibody-Mediated Kidney Transplant Rejection with Eculizumab.
Antibody-mediated rejection (ABMR) jeopardises short- and long-term transplant survival and remains a challenge in the field of organ transplantation. We report the first use of the anticomplement agent eculizumab in Oman in the treatment of a 61-year-old female patient with ABMR following a living unrelated kidney transplant. The patient was admitted to the Sultan Qaboos University Hospital in Muscat, Oman, in 2013 on the eighth day post-transplantation with serum creatinine (Cr) levels of 400 µmol/L which continued to rise, necessitating haemodialysis. A biopsy indicated ABMR with acute cellular rejection. No improvement was observed following standard ABMR treatment and she continued to require dialysis. Five doses of eculizumab were administered over six weeks with a subsequent dramatic improvement in renal function. The patient became dialysis-free with serum Cr levels of 119 µmol/L within four months. This case report indicates that eculizumab is a promising agent in the treatment of ABMR.


Molecular crystal global phase diagrams. I. Method of construction.
A method is described to produce global phase diagrams for single-component molecular crystals with separable internal and external modes. The phase diagrams present the equilibrium crystalline phase as a function of the coefficients of a general intermolecular potential based on rotational symmetry-adapted basis functions. It is assumed that phase transitions are driven by orientational ordering of molecules with a fixed time-averaged shape. The mean-field approximation is utilized and the process begins in a high-temperature disordered reference state, then spontaneous symmetry-breaking phase transitions and phase structure information at lower temperature are sought. The information is mapped onto phase diagrams using the intermolecular expansion coefficients as independent variables. This is illustrated by global phase diagrams for molecules having tetrahedral symmetry (e.g. carbon tetrachloride, adamantane and white phosphorus). Uses of global phase diagrams include crystal structure data mining, guidance for crystal design and enumeration of likely or missing polymorphic structures.


[Scintigraphy of bleeding. The diagnostic value based on a 10-year period].
The purpose was to examine the diagnostic value of 99mTc-labelled red blood cell scintigraphy for detection of gastrointestinal haemorrhage. In a retrospective investigation 85 patient files over a 10 year period (1.1.1984-31.12.1993) were evaluated. Data regarding the patients' clinical condition, number of blood transfusions, findings with angiography, gastroscopy, colonoscopy, proctoscopy, operation, x-ray of colon and autopsy were registered. A bleeding site was localized in 52% of the scintigraphies. Among these patients the scintigraphic localization was confirmed or made "very possible" in 65% by operation, autopsy or one of the other mentioned diagnostic modalities. Among the 25 operated patients the localization of the bleeding site was confirmed in 19 patients. In 40 patients with a "negative" scintigraphy a bleeding site was found in 10 patients 1-18 days after the scintigraphy by operation or one of the listed diagnostic modalities. It is concluded that 99mTc-labelled red blood cell scintigraphy is a valuable diagnostic tool for identification of acute gastrointestinal haemorrhage. Operation after scintigraphic guidance is well indicated. A "negative" scintigraphy can only exclude ongoing bleeding from the gastrointestinal tract.


Fixation of three-part proximal humeral fractures: a biomechanical evaluation.
To examine the biomechanical stability of three constructs currently used for the management of three-part proximal humerus fractures. Tension band wires (TBW) with supplemental Enders nails, modified cloverleaf plate and screws, and intramedullary (IM) nailing with proximal and distal interlocks were tested to determine relative stability. A reproducible three-part fracture was made in fresh-frozen stripped proximal humeri. The fracture was stabilized using TBW/Enders nail (n = 6), plate/screws (n = 5), or IM nailing (n = 5). Mechanical testing was performed with a small preload followed by deflection of five millimeters at a rate of one millimeter per second in flexion, extension, and varus and valgus relative to the humeral shaft. A load-displacement curve was obtained. Torsional testing was performed in internal and external rotation, and torque-rotation curves were recorded. In cantilever bending, the plate/screws construct and the IM nail construct were superior to the TBW/Enders nail construct for all parameters except extension. There was no statistically significant difference between the IM nail and the plate/screws groups. Torsional stiffness testing revealed that the plate/screws and the IM nail were superior to the TBW/Enders nail construct. There was no statistical difference between the IM nail and the plate/screws groups. In a cadaveric model of three-part proximal humerus fractures stripped of soft tissue, plate/screws fixation and IM nailing provide greater torsional and bending stiffness than does fixation with TBW/Enders nail. There was no statistically significant difference in torsional or bending stiffness between IM nailing with interlocks and plate/screws fixation in this model.


CRT in Patients with Heart Failure: Time Course of Perfusion and Wall Motion Changes.
In patients treated with CRT no data relative to the relationship between regional wall motion and perfusion and reverse remodelling of the left ventricle at short and medium term followup were available. To this aim, 36 heart failure patients were studied by G-SPECT before (T0), within 2 months (T1) and 6 months (T2) after CRT. A clinical followup was completed for 36 months. In 30/36 patients there was an improvement of NYHA Class at T1 that persisted at T2. G-SPECT showed significant improvement of perfusion at T1 in 92% of patients without further changes at T2. A reduction of LV volumes, an increase of EF and an improvement of regional wall motion and thickening were observed at T1 versus baseline, with only minor changes at T2. Moreover, baseline extension of perfusion defects was scarcely correlated with improvement after CRT. Finally, end diastolic volume, perfusion defect and diabetes mellitus were independent predictors of survival. The main effects of CRT on regional myocardial perfusion and wall motion are obtained within 2 months. Volume overload modulates recovery of ventricular function independently of reperfusion and, with extension of perfusion abnormalities and diabetes were independent predictors of survival during followup.


Developmental "roots" in mature biological knowledge.
Young children tend to claim that moving artifacts and nonliving natural kinds are alive, but neglect to ascribe life to plants. This research tested whether adults exhibit similar confusions when verifying life status in a speeded classification task. Experiment 1 showed that undergraduates encounter greater difficulty (reduced accuracy and increased response times) in determining life status for plants, relative to animals, and for natural and moving nonliving things, relative to artifacts and non-moving things. Experiment 2 replicated these effects in university biology professors. The professors showed a significantly reduced effect size for living things, as compared with the students, but still showed greater difficulty for plants than animals, even as no differences from the students were apparent in their responses to nonliving things. These results suggest that mature biological knowledge relies on a developmental foundation that is not radically overwritten or erased with the profound conceptual changes that accompany mastery of the domain.


The association between language-based task-functional magnetic resonance imaging hemodynamics and baseline GABA+ and glutamate-glutamine measured in pre-supplementary motor area: A pilot study in an aging model.
Aging is a natural phenomenon that elicits slow and progressive cerebrovascular and neurophysiological changes that eventually lead to cognitive decline. The objective of this pilot study is to examine the association of GABA+ and glutamate-glutamine (Glx) complex with language-based blood oxygen level dependent (BOLD) hemodynamics in an aging model. More specifically, using standard BOLD we will first attempt to validate whether previously reported findings for BOLD amplitude and resting neurochemical relationships hold in an aging model. Secondly, we will investigate how our recently established neurosensitized task-BOLD energetics relate to resting GABA+ and Glx, especially accounting for titration of task difficulty. To support the above endeavors, we optimize the baseline fitting for edited magnetic resonance spectroscopy (MRS) difference spectra to sensitize GABA+ and Glx concentrations to aging-related differences. We identify a spline-knot spacing of 0.6ppm to yield the optimal aging-related differences in GABA+ and Glx. The optimized MRS values were then graduated to relate to task-BOLD hemodynamics. Our results did not replicate previous findings that relate task-BOLD amplitude and resting GABA+ and Glx. However, we did identify neurochemistry relationships with the vascularly-driven dispersion component of the hemodynamic response function, specifically in older participants. In terms of neuro-sensitized BOLD energetics and the underlying role of GABA+ and Glx, our data suggests that the task demands are supported by both neurometabolites depending on the difficulty of the task stimuli. Another novelty is that we developed task-based functional parcellation of pre-SMA using both groups. In sum, we are the first to demonstrate that multimodal task-fMRI and MRS studies are beneficial to improve our understanding of the aging brain physiology, and to set the platform to better inform approaches for clinical care in aging-related neurovascular diseases. We also urge future studies to replicate our findings in a larger population incorporating a lifespan framework.


Safety of Gastrointestinal Endoscopy in Korea: A Nationwide Survey and Population-Based Study.
Attention should be paid to endoscopy-related complications and safety-related accidents that may occur in the endoscopy unit. This study investigated the current status of complications associated with diagnostic and therapeutic endoscopy in Korea. A questionnaire survey on endoscopy-related complications was conducted in a total of 50 tertiary or general hospitals in Korea. The results were compared to the population-level claims data from the Health Insurance Review & Assessment Service (HIRA), which analyzed endoscopy procedures conducted in 2017 in Korea. The incidences of bleeding associated with diagnostic and therapeutic esophagogastroduodenoscopy (EGD) and with diagnostic and therapeutic colonoscopy were 0.224% and 3.155% and 0.198% and 0.356%, respectively, in the 2017 HIRA claims data, compared to 0.012% and 1.857%, and 0.024% and 0.717%, in the 50 hospitals surveyed. The incidences of perforation associated with diagnostic and therapeutic EGD and with diagnostic and therapeutic colonoscopy were 0.023% and 0.613%, and 0.007% and 0.013%, respectively, in the 2017 HIRA claims data compared to 0.001% and 0.325%, and 0.017% and 0.206%, in the 50 hospitals surveyed. In the HIRA claims data, the incidence of bleeding/perforation after diagnostic colonoscopy in clinics, community hospitals, general hospitals, and tertiary hospitals was 0.129%/0.000%, 0.088%/0.004%, 0.262%/0.009%, and 0.479%/0.030% respectively, and the corresponding incidence of bleeding/perforation after therapeutic colonoscopy was 0.258%/0.004%, 0.401%/0.007%, 0.408%/0.024%, and 0.731%/0.055%. The incidences of complications associated with diagnostic and therapeutic EGD or colonoscopy tended to increase with the hospital volume in Korea. Clinical Research Information Service Identifier: KCT0001728.


Diagnosis and treatment of ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in the ICU. Patients who acquire VAP have higher mortality rates and longer ICU and hospital stays. Because there are other potential causes of fever, leukocytosis, and pulmonary infiltrates, clinical diagnostic criteria are overly sensitive in the diagnosis of VAP. Employing quantitative cultures of bronchopulmonary secretions in the diagnostic algorithm leads to less antibiotic use and probably to lower mortality. With respect to microbiologic diagnosis, it is not clear that the use of a particular sampling method (bronchoscopic or nonbronchoscopic), when quantitatively cultured, is associated with better outcomes. Delayed administration of adequate antibiotic therapy is linked to an increased mortality rate. Hence, the focus of initial antibiotic therapy should be to rapidly provide antibiotic coverage for all likely pathogens and to then narrow or focus the antibiotic spectrum based on the results of quantitative cultures. Eight days of antibiotic therapy appears equivalent to 15 days of therapy except when treating nonlactose-fermenting Gram-negative organisms. In this latter situation, longer treatment durations appear to reduce the risk of recrudescence after discontinuation of antibiotic therapy. A guideline-based approach using the local hospital or ICU antibiogram can increase the likelihood that adequate initial antibiotic therapy is used and reduce the overall use of antibiotics and the associated selection pressure for multidrug-resistant organisms.


Pancreatic resection with ultrasonically activated scalpel: preliminary observations.
Resection of the pancreas was performed with a surgical knife, electrocautery, or an automatic stapler. We histologically and radiologically evaluated the applicability of the ultrasonically activated scalpel (Coagulating Shears, CS, Ethicon Endo-Surgery, Cincinnati, OH, USA) for resecting pancreatic parenchyma and reported our clinical observations on the use of the coagulating shears. Resection of the pancreas was performed with the coagulating shears in 8 patients and with electrocautery in 5. The pancreas was transected with blunt mode of the coagulating shears at output power level of 3. Histologic thermal degeneration of the surface was evaluated with hematoxylin-eosin and Azan-Mallory staining. Radiologic pancreaticography was carried out on 4 resected specimens. We report 8 practical applications of the coagulating shears and compared its use with that of electrocautery in pancreatic surgery. Histologically, a coagulum of degenerated tissue completely closed each end of the vessels in the transected surface of all cases. The mean breadth of thermal degeneration resulting from the use of the coagulating shears was significantly less than that caused by electrocautery (1.33 +/- 0.21 vs. 3.05 +/- 0.34 mm, respectively) Pancreaticograms showed the closed branches of the pancreatic duct, but the closed main pancreatic duct had burst in 1 of 4 cases. Clinically, pancreatic fistula occurred in 1 of 8 patients who underwent pancreatic surgery with the coagulating shears. Pancreatic resection with the coagulating shears might be effective and feasible as long as the main pancreatic duct is ligated.


Service evaluation of diabetes management during pregnancy in a regional maternity hospital: potential scope for increased self-management and remote patient monitoring through mHealth solutions.
Pre-gestational and gestational diabetes mellitus are common complications in pregnancy affecting one in six pregnancies. The maternity services are under significant strain managing the increasing number of complex pregnancies. This has an impact on patients' experience of antenatal care. Therefore, there is a clear need to address pregnancy care. One possible solution is to use home-based digital technology to reduce clinic visits and improve clinical monitoring. The aim of this study was to evaluate the antenatal services provided to pregnant women with diabetes who were monitored at the joint metabolic and obstetric clinic at the Southern Health and Social Care Trust in Northern Ireland. The questionnaires were completed by sixty-three women, most of whom had gestational diabetes mellitus. Most of the participants were between 25 and 35 years of age (69.8%), had one or more children (65.1%) and spent over 2 h attending the clinics (63.9%); 78% of women indicated that their travel time to and from the clinic appointment was over 15 min. Over 70% of women used smartphones for health-related purposes. However, only 8.8% used smartphones to manage their health or diabetes. Less than 25% of the women surveyed expressed concerns about using digital technology from home to monitor various aspects of their health in pregnancy. Overall, pregnant women who had or developed diabetes in pregnancy experience frequent hospital visits and long waiting times in the maternity clinics. Most of these pregnant women are willing to self-manage their condition from home and to be monitored remotely by the healthcare staff.


A 6-mer photocontrolled oligonucleotide as an effective telomerase inhibitor.
Telomerase is a relevant target for cancer therapy. A small 6-mer psoralen-containing oligonucleotide is shown to cause efficient photo-cross-linking to human telomere DNA by G-quadruplex formation. The small, photocontrolled oligonucleotide shows effective telomerase inhibition, both in vitro and in vivo, only when light irradiated. Data suggest that it is a promising agent for the treatment of cancer.


Identification and Validation of Reference Genes for Gene Expression Analysis in Different Development Stages of Amylostereum areolatum.
A strict relationship exists between the Sirex noctilio and the Amylostereum areolatum, which is carried and spread by its partner. The growth and development of this symbiotic fungus is key to complete the life history of the Sirex woodwasp. Real-time quantitative polymerase chain reaction (RT-qPCR) is used to measure gene expression in samples of A. areolatum at different growth stages and explore the key genes and pathways involved in the growth and development of this symbiotic fungus. To obtain accurate RT-qPCR data, target genes need to be normalized by reference genes that are stably expressed under specific experimental conditions. In our study, the stability of 10 candidate reference genes in symbiotic fungal samples at different growth and development stages was evaluated using geNorm, NormFinder, BestKeeper, delta Ct methods, and RefFinder. Meanwhile, laccase1 was used to validate the stability of the selected reference gene. Under the experimental conditions of this study, p450, CYP, and γ-TUB were identified as suitable reference genes. This work is the first to systematically evaluate the reference genes for RT-qPCR results normalization during the growth of this symbiotic fungus, which lays a foundation for further gene expression experiments and understanding the symbiotic relationship and mechanism between S. noctilio and A. areolatum.


Variation in bittersweet nostalgic feelings and their divergent effects on daily well-being.
Experimental manipulations of nostalgia that privilege positive aspects of the bittersweet emotion have led to the conclusion that nostalgia is a predominantly positive emotion, yet nostalgia covaries negatively with well-being in daily life. To reconcile this discrepancy, we developed and tested the bittersweet variation model of nostalgia that posits that (a) nostalgic feelings vary not only in intensity but also in valence (i.e., how bitter or sweet a nostalgic feeling is); (b) daily events influence the valence of nostalgic feelings; and (c) nostalgia's valence influences well-being. Across two daily diary studies (N = 151; 1,356 daily reports), we found that the valence of nostalgic feelings varied considerably within-persons. Daily positive events predicted more positively rated nostalgic feelings, whereas daily negative events predicted more negatively rated nostalgic feelings. Controlling for the effects of daily events on well-being, positive nostalgic feelings predicted greater well-being, whereas negative nostalgic feelings predicted lower well-being. To provide more robust causal evidence of the effect of nostalgia valence on well-being, we conducted two experiments (N = 445) in which we manipulated nostalgia valence by asking participants to write about positive nostalgic feelings (involving people they remain close to) or negative nostalgia feelings (involving people they no longer remain close to), mimicking typical nostalgic feelings in daily life. Positive nostalgic feelings improved well-being compared with negative nostalgic feelings. Thus, nostalgia is not inherently positive or negative. Rather, the effect of nostalgia on well-being depends on its valence, which is influenced by the eliciting event. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Silencing of the ER and Integrative Stress Responses in the Liver of Mice with Error-Prone Translation.
Translational errors frequently arise during protein synthesis, producing misfolded and dysfunctional proteins. Chronic stress resulting from translation errors may be particularly relevant in tissues that must synthesize and secrete large amounts of secretory proteins. Here, we studied the proteostasis networks in the liver of mice that express the Rps2-A226Y ribosomal ambiguity (ram) mutation to increase the translation error rate across all proteins. We found that Rps2-A226Y mice lack activation of the eIF2 kinase/ATF4 pathway, the main component of the integrated stress response (ISR), as well as the IRE1 and ATF6 pathways of the ER unfolded protein response (ER-UPR). Instead, we found downregulation of chronic ER stress responses, as indicated by reduced gene expression for lipogenic pathways and acute phase proteins, possibly via upregulation of Sirtuin-1. In parallel, we observed activation of alternative proteostasis responses, including the proteasome and the formation of stress granules. Together, our results point to a concerted response to error-prone translation to alleviate ER stress in favor of activating alternative proteostasis mechanisms, most likely to avoid cell damage and apoptotic pathways, which would result from persistent activation of the ER and integrated stress responses.


Colloidal Nanosurfactants for 3D Conformal Printing of 2D van der Waals Materials.
Printing techniques using nanomaterials have emerged as a versatile tool for fast prototyping and potentially large-scale manufacturing of functional devices. Surfactants play a significant role in many printing processes due to their ability to reduce interfacial tension between ink solvents and nanoparticles and thus improve ink colloidal stability. Here, a colloidal graphene quantum dot (GQD)-based nanosurfactant is reported to stabilize various types of 2D materials in aqueous inks. In particular, a graphene ink with superior colloidal stability is demonstrated by GQD nanosurfactants via the π-π stacking interaction, leading to the printing of multiple high-resolution patterns on various substrates using a single printing pass. It is found that nanosurfactants can significantly improve the mechanical stability of the printed graphene films compared with those of conventional molecular surfactant, as evidenced by 100 taping, 100 scratching, and 1000 bending cycles. Additionally, the printed composite film exhibits improved photoconductance using UV light with 400 nm wavelength, arising from excitation across the nanosurfactant bandgap. Taking advantage of the 3D conformal aerosol jet printing technique, a series of UV sensors of heterogeneous structures are directly printed on 2D flat and 3D spherical substrates, demonstrating the potential of manufacturing geometrically versatile devices based on nanosurfactant inks.


Helicobacter pylori infection and postoperative nausea and vomiting.
The aim of this study was to identify factors most relevant to postoperative nausea and vomiting (PONV) and determine the association of Helicobacter pylori with PONV. A cross-sectional analytic survey was conducted on 127 elective patients who underwent general and urological surgery at Sina Hospital in Tehran between March 2005 and March 2006. Related factors considered to have a possible effect on the prevalence of PONV events were evaluated by using a special questionnaire and serological laboratory test of H. pylori. Data was analyzed using t test and chi2 test and logistic regression analysis for comparing the variables. Prevalence of PONV was 54.7% in patients having H. pylori infection. There was no relationship between H. pylori infection and PONV (p>0.05). Prior history of PONV was a significant risk factor for increasing the prevalence of PONV (p<0.05). Also, history of PONV beside female gender, overweighting/obesity and operation type (urologic surgery) could increase the severity of PONV (p<0.05). But, administration of opioids could decrease the severity of PONV (p<0.05). It was found that PONV had a high prevalence among patients undergoing urologic and general surgery. H. pylori infection cannot affect the prevalence of PONV. More surveys are needed to develop effective protocols for preventing this common and unpleasant problem.


Characteristics of Pediatric Emergency Department Presentations of Anaphylaxis in Spain.
This study aimed to identify the triggers of pediatric anaphylaxis in Spain and to analyze the circumstances of the episode. Planned secondary analysis of a prospective observational multicenter study endorsed by the Spanish Society of Pediatric Emergencies including children aged younger than 18 years diagnosed with anaphylaxis in 7 Spanish pediatric emergency departments (EDs) between 2016 and 2018. We analyzed factors related to the anaphylaxis episode and its management. Four hundred fifty-three cases were registered, happening mainly at home (295 [65.1%]), school (65 [14.3%]), and street (61 [13.5%]). The median age was 5 years, 143 (31.6%) had previous episodes, and 165 (36.4%) had previously been prescribed an epinephrine autoinjector, used in 40 (24.2% of those prescribed). Two thirds were well-appearing when arriving to the pediatric ED. Food was the trigger in 396 (87.4%). In 349 with a single food involved, the most frequent were milk (108 [30.4%]), nuts (103 [29.0%]), hen's egg (40 [11.3%]), and fish (31 [8.7%]), with variations related to the age of the child. Food, especially milk and nuts, are responsible for most anaphylaxis diagnosed in Spanish pediatric EDs. Consideration should be given to improving health education due to the low use of epinephrine autoinjectors.


Human and rat primary hepatocyte CYP1A1 and 1A2 induction with 2,3,7,8-tetrachlorodibenzo-p-dioxin, 2,3,7,8-tetrachlorodibenzofuran, and 2,3,4,7,8-pentachlorodibenzofuran.
The concentration dose response for aryl hydrocarbon receptor (AHR)-mediated CYP1A1 and CYP1A2 messenger RNA (mRNA) induction and enzyme activity was determined in primary cultures of rat and human hepatocytes for 2,3,7,8-tetrachlorodibenzo-p-dioxin, 2,3,4,7,8-pentachlorodibenzofuran, and 2,3,7,8-tetrachlorodibenzofuran. Eleven different congener concentrations from 0.00001 to 100 nM were used, thus spanning seven orders of magnitude. The Hill model was used to obtain values of EC(x) and maximal response from the individual data sets. No-observed effect concentration values were derived using several statistical methods including Dunnett's test, the Welch-Aspin test, and step-down bilinear regression. Thresholds were estimated using baseline projection methods and a "hockey stick" fitting method. Human hepatocytes were less responsive and less sensitive with respect to CYP1A1 activity and mRNA induction than rats. On the other hand, the human CYP1A2 response was more robust than the response in rats but generally less sensitive. These data allow an evaluation of relative species sensitivities for developing interspecies toxicodynamic adjustment factors, for assessing AHR activation thresholds, and for evaluating relative congener potencies. Overall, these data support the position that humans are less sensitive than rats to these AHR-dependent end points and support the use of a data-derived adjustment factor of 1.0 or less for extrapolating between rats and humans.


[Chronic necrotizing pulmonary aspergillosis in an immunocompromised patient].
A case with chronic necrotizing pulmonary aspergillosis that was mimicking the radiomorphology of malignant tumor was reported. The patient was admitted to hospital with progression of a left upper lobe infiltrate which was known and under regular observation for 8 years, and haemoptoe. Computer tomography scan showed a spiculated abnormality in the left upper lobe with mediastinal lymphadenomegaly. Based on this finding pulmonary malignancy was suspected and, therefore, the patient was referred to surgical intervention. The post surgical histology revealed aspergillus in the specimen. Since signs of vascular invasion could not be detected microscopically and the disease developed in immunocompromised patient (due to diabetes mellitus and long term steroid treatment) the clinical condition was determined as chronic necrotizing aspergillosis. It is very likely that the pathogen infected the patient during his daily work in a bakery. The present paper also summarizes the clinical aspects, differential diagnosis and therapy of different forms of pulmonary aspergillosis with emphasis on chronic necrotizing pulmonary aspergillosis.


P2RY14 downregulation in lung adenocarcinoma: a potential therapeutic target associated with immune infiltration.
The current study aimed to investigate the interrelation between P2RY14 and the prognosis of patients suffering from lung adenocarcinoma (LUAD) following surgery. The differentially expressed gene (DEG) P2RY14 was screened by the Gene Expression Omnibus (GEO), The Cancer Genome Atlas (TCGA), and Immunology Database and Analysis Portal (ImmPort) databases. The relationship between P2RY14 and clinical data of LUAD was analyzed in TCGA and Kaplan-Meier (KM)-plotter databases. The association of P2RY14 with immune cells and immune-related expressed genes was analyzed in the Tumor Immune Estimation Resource (TIMER) database. A retrospective analysis of the 100 patients clinical data undergoing pulmonary adenocarcinoma surgery admitted to Nanjing Chest Hospital. Immunohistochemistry (IHC) analysis was carried out to evaluate the P2RY14 expression in lung cancer tissues, and quantitative reverse transcription PCR (RT-qPCR) was used to confirm the mRNA expression of this gene in LUAD tissues. And their survival was evaluated. KM method and the log-rank test were used for univariate survival analysis, and the Cox regression method was employed for multivariate survival analysis. P2Y14 was the DEG identified by the database. P2Y14 expression was upregulated in para-cancer tissues in comparison to cancer tissues. Patients suffering from LUAD who have high P2RY14 expression had a better prognosis than those with low expression. P2RY14 expression was shown to be substantially linked with immune invasion in the TIMER database. Finally, the trial included 100 patients, of which 80 died and 20 survived with a mean overall survival (OS) of 48 months. Between the high and low expression groups of P2RY14, there were statistically significant variations in the clinical stage and differentiation degree (P<0.05). Cox regression analysis revealed that differentiation degree, smoking history, and P2RY14 expression were independent risk factors for the prognosis of LUAD patients (all P<0.05). P2RY14 can substantially prolong the OS of patients suffering from LUAD and can be utilized as a new LUAD predictive biomarker. P2RY14 may be related to LUAD immune invasion and have an essential role in inhibiting tumor cell immune escape within the LUAD microenvironment.


In Vitro Characteristics of Porcine Tendon Hydrogel for Tendon Regeneration.
Previous work has characterized the development of a human tendon hydrogel capable of improving mechanical strength after tendon injury. Animal tendon hydrogel has not yet been described, but would prove beneficial due to the cost and ethical concerns associated with the use of human cadaveric tendon. This study details the manufacture and assesses the biocompatibility of porcine tendon hydrogel seeded with human adipoderived stem cells (ASCs). Porcine tendon was dissected from surrounding connective and muscle tissue and decellularized via 0.2% sodium dodecyl sulfate and 0.2% sodium dodecyl sulfate/ethylenediaminetetraacetic acid wash solutions before lyophilization. Tendon was milled and reconstituted by previously described methods. Decellularization was confirmed by hematoxylin-eosin staining, SYTO Green 11 nucleic acid dye, and DNeasy assay. The protein composition of milled tendon matrix before and after digestion was identified by mass spectrometry. Rheological properties were determined using an ARG2 rheometer. Biocompatibility was assessed by live/dead assay. The proliferation of human ASCs seeded in porcine and human hydrogel was measured by MTS assay. All experimental conditions were performed in triplicate. Decellularization of porcine tendon was successful. Mass spectrometry showed that collagen composes one third of milled porcine tendon before and after pepsin digestion. Rheology demonstrated that porcine hydrogel maintains a fluid consistency over a range of temperatures, unlike human hydrogel, which tends to solidify. Live/dead staining revealed that human ASCs survive in hydrogel 7 days after seeding and retain spindle-like morphology. MTS assay at day 3 and day 5 showed that human ASC proliferation was marginally greater in human hydrogel. After reconstitution and digestion, porcine hydrogel was capable of supporting growth of human ASCs. The minimal difference in proliferative capacity suggests that porcine tendon hydrogel may be an effective and viable alternative to human hydrogel for the enhancement of tendon healing.


Growth factors and nonparenchymal cell conditioned media induce mitogenic responses in stable long-term adult rat hepatocyte cultures.
Most prior studies have characterized hepatocyte proliferative responses in culture systems that do not express a stable differentiated phenotype. We investigated the DNA synthetic response of long-term stable hepatocyte cultures to growth factor stimulation as well as conditioning with nonparenchymal cells (NPCs). Primary rat hepatocytes were cultured on a single layer of collagen (h/C) or Matrigel (h/M), or in a collagen sandwich (C/h/C) or collagen-Matrigel sandwich (M/h/C). Hepatocytes were cultured for 7 days to allow phenotypic stabilization before growth factor addition, except for h/C cultures, which are unstable, where growth factors were added 1 day after seeding. Culture medium was supplemented with a mixture of hepatocyte, epidermal, and vascular endothelial growth factors and interleukin-6, either directly or after conditioning with NPCs for 24 h. Growth factors alone induced hepatocyte DNA synthesis, as measured via [3H]thymidine uptake, in the h/C, C/h/C, and M/h/C configurations. h/M exhibited very low levels of DNA synthesis. In the C/h/C and M/h/C configurations, the greatest stimulation was obtained using NPC-conditioned growth factors. This response was sustained for several days and without decreasing albumin or urea synthesis. These results suggest that hepatocyte mitogens and NPC-derived factors can stimulate DNA synthesis in stable and differentiated hepatocyte cultures.


Developing sustainable, high-performance perovskites in photocatalysis: design strategies and applications.
Solar energy is attractive because it is free, renewable, abundant and sustainable. Photocatalysis is one of the feasible routes to utilize solar energy for the degradation of pollutants and the production of fuel. Perovskites and their derivatives have received substantial attention in both photocatalytic wastewater treatment and energy production because of their highly tailorable structural and physicochemical properties. This review illustrates the basic principles of photocatalytic reactions and the application of these principles to the design of robust and sustainable perovskite photocatalysts. It details the structures of the perovskites and the physics and chemistry behind photocatalytic reactions and describes the advantages and limitations of popular strategies for the design of photoactive perovskites. This is followed by examples of how these strategies are applied to enhance the photocatalytic efficiency of oxide, halide and oxyhalide perovskites, with a focus on materials with potential for practical application, that is, not containing scarce or toxic elements. It is expected that this overview of the development of photocatalysts and deeper understanding of photocatalytic principles will accelerate the exploitation of efficient perovskite photocatalysts and bring about effective solutions to the energy and environmental crisis.


An Experimental Comparison of Two Methods on Photosynthesis Driving Soil Respiration: Girdling and Defoliation.
Previous studies with different experimental methods have demonstrated that photosynthesis significantly influences soil respiration (RS). To compare the experimental results of different methods, RS after girdling and defoliation was measured in five-year-old seedlings of Fraxinus mandshurica from June to September. Girdling and defoliation significantly reduced RS by 33% and 25% within 4 days, and 40% and 32% within the entire treatment period, respectively. The differential response of RS to girdling and defoliation was a result of the over-compensation for RS after girdling and redistribution of stored carbon after defoliation. No significant effect on RS was observed between girdling and defoliation treatment, while the soluble sugar content in fine roots was higher in defoliation than in girdling treatment, indicating that defoliation had less compensation effect for RS after interrupting photosynthates supply. We confirm the close coupling of RS with photosynthesis and recommend defoliation for further studies to estimate the effect of photosynthesis on RS.


Association of vitamin B12/ferritin deficiency in cancer patients with methylomic changes at promotors of TET methylcytosine dioxygenases.
Aim: To investigate potential DNA methylation in methylcytosine dioxygenases and correlation of TET genes with vitamin B12/ferritin levels in cancer patients. Materials & methods: 200 blood samples were obtained from both cancer patients and healthy individuals. Results: The expression of DNMT1, DNMT3a and DNMT3b was increased in patients with low vitamin B12 and ferritin levels, while the expression of MTR, TET1 and TET3 significantly decreased. DNA methylation analysis in patients with deficient vitamin B12/ferritin levels showed methylomic changes within the location 318/CG and 385/CG in the promoter region of TET1 and TET3, respectively. Conclusion: Vitamin B12/ferritin deficiency contributes to DNA methylation progress in cancer patients.


Diet of the Delacour's langur (Trachypithecus delacouri) in Van Long Nature Reserve, Vietnam.
The six limestone langur taxa of Southeast Asia inhabit the rugged limestone karst mountains, although the reason for their current restriction to this habitat is unclear. From August 2007 to July 2008, I collected data on the diet and feeding behavior of the critically endangered Delacour's langur (Trachypithecus delacouri) in Van Long Nature Reserve, Vietnam. I used these data to evaluate the hypothesis that limestone langurs are found on karst habitat because they depend on endemic limestone plants. Feeding accounted for 29% of the langurs' activity budget. Young leaves dominated the diet monthly, seasonally, and annually. The annual diet consists of nearly 79% foliage with almost 60% young leaves. Despite a distinct wet and dry season, over the study period, seasonal variation in plant part consumption was slight. Fruit and seeds were a small contribution to the diet. Delacour's langurs ate 42 of 145 available species, and they concentrated on a subset of this number. Five plant species comprised more than 60% of the diet and 16 species comprised more than 93%. More than half of the diet came from climbers. Delacour's langurs are among the most highly folivorous of studied colobines and, along with the closely related T. leucocephalus of southern China, the most folivorous of the Asian langurs. Whether high folivory is owing to a lack of available fruits and seeds in limestone habitats is unknown. What is certain, however, is that the plant species most important in the Delacour's langurs' diet at VLNR, throughout the study, were not plants endemic to limestone. Feeding dependence alone, therefore, cannot explain the current distribution of limestone langurs on karst habitat.


Phosphatidylcholine synthesis in castor bean endosperm.
Three pathways for phosphatidylcholine synthesis were assayed in castor bean (Ricinus communis var. Hale) endosperm. Phosphatidylethanolamine: S-adenosylmethionine methyl transferase occurred predominantly in the endoplasmic reticulum fraction, but some activity appeared in the mitochondria. Phosphorylcholine glyceride transferase occurred exclusively in the endoplasmic reticulum. The phosphorylcholine glyceride transferase activity was approximately 20-fold greater than the methylation pathway in the endoplasmic reticulum. No exchange activity was found. The Michaelis constant for the methylation was 31 mum for S-adenosylmethionine; phosphatidylethanolamine promoted the reaction slightly while other intermediates stimulated it by about 50%. The pH optimum was 9. Phosphorylcholine glyceride transferase had a Michaelis constant of 9.7 mum for cytidine diphosphate choline but variable results were obtained from diglycerides. The pH optimum was 7.5 and a divalent cation was required, Mg(2+) giving the greatest stimulation.


Late steroid withdrawal after ABO blood group-incompatible living donor kidney transplantation: high rate of mild cellular rejection.
Little is known about the safety of steroid withdrawal after ABO blood group-incompatible living donor kidney transplantation. Between September 2005 and November 2007, a total of 15 patients were successfully transplanted over the blood group barrier in our transplantation centers. Similarly to transplant recipients with normal immunological risk, we aimed to taper and eventually stop oral prednisone because of the well-known negative impact of steroids on cardiovascular morbidity and mortality, which in turn is limiting graft survival. Up to now, patient and graft survival is 100% after a median follow-up of 839 days (range, 513-1281 days). On the basis of serial protocol biopsies, late steroid withdrawal could successfully be performed in only 5 of 11 patients. Nevertheless, the remaining 6 patients showed histologic signs of mild and subclinical acute rejection shortly after complete withdrawal or even during steroid tapering. With this elevated risk of at least subclinical acute rejection after late steroid withdrawal, we propose that steroid withdrawal in ABO blood group-incompatible kidney graft recipients should only be performed after a protocol biopsy showing normal tissue and together with a thorough clinical and in doubtful cases also histologic follow-up.


Characterization and localization of insoluble organic matrices associated with diatom cell walls: insight into their roles during cell wall formation.
Organic components associated with diatom cell wall silica are important for the formation, integrity, and function of the cell wall. Polysaccharides are associated with the silica, however their localization, structure, and function remain poorly understood. We used imaging and biochemical approaches to describe in detail characteristics of insoluble organic components associated with the cell wall in 5 different diatom species. Results show that an insoluble organic matrix enriched in mannose, likely the diatotepum, is localized on the proximal surface of the silica cell wall. We did not identify any organic matrix embedded within the silica. We also identified a distinct material consisting of glucose polymer with variable localization depending on the species. In some species this component was directly involved in the morphogenesis of silica structure while in others it appeared to be only a structural component of the cell wall. A novel glucose-rich structure located between daughter cells during division was also identified. This work for the first time correlates the structure, composition, and localization of insoluble organic matrices associated with diatom cell walls. Additionally we identified a novel glucose polymer and characterized its role during silica structure formation.


Anxiety as a Predictor for Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis.
Because anxiety is postulated as a risk factor for dementia, we performed a systematic review and meta-analysis to investigate whether anxiety predicts cognitive decline and/or dementia, taking the stage of cognitive decline as well as setting into account. A systematic literature search up to January 2015 was performed to identify all longitudinal studies on the association between anxiety and cognition. Data extraction and methodological quality assessment were conducted independently by two authors. Where possible, pooled relative risks were calculated to examine anxiety as a possible risk factor for cognitive decline cognitive impairment and dementia in community studies (objective 1), as well as for conversion to dementia patients referred to memory clinics (objective 2). Twenty studies met inclusion criteria. Data on cognitive decline were too heterogeneous for meta-analysis. Anxiety predicted incident cognitive impairment (4 studies, relative risk [RR]: 1.77, 95% confidence interval [CI]: 1.38-2.26, z = 4.50, p < 0.001) and dementia (6 studies, RR: 1.57, 95% CI: 1.02-2.42, z = 2.05, p = 0.040) in the community, the latter driven by studies with a mean age of 80 years or above. Among clinical mild cognitive impairment samples, anxiety did not predict conversion to dementia (RR: 1.21, 95% CI: 0.90-1.63, z = 1.28, p = 0.200). Anxiety is associated with an increased risk for cognitive impairment and dementia in the community. Stronger associations were driven by higher age, suggesting that it is a prodromal symptom. Causal biological pathways have also been described, which could explain the risk for incident cognitive impairment in the community. Future studies should include mediating mechanism when studying anxiety as a predictor for cognitive decline and/or dementia.


Spatiotemporal analysis of axonal autophagosome-lysosome dynamics reveals limited fusion events and slow maturation.
Macroautophagy is a homeostatic process required to clear cellular waste. Neuronal autophagosomes form constitutively in the distal tip of the axon and are actively transported toward the soma, with cargo degradation initiated en route. Cargo turnover requires autophagosomes to fuse with lysosomes to acquire degradative enzymes; however, directly imaging these fusion events in the axon is impractical. Here we use a quantitative model, parameterized and validated using data from primary hippocampal neurons, to explore the autophagosome maturation process. We demonstrate that retrograde autophagosome motility is independent of fusion and that most autophagosomes fuse with only a few lysosomes during axonal transport. Our results indicate that breakdown of the inner autophagosomal membrane is much slower in neurons than in nonneuronal cell types, highlighting the importance of this late maturation step. Together, rigorous quantitative measurements and mathematical modeling elucidate the dynamics of autophagosome-lysosome interaction and autophagosomal maturation in the axon.


Prognostic modeling of patients with metastatic melanoma based on tumor immune microenvironment characteristics.
Most of the malignant melanomas are already in the middle and advanced stages when they are diagnosed, which is often accompanied by the metastasis and spread of other organs. Besides, the prognosis of patients is bleak. The characteristics of the local immune microenvironment in metastatic melanoma have important implications for both tumor progression and tumor treatment. In this study, data on patients with metastatic melanoma from the TCGA and GEO datasets were selected for immune, stromal, and estimate scores, and overlapping differentially expressed genes were screened. A nine-IRGs prognostic model (ALOX5AP, ARHGAP15, CCL8, FCER1G, GBP4, HCK, MMP9, RARRES2 and TRIM22) was established by univariate COX regression, LASSO and multivariate COX regression. Receiver operating characteristic curves were used to test the predictive accuracy of the model. Immune infiltration was analyzed by using CIBERSORT and Xcell in high-risk and low-risk groups. The immune infiltration of the high-risk group was significantly lower than that of the low-risk group. Immune checkpoint analysis revealed that the expression of PDCD1, CTLA4, TIGIT, CD274, HAVR2 and LAG3 demonstrated the visible difference in groups with different levels of risk scores. WGCNA analysis found that the yellow-green module contained seven genes from the nine-IRG prognostic model, and the yellow-green module had the highest correlation with risk scores. The results of GO and KEGG suggested that the genes in the yellow-green module were mainly enriched in immune-related biological processes. Finally, the expression characteristics of ALOX5AP, ARHGAP15, CCL8, FCER1G, GBP4, HCK, MMP9, RARRES2 and TRIM22 were analyzed between metastatic melanoma and normal samples. Overall, a prognostic model for metastatic melanoma based on the tumor immune microenvironment characteristics was established, which left plenty of space for further studies. It could function well in helping people to understand characteristics of the immune microenvironment in metastatic melanoma.


Antibiotic guidance on the web: an opportunity for open review.
The report The Path of Least Resistance recommended that local antibiotic prescribing information should be based on national guidelines produced under the aegis of the National Institute for Clinical Excellence (NICE). During the period when NICE guidelines on the management of infectious disease are being developed, interim guidelines are needed in primary care. Draft antibiotic guidance developed by Primary Care Groups and the Public Health Laboratory Service was posted on the PHLS website for consultation. An explanatory letter containing the website address was sent to all regional prescribing leads, asking them to draw it to the attention of all those involved in the development of antibiotic guidance. As a result of the numerous comments received from around the UK in the 18 months after posting on the website, 125 substantial changes were made and grading of evidence was added. The electronic production of guidance greatly facilitated the open review process and consequent modifications and reduced printing costs.


Metformin prevents the development of monocrotaline-induced pulmonary hypertension by decreasing serum levels of big endothelin-1.
Pulmonary hypertension (PH) is a disease with poor prognosis, and it is characterized by the progressive elevation of pulmonary vascular resistance and pressure. Various factors are associated with the pathology of PH, including AMP-activated protein kinase (AMPK) deficiency. The present study aimed to evaluate the therapeutic effect of metformin, an AMPK activator, in a monocrotaline (MCT)-induced PH rat model. Rats were randomly divided into the following three groups: i) Saline-injected group (sham group); ii) monocrotaline (MCT)-injected group (PH group); iii) MCT-injected and metformin-treated group (MT group). Four weeks following MCT injection, cardiac ultrasonography, invasive hemodynamic measurements, measurement of serum levels of big endothelin-1 (big ET-1) and histological analysis were performed to evaluate the effect of metformin treatment in PH. Pulmonary arterial pressure and serum big ET-1 concentrations were reduced in the MT group compared with the PH group. Medial wall thickness and wall area of the pulmonary arterioles in the MT group were decreased compared with the PH group. Comparing the right heart functional parameters among groups revealed that the acceleration time/ejection time ratio improved in the MT group compared with the PH group. Thus, the present study demonstrated the efficacy of metformin in an MCT-induced PH rat model and suggested that metformin may be a valuable, potential novel therapeutic for the treatment of PH.


CircRNAs in lung cancer - Biogenesis, function and clinical implication.
Lung cancer is the leading cause of malignancy-related incidence and mortality worldwide. Molecular mechanisms underlying tumorigenesis and development of lung cancer are still warranted to be elucidated. Previous studies have shown that non-coding RNAs are related to the tumorigenesis and progression of various cancers. However, the expression patterns and clinical implications of circRNAs in lung cancer remain obscure. CircRNAs are a special class of non-coding RNAs with stable covalently closed circular structures, high abundance and tissue/cell/development-specific expression patterns. Thus, circRNAs are a new frontier in lung cancer research. Therefore, in this review, we elucidated the biological function and mechanism of circRNAs, as well as the role of aberrant expressed circRNAs in proliferation, invasion, drug resistance and tumor microenvironment. Furthermore, we discussed that circRNAs may serve as potential clinical biomarkers for the diagnosis, prognosis and treatment of lung cancer.


Classification and evaluation of the environment of the professional nursing practice in a teaching hospital.
to classify and evaluate the environment of the professional nursing practice in a teaching hospital. a cross-sectional study conducted with 188 nurses from a teaching hospital in the state of São Paulo, SP, Brazil. A questionnaire with sociodemographic and professional data and the Brazilian version of the Practice Environment Scale were used to classify and evaluate the environment of the professional nursing practice. Data was analyzed using Student's t-test, analysis of variance, Mann-Whitney, and Kruskal-Wallis tests with a significance level of 5% (p<0.05). The internal consistency of the instrument was evaluated using Cronbach's alpha. the score's mean for the Brazilian version of the Practice Environment Scale was 2.54, and the participants considered two of the five subscales as unfavorable for the practice, namely: subscale 1, "Nurse Participation in Hospital Affairs" (2.37), and subscale 4, "Staffing and Resource Adequacy" (2.23). the environment of the professional nursing practice has been classified as mixed, being evaluated with favorable conditions for the nursing practice, but the participation and involvement of nurses in hospital matters and the adequacy of resources to provide quality care need improvements.


Patterns of presentation of malaria in a tertiary care institute in Saudi Arabia.
The occurrence of malaria in a non-endemic area is an exceptional event. Review of clinical experience at the King Faisal Specialist Hospital & Research Centre (a tertiary medical centre located in a non-endemic area) demonstrated a relatively frequent infection rate among patients. We therefore examined circumstances that could contribute to the high rate of occurrence observed. We retrieved archived blood smears of patients diagnosed with malaria from the records of the Hematology Section of King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia, followed by a review of the clinical records to extract demographic data, clinical presentations including history of proximate blood transfusion, and travel to, or residence in, areas endemic for malaria. There were 217 patients diagnosed with malaria between 1978 and 1999, (1398 to 1419 Hejira calendar) resulting in an average yearly frequency of 9.86 cases. Males were 2.6 times more frequently affected than females (p<0.001). The majority of patients were infected through natural means, either by residence in endemic areas (N=83) or by travel to one (N=90). A significant minority, 44 (20.3%), became infected through blood transfusion. The majority of blood transfusion-induced malaria occurred in patients who were immunocompromised for various reasons, mostly related to dysfunction of the hematopoietic system or to major surgical insult. The most frequently implicated organism was Plasmodium falciparum, accounting for 74.2% of cases, whilst Plasmodium vivax accounted for 25.4%. We demonstrate that patients presenting with malaria are more likely to be males who have been exposed during travel to endemic areas or through blood transfusion. In all cases, Plasmodium falciparum is the most likely organism to be implicated.


Fabrication of three-dimensional hybrid nanostructure-embedded ITO and its application as a transparent electrode for high-efficiency solution processable organic photovoltaic devices.
Well-aligned, high-resolution (10 nm), three-dimensional (3D) hybrid nanostructures consisting of patterned cylinders and Au islands were fabricated on ITO substrates using an ion bombardment process and a tilted deposition process. The fabricated 3D hybrid nanostructure-embedded ITO maintained its excellent electrical and optical properties after applying a surface-structuring process. The solution processable organic photovoltaic device (SP-OPV) employing a 3D hybrid nanostructure-embedded ITO as the anode displayed a 10% enhancement in the photovoltaic performance compared to the photovoltaic device prepared using a flat ITO electrode, due to the improved charge collection (extraction and transport) efficiency as well as light absorbance by the photo-active layer.


Xiaochaihutang attenuates liver fibrosis by activation of Nrf2 pathway in rats.
Xiaochaihutang (XCHT) is a decoction of seven botanical extracts used for liver diseases traditionally in East Asia. However, few studies have investigated its anti-hepatic fibrosis effects and the mechanisms of action. Oxidative stress is one of the key factors responsible for occurrence and development of hepatic fibrosis and nuclear factor erythroid 2-related factor 2 (Nrf2) serves as a major regulator of the cellular defense system against oxidative stress. The aim of the present study was to investigate the effect of XCHT on liver fibrosis and focuse on the Nrf2 pathway in the protection of XCHT against CCl4-induced oxidative stress. Liver fibrosis was induced by repeated injection of CCl4 over a period of 9 weeks. Starting from the 6th week, rats in treatment groups were given the appropriate doses of XCHT granules and Silybin. We discovered that CCl4 caused significant fibrosis damage in rat liver, and XCHT (5g/kg and 10g/kg, po for 4 weeks) significantly improved the liver functions and fibrosis degree. XCHT treatment significantly decreased the number of α-SMA positive stained cells, indicating suppression of activated hepatic stellate cells (HSCs). Compared with the CCl4 treatment, administration of XCHT significantly increased the hepatic levels of Nqo1, HO-1, GCLC and GCLM, the major components of the Nrf2 pathway. These studies demonstrated that XCHT is an effective therapeutic agent for treatment of hepatic fibrosis and the mechanism of action might be due to up-regulation of the Nrf2 pathway against oxidative stress, making further inhibition of activated HSCs.


Man-Specific, GalNAc/T/Tn-Specific and Neu5Ac-Specific Seaweed Lectins as Glycan Probes for the SARS-CoV-2 (COVID-19) Coronavirus.
Seaweed lectins, especially high-mannose-specific lectins from red algae, have been identified as potential antiviral agents that are capable of blocking the replication of various enveloped viruses like influenza virus, herpes virus, and HIV-1 in vitro. Their antiviral activity depends on the recognition of glycoprotein receptors on the surface of sensitive host cells-in particular, hemagglutinin for influenza virus or gp120 for HIV-1, which in turn triggers fusion events, allowing the entry of the viral genome into the cells and its subsequent replication. The diversity of glycans present on the S-glycoproteins forming the spikes covering the SARS-CoV-2 envelope, essentially complex type N-glycans and high-mannose type N-glycans, suggests that high-mannose-specific seaweed lectins are particularly well adapted as glycan probes for coronaviruses. This review presents a detailed study of the carbohydrate-binding specificity of high-mannose-specific seaweed lectins, demonstrating their potential to be used as specific glycan probes for coronaviruses, as well as the biomedical interest for both the detection and immobilization of SARS-CoV-2 to avoid shedding of the virus into the environment. The use of these seaweed lectins as replication blockers for SARS-CoV-2 is also discussed.


Microcirculatory norepinephrine constrictor response in hemorrhagic shock.
Hemorrhagic shock is characterized by a phase of compensation that preserves central blood flow and intravascular pressure through an integrated vasoconstrictor response mediated by catecholamines, particularly norepinephrine (NE). The skeletal muscle microcirculation is important in this response. Decompensation occurs when arteriolar vasodilation occurs despite continued hypovolemia and high circulatory levels of NE. Using an isolated decerebrate rat cremaster muscle, we measured constrictor response to NE (10(-7)M tissue concentration) in compensated and decompensated shock. Our data indicate that larger arterioles (143 to 152 microns) show persistent constrictor response with lowered sensitivity to NE. Smaller arterioles (11 to 22 microns) and all venules dilate late in shock but retain constrictor responses to NE. Dilator responses contribute to decompensation in small arterioles and venules but not because of altered NE constrictor response.


Regulation of epidermin biosynthetic genes by EpiQ.
We investigated the role of epiQ in the biosynthesis of the lantibiotic epidermin. epiQ was essential for epidermin production. It was shown that EpiQ controls epidermin production by transcriptionally activating the epiA promoter, used for transcription of most of the epidermin biosynthetic genes. Additional copies of epiQ increased epidermin production in the epidermin-producing wild-type strain Staphylococcus epidermidis Tü3298. The epiA promoter region was characterized by primer extension analysis. Two inverted repeats, putative operator sites for EpiQ binding, are located upstream of the -35 region and one is localized downstream of the -10 region. Crude protein extracts from S. epidermidis Tü3298 and epiQ expressing Escherichia coli cells led to gel mobility shifts of a DNA fragment bearing the inverted repeat which is located immediately upstream of the -35 region. DNA fragments bearing the other two inverted repeats were not shifted. The epiQ gene product could be detected by overexpression in the E. coli T7 system using antiserum raised against synthetic peptides of EpiQ. Furthermore, EpiQ, like other DNA-binding proteins, was shown to bind strongly to heparin sepharose.