Evaluation of spectrophotometric methods for screening of green rooibos (Aspalathus linearis) and green honeybush (Cyclopia genistoides) extracts for high levels of Bio-active compounds.
The potential of UV spectrophotometry and an aluminium chloride (AlCl(3)) colorimetric method to determine the dihydrochalcone (DHC) and mangiferin contents of green rooibos and honeybush (C. genistoides) extracts, respectively, was investigated. The DHC content of rooibos water extracts, determined using UV spectroscopy, correlated with the sum of the aspalathin and nothofagin contents as quantified using HPLC (r = 0.98). A correlation coefficient of 0.91 was obtained when correlating the mangiferin content of C. genistoides methanol extracts, determined by the AlCl(3) colorimetric method, with the results obtained by HPLC. Using the linear equations from the correlations it was possible to predict the DHC and mangiferin contents of extracts from the respective spectrophotometric measurements to a reasonable accuracy as an alternative to HPLC. The total polyphenol (TP) content of rooibos water extracts can also be determined using UV spectrophotometry and aspalathin as a standard (r = 0.99) as an alternative to the Folin-Ciocalteau method. The TP content of rooibos extracts correlated (r = 0.99) with its total antioxidant activity (TAA) as determined with the ABTS radical cation scavenging assay, but the TP content of C. genistoides water extracts is not a good indication of their TAA (r = 0.27). The aspalathin content of rooibos extracts correlated with their TAA (r = 0.96), but the mangiferin content of honeybush water extracts only gave a moderate correlation with their TAA (r = 0.75).


Ultralow-intensity near-infrared light induces drug delivery by upconverting nanoparticles.
Mesoporous silica coated upconverting nanoparticles are loaded with the anticancer drug doxorubicin and grafted with ruthenium complexes as photoactive molecular valves. Drug release was triggered by 974 nm light with 0.35 W cm(-2). Such low light intensity minimized overheating problems and prevented photodamage to biological samples.


[Possibility of memory reparation: conditioned freezing disrupted by protein synthesis inhibition can be restored by reminder stimulation in mice].
Memory consolidation is a term used to describe the process of memory stabilization from labile, easily disrupted state into disruption-resistant long-term form. Protein synthesis inhibitors injected before or immediately after learning episode, produce significant amnesia. However in a limited number of studies the possibility of memory recovery after such pharmacologically-produced amnesia was shown. The aim of present study was to investigate the possibility of memory recovery in single-session fear conditioning paradigm in mice. Mice were injected with protein synthesis inhibitor cycloheximide twenty minutes prior learning to induce amnesia. Twenty four hours after training mice were subjected to reminder shock, similar to one used during training. Amnestic animals have demonstrated complete recovery of cued fear memory to the level of normal animals when tested 24h after reminder presentation. Thus our data indicate that specific type of memory might be restored using nonspecific stimulus as a reminder. Possible mechanisms of memory reparation after PSI injection during learning are discussed.


SIBLING SPECIES, CALL DIFFERENCES, AND SPECIATION IN GREEN LACEWINGS (NEUROPTERA: CHRYSOPIDAE: CHRYSOPERLA).
Green lacewings of the morphologically homogeneous carnea-plorabunda-downesi group within the chrysopid genus Chrysoperla produce unique, species-specific, substrate-borne songs during courtship and mating; both sexes sing, and partners must reciprocally exchange their acoustical signals before copulation will occur. Two widespread, sympatric North American representatives of this complex, the sibling species pair C. plorabunda and C. downesi, hybridize readily in the laboratory but not in nature. This species pair has been presented as exemplifying sympatric speciation by disruptive selection. Here, it is shown from tape-playback and female-choice experiments that calls represent bona fide reproductive isolating mechanisms between the two species. Furthermore, call analyses of F1 , F2 , F3 , and backcross progeny of the two species confirm polygenic control of call expression, in which different alleles at each of several loci are fixed in each taxon. Sex linkage of traits is absent, but the various features of the calls are not completely independent of one another in their patterns of inheritance. These and other life-history data cast doubt on several major premises of the sympatric speciation hypothesis and suggest that call alteration might have triggered the speciation event giving rise to the siblings. A complex of cryptic "song morphs" physically and ecologically identical to C. plorabunda and C. downesi, but singing different songs, exists in the mountains of western North America, while the Alps of central Europe harbor populations of C. carnea that have undergone call differentiation in an analogous but independent manner. It is proposed that call divergence may in itself be driving the speciation process within this section of Chrysoperla, by greatly accelerating the rate at which full reproductive isolation between populations can be achieved.


XPS and FTIR Studies of Polytetrafluoroethylene Thin Films Obtained by Physical Methods.
Two methods-attenuated total reflection Fourier infrared spectroscopy (ATR-FTIR) and X-ray photoelectron spectroscopy (XPS)-have been used to analyze the chemical structure of polytetrafluorethylene (PTFE) thin coatings deposited by pulsed laser (PLD) and pulsed electron beam (PED) ablations. The volume of the analyzed materials is significantly different in these techniques which can be of great importance in the characterization of highly heterogeneous thin films. Optical microscopy, atomic force microscopy (AFM) and scanning electron microscopy (SEM) have been additionally used to examine the coating surface morphology. The studies have shown that in the case of thin polymer coatings deposited by physical methods, the application for chemical structure evaluation of complementary techniques, with different surface sensitivity, together with the use of surface topography imaging, provide unique insight into the film morphology. The results can provide information contributing to an in-depth understanding of the deposition mechanism of polymer coatings.


Oncotic aneurysm. Case report.
The author describes a case of intracerebral and subarachnoid hemorrhage associated with an intracranial aneurysm caused by a metastatic tumor. The aneurysm formation is explained as being result of tumor cells invading the vessel wall while still preserving the arterial circulation.


Mixed unsymmetric oxadiazoline and/or imine platinum(II) complexes.
Iminoacylation of acetone oxime Me(2)C[double bond, length as m-dash]NOH upon reaction with trans-[PtCl(2)(NCCH(2)CO(2)Me)(2)] and [2 + 3] cycloaddition of acyclic nitrone (-)O(+)N(Me) = C(H)(C(6)H(4)Me-4) to a nitrile ligand in lead to the formation of mono-imine trans-[PtCl(2)(imine-a)(NCCH(2)CO(2)Me)] [imine-a = NH[double bond, length as m-dash]C(CH(2)CO(2)Me)ON = CMe(2)] and mono-oxadiazoline trans-[PtCl(2)(oxadiazoline-a)(NCCH(2)CO(2)Me)] [oxadiazoline-a = [upper bond 1 start]N[double bond, length as m-dash]C(CH(2)CO(2)Me)ON(Me)C[upper bond 1 end](H)(C(6)H(4)Me-4)] unsymmetric mixed ligand complexes, respectively, as the main products. Reactions of or with acetone oxime , cyclic nitrone (-)O(+)N = CHCH(2)CH(2)C[upper bond 1 end]Me(2) or N,N-diethylhydroxylamine give access, in moderate to good yields, to the unsymmetric mixed ligand oxadiazoline and/or imine complexes trans-[PtCl(2)(oxadiazoline-a)(imine-a)] , trans-[PtCl(2)(oxadiazoline-a)(oxadiazoline-b)] [oxadiazoline-b = [upper bond 1 start]N[double bond, length as m-dash]C(CH(2)CO(2)Me)O[lower bond 1 start]NC[upper bond 1 end](H)CH(2)CH(2)C[lower bond 1 end]Me(2)], trans-[PtCl(2)(imine-a)(imine-b)] [imine-b = NH = C(CH(2)CO(2)Me)ONEt(2)] or trans-[PtCl(2)(imine-a)(oxadiazoline-b)] . The cis mono-imine mixed ligand complex cis-[PtCl(2)(imine-a)(NCCH(2)CO(2)Me)] is the major product from the reaction of cis-[PtCl(2)(NCCH(2)CO(2)Me)(2)] with the oxime , while the di-imine compound cis-[PtCl(2)(imine-a)(2)] is a minor product. Reaction of cis-[PtCl(2)(imine-a)(NCCH(2)CO(2)Me)] with N,N-diethylhydroxylamine or the cyclic nitrone affords, in good yields, the unsymmetric mixed ligand complexes cis-[PtCl(2)(imine-a)(imine-b)] or cis-[PtCl(2)(imine-a)(oxadiazoline-b)] , respectively. All these complexes were characterized by elemental analyses, IR and (1)H, (13)C and (195)Pt NMR spectroscopies, and FAB(+)-MS. The X-ray structural analysis of trans-[PtCl(2){NH=C(CH(2)CO(2)Me)ON=CMe(2)}(NCCH(2)CO(2)Me)] is also reported.


De novo lipogenesis in human fat and liver is linked to ChREBP-β and metabolic health.
Clinical interest in de novo lipogenesis has been sparked by recent studies in rodents demonstrating that de novo lipogenesis specifically in white adipose tissue produces the insulin-sensitizing fatty acid palmitoleate. By contrast, hepatic lipogenesis is thought to contribute to metabolic disease. How de novo lipogenesis in white adipose tissue versus liver is altered in human obesity and insulin resistance is poorly understood. Here we show that lipogenic enzymes and the glucose transporter-4 are markedly decreased in white adipose tissue of insulin-resistant obese individuals compared with non-obese controls. By contrast, lipogenic enzymes are substantially upregulated in the liver of obese subjects. Bariatric weight loss restored de novo lipogenesis and glucose transporter-4 gene expression in white adipose tissue. Notably, lipogenic gene expression in both white adipose tissue and liver was strongly linked to the expression of carbohydrate-responsive element-binding protein-β and to metabolic risk markers. Thus, de novo lipogenesis predicts metabolic health in humans in a tissue-specific manner and is likely regulated by glucose-dependent carbohydrate-responsive element-binding protein activation.


The whys of cancer quackery.
The nation appears to have weathered the laetrile phenomenon. In just having passed through the greatest episode of quackery in our history, it would be appropriate to reflect on the whys of quackery: Why do some promote it? Why do so many use it? Why should the medical profession care? Using the laetrile experience as a model, the author attempts to deal with these fundamental questions, and tries in particular to sort out which factors were unique to laetrile and which factors have always been associated with quack promotions and are likely to continue. When a successful quack promotion is analyzed, a complex interplay of failures on the part of physicians and the public is observed, and the triumphs of the promoters are recognized. Finally, it is necessary to deal with the issue of the responsibility of the individual physician and of the profession in general in coping with an unsound, antiscientific medical therapeutic.


[The Effect of Preoperative Oral Rehydration on Hemodynamic Changes during Induction of Anesthesia and Intraoperative Fluid Management].
Preoperative oral rehydration solution (ORS) prevents dehydration before surgery. Therefore taking enough ORS possibly reduces the hemodynamic changes during induction of anesthesia, and reduces the amount of fluid needed during anesthesia. Forty patients undergoing elective surgery were randomly assigned to two groups: drinking 1,500 ml ORS 6 to 2 hours before anesthesia (ORS group) and nothing by mouth from 6 hours before anesthesia (Control group). Anesthesia induction was performed using propofol and remifentanil. To evaluate the hemodynamic changes, hemodynamic parameters including heart rate, blood pressure, cardiac index (CI), and stroke volume variation (SVV) were recorded before induction, after propofol administration, and after remifentanil administration. Total urine volume and the amount of fluid were also recorded at the end of the anesthesia. In ORS group, CI showed a significantly higher value after propofol administration (P = 0.046). SVV was significantly lower (P < 0.0001) and total amount of fluid during anesthesia was significantly reduced (P < 0.0001) in ORS group. Preoperative oral rehydration increases circulating blood volume, it keeps high CI during induction of anesthesia, and reduces the amount of intraoperative fluid.


Fish meal supplementation and ambulatory blood pressure in patients with hypertension: relevance of baseline membrane fatty acid composition.
Studies on fish oil effects on ambulatory blood pressure (ABP) are inconclusive. We evaluated fish effects on fatty acid composition of red blood cell (RBC) membrane and ABP values and tested the hypothesis that the starting membrane fatty acid composition affects the ability to incorporate additional polyunsaturated fatty acids (PUFA) and decrease blood pressure. In 55 hypertensive patients, we measured RBC membrane fatty acid by gas chromatography and performed ABP monitoring. Patients received nutritional counseling and 3 weekly meals of trout rich in PUFA. In 42 patients, RBC membrane fatty acid and ABP were reassessed after 6 months. At baseline, the PUFA/saturated fatty acid (SFA) ratio of RBC membrane (PUFA/SFA) was inversely related to 24-hour, daytime, and nighttime systolic and pulse pressure, a relationship that was independent of covariables. At follow-up, the PUFA/SFA ratio increased in 20 (48%) of 42 patients. Patients with increased PUFA/SFA ratio at follow-up had lower baseline PUFA/SFA ratio than patients without such increase. Fish meal supplementation decreased 24-hour systolic and diastolic pressure only in patients who had increased PUFA/SFA ratio, a change that was more prominent during the nighttime. The change in PUFA/SFA was inversely and independently related to the change in 24-hour systolic and pulse pressure, and a logistic regression analysis indicated low baseline PUFA/SFA ratio as the only independent predictor of PUFA/SFA increase and blood pressure decrease. The ability of fish meals to increase membrane PUFA content and decrease blood pressure in hypertensive patients depends upon the starting membrane fatty acid composition.


A Review of Routine Laboratory Biomarkers for the Detection of Severe COVID-19 Disease.
As the COVID-19 pandemic continues, there is an urgent need to identify clinical and laboratory predictors of disease severity and prognosis. Once the coronavirus enters the cell, it triggers additional events via different signaling pathways. Cellular and molecular deregulation evoked by coronavirus infection can manifest as changes in laboratory findings. Understanding the relationship between laboratory biomarkers and COVID-19 outcomes would help in developing a risk-stratified approach to the treatment of patients with this disease. The purpose of this review is to investigate the role of hematological (white blood cell (WBC), lymphocyte, and neutrophil count, neutrophil-to-lymphocyte ratio (NLR), platelet, and red blood cell (RBC) count), inflammatory (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and lactate dehydrogenase (LDH)), and biochemical (Albumin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), blood urea nitrogen (BUN), creatinine, D-dimer, total Cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL)) biomarkers in the pathogenesis of COVID-19 disease and how their levels vary according to disease severity.


Cell-strain-energy costs of active control of contractility.
Cell mechanosensing is implicated in the control of a broad range of cell behaviors, with cytoskeletal contractility a key component. Experimentally, it is observed that the contractility of the cell responds to increasing substrate stiffness, showing increased contractile force and changing the distribution of cytoskeletal elements. Here, we show using a theoretical model of active cell contractility that upregulation of contractility need not be energetically expensive, especially when combined with changes in adhesion and contractile distribution. Indeed, we show that a feedback mechanism based on the maintenance of strain energy would require an upregulation in contractile pressure on all but the softest substrates. We consider both the commonly reported substrate strain energy and active work done. We demonstrate substrate strain energy would preferentially select for the experimentally observed clustering of cell adhesions on stiffer substrates which effectively soften the substrate and enable an upregulation of total contractile pressure, while the localization of contractility has the greatest impact on the internal work.


Gordiichthys combibus, a new species of eastern Pacific sand-eel (Anguilliformes: Ophichthidae).
A new species of bascanichthyin ophichthid, Gordiichthys combibus, is described from shallow water along the Pacific coast of Colombia. It is the first known eastern Pacific species of Gordiichthys and is very similar to G. randalli from Puerto Rico. It differs from its other western Atlantic congeners in vertebral number and other characters. A key to the genus is provided.


Helicobacter pylori antibody responses in association with eradication outcome and recurrence: a population-based intervention trial with 7.3-year follow-up in China.
To identify serum biomarkers that may predict the short or long term outcomes of anti-Helicobacter pylori (H. pylori) treatment, a follow-up study was performed based on an intervention trial in Linqu County, China. A total of 529 subjects were selected randomly from 1,803 participants to evaluate total anti-H. pylori immunoglobulin G (IgG) and 10 specific antibody levels before and after treatment at 1-, 2- and 7.3-year. The outcomes of anti-H. pylori treatment were also parallelly assessed by13C-urea breath test at 45-d after treatment and 7.3-year at the end of follow-up. We found the medians of anti-H. pylori IgG titers were consistently below cut-off value through 7.3 years in eradicated group, however, the medians declined in recurrence group to 1.2 at 1-year after treatment and slightly increased to 2.0 at 7.3-year. While the medians were significantly higher (>3.0 at 2- and 7.3-year) among subjects who failed the eradication or received placebo. For specific antibody responses, baseline seropositivities of FliD and HpaA were reversely associated with eradication failure [for FliD, odds ratio (OR)=0.44, 95% confidence interval (95% CI): 0.27-0.73; for HpaA, OR=0.32, 95% CI: 0.17-0.60]. The subjects with multiple positive specific antibodies at baseline were more likely to be successfully eradicated in a linear fashion (Ptrend=0.006). Our study suggested that total anti-H. pylori IgG level may serve as a potential monitor of long-term impact on anti-H. pylori treatment, and priority forH. pylori treatment may be endowed to the subjects with multiple seropositive antibodies at baseline, especially for FliD and HapA.


Potential Association of Triglyceride Glucose Index with Cardiac Autonomic Neuropathy in Type 2 Diabetes Mellitus Patients.
Cardiac autonomic neuropathy (CAN) is a common and most neglected complication of diabetes, estimated to be roughly 8% in recently diagnosed patients and greater than 50% in patients with chronic disease history. The insulin resistance (IR) itself is bidirectionally associated with increased risk of type 2 diabetes mellitus (T2DM) and CAN is a predisposing factor. The primary objective of the present study was aimed to find a correlation of triglyceride glucose index (TyG index) in CAN patients along with the prevalence of CAN in T2DM patients as a secondary objective. This prevalence study was conducted on 202 patients visiting the diabetic clinic of Hamdard Institute of Medical Sciences and Research, Jamia Hamdard (HIMSR) teaching hospital in New Delhi, India who fulfilled the inclusion criteria. The Ewings autonomic function test was used for diagnosis of CAN. TyG index was calculated for patients based on fasting levels of glucose and triglyceride. The CAN was diagnosed in 62 participants out of 202 T2DM patients (overall prevalence 30.7%). The mean ± standard deviation (SD) for TyG index was 10.3 ± 0.2 and 9.5 ± 0.2 in CAN positive, T2DM patients, respectively. The difference of TyG index, in CAN positive and T2DM patients, was highly significant (P < 0.001). Further correlation analysis was performed to find an association of TyG index, duration, and age with patient groups. TyG index showed a positive correlation with heart rate during deep breathing (HRD), heart rate variation during standing (HRS), blood pressure (BP) response to handgrip and BP response to standing. Our finding highlights the TyG index, low-cost IR index, might be useful as an alternative tool for the early screening of patients at a high risk of diabetic neuropathy.


CD8 T-cell recognition of acquired alloantigen promotes acute allograft rejection.
Adaptive CD8 T-cell immunity is the principal arm of the cellular alloimmune response, but its development requires help. This can be provided by CD4 T cells that recognize alloantigen "indirectly," as self-restricted allopeptide, but this process remains unexplained, because the target epitopes for CD4 and CD8 T-cell recognition are "unlinked" on different cells (recipient and donor antigen presenting cells (APCs), respectively). Here, we test the hypothesis that the presentation of intact and processed MHC class I alloantigen by recipient dendritic cells (DCs) (the "semidirect" pathway) allows linked help to be delivered by indirect-pathway CD4 T cells for generating destructive cytotoxic CD8 T-cell alloresponses. We show that CD8 T-cell-mediated rejection of murine heart allografts that lack hematopoietic APCs requires host secondary lymphoid tissue (SLT). SLT is necessary because within it, recipient dendritic cells can acquire MHC from graft parenchymal cells and simultaneously present it as intact protein to alloreactive CD8 T cells and as processed peptide alloantigen for recognition by indirect-pathway CD4 T cells. This enables delivery of essential help for generating cytotoxic CD8 T-cell responses that cause rapid allograft rejection. In demonstrating the functional relevance of the semidirect pathway to transplant rejection, our findings provide a solution to a long-standing conundrum as to why SLT is required for CD8 T-cell allorecognition of graft parenchymal cells and suggest a mechanism by which indirect-pathway CD4 T cells provide help for generating effector cytotoxic CD8 T-cell alloresponses at late time points after transplantation.


Expression of Wiskott-Aldrich syndrome protein in dendritic cells regulates synapse formation and activation of naive CD8+ T cells.
The Wiskott-Aldrich syndrome protein (WASp) is a key regulator of actin polimerization in hematopoietic cells. Mutations in WASp cause a severe immunodeficiency characterized by defective initiation of primary immune response and autoimmunity. The contribution of altered dendritic cells (DCs) functions to the disease pathogenesis has not been fully elucidated. In this study, we show that conventional DCs develop normally in WASp-deficient mice. However, Ag targeting to lymphoid organ-resident DCs via anti-DEC205 results in impaired naive CD8(+) T cell activation, especially at low Ag doses. Altered trafficking of Ag-bearing DCs to lymph nodes (LNs) accounts only partially for defective priming because correction of DCs migration does not rescue T cell activation. In vitro and in vivo imaging of DC-T cell interactions in LNs showed that cytoskeletal alterations in WASp null DCs causes a reduction in the ability to form and stabilize conjugates with naive CD8(+) T lymphocytes both in vitro and in vivo. These data indicate that WASp expression in DCs regulates both the ability to traffic to secondary lymphoid organs and to activate naive T cells in LNs.


A controlled randomized clinical trial to assess postoperative analgesia after thiopental-isoflurane anaesthesia or total intravenous anaesthesia with alfaxalone in dogs.
Alfaxalone, a synthetic neuroactive steroid, has been attributed with properties including sedation, anaesthesia and analgesia. The clinical relevance of any analgesic properties of alfaxalone has not been demonstrated. This study was a prospective, blinded, randomized, negative control clinical trial in 65 healthy dogs presented for ovariohysterectomy. Anaesthesia was induced and maintained, for Group 1 (TIVA) dogs (n = 30) with intravenous alfaxalone alone and for Group 2 dogs (n = 35) with thiopental followed by isoflurane in 100% oxygen inhalation. After ovariohysterectomy, quantitative measures of pain or nociception were recorded at 15 min intervals for 4 hr using three independent scoring systems, a composite measure pain scale (CMPS), von Frey threshold testing and measures of fentanyl rescue analgesia. The mean CMPS scores of Group 2 (THIO/ISO) dogs remained higher than Group 1 (TIVA) dogs from 15 to 135 min post-surgery but this difference was not statistically significant. There were no significant differences between groups in the proportions of dogs requiring rescue fentanyl analgesia, the total fentanyl dose used or the time to first fentanyl dose. The Von Frey threshold testing was found to be unsuitable for measurement of pain in this experimental model. When administered as total intravenous anaesthesia, alfaxalone did not provide analgesia in the postoperative period.


Immobilization of operated ankle fractures.
Forty-three patients with stable internal fixation of fresh ankle fractures were treated at random with a plaster cast for 6 weeks without weight bearing or were only immobilized for 3 days, after which active movements were encouraged. The two groups were followed for a year. Only at 6 weeks were there significant differences between the groups.


The impact of coronary microvascular dysfunction on the discordance between fractional flow reserve and resting full-cycle ratio in patients with chronic coronary syndromes.
Resting full-cycle ratio (RFR) is an alternative to fractional flow reserve (FFR) for the evaluation of borderline coronary artery lesions. Although FFR and RFR results are discordant in some cases, factors associated with the discordance remain unclear. The role of coronary microvascular dysfunction (CMD) is discussed as a potential mechanism to explain these discrepancies. The study aimed to assess concordance between RFR and FFR in a real-life cohort from a high-volume center regarding the role of CMD. Consecutive patients with borderline coronary lesions undergoing coronary functional testing for chronic coronary syndromes were included in the study. Measurements of RFR and FFR were performed alongside additional coronary flow reserve (CFR), resistance reserve ratio (RRR), and an index of microcirculatory resistance (IMR) measurements. CMD was defined according to the current guideline by either IMR ≥25 or CFR ≤2.0 in vessels with no significant stenosis. Measurements were performed in 157 coronary arteries, in 101 patients, with a median age of 66 y., 74% male, with prior history of arterial hypertension (96%), dyslipidaemia (91%), and diabetes (40%). The median value of vessel diameter stenosis was 45% according to QCA.Overall, FFR and RFR values were significantly correlated (r = 0.66, p < 0.001), where positive FFR/negative RFR and negative FFR/positive RFR were observed in 6 (3.8%) and 38 (24.2%) of 157 vessels. The RFR/FFR discrepancy was present in 44 (28%) of measurements. CMD was confirmed in 28 (64%) of vessels with discrepant RFR/FFR and in 46 (41%) of vessels with concordant results (p = 0.01). In discordant RFR/FFR vessels, as compared to concordant ones, significantly lower values of CFR [median 1.95 (IQR: 1.37, 2.30) vs. 2.10 (IQR: 1.50, 3.00), p = 0.030] and RRR [median 2.50 (IQR: 1.60, 3.10) vs. 2.90 IQR (1.90, 3.90), p = 0.048] were observed.Main predictors of RFR/FFR discrepancy in a univariate regression analysis were: higher age of patients [OR = 1.06 (1.01; 1.10), p = 0.010], presence of CMD [OR = 2.51 (1.23; 5.25), p = 0.012], lower CFR [OR = 1.64 (1.12; 2.56), p = 0.018], and lower RRR values [OR = 1.35 (95% CI: 1.03; 1.83), p = 0.038]. In discrepant RFR/FFR vessels, CMD is more prevalent than in concordant RFR/FFR measurements, which can be driven by lower CFR or RRR values. Further research is needed to confirm this observation.


The Real-World Economic and Clinical Management of Adult Patients with Skin and Soft Tissue Infections (SSTIs) with Oritavancin: Data from Two Multicenter Observational Cohort Studies.
Oritavancin is a FDA-approved single-dose IV therapy for the treatment of acute bacterial skin and skin structure infections caused (or suspected to be caused) by certain Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus (MRSA). Published data describing the outcomes of patients with skin and soft tissue infections (SSTIs) who received oritavancin beyond its pivotal phase III clinical trials are scant. The purpose of this report was to describe the results of two separate multicenter observational cohort studies that described the outcomes associated with two unique real-world usage patterns of oritavancin. The first cohort (n = 115) examined patients 18 years or older who were treated with oritavancin at three outpatient sites for SSTIs caused by suspected or confirmed Gram-positive pathogens, including MRSA, to avoid hospital admission. Patients were included if they had not been discharged from the inpatient setting within the previous 24 h and received their single-dose oritavancin treatment at a hospital-based outpatient infusion center. The primary outcomes measured were 30-day healthcare costs and admissions (all cause and infection related). The second cohort (n = 151) was a multicenter, retrospective chart review of adult patients who were discharged early from seven hospitals in 2015 on oritavancin for SSTIs. The primary outcome was readmission of patients within 30 days (all cause and infection related). In cohort 1, 30-day mean healthcare costs were USD 3698. In the study of patients who started oritavancin in the outpatient setting, 7 patients (6.1%) were admitted to hospital within 30 days of the index treatment, and 3 of those (2.6% overall) were deemed to be due to an infection. In cohort 2, all-cause and infection-related 30-day readmission rates were 6.6% and 2.6%, respectively, among patients who received oritavancin at hospital discharge. Findings from these studies suggest that oritavancin may be a potentially useful agent to avoid hospitalization or shorten hospital length of stay among appropriate SSTI patients. Future comparator studies are required to properly ascertain the outcomes and potential benefits associated with oritavancin relative to other commonly used antibiotics in patients with SSTIs.


An arteriovenous loop in a protected space generates a permanent, highly vascular, tissue-engineered construct.
A major obstacle to 3-dimensional tissue engineering is incorporation of a functional vascular supply to support the expanding new tissue. This is overcome in an in vivo intrinsic vascularization model where an arteriovenous loop (AVL) is placed in a noncollapsible space protected by a polycarbonate chamber. Vascular development and hypoxia were examined from 3 days to 112 days by vascular casting, morphometric, and morphological techniques to understand the model's vascular growth and remodeling parameters for tissue engineering purposes. At 3 days a fibrin exudate surrounded the AVL, providing a scaffold to migrating inflammatory, endothelial, and mesenchymal cells. Capillaries formed between 3 and 7 days. Hypoxia and cell proliferation were maximal at 7 days, followed by a peak in percent vascular volume at 10 days (23.20+/-3.14% compared with 3.59+/-2.68% at 3 days, P<0.001). Maximal apoptosis was observed at 112 days. The protected space and spontaneous microcirculatory development in this model suggest it would be applicable for in vivo tissue engineering. A temporal window in a period of intense angiogenesis at 7 to 10 days is optimal for exogenous cell seeding and survival in the chamber, potentially enabling specific tissue outcomes to be achieved.


Evaluation of the dorsal acetabular coverage obtained by a modified triple pelvic osteotomy (2.5 pelvic osteotomy): an ex vivo study on a cadaveric canine codel.
To evaluate the acetabular ventroversion obtained with a modified triple pelvic osteotomy (2.5 PO) compared with that resulting from standard double pelvic osteo-tomy (DPO). Ex vivo study. Seven pelves obtained from skeletally mature dogs with a total body weight ranging from 26-41 kg were used. Unilateral DPO technique and dorsal ischial mono-cortical osteotomy were performed on every right hemipelvis. Angular ventral rotation was measured by determining the relative orientation of two Kirschner wires placed in the ilial wing and in the dorsal acetabular rim. The mean angle of ventroversion was 9.5 ± 5.2 degrees for the DPO group (range 2.1-18.1) and 10.9 ± 4.8 degrees for the 2.5 PO group (range 4.1-19.5). The mean difference between the 2.5 PO and DPO was 1.5 ± 0.6 degrees (range 0.5-2.1). The 2.5 PO technique increased acetabular ventroversion versus DPO.


Wolbachia diversity and cytoplasmic incompatibility patterns in Culex pipiens populations in Turkey.
Wolbachia are maternally transmitted bacteria that can manipulate their hosts' reproduction causing cytoplasmic incompatibility (CI). CI is a sperm-egg incompatibility resulting in embryonic death. Due to this sterilising effect on mosquitoes, Wolbachia are considered for vector control strategies. Important vectors for arboviruses, filarial nematodes and avian malaria, mosquitoes of Culex pipiens complex are suitable for Wolbachia-based vector control. They are infected with Wolbachia wPip strains belonging to five genetically distinct groups (wPip-I to V) within the Wolbachia B supergroup. CI properties of wPip strongly correlate with this genetic diversity: mosquitoes infected with wPip strains from a different wPip group are more likely to be incompatible with each other. Turkey is a critical spot for vector-borne diseases due to its unique geographical position as a natural bridge between Asia, Europe and Africa. However, general wPip diversity, distribution and CI patterns in natural Cx. pipiens (s.l.) populations in the region are unknown. In this study, we first identified wPip diversity in Turkish Cx. pipiens (s.l.) populations, by assigning them to one of the five groups within wPip (wPip-Ito V). We further investigated CI properties between different wPip strains from this region. We showed a wPip fixation in Cx. pipiens (s.l.) populations in Turkey by analysing 753 samples from 59 sampling sites. Three wPip groups were detected in the region: wPip-I, wPip-II and wPip-IV. The most dominant group was wPip-II. While wPip-IV was restricted to only two locations, wPip-I and wPip-II had wider distributions. Individuals infected with wPip-II were found co-existing with individuals infected with wPip-I or wPip-IV in some sampling sites. Two mosquito isofemale lines harbouring either a wPip-I or a wPip-II strain were established from a population in northwestern Turkey. Reciprocal crosses between these lines showed that they were fully compatible with each other but bidirectionally incompatible with wPip-IV Istanbul infected line. Our findings reveal a high diversity of wPip and CI properties in Cx. pipiens (s.l.) populations in Turkey. Knowledge on naturally occurring CI patterns caused by wPip diversity in Turkey might be useful for Cx. pipiens (s.l.) control in the region.


Kohninia linnaeicola, a new genus and species of the Sclerotiniaceae pathogenic to Linnaea borealis.
A new genus and species is described to accommodate a newly discovered fungus pathogenic to Linnaea borealis. The fungus forms true sclerotia on stems and leaves of its host and apothecia arise singly or gregariously on the surface of ripe sclerotia. The new fungus was collected together with a stromatic conidiomal fungus that occurred on the same host. A putative teleomorph-anamorph connection of the observed taxa was ruled out by sequence comparison of the nuclear ribosomal internal transcribed spacer DNA sequences (ITS rDNA). Based on morphology and pathogenicity, the new fungus belongs in the family Sclerotiniaceae, Helotiales, Ascomycota. A phylogenetic analysis of ITS rDNA sequences from 26 taxa of the family Sclerotiniaceae was performed to conclude on the systematic position of the new fungus. The small tuberoid sclerotia, brownish subsessile to substipitate apothecia, four-spored asci, ellipsoid to isthmoid ascospores, inability to grow on PDA culture media and a number of ITS rDNA sequence autapomorphies characterize and distinguish the fungus from other taxa of the Sclerotiniaceae.


Single amino acid substitutions affecting the substrate specificity of the Escherichia coli K-12 nucleoside-specific Tsx channel.
The Tsx protein from the Escherichia coli outer membrane is a channel-forming protein containing a nucleoside-specific binding site. The antibiotic albicidin enters the cell via this substrate-specific channel. Because albicidin is toxic for E. coli at a very low external substrate concentration, the Tsx channel is likely to contain a binding site for this antibiotic. To identify residues involved in the Tsx substrate-specific channel activity, we devised a selection scheme to isolate albicidin-resistant tsx mutants synthesizing Tsx proteins with defects in their nucleoside uptake function. We recovered seven distinct albicidin-resistant tsx alleles, six point mutations and a 39-base pair duplication. The mutants with a duplication of residues 21-33 of Tsx or with single amino acid substitutions of residue Gly28 (to Arg) and Ser217 (to Arg) are completely deficient in nucleoside uptake at a low substrate concentration. Substitutions of Phe27 to Leu, Gly28 to Glu, Gly239 to Asp, and Gly240 to Asp result in a Tsx protein partially defective in nucleoside transport. These mutant proteins still permit nonspecific diffusion of serine indicating that the mutations do not result in a block of the Tsx channel. Our results are discussed in terms of a model for the topological organization of the Tsx protein within the outer membrane of E. coli.


Usefulness of Ultrasonography in the Diagnosis of Peptic Ulcer Disease in Children.
This study was performed to assess the clinical usefulness of transabdominal ultrasonography (TUS) in detecting peptic ulcer disease (PUD) in children. Twenty-four patients (19 boys, 5 girls; mean age, 10.6±4.5 years [range, 3.0-17.9 years]) who were admitted to the hospital for acute abdomen or gastrointestinal bleeding and diagnosed with PUD by endoscopy and who underwent TUS were included. Clinical data were retrospectively collected by reviewing patient medical records. Gastric ulcer (GU) was suspected when the gastric wall exceeded 8 mm in thickness and had lost its five-layer structure on TUS. Duodenal ulcer (DU) was suspected if the duodenal wall thickness exceeded 5 mm. Sensitivity of TUS in diagnosing PUD was 66.7% for GU and 38.9% for DU. Mean age and body weight of the 11 patients suspected with PUD on TUS were 10.9±4.4 years and 38.1±17.2 kg, respectively. For 13 patients without suspected PUD, they were 12.1±4.1 years and 39.6±17.0 kg, respectively. There was a significant difference in height, weight, and body mass index between patients who were suspected to have PUD and those who were not suspected on TUS (p=0.014, 0.008, and 0.005, respectively). A significant difference in the sensitivity of TUS in diagnosing PUD was found between patients under 30 kg and those over 30 kg (88.9% and 20.0%, respectively; p=0.003). TUS investigation of the stomach and duodenum is an efficient method for PUD detection in children with low body weight. TUS can be used in preliminary diagnostic work-up before further invasive tests.


Possible role of substance P on regulation of pituitary-adrenal axis.
The effects of chronic immobilization stress on the physiological responses of male rats were studied. The results indicate that the SP-like immunoreactivity (SPLIR) is diminished in the adrenals and pituitary after chronic stress. In vitro noradrenaline (NA) release from adrenals was increased. The i.p. administration of SP during the stress procedure normalized the increased NA release in vitro indicating that the catecholamine secretion may be influenced by SP. On the other hand, in demedullated animals the SPLIR in the pituitary was partly reduced and the blood pressure was increased. In such animals chronic stress resulted in an increase of SPLIR in the pituitary in comparison with nonstressed, demedullated animals, but was without effect on the blood pressure. It is concluded that exposure to SP and the resulting decrease of noradrenaline release may have a significant influence on the pituitary-adrenal responsiveness to stress.


Mucocutaneous leishmaniasis and HIV.
Mucocutaneous leishmaniasis is a rare disease in Europe. Relapses after treatment are more frequent than in visceral leishmaniasis. HIV patients infected by Leishmania have frequently visceral involvement, and responses to treatment are poor. Mucocutaneous leishmaniasis in HIV-infected patients has rarely been reported. A patient with centrofacial granuloma was diagnosed as having mucocutaneous leishmaniasis; simultaneously HIV infection was detected. To our knowledge this is the first case acquired in Europe. Intravenous meglumine antimonate 20 mg/kg/day for 28 days was proven to be useful.


Generic affinities among crocodilians as revealed by DNA fingerprinting with a Bkm-derived probe.
Genetic fingerprint profiles have been successfully used for establishing biological relationships, in linkage analysis, and in studies of population structure but have not so far been used for ascertaining phylogenetic relationships among related groups of species and genera. This is largely because these profiles are thought to evolve too rapidly to be informative over large time intervals. However, we show here that among the Crocodilia, whose phylogeny is a debated issue, these profiles can provide phylogenetically useful information. By using the probe Bkm-2(8), DNA fingerprints with distinct bands distributed in the size range 0.5-23.0 kb were obtained for individuals of 18 species belonging to seven of the eight genera of crocodilians. These genetic profiles showed individual-, species-, and restriction enzyme-specific patterns. In addition, striking differences were observed in the copy number of Bkm-related sequences in genomes of different crocodilian species. The qualitative data from DNA fingerprint profiles, and quantitative data on copy number variation in Bkm-related sequences, suggest that these genera belong to two distinct groups, one of which includes Alligator, Paleosuchus, and Caiman; the other includes Crocodylus, Osteolaemus, Tomistoma, and Gavialis. A close relationship between Tomistoma and Gavialis is also suggested by these results.


Parental occupation and childhood brain tumors: astroglial and primitive neuroectodermal tumors.
Data from a population-based case-control study in 19 counties in California and Washington State were used to investigate the association between parental employment and childhood brain tumors. Parents of 540 cases (including 308 astroglial and 109 primitive neuroectodermal tumors) and 801 controls diagnosed from 1984 to 1991 were interviewed. Analysis was completed for parents' self-reported industry of employment and job tasks during the five years preceding the birth of the child. Parents who worked in the chemical industry were at increased risk of having had children with astroglial tumors (fathers' odds ratio [OR] = 2.1; 95% confidence interval [CI], 1.1-3.9); mothers' OR = 3.3; 95% CI, 1.4-7.7), but no trend by duration of employment was seen for mothers. Children of fathers employed as electrical workers were at increased risk of developing brain tumors of any histologic type (OR = 2.3; 95% CI, 1.3-4.0).


Microbial hydrocarbon co-oxidation. I. Oxidation of mono- and dicyclic hydrocarbons by soil isolates of the genus Nocardia.
Nocardia cultures, isolated from soil by use of n-paraffins as the sole carbon source, have been shown to bring about significant oxidation of several methyl-substituted mono- and dicyclic aromatic hydrocarbons. Oxygen uptake by washed cell suspensions was not a reliable indicator of oxidation. Under co-oxidation conditions in shaken flasks, o- and p-xylenes were oxidized to their respective mono-aromatic acids, o-toluic and p-toluic acids. In addition, a new fermentation product, 2, 3-dihydroxy-p-toluic acid, was found in the p-xylene oxidation system. Of 10 methyl-substituted naphthalenes tested (1-methyl, 2-methyl, 1, 3-dimethyl, 1, 4-dimethyl, 1, 5-dimethyl, 1, 8-dimethyl, 1, 6-dimethyl, 2, 3-dimethyl, 2, 6-dimethyl, 2, 7-dimethyl), only those containing a methyl group in the beta position were oxidized at this position to the mono acid.


Single-Cell RNA-Seq Identifies Pathways and Genes Contributing to the Hyperandrogenemia Associated with Polycystic Ovary Syndrome.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by hyperandrogenemia of ovarian thecal cell origin, resulting in anovulation/oligo-ovulation and infertility. Our previous studies established that ovarian theca cells isolated and propagated from ovaries of normal ovulatory women and women with PCOS have distinctive molecular and cellular signatures that underlie the increased androgen biosynthesis in PCOS. To evaluate differences between gene expression in single-cells from passaged cultures of theca cells from ovaries of normal ovulatory women and women with PCOS, we performed single-cell RNA sequencing (scRNA-seq). Results from these studies revealed differentially expressed pathways and genes involved in the acquisition of cholesterol, the precursor of steroid hormones, and steroidogenesis. Bulk RNA-seq and microarray studies confirmed the theca cell differential gene expression profiles. The expression profiles appear to be directed largely by increased levels or activity of the transcription factors SREBF1, which regulates genes involved in cholesterol acquisition (LDLR, LIPA, NPC1, CYP11A1, FDX1, and FDXR), and GATA6, which regulates expression of genes encoding steroidogenic enzymes (CYP17A1) in concert with other differentially expressed transcription factors (SP1, NR5A2). This study provides insights into the molecular mechanisms underlying the hyperandrogenemia associated with PCOS and highlights potential targets for molecular diagnosis and therapeutic intervention.


Emergence, spread, and environmental effect of antimicrobial resistance: how use of an antimicrobial anywhere can increase resistance to any antimicrobial anywhere else.
Use of an antimicrobial agent selects for overgrowth of a bacterial strain that has a gene expressing resistance to the agent. It also selects for the assembly and evolution of complex genetic vectors encoding, expressing, linking, and spreading that and other resistance genes. Once evolved, a competitive construct of such genetic elements may spread widely through the world's bacterial populations. A bacterial isolate at any place may thus be resistant-not only because nearby use of antimicrobials had amplified such a genetic construct locally, but also because distant use had caused the construct or its components to evolve in the first place and spread there. The levels of resistance at any time and place may therefore reflect in part the total number of bacteria in the world exposed to antimicrobials up until then. Tracing the evolution and spread of such genetic elements through bacterial populations far from one another, such as those of animals and humans, can be facilitated by newer genetic methods.


Flat Electroretinography and Acute Visual Loss After Ocriplasmin Injection for Vitreomacular Adhesion Complicating Macular Schisis.
A 53-year-old woman with macular and diffuse retinoschisis complicated by presumed vitreomacular traction underwent unilateral intravitreal ocriplasmin injection. Within hours after injection, she noted a loss of vision and the perception of "negative" images in the treated eye. Electrophysiologic testing revealed flat waveforms, and optical coherence tomography (OCT) showed initial decreased central macular thickness at day 1, followed by massive increased macular thickness with subfoveal neurosensory retinal detachment at 1 week. Her central macular thickness on OCT slowly returned to baseline during a period of 1 month until development of a macula-off rhegmatogenous retinal detachment at 6 months after injection. The authors believe this unique case of vitreomacular adhesion and macular schisis complicated by post-injection visual loss and electroretinography changes may offer further insight into this unusual complication.


[Effectiveness of arthroscopic synovectomy in treatment of pigmented villonodular synovitis of knee].
To explore the effectivness of arthroscopic synovectomy in the treatment of pigmented villonodular synovitis (PVNS) of the knee. A retrospective analysis was conducted on 13 patients with PVNS of the knee treated with arthroscopic synovectomy between June 2008 and December 2011, including 8 left knees and 5 right knees. There were 9 males and 4 females, aged 25-45 years (mean, 33 years). Of 13 patients, 5 had a history of trauma, and 8 had no history of trauma. The disease duration ranged from 4 months to 80 months (mean, 44 months). The preoperative Lysholm score was 45.3 +/- 4.2, and International Knee Documentation Committee (IKDC) 2000 score was 46.8 +/- 4.9. All patients underwent arthroscopic synovectomy and postoperative radiotherapy. The pathological examination proved PVNS in all cases. All incisions obtained healing by first intention after operation. There was no neurovascular injury or knee infection. The average follow-up period was 21.8 months (range, 12-30 months). The Lysholm score was 90.2 +/- 7.4, and IKDC2000 score was 87.8 +/- 3.8 at last follow-up, showing significant differences when compared with preoperative scores (t = 22.64, P = 0.00; t = 24.32, P = 0.00). No recurrence was observed during follow-up. Arthroscopic synovectomy can be effective in the treatment of PVNS of the knee, and it has the merits of minimal invasion, rapid function recovery of the knee joint, and satisfactory results. So it is a safe, promising, and minimal invasive procedure in treatment of PVNS.


Intrauterine Growth Restriction (IUGR) Induces Signs of Subclinical Atherosclerosis in 6-Year-Old Infants Despite Absence Of Excessive Growth.
Background Postnatal catch-up growth and rapid weight gain after intrauterine growth restriction (IUGR) seem to increase the risk for later disease. This study aimed to compare features of the metabolic syndrome early in life between IUGR and appropriate for gestational age (AGA) infants. Patients Data for 9 infants with IUGR defined by a birth weight<10th percentile and ultrasound-proven placental insufficiency and 11 AGA children were available. Method Postnatal growth, auxological, cardiovascular, and metabolic parameters up to a chronological age of 6 years were assessed: Fasting serum concentrations of LDL-cholesterol, insulin, leptin, IGF-I, DHEAS, skinfold thicknesses, blood pressure, and mean carotid intima-media thickness (cIMT). Results All IUGR infants showed catch-up growth, although mean BMI SDS and total subcutaneous fat mass at the age of 6 years were still slightly lower compared to the AGA cohort. Reduced serum leptin concentrations were observed in IUGR infants (p=0.02), whereas no significant difference was found for IGF-I, insulin, LDL-cholesterol and DHEAS concentrations. Mean cIMT was significantly higher in IUGR infants (p<0.05). Mean arterial pressure did no differ. Discussion and Conclusion In 6-year-old IUGR infants with catch-up growth, who still had a slightly reduced BMI SDS compared to the AGA group, signs of subclinical atherosclerosis were detectable suggesting that cardiovascular risk in IUGR may be present even in the absence of excessive growth.


The prosthetic implant of MBA Optetrak in the treatment of knee osteoarthritis: 5 years of experience.
In this study the authors report their experience in treating knee osteoarthritis with MBA Optetrak prosthetic implant, designed to minimize the stress of high density polyethylene. In all patients, we implanted two different Optetrak prosthesis according to the validity or not of the posterior cruciate ligament. At follow-up visit, which was performed after an average follow-up of 3.6 years, we analyzed 53 patients radiographically and clinically using the Knee Society Score (KSS). Depending on our experience, we consider mandatory to have a precise selection of the patients as well as to perform an accurate capsular and ligamentous balance during operation. Furthermore, the use of prosthesis models which are similar to the normal knee allows to obtain good and durable results.


Disambiguation of biomedical text using diverse sources of information.
Like text in other domains, biomedical documents contain a range of terms with more than one possible meaning. These ambiguities form a significant obstacle to the automatic processing of biomedical texts. Previous approaches to resolving this problem have made use of various sources of information including linguistic features of the context in which the ambiguous term is used and domain-specific resources, such as UMLS. We compare various sources of information including ones which have been previously used and a novel one: MeSH terms. Evaluation is carried out using a standard test set (the NLM-WSD corpus). The best performance is obtained using a combination of linguistic features and MeSH terms. Performance of our system exceeds previously published results for systems evaluated using the same data set. Disambiguation of biomedical terms benefits from the use of information from a variety of sources. In particular, MeSH terms have proved to be useful and should be used if available.


Laser surgery versus radiotherapy for T1a glottic carcinoma: a meta-analysis of oncologic outcomes.
A meta-analysis was conducted to compare oncologic outcomes for patients of T1a glottic carcinoma who were treated with laser surgery (LS) or radiotherapy (RT). All related studies published up to October 2016 were acquired by searching PubMed, EMBASE, and Cochrane were conducted by two authors, with the index words: vocal, glottis, larynx, laser, surgery, cordectomy, radiotherapy, radiation, irradiation, carcinoma, and cancer. Relative studies which compared oncologic outcomes between LS and RT were included. A total of nine eligible studies were included for the analysis, which contained two prospective studies and seven retrospective studies. LS has increased larynx preservation (OR = 3.86, 95% CI = 1.47-10.13, p = .006) compared with RT group. No statistical difference was observed between LS group and RT group in terms of local control, overall survival, and disease-specific survival. There was a slight trend in terms of local control, overall survival, and disease-specific survival that all favored LS, although all data did not reach the level of statistical significance. The results of this meta-analysis indicate that LS may be a better option for the treatment of T1a glottic carcinoma because patients underwent LS may benefit from increased larynx preservation compared with RT. However, more multi-center randomized controlled trials would be urgently needed to prove these differences.


Electrical properties of the pacemaker neurons in the heart ganglion of a stomatopod, Squilla oratoria.
In the Squilla heart ganglion, the pacemaker is located in the rostral group of cells. After spontaneous firing ceased, the electrophysiological properties of these cells were examined with intracellular electrodes. Cells respond to electrical stimuli with all-or-none action potentials. Direct stimulation by strong currents decreases the size of action potentials. Comparison with action potentials caused by axonal stimulation and analysis of time relations indicate that with stronger currents the soma membrane is directly stimulated whereas with weaker currents the impulse first arises in the axon and then invades the soma. Spikes evoked in a neuron spread into all other neurons. Adjacent cells are interconnected by electrotonic connections. Histologically axons are tied with the side-junction. B spikes of adjacent cells are blocked simultaneously by hyperpolarization or by repetitive stimulation. Experiments show that under such circumstances the B spike is not directly elicited from the A spike but is evoked by invasion of an impulse or electrotonic potential from adjacent cells. On rostral stimulation a small prepotential precedes the main spike. It is interpreted as an action potential from dendrites.


Implementing a Warm Handoff Between Hospital and Skilled Nursing Facility Clinicians.
Care transitions between hospitals and skilled nursing facilities (SNFs) are associated with disruptions in patient care and high risk for adverse events. Communication between hospital-based and SNF-based clinicians is often suboptimal; there have been calls to foster direct, real-time communication between sending and receiving clinicians to enhance patient safety. This article described the implementation of a warm handoff between hospital and SNF physicians and advanced practice providers at the time of hospital discharge. Before patient transfer, hospital clinicians called SNF clinicians to provide information relevant to the continuation of safe patient care and offer SNF clinicians the opportunity to ask clarifying questions. The calls were documented in the hospital discharge summary. A total of 2417 patient discharges were eligible for inclusion. Warm handoffs were documented at an increasing rate throughout implementation of the intervention, beginning with 15.78% (n = 3) in stage 1, then 20.27% (n = 75) in stage 2, and finally 46.89% (n = 951) in stage 3. The overall average rate of documentation was 42.57%. Participant feedback indicated that clinicians were most concerned about understanding the purpose of the warm handoff, managing their workload, and improving the efficiency of the process. Use of a warm handoff showed promise in improving communication during hospital-SNF patient transfers. However, the implementation also highlighted specific barriers to the handoff related to organizational structures and clinician workload. Addressing these underlying issues will be critical in ensuring continued participation and support for efforts that foster direct communication among clinicians from different healthcare institutions.


Exploring a novel two-dimensional metallic Y4C3 sheet applied as an anode material for sodium-ion batteries.
As novel "post lithium-ion batteries" and promising alternatives to lithium-ion batteries (LIBs) suffering from the limited Li resources, sodium-ion batteries (SIBs) are nowadays emerging and show bright prospects in large-scale energy storage applications due to abundant Na resources. However, a lack of suitable anode materials has become a key obstacle for the development of SIBs. Here we explore the potential of the two-dimensional (2D) Y-C space and identify a novel anode material for SIBs, a new Y4C3 sheet with P3̄m1 crystal symmetry, by means of first-principles swarm structure calculations. This Y4C3P3̄m1 structure has rather good kinetic and thermodynamic stability, possesses intrinsic metallicity, and remains metallic after adsorbing Na atoms, ensuring good electrical conductivity during the SIB cycle. Remarkably, a Y4C3 sheet as an anode for SIBs possesses the essential properties of a high specific capacity (∼752 mA h g-1), a low barrier energy (∼0.1 eV), and suitable open-circuit voltage (0-0.15 V). These characteristics are comparable and even superior to those of another known 2D Y2C anode material, indicating that the Y4C3 sheet can act as an appealing new candidate as an anode material for SIBs and offering new insights into the 2D Y-C space.


Drivers of excess costs of opioid abuse among a commercially insured population.
To replicate and extend a recently published analysis of the drivers of excess costs of opioid abuse. Retrospective data analysis using de-identified claims data from the Truven MarketScan Commercial Claims and Encounter database. Medical and prescription drug claims from beneficiaries covered by large self-insured US companies were used to select patients with incident diagnoses of opioid abuse between 2012 and 2015. Two cohorts, abusers and nonabusers, were matched using propensity score methods. Excess healthcare costs were estimated over a 6-month baseline period and 12-month follow-up period. Cost drivers were assessed by diagnosis (3-digit International Classification of Diseases, Ninth Revision, Clinical Modification groupings) and place of service. The analysis included 73,714 matched pairs of abusers and nonabusers. Relative to nonabusers, abusers had considerably higher annual healthcare costs of $10,989 per patient, or $1.98 per member per month. Excess costs were similar, yet lower, than the previous analysis using another commercial claims database. In both analyses, a ramp-up in excess costs was observed prior to the incident abuse diagnosis, followed by a decline post diagnosis, although not to baseline levels. Key drivers of excess costs in the 2 studies included opioid use disorders, nonopioid substance misuse, and painful and mental health conditions. From 2010 to 2014, the prevalence of diagnosed opioid abuse doubled, with incidence rates exhibiting an increasing, though flatter, trend than earlier in the period. Opioid abuse imposes a considerable economic burden on payers. Many abusers have complex healthcare needs and may require care beyond that which is required to treat opioid abuse. These results are robust and consistent across different data sources.


Hybrid Navigation Technique for Improved Precision in Implantology.
The hybrid navigation technique involves the merging of the Dynamic navigation (DN) system (Navident, Claronav, Canada) and static navigation technique (3Shape, Copenhagen, Denmark). Combining the advantages of both techniques, devising a protocol of hybrid navigation will be advantageous to eliminate the difficulties faced by operators in using either methods separately. Three patients requiring dental implants were included in this study. This requires the cone beam computed tomography (CBCT) (Digital Imaging and Communications in Medicine (DICOM) data) and intra-oral scan (Standard Tessellation Language (STL) format) data for the accurate planning of the implant positions in both the static and dynamic approaches. The steps carried out were repeated for each of the patients, the accuracy of the implant placement was verified postoperatively by merging the CBCT data pre and post through the Evalunav software (NaviDent, Claronav). The accuracy of the implants placed were assessed based on the mesio-distal, bucco-lingual, apical deviations in distance and in angulation. The semi-robotic DN and static guide combination as a hybrid technique is an interesting method to improve the accuracy of flapless implant surgeries and can be used in cases where the anatomical landmarks are determinant factors for the implant placement.


[Tics and Tourette syndrome in literature, cinema and television].
Different neurological diseases have often been portrayed in literature, cinema and television. Tics and Tourette syndrome, for example, are commonly represented from different perspectives, which are sometimes very realistic but in some cases are used for more dramatic purposes or to make a character look ridiculous. One of the main effects of these inadequate views is to further stigmatise those who suffer these movement disorders. To review the way tics and Tourette syndrome have been portrayed in certain literary works, films and television. Tics are rapid, stereotypic, involuntary, recurring, non-purposeful movements of the skeletal and pharyngeal-laryngeal muscles. In Gilles de la Tourette syndrome a number of tics are associated to involuntary vocalisations (echolalia, coprolalia). They begin in childhood and are usually associated to obsessive-compulsive behaviours. These disorders have appeared in literature in works such as Little Dorrit, Angel Guerra, La torre de los siete jorobados or Motherless Brooklyn. Film-makers have also shown an interest in tics and Tourette syndrome and they have been portrayed in films such as Young and Innocent, The Tic Code or Matchstick Men. Likewise, a number of television series also contain characters with these disorders, including Shameless, Ally McBeal, Quincy, M.E. or L.A. Law. Tics and Tourette syndrome have frequently been portrayed in literature, cinema and television, sometimes in a very realistic manner. In other cases, however, the way they are dealt with has only helped to create false beliefs and stereotyped images of the disorders.


First report of Chikungunya fever in Rawalpindi, Pakistan.
Chikungunya shares many clinical features with dengue fever, but to date, no case has been reported in Rawalpindi and surrounding areas. To detect the presence in Rawalpindi of chikungunya masquerading as dengue fever. An observational study was conducted at Rawalpindi Medical University from July to December 2017. Patients with clinical features suggestive of dengue fever, but negative for dengue virus NS1 antigen were included and tested at the National Institute of Health Islamabad, Pakistan, for chikungunya using reverse transcription polymerase chain reaction. We tested 129 patients and 28 were positive for chikungunya. There were 17 (60.7%) men and 11 (39.3%) women, with a mean age of 32.53 years (range 16-60 years). All had fever at presentation. Other clinical features at presentation were noted, such as fever, chills, fatigue, headache, myalgia, arthralgia, retro-orbital pain, abdominal pain, nausea, and diarrhoea. No long-term sequelae or bleeding diatheses were seen and there was no mortality reported. The clinical features observed and investigated confirmed our reporting of the first case of chikungunya in Rawalpindi, Pakistan.


Effects of propofol on pulmonary and systemic arterial pressure-flow relationships in hyperoxic and hypoxic dogs.
We have investigated the effects of a continuous infusion (18 mg kg-1 h-1) of the aqueous emulsion formulation of propofol on mean pulmonary arterial (PAP)/cardiac output (O) and mean systemic arterial pressure (SAP)/Q relationships in 15 intact pentobarbitone-anaesthetized dogs subjected to hyperoxia (F/O2 0.4) and hypoxia (F/O2 0.1). Five-point PAP/Q and SAP/Q plots were obtained by opening an arterio-venous femoral fistula or by stepwise inflations of an inferior vena cava balloon. Over the range of Q studied (2-5 litre min-1), hypoxia increased PAP in eight dogs ("responders") and did not affect PAP in seven others ("non-responders"). Hypoxic pulmonary vasoconstriction (HPV) was restored in non-responders by the administration of acetylsalicylic acid (ASA) 1 g i.v. Hypoxia did not affect SAP over the range of Q studied in the responders or in the non-responders treated with ASA. Propofol had no effect on hyperoxic or on hypoxic PAP at all values of Q either in responders or in non-responders with HPV restored by ASA. Propofol did not change Q at uncontrolled flow, but decreased SAP at the lowest Q (2 and 3 litre min-1) during hyperoxia and at all values of Q during hypoxia. The systemic vascular effects were the same in animals of both groups, treated with ASA or not. We conclude that propofol does not influence pulmonary vascular tone and does not inhibit HPV, but reduces systemic vascular tone when venous return or oxygenation is decreased. The haemodynamic response to propofol was not affected by cyclo-oxygenase inhibition.


Super-Airy beam: self-accelerating beam with intensified main lobe.
We introduce, theoretically and experimentally, the concept of a diffraction-free "super-Airy" beam, in which the main lobe is reduced to nearly half in size with increased intensity in comparison to the main lobe of the optical Airy beam, while maintaining the same transverse acceleration. It is also observed that when the super-Airy main lobe is blocked during propagation, it recovers to the original size faster than the Airy main lobe.


Ionic Compatibilization of Polymers.
The small specific entropy of mixing of high molecular weight polymers implies that most blends of dissimilar polymers are immiscible with poor physical properties. Historically, a wide range of compatibilization strategies have been pursued, including the addition of copolymers or emulsifiers or installing complementary reactive groups that can promote the in situ formation of block or graft copolymers during blending operations. Typically, such reactive blending exploits reversible or irreversible covalent or hydrogen bonds to produce the desired copolymer, but there are other options. Here, we argue that ionic bonds and electrostatic correlations represent an underutilized tool for polymer compatibilization and in tailoring materials for applications ranging from sustainable polymer alloys to organic electronics and solid polymer electrolytes. The theoretical basis for ionic compatibilization is surveyed and placed in the context of existing experimental literature and emerging classes of functional polymer materials. We conclude with a perspective on how electrostatic interactions might be exploited in plastic waste upcycling.


Targeting Age-Related Neurodegenerative Diseases by AAV-Mediated Gene Therapy.
Age-related neurodegenerative diseases have detrimental consequences on health of many patients and result in mortality. The current treatment options are limited and usually fail to correct the underlying pathology. AAV-based gene therapies have proved to be safe based on the data available on clinical trials for several monogenic diseases. Therefore, such therapies can pave the way to treat neurodegenerative diseases likes Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS). Here, the advantages of AAV-based gene therapies are discussed with emphasis on efforts of developing novel capsids with superior therapeutic efficacy. Furthermore, the results of clinical trials on AD, PD, and ALS are summarized.


Ethnically mismatched cord blood transplants in African Americans: the Saint Louis Cord Blood Bank experience.
For ethnic minority patients where a suitably matched BM or peripheral blood donor is frequently unavailable, cord blood offers an opportunity for hematopoietic stem cell transplantation. Focused recruitment of ethnic minorities for cord blood donation has been proposed as the preferred strategy to improve access for minority recipients to cord blood for transplantation. The aim of this study was to evaluate cord blood characteristics for Caucasian and African American donors and the success of ethnically mismatched UC blood transplantation in African American recipients. Retrospective data analysis was performed comparing the characteristics of 556 cord blood units from African American and Caucasian donors. The outcomes of 18 African American ethnically mismatched transplant recipients were compared with a paired sample of 18 ethnically matched Caucasian recipients. The fraction of collected units meeting acceptability criteria from African Americans was significantly lower compared with Caucasians (P = <0.0001). Additionally, African Americans had a significantly lower post-processing total nucleated cell count (TNC) compared with Caucasians (P=0.007) but there were no other significant differences in conventionally measured product characteristics. In the transplant analysis, there was no difference in overall survival at 1 year (P=0.85) or time to neutrophil engraftment (P=0.92) between the two patient populations. At comparable levels of TNC dose and HLA matching, the use of ethnically mismatched UC blood units as a source for allogeneic unrelated transplant can result in successful transplant outcomes for African American patients.


Rare sphenoid ridge intracranial mature teratoma in an adult female.
Intracranially located teratomas usually involve midline brain structures. However, they rarely occur in adults. A 26-year-old woman presented with a growing intracranial mass lesion in the left sphenoid ridge without neurological deficits. Magnetic resonance imaging revealed homogenous hyperintensities without contrast enhancement. The patient underwent gross total excision of the soft, yellowish sphenoid ridge tumor with no cystic component. The surgery was uneventful, with no intraoperative complications. Histological analysis revealed a mature teratoma. She attended regular outpatient neuroradiology follow-up appointments. The present case is an unusual example of a mature teratoma with regard to location, neuroimaging appearance, macroscopic intraoperative findings, histological tumor subtype, and patient age and sex.


Emergency Neurological Life Support: Pharmacotherapy.
The appropriate use of medications during Emergency Neurological Life Support (ENLS) is essential to optimize patient care. Important considerations when choosing the appropriate agent include the patient's organ function and medication allergies, potential adverse drug effects, drug interactions, and critical illness and aging pathophysiologic changes. Critical medications used during ENLS include hyperosmolar therapy, anticonvulsants, antithrombotics, anticoagulant reversal and hemostatic agents, anti-shivering agents, neuromuscular blockers, antihypertensive agents, sedatives, vasopressors and inotropes, and antimicrobials. This article focuses on the important pharmacokinetic and pharmacodynamics characteristics, advantages and disadvantages, and clinical pearls of these therapies, providing practitioners with essential drug information to optimize pharmacotherapy in acutely ill neurocritical care patients.


Establishment of a rapid ELISPOT assay for influenza virus titration and neutralizing antibody detection.
Seasonal influenza is an acute respiratory infection causing around 500 000 global deaths annually. There is an unmet medical need to develop more effective antiviral drugs and vaccines against influenza infection. A rapid, accurate, high-throughput titration assay for influenza virus particles or neutralizing antibodies would be extremely useful in these research fields. However, commonly used methods such as tissue culture infective dose and plaque-forming units (PFU) for virus particle quantification, and the plaque reduction neutralization test (PRNT) for antibody determination are time-consuming, laborious, and have limited accuracy. In this study, we developed an efficient assay based on the enzyme-linked immunospot (ELISPOT) technique for the influenza virus and neutralizing antibody titration. Two broad-spectrum antibodies recognizing the nucleoproteins of influenza A and B viruses were used in the assay to broadly and highly sensitively detect influenza virus-infected cells at 16 hours postinfection. An optimized cell culture medium with no tosyl phenylalanyl chloromethyl ketone trypsin and high dose oseltamivir acid was used to improve quantitation accuracy. This ELISPOT assay displayed a good correlation (R2 = 0.9851) with the PFU assay when used to titrate 30 influenza virus isolates. The assay was also applied to measure influenza-neutralizing antibodies in 40 human sera samples, showing a good correlation (R2 = 0.9965) with the PRNT assay. This ELISPOT titration assay is a rapid, accurate, high-throughput assay for quantification of influenza virus and neutralizing antibodies, and provides a powerful tool for research into and development of drugs and vaccines against influenza.


How Individuals With Down Syndrome Process Faces and Words Conveying Emotions? Evidence From a Priming Paradigm.
Emotion recognition from facial expressions and words conveying emotions is considered crucial for the development of interpersonal relations (Pochon and Declercq, 2013). Although Down syndrome (DS) has received growing attention in the last two decades, emotional development has remained underexplored, perhaps because of the stereotype of high sociability in persons with DS. Yet recently, there is some literature that is suggesting the existence of specific deficits in emotion recognition in DS. The current study aimed to expand our knowledge on how individuals with DS process emotion expressions from faces and words by adopting a powerful methodological paradigm, namely priming. The purpose is to analyse to what extent emotion recognition in DS can occur through different processes than in typical development. Individuals with DS (N = 20) were matched to a control group (N = 20) on vocabulary knowledge (PPTV) and non-verbal ability (Raven's matrices). Subsequently a priming paradigm was adopted: stimuli were photos of faces with different facial expressions (happy, sad, neutral) and three words (happy, sad, neutral). On a computer screen the first item (face or word) was presented for a very short time (prime) and afterward a stimulus (face or word) appeared (target). Participants had to recognize whether the target was an emotion (sad/happy) or not (neutral). Four prime-target pairs were presented (face-word; word-face; word-word; face-word) in two conditions: congruent (same emotion prime/target) and incongruent (different emotion prime/target). The results failed to show evidence for differential processing during emotion recognition between the two groups matched for verbal and non-verbal abilities. Both groups showed a typical priming effect: In the incongruent condition, slower reaction times were recorded, in particular when the target to be recognized is the face, providing evidence that the stimuli were indeed processed. Overall, the data of the current work seem to support the idea of similar developmental trajectories in individuals with DS and TD of the same verbal and non-verbal level, at least as far as the processing of simple visual and linguistic stimuli conveying basic emotions is concerned. Results are interpreted in relation to recent finding on emotion recognition from faces and words in DS.


Effects of three bacterial infections on serum lipids of rabbits.
Alteration of the rabbit serum lipids as a result of three bacterial infections was studied by quantitative thin-layer and gas-liquid chromatography. Anthrax infection slightly changed the serum lipid. Cholesterol did not change, though free fatty acids, triglycerides, and cholesteryl esters doubled, and lecithin increased threefold. Tularemia infection produced drastic changes in the serum lipid content of rabbits, increasing levels of cholesterol over 4-fold, free fatty acids 17-fold, triglycerides 11-fold, cholesteryl esters 2.5-fold, and lecithin almost 3-fold. Pneumococcus infection increased cholesterol 2.5 times, free fatty acids were more than doubled, triglycerides were increased 9.5 times, and lecithin was increased almost 4 times. Gas-liquid chromatographic analysis of the methyl esters of free fatty acids showed only quantitative changes in these acids due to infection. Some possible mechanisms of alteration of serum lipid content are discussed.


Built-in axial base binding on phenanthroline-strapped zinc(II) and iron(III) porphyrins.
In addition to the need for functional models of cytochrome c oxidase, structural models are still required for a better understanding of the small reorganizations occurring during the catalytic cycle. An efficient synthetic approach has been designed to prepare several phenanthroline-strapped porphyrins, two of them bearing two pendant imidazoles. These built-in bases are both potentially able to act as axial bases for the metalloporphyrin and as complementary ligands for copper if necessary. Diamagnetic zinc(II) was used to demonstrate that the distal/proximal selectivity demonstrated by exogenic bases binding studies can be extended to the coordination of iron(III). Combination of EPR and paramagnetic 1H NMR shows that the imidazole binding on the zinc species can be further extended to the iron(III) species in dilute conditions.


Co-crystallized cis and trans isomers of dichlorobis(2-picolylamine)iron(II).
The octahedral cis and trans isomers of dichlorobis(2-picolylamine)iron(II), [FeCl2(C6H8N2)2], co-crystallize in a 1:1 ratio. The cis isomer lies on a twofold axis, whereas the trans isomer lies on an inversion centre. The structure is fully ordered, with both Fe atoms in a pure high-spin state. The Fe, Cl and N(H2) atoms of both isomers lie in the same plane, allowing all Cl and amine H atoms to be engaged in extensive two-dimensional hydrogen bonding. The hydrogen-bonded layers are interconnected through pi-pi interactions between the pyridine rings. Searches in the Cambridge Structural Database uncover very few examples of such isomer co-existence.


Stimulation of ornithine decarboxylase activity and DNA synthesis by phorbol esters or bile acids in rat colon.
The changes of colonic epithelial ornithine decarboxylase (ODC) activity and DNA synthesis following intrarectal administration of a tumor-promoting agent, 12-O-tetradecanoylphorbol-13-acetate (TPA), or various bile acids to male noninbred rats were studied. A single instillation of TPA, at a dose as low as 16 nmol, led to a significant (about 10-fold) increase in colonic ODC activity. Peak ODC activity was observed at 4 hr, and the enzyme activity returned to the control level about 24 hr after intrarectal TPA. This pattern was almost the same as that observed after sodium deoxycholate treatment. TPA showed more potent induction of ODC activity than deoxycholate, although the maximal induction was greater in the case of deoxycholate treatment. Both TPA and deoxycholate stimulated DNA synthesis at 2 days after intrarectal instillation, after an initial depression at 4-12 hr. A structure-activity study of 26 bile acids revealed that 5 beta-cholanoic acid with alpha-hydroxy groups in two of the 3 alpha, 7 alpha, 12 alpha positions and 5 beta-cholanoic acid with a 3 alpha-hydroxy group induced colonic ODC activity significantly, while the 3 alpha, 6 alpha-dihydroxy acid did not. Replacement of hydroxy groups by keto groups or a change from alpha to beta configuration decreased the ODC-inducing activities. Tri-substituted 5 beta-cholanoic acid derivatives, whether hydroxy or keto, did not stimulate ODC. These data indicate that a specific bile acid structure with a definite spatial relationship of the hydroxy groups is required for induction of colonic ODC activity.


Subcortical brain anatomy as a potential biomarker of persistent pain after total knee replacement in osteoarthritis.
The neural mechanisms for the persistence of pain after a technically successful arthroplasty in osteoarthritis (OA) remain minimally studied, and direct evidence of the brain as a predisposing factor for pain chronicity in this setting has not been investigated. We undertook this study as a first effort to identify presurgical brain and clinical markers of postarthroplasty pain in knee OA. Patients with knee OA (n = 81) awaiting total arthroplasty underwent clinical and psychological assessment and brain magnetic resonance imagining. Postoperative pain scores were measured at 6 months after surgery. Brain subcortical anatomic properties (volume and shape) and clinical indices were studied as determinants of postoperative pain. We show that presurgical subcortical volumes (bilateral amygdala, thalamus, and left hippocampus), together with shape deformations of the right anterior hippocampus and right amygdala, associate with pain persistence 6 months after surgery in OA. Longer pain duration, higher levels of presurgical anxiety, and the neuropathic character of pain were also prognostic of postsurgical pain outcome. Brain and clinical indices accounted for unique influences on postoperative pain. Our study demonstrates the presence of presurgical subcortical brain factors that relate to postsurgical persistence of OA pain. These preliminary results challenge the current dominant view that mechanisms of OA pain predominantly underlie local joint mechanisms, implying novel clinical management and treatment strategies.


Signal coding in cochlear implants: exploiting stochastic effects of electrical stimulation.
Speech perception in quiet with cochlear implants has increased substantially over the past 17 years. If current trends continue, average monosyllabic word scores will be nearly 80% by 2010. These improvements are due to enhancements in speech processing strategies, to the implantation of patients with more residual hearing and shorter durations of deafness, and to unknown causes. Despite these improvements, speech perception in noise and music perception are still poor in most implant patients. These deficits may be partly due to poor representation of temporal fine structure by current speech processing strategies. It may be possible to improve both this representation and the dynamic range of electrical stimulation through the exploitation of stochastic effects produced by high-rate (eg, 5-kilopulse-per-second) pulse trains. Both the loudness growth and the dynamic range of low-frequency sinusoids have been enhanced via this technique. A laboratory speech processor using this strategy is under development. Although the clinical programming for such an algorithm is likely to be complex, some guidelines for the psychophysical and electrophysiological techniques necessary can be described now.


Effectiveness of massage, sucrose solution, herbal tea or hydrolysed formula in the treatment of infantile colic.
The aim of the study was to evaluate the effectiveness of massage, sucrose solution, herbal tea or hydrolysed formula, each used individually in the treatment of infantile colic. The term colic describes a group of symptoms that occur frequently in infants, consisting of paroxysmal abdominal pain and severe crying. Infant colic is of importance for both parents and the community health services that provide families with care, and is therefore an important clinical problem that is amenable to nursing interventions. This prospective and randomised-controlled study involved 175 infants in Turkey. Data were gathered by using Wessel criteria; parents wrote a daily structured diary, recording the onset and duration of crying. Patients were assigned randomly into four different intervention groups (massage, sucrose solution, herbal tea and hydrolysed formula) and control group. Duration of crying following each intervention was recorded in the diary by parents for a one week period. There was a significant reduction in crying hours per day in all intervention groups. The difference between mean duration of total crying (hours/day) before and after the intervention infants in hydrolysed formula group was found higher than massage, sucrose and herbal tea group. The difference between mean duration of total crying(hours/day) before and after the intervention infants in massage group was found lower than other intervention groups and all groups. Our findings demonstrated that varied interventions such as administration of massage, sucrose solution, herbal tea and hydrolysed formula are effective in the treatment of colic. The difference between mean duration of total crying (hours/day) before and after the intervention in hydrolysed formula group was found higher than other intervention groups. Hydrolysed formula was the most effective in reducing the duration of crying (hours/day) when compared with the other intervention groups. Massage intervention yielded the least symptomatic improvement among all the interventions. Colic treatment models used in this study can be used by nurses in neonatal and primary healthcare settings as an aid to families for the treatment of infantile colic.


Dimethyldihydropyrene-cyclophanediene photochromic couple functionalized with terpyridyl metal complexes as multi-addressable redox- and photo-switches.
A series of dimethyldihydropyrene-appended metal complexes has been synthesized and thoroughly characterized using electrochemical and spectroscopic methods. The ring-opening reaction undergone by the dimethyldihydropyrene core under visible light irradiation proceeds much more efficiently when the metal complexes and the photochromic moiety are connected through a pyridinium-bridge vs a phenyl bridge. The clean electrochemical and photochemical responses of these hybrid systems make them good candidates for the conception of new multi-addressable photo- and redox-switches.


Treatment and care of patients with metastatic breast cancer.
This article provides an overview of the treatment options available for patients diagnosed with metastatic breast cancer. The article focuses on the four common organ sites affected by metastatic breast cancer, including the bone, lungs, liver and brain. The implications for nursing care are addressed, highlighting common side effects of treatment and frequent areas of concern for patients.


Risk factors for heart failure in the general population: the study of men born in 1913.
In 1963 a sample of 973 men, all 50 years old, was drawn from the population register of Gothenburg, Sweden. These men have been followed up for 17 years with repeated examinations regarding a number of variables possibly related to cardiovascular disease. The latest examination, at the age of 67 years, focused on congestive heart failure (CHF). The incidence rate of manifest CHF varied from 1.5 to 10.2 cases (1000 population)-1 yr-1, depending on which age group was being studied. For the age group 50-67 years the incidence of manifest CHF was 5.5 (1000)-1 yr-1. A large number of factors associated with the risk of acquiring CHF were identified. In multivariate regression analyses, hypertension and smoking were the major independent risk factors. Body weight, heart volume, T-wave abnormalities, heart rate variability, peak expiratory flow rate, psychological stress and Fy-antigen (a genetic marker?) were also independent risk factors. Possible strategies for prevention are discussed.


Does Use of Lidocaine Affect Culture of Synovial Fluid Obtained to Diagnose Periprosthetic Joint Infection (PJI)? An In Vitro Study.
BACKGROUND Synovial fluid culture (SFC) is recommended as one of the major diagnostic criteria by the Musculoskeletal Infection Society (MSIS) for diagnosing periprosthetic joint infection (PJI). Local anesthetic agents are used for anesthesia and analgesia in some clinical settings to relieve pain. As a local anesthetic, lidocaine is safely used in arthrocentesis to obtain synovial fluid. The goal of this study was to determine if infiltration anesthesia with additive-free lidocaine 2% has antibacterial effects that might interfere with subsequent SFC. MATERIAL AND METHODS Eight isolates of reference strains of Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Streptococcus pyogenes, and Candida albicans were incubated on the plates. Each bacterial suspension was formed by 50-fold dilution before the test lidocaine 2% was added. For each strain, bacterial suspension was divided into 2 groups (5 samples each) exposed either lidocaine 2% or sterile non-bacteriostatic 0.45% saline. The antimicrobial property of lidocaine 2% was determined by measuring the bacterial density on agar plates incubated for 24 h and comparing it with controls unexposed to lidocaine 2%. RESULTS Exposure to lidocaine 2% negatively affected microbial viability in vitro. Of the lidocaine 2% exposure, reference strains but no Streptococcus pyogenes strain resulted in fewer colony-forming units compared with the sterile saline control. The antibacterial property of lidocaine 2% appears to affect the ability to culture the organism in synovial fluid. CONCLUSIONS Lidocaine 2% has strong antimicrobial activities against some commonly encountered bacterial strains in PJI. As a result, infiltration anesthesia with additive-free lidocaine 2% before the arthrocentesis procedure may affect the results of SFC. To further evaluate its potential antibacterial usefulness in clinical applications, studies are needed to assess the ability of lidocaine to reduce the risk of iatrogenic infections.


[Yiqi Yangyin Tongluo Recipe(YYTR)alleviates renal injury in diabetic nephropathy rats by inhibiting PI3K/AKT pathway and aquaporin 2 (AQP2)].
Objective To explore the effects of Yiqi Yangyin Tongluo Recipe (YYTR) on the expressions of phosphatidylinositol 3 kinase/protein kinase B (PI3K/AKT) and aquaporin 2(AQP2) in diabetic renal tissue and its mechanism. Methods Sixty Wistar rats were randomly divided into the blank group, model group, valsartan (20 mg/kg) group, YYTR (4 mg/kg or 1 mg/kg), 4 mg/kg YYTR combined with 0.5 μmol/kg 740Y-P group, with 10 rats in each group. Except the blank group, the rats in other groups were fed with high-glucose and high-fat diet and injected with streptozocin to create diabetic nephropathy (DN) rat models. The day after successful modeling, the rats were administrated intragastrically for 8 weeks. At the end of the experiment, renal function indexes were measured, and glomerular sclerosis index and renal interstitial injury index were evaluated according to the results of HE staining and Masson staining. Western blot analysis was used to detect the levels of AQP2, PI3K, AKT, p-PI3K and p-AKT. Immunohistochemical staining was used to detect the expression and distribution of AQP2 in renal tissue. Results Compared with the normal group, urine protein quantitation in 24 hours (24 h UTP), serum creatinine, urea nitrogen and β2-microglobulin (β2-MG) content in model group were increased. It also reported a rise of kidney index, glomerulo sclerosis index, renal interstitial injury index, AQP2 protein and PI3K, AKT, p-PI3K and p-AKT protein expressions in model group. But compared with model group, the above indexes all decreased in 4 mg/kg YYTR group. In addition, compared with 4 mg/kg YYTR group, the above indexes in YYTR combined with 740Y-P group were increased. Conclusion YYTR can protect renal function by down-regulating AQP2 protein expression and inhibiting PI3K/AKT signaling pathway activation.


Multiple-stressor exposure of aquatic food webs: Nitrate and warming modulate the effect of pesticides.
Shallow lakes provide essential ecological and environmental services but are exposed to multiple stressors, including agricultural runoff (ARO) and climate warming, which may act on different target receptors disrupting their normal functioning. We performed a microcosm experiment to determine the individual and combined effects of three stressors-pesticides, nitrate and climate warming-on two trophic levels representative of communities found in shallow lakes. We used three submerged macrophyte species (Myriophyllum spicatum, Potamogeton perfoliatus, Elodea nuttallii), eight benthic or pelagic microalgal species and three primary consumer species (Daphnia magna, Lymnaea stagnalis, Dreissena polymorpha) with different feeding preferences for benthic and pelagic primary producers. Eight different treatments consisted of a control, only nitrate, a pesticide cocktail, and a combination of nitrate and pesticides representing ARO, each replicated at ambient temperature and +3.5°C, mimicking climate warming. Pesticides negatively affected all functional groups except phytoplankton, which increased. Warming and nitrate modified these effects. Strong but opposite pesticide and warming effects on Myriophyllum drove the response of the total macrophyte biomass. Nitrate significantly suppressed Myriophyllum final biomass, but not overall macrophyte and microalgal biomass. Nitrate and pesticides in combination caused a macrophyte decline, and the system tipped towards phytoplankton dominance. Strong synergistic or even reversed stressor interaction effects were observed for macrophytes or periphyton. We emphasize the need for more complex community- and ecosystem-level studies incorporating multiple stressor scenarios to define safe operating spaces.


Metal Halide Perovskite Based Heterojunction Photocatalysts.
With fascinating photophysical properties and a strong potential to utilize solar energy, metal halide perovskites (MHPs) have become a prominent feature within photocatalysis research. However, the effectiveness of single MHP photocatalysts is relatively poor. The introduction of a second component to form a heterojunction represents a well-established route to accelerate carrier migration and boost reaction rates, thus increasing the photoactivity. Recently, there have been several scientific advances related to the design of MHP-based heterojunction photocatalysts, including Schottky, type II, and Z-scheme heterojunctions. In this Review, we systematically discuss and critically appraise recent developments in MHP-based heterojunction photocatalysis. In addition, the techniques for identifying the type of active heterojunctions are evaluated and we conclude by briefly outlining the ongoing challenges and future directions for promising photocatalysts based on MHP heterojunctions.


Paranthias furcifer (Perciformes: Serranidae), a new alien fish in the Mediterranean Sea.
A specimen of a creole fish Paranthias furcifer (285 mm total length) was captured in Marina Bay (Croatian coast) in the eastern Adriatic Sea. This is the first Mediterranean record of this species. The possible modes of introduction of species are discussed.