Dental management of patients with diabetes.
Diabetes is a disease of metabolism resulting from impaired insulin secretion, varying degrees of insulin resistance, or both. Management of the diabetic dental patients must take into consideration the impact of dental disease and dental treatment on the management of diabetes as well as an appreciation for the comorbidities that accompany long-standing diabetes. Those comorbidities include obesity, hypertension, and dyslipidemia. Central to the management of diabetes is the intensive regulation of plasma glucose along with management of comorbidities comprising the "metabolic syndrome." Management of the diabetic dental patient should focus on periodontal health and the delivery of comprehensive dental care with minimal disruption of metabolic homeostasis and recognition of diabetic comorbidities.


Ultraviolet-B responses of nuclear genes encoding light-harvesting complex II proteins in pea (Pisum sativum) are altered by norflurazon- and photobleaching-induced chloroplast changes.
The role of functional and intact chloroplasts in mediating the ultraviolet-B (UV-B, 290-320 nm) regulation of two nuclear genes encoding light-harvesting complex II proteins in pea (Pisum sativum L. cv. Extra Early Alaska) was studied. Plants with chloroplasts lacking or containing carotenoids and functional photosystem II were obtained by growth under dim red light (0.2 µmol m-2 s-1 ) in the presence or absence of norflurazon (NF), an inhibitor of carotenoid biosynthesis. The NF-treatment resulted in an increase in AB80 (lhcb1* 2) mRNA but no substantial change in Cab-8 (lhcb1* 4) mRNA, indicating that the mRNA accumulations for AB80 and Cab-8 were differently correlated with the presence and absence of carotenoids. The mRNA levels for both Cab-8 and AB80 in the NF-treated plants were reduced to the same extent by partially photobleaching the chloroplasts with 3 h of higher intensity white light (W, 110 µmol m-2 s-1 ), suggesting that chloroplast integrity was equally important for transcript accumulation of both genes. The mRNAs of both Cab-8 and AB80 in non-NF-treated control plants were decreased by UV-B irradiation, with the level of AB80 mRNA reduced to a greater extent. The UV-B-induced mRNA reduction of both genes was inhibited by NF. The difference between the UV-B responses of the two genes was unaffected by NF, but was abolished by photobleaching the NF-treated plants prior to the UV-B irradiation. Therefore, the presence of carotenoids enhanced rather than prevented the UV-B down-regulation, and the difference in UV-B responses of the two genes may be dependent on chloroplast integrity.


Correction: A tetramer micelle: the smallest aggregation number corresponding to the vertex number of regular polyhedra in platonic micelles.
Correction for 'A tetramer micelle: the smallest aggregation number corresponding to the vertex number of regular polyhedra in platonic micelles' by Shota Fujii et al., Soft Matter, 2018, DOI: .


Helical CT angiography for examination of living renal donors.
This prospective study was intended to determine if helical CT arteriography plus conventional radiography is sufficiently accurate to replace and less costly than excretory urography and conventional renal arteriography, the techniques currently used to examine living renal donors. Patients underwent CT arteriography with a helical CT scanner. Conventional radiographs were obtained during the pyelographic phase to evaluate the urothelium. Findings on CT arteriograms were compared with findings on conventional arteriograms and at surgery. Of 57 patients who underwent CT arteriography, 46 also underwent conventional arteriography and 40 underwent surgery. For those 46 patients, we found agreement between results of CT arteriography and conventional arteriography in 89% of kidneys. For those 40 patients, we found agreement between results of CT arteriography and findings at surgery in 90% of kidneys and agreement between results of conventional arteriography and findings at surgery in 87% of kidneys. Of the 57 patients, six (11%) had findings on CT angiograms that precluded further consideration for donation. Eight to ten percent of renal arteries are not seen on renal arteriograms when compared with findings at surgery. Our results indicate that CT arteriography is as accurate as conventional arteriography at revealing the number of vessels that perfuse and drain the kidneys and can replace conventional arteriography. Use of CT angiography plus conventional radiography instead of excretory urography and conventional arteriography can result in a 35-50% reduction in cost of the imaging studies in potential renal donors.


Nutritional assessment in chronic wound care.
The WOC nurse may be the only clinician available to assess patients' nutritional status. Thus, the aim of this article is to assist the WOC nurse in any setting to provide a nutritional assessment of all wound care patients. This article reviews the most commonly ordered laboratory tests and provides a brief explanation of how to interpret the findings and why prealbumin levels are the laboratory test of choice for nutritional assessment.


Pediatric health-related quality of life: a structural equation modeling approach.
One of the most referenced theoretical frameworks to measure Health Related Quality of Life (HRQoL) is the Wilson and Cleary framework. With some adaptions this framework has been validated in the adult population, but has not been tested in pediatric populations. Our goal was to empirically investigate it in children. The contributory factors to Health Related Quality of Life that we included were symptom status (presence of chronic disease or hospitalizations), functional status (developmental status), developmental aspects of the individual (social-emotional) behavior, and characteristics of the social environment (socioeconomic status and area of education). Structural equation modeling was used to assess the measurement structure of the model in 214 German children (3-5 years old) participating in a follow-up study that investigates pediatric health outcomes. Model fit was χ2 = 5.5; df = 6; p = 0.48; SRMR = 0.01. The variance explained of Health Related Quality of Life was 15%. Health Related Quality of Life was affected by the area education (i.e. where kindergartens were located) and development status. Developmental status was affected by the area of education, socioeconomic status and individual behavior. Symptoms did not affect the model. The goodness of fit and the overall variance explained were good. However, the results between children' and adults' tests differed and denote a conceptual gap between adult and children measures. Indeed, there is a lot of variety in pediatric Health Related Quality of Life measures, which represents a lack of a common definition of pediatric Health Related Quality of Life. We recommend that researchers invest time in the development of pediatric Health Related Quality of Life theory and theory based evaluations.


LIS-less neurons don't even make it to the starting gate.
The manuscript by Tsai et al. (935-945) is a tour de force analysis of a controversial issue in developmental neurobiology, namely the molecular basis of the devastating human brain malformation, type I lissencephaly (Lis1) (Jellinger, K., and A. Rett. 1976. Neuropadiatrie. 7:66-91). For several decades, defects in neuronal migration have been assumed to underlie all defects in cortical histogenesis. In the paper by Tsai et al., the authors use a variety of elegant approaches, including the first real-time imaging of cortical neurons with reduced levels of LIS1, to demonstrate that LIS1 and dynactin act as regulators of dynein during cortical histogenesis. A loss of LIS1 results in both a failure to exit the cortical germinal zone and abnormal neuronal process formation. Thus, the primary action of the mutation is to disrupt the production of neurons in the developing brain as well as their migration.


Primary sclerosing cholangitis in children: a histologic follow-up study.
Primary sclerosing cholangitis (PSC) is rare in the pediatric population. Little information exists on the progression of the disease in children. This study evaluated the experience with PSC at the Children's Hospital of Philadelphia over the past 20 years, with an emphasis on the histologic features at presentation, during disease progression, and after liver transplantation. We retrospectively reviewed the medical records of patients diagnosed with PSC between 1981 and 2001. Nineteen patients met the inclusion criteria with classic radiographic evidence of PSC. One additional patient with normal biliary imaging was subsequently diagnosed at the time of liver transplantation. The 20 patients with PSC (14 males) ranged in age from 1 month to 15 years at time of presentation. Inflammatory bowel disease was evident in 50% of patients. Initial histology revealed advanced disease (bridging fibrosis or cirrhosis) in 13 patients and an earlier histologic stage in 7 patients. Of the latter, 3 remain stable, 2 required transplantation, and 2 were lost to follow-up. Seven of the 13 patients with advanced disease required orthotopic liver transplantation, and 3 of these subsequently showed recurrence of primary disease in the allograft. Thus, most subjects presented insidiously at an advanced stage that required transplantation. Subjects who presented at an earlier stage progressed or remained stable, but the histologic findings at diagnosis were generally not predictive of disease progression. Recurrence of PSC after transplantation is a significant complication in children.


Defensive testing in Dutch family practice. Is the grass greener on the other side of the ocean?
Ordering laboratory tests and diagnostic imaging can be part of the defensive behavior of the physician. How often does this occur in family practice in the Netherlands? Defensive behavior is defined as a clear deviation from the family physician's usual behavior and from what is considered to be good practice in order to prevent complaints or criticism by the patient or the patient's family. Over a 1-year period, 1989-1990, 16 family physicians in 11 practices with 31,343 patients recorded all episodes of care involving an order for laboratory tests or diagnostic imaging or both (n = 8897). The physicians selected one or more reasons to order each test from a fixed list of clinical considerations. In addition, they recorded whether they acted defensively for every test order. The participating physicians reported that some degree of defensive medicine was associated with 27% of all test orders. Defensive testing varied with the clinical reasons to order a test: the wish to exclude a disease or to reassure the patient was a much stronger motive for defensive testing than the intention to confirm a diagnosis or to screen. Defensive tests generally resulted in fewer abnormal findings. Defensive testing is an important phenomenon in Dutch family practice: it forms a well-defined element of practice despite the variations implicit in the different clinical reasons to order a test. Defensive testing is associated with a lower probability of finding an abnormal test result. The analysis of family physicians' clinical reasons for ordering tests becomes more meaningful when defensive testing is included.


Can we ease the financial burden of colonoscopy? Using real-time endoscopic assessment of polyp histology to predict surveillance intervals.
Polyps identified at colonoscopy are predominantly diminutive (<5 mm) with a small risk (>1%) of high-grade dysplasia or carcinoma; however, the cost of histological assessment is substantial. The aim of this study was to determine whether prediction of colonoscopy surveillance intervals based on real-time endoscopic assessment of polyp histology is accurate and cost effective. A prospective cohort study was conducted across a tertiary care and private community hospital. Ninety-four patients underwent colonoscopy and polypectomy of diminutive (≤5 mm) polyps from October 2012 to July 2013, yielding a total of 159 polyps. Polyps were examined and classified according to the Sano-Emura classification system. The endoscopic assessment (optical diagnosis) of polyp histology was used to predict appropriate colonoscopy surveillance intervals. The main outcome measure was the accuracy of optical diagnosis of diminutive colonic polyps against the gold standard of histological assessment. Optical diagnosis was correct in 105/108 (97.2%) adenomas. This yielded a sensitivity, specificity and positive and negative predictive values (with 95%CI) of 97.2% (92.1-99.4%), 78.4% (64.7-88.7%), 90.5% (83.7-95.2%) and 93% (80.9-98.5%) respectively. Ninety-two (98%) patients were correctly triaged to their repeat surveillance colonoscopy. Based on these findings, a cut and discard approach would have resulted in a saving of $319.77 per patient. Endoscopists within a tertiary care setting can accurately predict diminutive polyp histology and confer an appropriate surveillance interval with an associated financial benefit to the healthcare system. However, limitations to its application in the community setting exist, which may improve with further training and high-definition colonoscopes.


Organotypic culture of HPV-transformed keratinocytes: a model for testing lymphocyte infiltration of (pre)neoplastic lesions of the uterine cervix.
The aim of our study was to establish the relevance of an in vitro model for analysing the ability of human lymphocytes to infiltrate human papillomavirus (HPV)-associated (pre)neoplastic lesions of the uterine cervix. To mimic these lesions, we have used the organotypic raft culture of HPV-transformed keratinocytes (SiHa). The SiHa organotypic raft culture was co-cultured with resting or prestimulated (IL-2 or IL-2+anti-CD3 mAb) allogeneic peripheral blood mononuclear cells (PBMC) for 24 and 72 h. The majority of infiltrating cells were T lymphocytes. Occasional NK cells were also identified. The stimulation with IL-2+anti-CD3 mAb induced the highest number of infiltrating cells, with the maximum lymphocyte infiltration observed after 24 h of co-culture. The lymphocyte infiltration was associated with an increased number of apoptotic cells in the organotypic cultures. The ability of PBMC and purified T cell and NK cell populations to lyse HPV-transformed keratinocytes was also investigated on monolayer cultures. As expected in an allogenic model, the highest cytotoxicity was mediated by NK cells activated by IL-2 or IL-2+anti-CD3 mAb. The cytotoxic activity of T cells was weak but, interestingly, increased in the presence of phytohaemagglutinin A (PHA), assuming that T cells were able to kill HPV-infected keratinocytes when a bridge between T cells and keratinocytes was provided. In conclusion, the organotypic culture of HPV-transformed keratinocytes may provide an effective in vitro model for investigating novel T cell-based immunotherapy protocols for the treatment of HPV-associated lesions.


[Prevalence of mental disorders in persons with Parkinson's disease].
To determine the prevalence of cognitive disorder, depression, anxiety and psychotic symptoms in persons with Parkinson's disease in the general population. Cross-sectional study. The Netherlands. Between May and September 1995, a random sample of 384 persons with Parkinson's disease (members of the Parkinson's disease patient organisation plus 24 Dutch nursing home patients) were investigated with the Composite International Diagnostic Interview (CIDI) and the General Health Questionnaire (GHQ-12). The 1-month prevalence of DSM-III-R psychiatric disorder was 39.1%, of which 13.3% cognitive impairment, 5.5% depression (2.3% major depression and 4.7% dysthymia), and 24.5% anxiety disorder (4.9% agoraphobia and 11.5% social phobia). Psychiatric comorbidity mainly concerned anxiety disorder, in combination with depression (21%) or cognitive disorder (28%). Four out of ten persons who ever had a depression or anxiety disorder, developed the first episode after the onset of Parkinson's disease. The prevalence of psychiatric disorder in persons with Parkinson's disease was high, compared with figures of the general population, notably for anxiety and cognitive disorder, but not for depression.


Urinary excretion levels of carcinogenic glutamic acid pyrolysis products and their N-acetyl derivatives in humans.
The carcinogenic glutamic acid pyrolysis products 2-amino-6-methyldipyrido [1, 2-a: 3', 2'-d]imidazole (Glu-P-1) and 2-amino-dipyrido [1, 2-a: 3', 2'-d] imidazole (Glu-P-2), and their N-acetyl derivatives were measured in 24-h urine of individual subjects by high-performance liquid chromatography. These compounds were detected in all urine samples analyzed, although the contents varied widely among subjects. The mean levels of Glu-P-1, N-acetyl-Glu-P-1, Glu-P-2 and N-acetyl-Glu-P-2 in 24-h urine were 0.53, 0.41, 2.12 and 4.60 pmol, respectively. In vitro experiments revealed N-acetyltransferase activity with Glu-P-1 and Glu-P-2 in the cytosolic fractions from rat kidneys and human autopsy kidney specimens as well as those from liver specimens, suggesting that extrahepatic tissues may also play significant roles in the N-acetylation of these carcinogens. These results show that Glu-P-1 and Glu-P-2, after being partially N-acetylated in metabolic organs such as liver and kidney, are excreted into urine together with their N-acetyl derivatives. It is suggested that daily excretion of carcinogenic glutamic acid pyrolysis products and their N-acetyl derivatives into urine can be a suitable biological monitor for exposure to these carcinogens. Glu-P-1, 2-amino-6-methyldipyrido [1, 2-a: 3', 2'-d] imidazole; Glu-P-2, 2-aminodipyrido [1, 2-a: 3', 2'-d] imidazole; N-acetyl-Glu-P-1, 2-acetylamino-6-methyldipyrido [1, 2-a: 3', 2'-d] imidazole; N-acetyl-Glu-P-2, 2-acetylaminodipyrido[1,2- a:3', 2'-d]imidazole; HPLC, high-performance liquid chromatography.


The Association of Metabolic Syndrome with Diabetic Retinopathy: The Korean National Health and Nutrition Examination Survey 2008-2012.
To explore gender differences and associations between metabolic syndrome (MetS) and its components, and diabetic retinopathy (DR) in Korean adults aged 40 years and older with diabetes. We analyzed data from the Korean National Health and Nutrition Examination Surveys (2008-2012). In total, 2,576 type 2 diabetic participants, aged 40 and older, were evaluated. Seven standard retinal fundus photographs were obtained after pupil dilation in both eyes. DR was graded using the modified Airlie House classification system. Vision-threatening diabetic retinopathy (VTDR) included proliferative diabetic retinopathy and clinically significant macular edema. MetS was defined according to the Joint Interim Statement, proposed in 2009, by the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. Multivariate logistic regression analysis was used to assess the relationship between MetS and its individual components with DR and VTDR. After controlling for confounders, MetS was not associated with DR in men or women. Moreover, the risk for DR or VTDR did not increase with increasing MetS components. However, high waist circumference was significantly inversely associated with VTDR (adjusted odds ratio = 0.36; 95% confidence interval = 0.14-0.93) only in men. MetS was not associated with DR or VTDR in a Korean diabetic population. However, among MetS components, it seems that abdominal obesity was inversely associated with VTDR in Korean diabetic men.


Biomimetic micropatterning of silica by surface-initiated polymerization and microcontact printing.
Micropatterns of silica on a gold substrate were generated by a biomimetic approach, namely, the biosilicification of silicic acids. The procedure consists of three simple steps: pattern generation of a polymerization initiator, (BrC(CH(3))(2)COO(CH(2))(11)S)(2), by microcontact printing; surface-initiated, atom-transfer radical polymerization of 2-(dimethylamino)ethyl methacrylate (DMAEMA) from the patterned area; and polycondensation of silicic acids. The tertiary amine-containing polymer, pDMAEMA, aided in the spatially controlled polycondensation of silicic acids on surfaces in the presence of phosphate ions, and micropatterns of silica on a gold substrate were successfully generated in combination with the technique of microcontact printing. The procedure could be extended to the controlled fabrication of silica patterns with any size, shape, or thickness.


Feasibility of Anti-reflux Gastric Bypass for Massive Paraesophageal Hernia in Obese Patients With Gastroesophageal Reflux Disease.
Background The objective of this study is to demonstrate the safety and feasibility of anti-reflux gastric bypass (ARGB) as a treatment for symptomatic massive paraesophageal hernias (PEH) in the obese population. Both gastroesophageal reflux disease (GERD) and PEH are particularly prevalent in the obese patient population, and obesity adversely affects the long-term outcomes of all anti-reflux procedures. Methods This is a single-center, retrospective review of 17 obese adults who underwent ARGB for the treatment of massive PEH between September 2019 and December 2021. Massive PEH was defined as >5 cm in a singular direction, and obesity as BMI ≥30 kg/m2. Patients without preoperative diagnostic testing were excluded. We reviewed and analyzed patient demographic data, postoperative symptom resolution, weight loss, and complications using descriptive statistics, change from baseline, and comparison of proportions. Results Sixteen of the 17 subjects were female. The median age was 48, and the median BMI was 39.10 kg/m2 (30.0-49.3 kg/m2). The average PEH size on imaging was 6.48 (H) x 6.25 (W) cm. The resolution of heartburn was 93.8% (p<0.001), and the resolution of nausea and vomiting was 80.0%. The mean postoperative length of follow-up was 9.12 months. Median excess body weight loss percentages at one, three, six, and 12 months were 16.43% (p<0.001), 35.92% (p<0.001), 40.64% (p=0.001), and 58.58% (p<0.01), respectively. Five patients experienced adverse events requiring additional intervention or hospitalization. There were no symptomatic hernia recurrences or mortality. Conclusion This study demonstrates that ARGB is feasible and potentially effective in treating symptomatic massive paraesophageal hernias in the obese patient population. Further investigation is needed to determine efficacy and long-term outcomes compared to standard surgical repair.


Microvesicles: ROS scavengers and ROS producers.
This review analyzes the relationship between microvesicles and reactive oxygen species (ROS). This relationship is bidirectional; on the one hand, the number and content of microvesicles produced by the cells are affected by oxidative stress conditions; on the other hand, microvesicles can directly and/or indirectly modify the ROS content in the extra- as well as the intracellular compartments. In this regard, microvesicles contain a pro-oxidant or antioxidant machinery that may produce or scavenge ROS: direct effect. This mechanism is especially suitable for eliminating ROS in the extracellular compartment. Endothelial microvesicles, in particular, contain a specific and well-developed antioxidant machinery. On the other hand, the molecules included in microvesicles can modify (activate or inhibit) ROS metabolism in their target cells: indirect effect. This can be achieved by the incorporation into the cells of ROS metabolic enzymes included in the microvesicles, or by the regulation of signaling pathways involved in ROS metabolism. Proteins, as well as miRNAs, are involved in this last effect.


[Elective videothoracoscopy--a tool for prevention of primary spontaneous pneumothorax?].
Based on the retrospective analysis of the selected group of patients with primary spontaneous pneumothorax (PSP), the authors aim to demonstrate contribution of CT scan examinations and elective videothoracoscopic procedures in diagnostics and treatment of pulmonary conditions, predisposing the patient to the disorder. During 2005-2007, 45 patients with PSPs underwent post-treatment CT lung examinations. Pathological findings potentially resulting in collapsed lung, were detected in nearly 25% of the subjects. All of the subjects (males, the mean age of 22.4 years) were then indicated for elective videothoracoscopy, in order to prevent potential PSP events. The procedure included peripheral endostapler lung lesion resection and mechanical pleurodesis (pleuroabrasion), resp. partial apical pleurectomy. Pathological changes of the lung tissue were detected with the same rate in the both, right and left lung apices. In miniinvasive procedures, they were always easily located, as anticipated. In all of the subjects, the changed tissue was removed using peripheral lung resections, with concomittant pleuroabrasion in a half of the subjects, while in the other half of the subject, the procedure was combined with partial apical pleurectomy. Intraoperative morbidity and mortality were nil. The mean period of postoperative drainage was 5.5 days, the mean duration of hospitalization was a week. During the study period, no further PSP events were recorded. CT examination-based detection of pneumothorax-predisposing pathological lung tissue changes and their subsequent removal using elective videothoracoscopy, is a valid and a patient-beneficial procedure.


The Blue Lotus Flower (Nymphea caerulea) Resin Used in a New Type of Electronic Cigarette, the Re-Buildable Dripping Atomizer.
The blue lotus flower (Nymphea caerulea) is an Egyptian water lily containing apomorphine and nuciferine. Apomorphine has been described as a psychoactive alkaloid and is a non-selective dopamine agonist primarily used to treat Parkinson's disease as it stimulates dopamine receptors and improves motor function. Nuciferine is an alkaloid associated with dopamine receptor blockade. Today, blue lotus flower is used as a sleep aid and anxiety reliever. The rebuildable dripping atomizer (RDA) is an electronic cigarette that allows direct application of an e-liquid onto the coil in the atomizer for aerosolization, compared to a typical electronic cigarette where the e-liquid is wicked from a storage vessel to the coil. Our laboratory received a dark-brown resin material from a concerned parent. The resin had been confiscated from an adolescent who had a reported history of marijuana use. The resin was later identified as blue lotus flower (N. caerulea). This resin, together with four commercially available blue lotus products, was analyzed for content. Apomorphine was detected in two samples, and nuciferine was detected in all five samples. The confiscated resin was determined to contain no apomorphine and 4300 ng/g of nuciferine. The nuciferine resin was shown to aerosolize using aRDA electric cigarette.


Psychopathology in epilepsy: prevalence, phenomenology and management.
Epilepsy is associated with interictal behavioral disturbances. The pattern of specific psychopathology differs from that of other chronic diseases because of the higher incidence of psychosis and characterological disorders. Approximately 7 percent of epileptics develop a chronic atypical psychosis with paranoid and affective features, and this may be more common in patients with a definite temporal lobe focus. Brief psychotic episodes occur and are more directly related to cerebral dysrhythmia. A subgroup of epileptics develop specific personality traits, aggressive behaviors under certain circumstances, and hyposexuality. Affective illness and suicide are also prevalent. There are special issues in the management of psychopathology in the setting of epilepsy such as the relative seizure threshold lowering effects of psychotropic drugs and the behavioral effects of altering the seizure control. This article discusses both diagnostic and management aspects of the interictal psychopathology of epilepsy.


Optical coherence tomography-based design for a real-time motion corrected scanning microscope.
While two-photon fluorescence microscopy is a powerful platform for the study of functional dynamics in living cells and tissues, the bulk motion inherent to these applications causes distortions. We have designed a motion tracking module based on spectral domain optical coherence tomography which compliments a laser scanning two-photon microscope with real-time corrective feedback. The module can be added to fluorescent imaging microscopes using a single dichroic and without additional contrast agents. We demonstrate that the system can track lateral displacements as large as 10 μm at 5 Hz with latency under 14 ms and propose a scheme to extend the system to 3D correction with the addition of a remote focusing module. We also propose several ways to improve the module's performance by reducing the feedback latency. We anticipate that this design can be adapted to other imaging modalities, enabling the study of samples subject to motion artifacts at higher resolution.


Long-Term Follow-up in Medullary Thyroid Carcinoma.
After surgery, patients with medullary thyroid carcinoma (MTC) should be assessed regarding the presence of residual disease, the localization of metastases, and the identification of progressive disease. Postoperatively, patients with MTC are staged to separate those at low risk from those at high risk of recurrence. The TNM staging system is based on tumor size, extra-thyroidal invasion, nodal metastasis, and distant spread of cancer. In addition, the number of lymph-node metastases, the number of compartments involved, and the postoperative calcitonin (CTN) and carcinoembryonic antigen (CEA) levels should be documented. The postoperative normalization of the serum CTN level is associated with a favorable outcome. When patients have basal serum CTN levels less than 150 pg/ml after a thyroidectomy, any persistent or recurrent disease is nearly always confined to lymph nodes in the neck. When the postoperative serum CTN level exceeds 150 pg/ml, patients should be evaluated with imaging procedures, including computed tomography (CT) of the neck and chest, contrast-enhanced magnetic resonance imaging (MRI) and ultrasound (US) of the liver, bone scintigraphy, MRI of the bone, and positron emission tomography (PET)/CT. One can estimate the growth rate of MTC metastases by quantifying increases in tumor size over time from sequential imaging studies analyzed with response evaluation criteria in solid tumors (RECIST), and by determining the tumor marker doubling time from sequential measures of serum CTN or CEA levels over multiple time points. One of the main challenges remains to find effective adjuvant and palliative options for patients with metastatic disease. Patients with persistent or recurrent MTC localized to the neck following thyroidectomy are candidates for neck operations, depending on the tumor extension. Once metastases appear, the clinician must decide which patients require therapy. This requires a balance between the (often) slow rate of tumor progression, which is associated with a good quality of life, and the limited efficacy and potential toxicities of local and systemic therapies. Considering that metastatic MTC is incurable, the management goals are to provide loco-regional disease control, palliate symptoms of hormonal excess, such as diarrhea, palliate symptomatic metastases, like pain or bone fracture, and control metastases that threaten life, such as bronchial obstruction or spinal cord compression. This can be achieved with palliative surgery, external beam radiation therapy (EBRT), or systemic therapy with tyrosine kinase inhibitor (TKI).


Oligo(dT) is not a correct native PAGE marker for single-stranded DNA.
Polyacrylamide gel electrophoresis is a widely used method to study short DNA fragments in solution. It is, however, a relative method requiring length markers to assess mobility, shape, flexibility, and molecularity of the DNA structures of interest. In recent literature we have encountered the use of oligo(dT) fragments as the native PAGE length markers. We show here that this practice is inadequate because oligo(dT) migration is strongly retarded in native polyacrylamide gels. This conclusion is qualitatively true irrespective of the conditions of electrophoresis, oligo(dT) length, and gel concentration. Depending on their length, oligo(dT) fragments migrate 2--4 times slower than that would correspond to their nucleotide number. This leads to erroneous conclusions, e.g., determination of the number of associated molecules in guanine quadruplexes or other DNA complexes.


Spontaneous Soft Tissue Haematomas- A Rare Presentation of Chronic Myeloid Leukemic (CML).
Spontaneous soft tissue haematomas are rarely found in haematological malignancies. Chronic myeloid leukemia (CML) is a myeloproliferative disorder which rarely present with thrombo-haemorrhagic phenomenon. It is a malignant clonal disorder of pleuripotent stem cells that results in increase in myeloid, erythroid and platelets cells in peripheral blood and marked myeloid hyperplasia in bone marrow. It is characterized by the presence of Philadelphia chromosome (Ph) with BCR - ABL 1 fusion gene. This gene is responsible for the formation of 210 KDa chimeric proteins with enhanced tyrosine kinase activity which leads to the abnormal bone marrow cell proliferation and to the clinical and morphologic manifestations of leukemia. Cutaneous and mucous membrane bleeding is common in CML whereas bleeding in deep soft tissue is rarely found because of qualitative and quantitative platelet abnormalities. Here, we report a case of CML (BCR-ABL rearrangement positive) who presented with large haematoma in the anterior as well as posterior compartment of left thigh and treated successfully with hydroxyurea and imatinib.


Outcomes and Disease Spectrum of LBW Neonates in a Secondary Health Facility.
Globally, 30 million low birth weight (LBW) babies are born every year and 95% of them are from developing countries. LBW neonates are at a high risk of mortality, morbidity, and long-term disability. The objective of this study is to investigate outcomes and disease spectrum among low birth weight neonates. This is a prospective, observational study conducted on 540 neonates admitted in the Mother and Child Hospital, Akure, Ondo State, Nigeria, from 2017 to 2018. Questionnaire, interview, clinical, and diagnostic procedures were used as research tools. There were 137 low birth weight (LBW) neonates, with the mean mothers' age of 31.92 ± 6.60. Of the 540 neonates, 69 (50.4%) and 68 (49.6%) were term and preterm, respectively. There were 64 female neonates (46.7%) and 73 male neonates (53.3%). The mean weight of the neonates was 1.82 ± 0.44 kg, and mean number of days on admission was 6.42 ± 6.75 days. Neonatal sepsis (NNS) was the highest morbidity 51 (37.2%) among the LBW neonates, followed by prematurity 47 (34.4%) and neonatal jaundice (NNJ) 18 (13.1%). Sex ( χ 2 = 3.584, p=0.310), mode of delivery ( χ 2 = 4.669, p=0.198), and gestational age ( χ 2 = 3.904, p=0.272) were not a significant determinant of outcome among LBW neonates. Men were 2.36 times more likely to be preterm (OR = 2.36, 95% CL = 1.01-5.54, p=0.048) among LBW neonates. Outcomes of LBW neonates who were delivered by SVD were not significant compared to preterm delivered by CS (OR = 0.46, 95% CL = 0.13-1.65, p=0.096). Sixty percent (60%) of the mothers had Prolonged Rupture of Membranes (PROM). Morbidities such as hypothermia (72.2%), apnoea (63.6%), haemorrhagic disease of the newborn (HDN) (66.7%), and respiratory distress syndrome (RDS) (66.7%) were more observed with preterm LBW neonates. Importance of qualitative antenatal care (ANC) should be emphasized; anticipation and prevention of LBW births can help mitigate some of the problems they are prone to.


[Successful surgical management of papillary muscle rupture following acute myocardial infarction in an elderly patient].
Papillary muscle rupture is rare but catastrophic complication of acute myocardial infarction. We report a 91-year-old woman who underwent successful management of papillary muscle rupture following acute myocardial infarction. She was transferred to our hospital because of severe pulmonary edema and cardiogenic shock. Echocardiography revealed severe mitral valve regurgitation due to total rupture of anterolateral papillary muscle. After intubation, intraaortic balloon pumping (IABP) and percutaneous cardiopulmonary support (PCPS) insertion, mitral valve replacement was successfully performed. She was discharged 134 days after operation. In papillary muscle rupture deteriorating hemodynamics, early diagnosis and immediate cardiopulmonary support are required before surgical treatment. She was, to the best of our knowledge, the oldest among the reported cases of successful surgical treatment of papillary muscle rupture in Japan.


An Improved Procedure for EI Nino Forecasting: Implications for Predictability.
A coupled ocean-atmosphere data assimilation procedure yields improved forecasts of El Niño for the 1980s compared with previous forecasting procedures. As in earlier forecasts with the same model, no oceanic data were used, and only wind information was assimilated. The improvement is attributed to the explicit consideration of air-sea interaction in the initialization. These results suggest that EI Niño is more predictable than previously estimated, but that predictability may vary on decadal or longer time scales. This procedure also eliminates the well-known spring barrier to EI Niño prediction, which implies that it may not be intrinsic to the real climate system.


Sexual medicine in the medical curriculum.
The new field of Sexual Medicine has now changed to the primary care physician because of the new symptom-treating pharmacological possibilities, a fact not to be foreseen 10 years ago. The future, therefore, is to create the platform for the 'basic doctor' to identify and correctly treat male and female sexual dysfunction on the basis of a sufficient knowledge (obtained through formalized, pre-graduate education) within the field of Sexual Medicine. All this will need positive support and good strategies, as well as evidence-based new knowledge created by endocrinology, gynaecology, andrology, genetics, neurology, angiology, but also psychology, sociology, anthropology and related disciplines to help the medical clinician to fulfil his Hippocratic Oath: to assist the individual who needs help - in sexual dilemmas as well.


Neurosurgical activity during COVID-19 pandemic: an experts' opinion from China, South Korea, Italy, the USA, Colombia, and the UK.
More than a million and a half people are infected worldwide with more than 90,000 casualties. The ongoing COVID-19 pandemic is radically altering both socio-economic and health care scenarios. On April 4th, 2020, at 13:30 CET, a webinar was broadcasted, organized by Global Neuro and supported by WFNS. Expert neurosurgeons from six different countries (China, Italy, South Korea, the USA, Colombia, and the UK) reported on the impact of the COVID-19 pandemic on their health care systems and neurosurgical activity. The first part focused on the epidemiology until that date. The USA were the most affected State with 450,000 cases, followed by Italy (140,000 cases and 19,000 casualties), China (83,305 cases and 3345 have died), South Korea (10,156 cases with 177 casualties), the UK (38,168 cases and 3605 deaths) and Colombia (1267 cases and 25 deaths). The second part concerned Institution and staff reorganization. In every country all surgical plans have been modified. The third part was about neurosurgical practice during the COVID-19 pandemic. The fourth and last part touched upon how to perform safe surgery and re-start after the pandemic. In general, the pandemic scenario was presented as a thought-provoking challenge in all countries which requires tireless efforts for both maintaining emergency and elective neurosurgical procedures.


Digital Image Correlation and Strain Gauges to Map and Compare Strain in Teeth with Different Quantity and Quality of Remaining Tooth Structure.
To evaluate strain in teeth with differing quality and quantity of tooth surface loss by utilizing surface displacement field measured using digital image correlation (DIC) and strain gauges (SG). A total of 80 mesio-occlusodistal preparations were carried out in human maxillary premolars. Ten sound premolars served as a control group, and treated samples were divided into two groups of 40 each according to the composition of the prepared walls (composed of either enamel and dentin [E + De] or dentin only [De]). Each group was then divided into four subgroups of 10 each according to the selected cusp height-to-width ratio (A = 2:1 mm; B = 3:1 mm; C = 3:1.5 mm; D = 4.5:1.5 mm). The samples were uni-axially loaded to 130 N, and strain was recorded using DIC and SG. With SG testing, control samples recorded the lowest strain values and were significantly different from all test groups. However, DIC failed to detect strain in control samples, as it was too low. With DIC, group D showed the lowest strain readings among all the dimension groups and was significantly different from groups A and B, but the composition of the remaining tooth structure did not show any significant effects. With SG testing, remaining wall dimension and composition both had significant effects: Group A scored the highest strain at all compositions, and E + De had better resistance to load stresses than De only. For both testing methodologies, height (≥ 3 mm) and width (1 to 1.5 mm) of the remaining tooth structure had an effect on strain. Tooth compositions of E + De resisted strain better than De counterparts at all dimensions.


GLUCOSE-6-PHOSPHATE DEHYDROGENASE IN DROSOPHILA: X-LINKED ELECTROPHORETIC VARIANTS.
Three electrophoretic patterns of glucose-6-phosphate dehydrogenase have been found in wild-type strains of Drosophila melanogaster. Genetical control of the variants in enzyme mobility (fast or slow) is X-linked; strains possessing both bands (fast and slow) appear to be heterogeneous, having individuals of three types (fast, slow, and double).


Urban aerosols harbor diverse and dynamic bacterial populations.
Considering the importance of its potential implications for human health, agricultural productivity, and ecosystem stability, surprisingly little is known regarding the composition or dynamics of the atmosphere's microbial inhabitants. Using a custom high-density DNA microarray, we detected and monitored bacterial populations in two U.S. cities over 17 weeks. These urban aerosols contained at least 1,800 diverse bacterial types, a richness approaching that of some soil bacterial communities. We also reveal the consistent presence of bacterial families with pathogenic members including environmental relatives of select agents of bioterrorism significance. Finally, using multivariate regression techniques, we demonstrate that temporal and meteorological influences can be stronger factors than location in shaping the biological composition of the air we breathe.


Relationship Between Nicotine Dependency and Occupational Injury in a Japanese Large-Scale Manufacturing Enterprise: A Single-Center Study.
Although several studies have shown the association between smoking and occupational injury, the exact mechanism by which smoking contributes to occupational injury remains unclear. We conducted a 5-year case-control study in a population of Japanese large-scale enterprise workers aimed to verify the hypothesis that nicotine dependency is positively associated with occupational injury. A total of 3179 to 3574 male workers annually participated in this study conducted from 2008 to 2012. Employees who had an occupational injury as detailed in the company records were included in the case group, while employees who did not have any occupational injury were included in the control group. Information on smoking status, nicotine dependency [assessed according to time to first cigarette (TTF) and cigarette per day (CPD)], and potential confounders were obtained via questionnaires administered during periodic health checkups. Odds ratios (ORs) were estimated via multiple logistic regression analysis and integrated using the general variance-based fixed effects model. The overall adjusted OR of occupational injury in smokers was 1.71 [95% confidence interval (95% CI): 1.10 to 2.66]. The OR for low and high nicotine dependency according to TTF was 1.52 (95% CI: 0.92 to 2.51) and 1.98 (95% CI: 1.15 to 3.41), respectively. Nicotine dependency was related to an increased risk of occupational injury. These findings support the hypothesis that smoking is associated with occupational injury.


Practical Management of New-Onset Urticaria and Angioedema Presenting in Primary Care, Urgent Care, and the Emergency Department.
A new episode of urticaria and/or angioedema can be an anxiety-inducing event for both the patient and the physician(s) seeing them in primary care, urgent care, or the emergency department. These events are commonly mistaken for "allergic" reactions and often mistreated. The most common causes of new onset urticaria in older children and adults, with or without angioedema, and normal vital signs or hypertension, are post-infection or acute idiopathic urticaria. These patients are not helped by systemic steroids, which may cause morbidity. An IgE-mediated allergy is almost never the cause. These episodes are easy to manage and virtually never life-threatening. Acute idiopathic urticaria is treated with high-dose nonsedating antihistamines acute avoidance of alcohol and nonsteroidal anti-inflammatory drugs, and time. An epinephrine prescription is not indicated for onset acute urticaria or angioedema, unless there is a strong suspicion of anaphylaxis, and they have been acutely treated with epinephrine. When anaphylaxis is suspected, because of hypotension or hypoxia, the treatment of choice is intramuscular epinephrine and supportive care. An acute tryptase then needs to be obtained within 1 to 3 hours of symptom onset, prior to a referral to Allergy. Most angioedema, without itching or hives, is idiopathic. Treatment is supportive care and time. Antihistamines, epinephrine, and systemic corticosteroids are completely ineffective in treating idiopathic or bradykinin-mediated angioedema. Suspect hereditary or acquired angioedema if there is recurrent non-itchy swelling with abdominal pain triggered by mechanical trauma. Only check a C4 prior to a referral to Allergy for a formal diagnosis and long-term management.


Citalopram has an antagonistic action on cortical spreading depression in well-nourished and early-malnourished adult rats.
Adult, well-nourished (W) and early-malnourished (M) male Wistar rats were injected intraperitoneally for 7 days with 20 mg/kg CIT and cortical spreading depression (CSD) was recorded for 4 h on the day following the treatment. M-animals presented lower body weights, as well as higher CSD velocities of propagation, than the W ones, as previously reported. Compared to saline-injected controls, rats treated with CIT for 7 days presented comparable body weights and lower mean CSD velocities, per hour of recording, the differences being significant at the second hour (3.29+/-0.31 versus 3.56+/-0.40 mm/min; P < 0.05). Topical, cortical application of CIT (1- and 5 mg/ml solutions over the intact dura-mater) reduced dose-dependently the CSD velocity (maximal reductions of 16.3 and 55.8% for the 1 and 5 mg/ml solutions, respectively; P < 0.05), as well as the amplitude of the CSD-slow potential change (58.2 and 88.3%). In three out of seven W-rats and in one out of seven M-rats, topical CIT (5 mg/ml) blocked CSD propagation. The effects were reverted by flushing the treated region with saline. In the M-groups, CIT affected CSD in the same manner as in the W ones. The results reinforce previous evidence for an antagonistic influence of the serotoninergic activity on CSD.


Angiolymphoid hyperplasia with arterial ectasia and arteriovenous malformation: Response to intra-arterial embolization.
Angiolymphoid hyperplasia with eosinophilia is a rare disease characterized by vascular proliferation of unknown origin. The lesions are mostly seen in the head and neck region and are characterized by papules or nodules. A 20-year-old man presented with a 1 year history of reddish papulo-nodular lesions overlying a pulsatile swelling on the left auricular area. Histopathology was suggestive of angiolymphoid hyperplasia with eosinophilia. B-mode ultrasonography, color Doppler and angiography revealed arterial ectasia and arteriovenous malformation of the left auricular artery. Such malformations have been reported previously, in association with angiolymphoid hyperplasia with eosinophilia. The cutaneous lesions responded well to transarterial embolization of the nidus.


Current Diagnostic and Treatment Methods of Alzheimer's Disease: A Narrative Review.
To diagnose and predict the possibility of Alzheimer's or a different kind of dementia, medical professionals employ tests that look at a patient's mental competence; however, such methods are impracticable. A reliable diagnosis at the start of treatment is essential for therapy. Except in situations with apparent genetic variations, most Alzheimer's patients lack a known etiology. Therefore, every Alzheimer's patient receives the same treatment plan, regardless of the etiology, which may or may not be successful in slowing or preventing the disease's progression. Tau pathology is further complicated by the amyloid buildup that arises from the cellular phase of Alzheimer's disease (AD). Alzheimer's is a degenerative, diverse, complicated, and incurable neurological disorder primarily affecting elderly individuals. The currently accepted drugs available for treating AD, which involve cholinesterase inhibitors and N-methyl-D-aspartate (NMDA)-receptor antagonists only provide temporary relief from symptoms. The neurological disorder primarily affecting elderly individuals is degenerative, diverse, complicated, and incurable. Accurate diagnosis is the most essential prerequisite before beginning therapy. Most Alzheimer's patients' causes are still unclear, except for instances where hereditary variations have been noted. The gut microbiota composition significantly influences AD and any age-associated neurological illness. Therapies are very useful in improving the cognitive functions of AD. New microbiota-based therapy alternatives may now be available due to the more recent connection between the altered gut microbiome and neurodegeneration through the gut microbiota-brain axis.


Physiology and pathophysiology of air-filled ear space and Eustachian tube function.
The function of the Eustachian tube under atmospheric pressure, on the grounds of our studies, is discussed as follows: (1) Criteria of natural valvular function of the auditory tube under a normal pressure environment. (2) Opening action of the Eustachian tube and mode of swallowing movement in comparison with soft palate movement. (3) High pressure environment and (opening action of) Eustachian tube. (4) Children undergoing tubing and their Eustachian tube function. (5) Ventilatory function of the Eustachian tube under normal pressure conditions. (6) Factors influencing changes in pressure in the tympanic cavity.


Progress in Functional Urology Reflected in Recent Papers in the Journal of Clinical Medicine.
Benign conditions of the lower urinary tract, including benign prostatic hyperplasia, overactive bladder syndrome, and stress urinary incontinence, are frequent in the general population. Despite their benign nature, they have major adverse effects on the quality of life of the afflicted patients and their partners. Despite major progress in the diagnosis and treatment of these conditions, improved understanding and management of these patients remain substantial medical needs. This editorial discusses some recent high-quality articles published in the Journal of Clinical Medicine on the understanding of the epidemiology, pathophysiology, diagnostic, and treatment of benign diseases of the lower urinary tract tissues such as the bladder and prostate.


Encapsulation of Mo₂C in MoS₂ inorganic fullerene-like nanoparticles and nanotubes.
Mo(2)C nanoparticles encapsulated within MoS(2) inorganic fullerene-like nanoparticles and nanotubes were produced by carbothermal reaction at 1200-1300 °C inside a vertical induction furnace. The particles were analyzed using various electron microscopy techniques and complementary methods.


A Rare Case of Headache in a Patient With McCune-Albright Syndrome: A Triple Threat.
A 26-year-old male presented with facial asymmetry since 11 years of age and painless progressive diminution of vision in the left eye since 16 years of age. He presented with an exacerbation of headaches for the past two months. On examination, he was tall and had acral enlargement, craniofacial deformity, and bilateral asymmetric testicular enlargement. Investigations revealed high insulin-like growth factor 1, non-suppressible growth hormone on oral glucose tolerance tests, and multiple pituitary hormone deficiencies. MRI showed pituitary macroadenoma with craniofacial and sphenoid fibrous dysplasia as well as multiple tuberculomas. Cerebrospinal fluid testing showed high protein, low glucose, and high adenosine deaminase, all consistent with a diagnosis of central nervous system (CNS) tuberculosis. His headache did not respond significantly to either octreotide or zoledronic acid. The patient was then initiated on antitubercular therapy, which led to near-complete resolution of the headache and CNS lesions within three months of therapy. CNS tuberculosis was a masquerader in the index case of acrogigantism due to McCune-Albright syndrome. Headaches may be multifactorial in a given case of acromegaly, and investigating for alternative or additional causes especially when dealing with treatment-refractory cases can be rewarding.


The Relationship between Sense of Belonging and Well-Being Outcomes in Emerging Adults with Care Experience.
Robust social resources that lead to a healthy sense of belonging are imperative during emerging adulthood. However, young adults with alternative care experience, such as residential or foster care, often lack the social resources necessary to transition to adulthood successfully. Though some research has examined the importance of social resources in this population, less is known about a sense of belonging, which is associated with these social resources. The current study examined the association between care experience, belonging, and well-being outcomes among emerging adults (n = 703) who were separated from their biological parents during care and received alternative care in 16 nations. The presence of belonging was associated with type of alternative care, age at separation, and reason for separation. There was also an association between belonging and well-being outcomes, including homelessness and suicidal ideation. Adults lacking a sense of belonging reported higher rates of homelessness and suicidal ideation, lower life satisfaction, and lower resilience. The study has global implications for enhancing social support for emerging adults with care experience in order to facilitate a sense of belonging as a social resource.


MR arthrography in the differential diagnosis of type II superior labral anteroposterior lesion and sublabral recess.
The objective of our study was to assess the utility of five MR arthrographic findings in differentiating type II superior labral anteroposterior (SLAP) lesion from superior sublabral recess. The MR arthrograms of 55 patients (57 cases) with either type II SLAP lesion (34 cases) or superior sublabral recess (23 cases) who underwent arthroscopic surgery and MR arthrography were retrospectively reviewed. Two independent reviewers searched for the extension, direction, and shape of high signal intensity in the superior labrum on MR arthrograms. In addition, the presence of concomitant anterosuperior labral tear and anteroposterior extension of high signal intensity on axial images was evaluated. The frequencies of these findings in cases of type II SLAP lesion and sublabral recess were evaluated, and the statistical significance of each finding in differentiation of the two groups was assessed. Extension of high signal intensity behind the biceps anchor that extended beneath the labrum on fat-saturated oblique coronal T1-weighted images was found in 33 (97%) of the cases of type II SLAP lesion and 21 (91%) of the cases of sublabral recess. Laterally curved high signal intensity was found in 17 (50%) of the cases of type II SLAP lesion but in only four (17%) of the cases of sublabral recess. Globular or irregular shape of the superior labrum was present in 22 (65%) of the cases of type II SLAP lesion and in 10 (43%) of the cases of sublabral recess. Concomitant anterosuperior labral tear was seen in 14 (41%) of the cases of type II SLAP lesion but in only two (8.7%) of the cases of sublabral recess. Anteroposterior extension of high signal intensity in the superior labrum on fat-saturated axial T1-weighted images was detected in 33 cases of type II SLAP lesion (97%) and in 14 cases of sublabral recess (61%). Although the MR arthrographic findings were similar for type II SLAP lesion and sublabral recess, laterally curved high signal intensity on oblique coronal images, concomitant anterosuperior labral tear, and anteroposterior extension of high signal intensity on axial images were helpful findings in the diagnosis of type II SLAP lesion.


Risk factors for retinal microvascular impairment in type 2 diabetic patients without diabetic retinopathy.
To determine the risk factors for retinal microvascular impairment on optical coherence tomography angiography (OCT-A) in type 2 diabetic patients without clinical diabetic retinopathy (DR). This retrospective and cross-sectional study enrolled 74 diabetic patients without clinically evident DR for the study group and 34 healthy subjects for the control group. OCT-A parameters were measured to determine vascular density (VD) and the foveal avascular zone (FAZ) size in the superficial and deep capillary plexuses (SCP/DCP) of the retina. Clinical data were collected on sex, age, diabetes duration, hemoglobin A1c (HbA1c), hypertension, dyslipidemia, low-density lipoprotein cholesterol (LDL-C), estimated glomerular filtration rate (eGFR) and smoking status. Multiple linear regression analyses were performed to represent the associated clinical variables with OCT-A parameters in diabetic patients. In comparison between the study and control groups, the VD in the SCP and DCP were significantly lower in diabetic patients compared to the controls (P = 0.022 and 0.003, respectively). The FAZ size in the SCP and DCP were significantly greater in diabetic patients compared to the controls (P = 0.035 and <0.001, respectively). In age- and sex-adjusted multiple regression analyses for the diabetic patients, dyslipidemia and hypertension were negatively associated with SCP-VD (β = -0.357, P = 0.002; β = -0.239, P = 0.039, respectively). Current smoking was correlated with lower DCP-VD (β = -0.255, P = 0.043). Greater SCP-FAZ size was associated with dyslipidemia and greater LDL-C (β = 0.254, P = 0.013; β = 0.232, P = 0.029, respectively), and greater DCP-FAZ size, with lower eGFR and greater LDL-C (β = -0.355, P = 0.004; β = 0.235, P = 0.037, respectively). Diabetic patients without clinical DR showed lower VD and greater FAZ size in the SCP and DCP compared to healthy controls. In diabetic patients without clinical DR, dyslipidemia and/or high LDL-C were important risk factors for retinal microvascular impairment. Hypertension, current smoking and lower eGFR also contributed to microvascular impairment.


Ultrasound evaluation in transthyretin-related amyloid neuropathy.
Familial amyloid polyneuropathy is a rare condition caused by mutations of the transthyretin gene (TTR). We assessed the pattern of nerve ultrasound (US) abnormalities in patients with TTR-related neuropathy. Seven patients with TTR-related neuropathy (TTR-N) and 5 asymptomatic TTR-mutation carriers (TTR-C) underwent neurological examination, nerve conduction studies, and US evaluation. Multifocal US abnormalities were identified in 6 of 7 TTR-N patients. A single patient with only a mild sensory polyneuropathy had normal nerves on US evaluation. In the TTR-C, we only detected an enlarged ulnar nerve at the elbow. Interestingly, disease severity correlated with number of nerves affected on US evaluation. No specific pattern of US abnormalities was identified in this cohort. However, in TTR-related amyloid neuropathy, US may be a helpful tool in monitoring disease progression, and/or clinical response to pharmacological treatment.


Genetic Characterization of Porcine Circovirus 3 Strains Circulating in Sardinian Pigs and Wild Boars.
Porcine circovirus 3 (PCV3) is a recently discovered member of the Circoviridae family. So far, its presence has been reported in North America, Asia, South America, and Europe. In this study, blood and tissue samples from 189 Sardinian suids (34 domestic pigs, 115 feral free ranging pigs, and 39 wild boars) were used to genetically characterize the PCV3 strains from Sardinia. PCV3 infection in the animals was confirmed by real time PCR. The detection rate in the three groups analyzed was l7.64% in domestic pigs, 77.39% in free ranging pigs, and 61.54% in wild boars. Moreover, our results showed that co-infection of PCV3 with other viruses is quite a common occurrence. Molecular characterization of Sardinian PCV3 strains was performed by sequencing 6 complete genomes and 12 complete cap genes. Our results revealed that there is a high similarity between our strains and those identified in different countries, confirming the genetic stability of PCV3 regardless of geographical origin. Haplotype network analysis revealed the presence of 6 whole genomes or 12 unique ORF2 haplotypes and a nonsynonymous mutation in ORF2 that leads to an R14K amino acid substitution. Phylogenetic analysis of whole genome and ORF2 was also conducted. The Sardinian strains were allocated in three different clusters of phylogenetic trees of both complete genome and ORF2. With this study, we have provided a snapshot of PCV3 circulation in Sardinia. Our findings might help to achieve a deeper understanding of this emerging porcine virus.


A qualitative analysis of the breastfeeding experiences of mothers who are nurses and nutritionists.
From a medical standpoint, breastmilk is the optimal option for feeding a baby, relegating the cultural, social, and material determinants to breastfeeding. Worldwide, breastfeeding rates are low, especially among working mothers. Healthcare providers have low breastfeeding rates due to several barriers to lactation, i.e. work schedule andlack of private places for pumping. A descriptive qualitative methodology was applied to examine the breastfeeding experiences of Ecuadorian mothers who are healthcare professionals. Twenty healthcare professionals who breastfed their babies took part in the research. Data gathering employed synchronous semi-structured interviews in Spanish. The data analysis followed the Phronetic Iterative Approach. Women shifted the preconceived idea of the ideal breastfeeding scenario concerning duration, promotion, and support, ideals which are constructed in their training as healthcare professionals. Although these women believe that breast milk and breastfeeding is the best way to feed a baby, the internalized ideal of breastfeeding shifted with the experience of motherhood. Although they had that clash between the ideal and the external reality, they continued breastfeeding their babies, and those experiences resulted in them improving their professional practice. This study demonstrated that breastfeeding for this group of women appears to be a unique relational and identity negotiation process. The findings emphasize that experiencing breastfeeding for this group of healthcare providers positively shifted how they communicate breastfeeding with their patients in the clinical encounter. Ensuring that healthcare professionals acquire a different approach for educating and communicating about lactation is an essential determinant in efforts to improve breastfeeding rates in Ecuador.


Delayed breast reconstruction with tram-flap and various modifications after radical mastectomy.
This study describes the experience of radical mastectomies with simultaneous breast reconstruction using TRAM flap in patients with inflammatory breast cancer. The study aimed to evaluate the effectiveness of primary breast reconstruction using the TRAM-flap procedure in patients with an inflammatory form of breast cancer. Our work is associated with some deviation from generally accepted standards: delayed breast reconstruction after radical mastectomy for inflammatory breast cancer. We describe the experience of radical mastectomies with the simultaneous reconstruction of the breast using a TRAM flap in patients with inflammatory breast cancer. This study included 12 patients diagnosed with breast cancer stages IIIB and IIIC. Almost all patients (eleven out of twelve patients) underwent radical mastectomy with one-stage reconstruction using a TRAM flap after chemotherapy. Two years later, one patient (8.3%) showed disease progression in the form of distant metastases in the bones of the spine. One patient (8.3%) had a regional relapse in the displaced flap near the postoperative scar. The rest of the patients (83.4%) showed no signs of continuing the disease. Patients with one-stage breast reconstruction improved socially, and their subjective well-being was better than those who underwent radical mastectomy without reconstruction. Experience in performing one-stage reconstructions in the surgical treatment of patients with inflammatory breast cancer is a reason for restrained optimism regarding the possibility and feasibility of these operations.


Clinical Pathway for Management of Suspected or Positive Novel Coronavirus-19 Patients With ST-Segment Elevation Myocardial Infarction.
Novel coronavirus-19 disease (COVID-19) is an escalating, highly infectious global pandemic that is quickly overwhelming healthcare systems. This has implications on standard cardiac care for ST-elevation myocardial infarctions (STEMIs). In the setting of anticipated resource scarcity in the future, we are forced to reconsider fibrinolytic therapy in our management algorithms. We encourage clinicians to maintain a high level of suspicion for STEMI mimics, such as myopericarditis which is a known, not infrequent, complication of COVID-19 disease. Herein, we present a pathway developed by a multidisciplinary panel of stakeholders at NewYork-Presbyterian/Columbia University Irving Medical Center for the management of STEMI in suspected or confirmed COVID-19 patients.


XIST Induced by JPX Suppresses Hepatocellular Carcinoma by Sponging miR-155-5p.
The influence of X-inactive specific transcript (XIST) and X-chromosome inactivation associated long non-coding RNAs (lncRNAs) just proximal to XIST (JPX) on hepatocellular carcinoma (HCC) remains controversial in light of previous reports, which the present study aimed to verify. The DIANA lncRNA-microRNA (miRNA) interaction database was used to explore miRNA interactions with JPX or XIST. JPX, XIST, and miR-155-5p expression levels in paired HCC specimens and adjacent normal tissue were analyzed by RT-qPCR. Interaction between XIST and miR-155-5p was verified by dual luciferase reporter assay. Expression levels of miR-155-5p and its known target genes, SOX6 and PTEN, were verified by RT-qPCR and Western blot in HepG2 cells with or without XIST knock-in. The potential suppressive role of XIST and JPX on HCC was verified by cell functional assays and tumor formation assay using a xenograft model. JPX and XIST expression was significantly decreased in HCC pathologic specimens, compared to adjacent tissue, which correlated with HCC progression and increased miR-155-5p expression. Dual luciferase reporter assay revealed XIST as a direct target of miR-155-5p. XIST knock-in significantly reduced miR-155-5p expression level and increased that of SOX6 and PTEN, while significantly inhibiting HepG2 cell growth in vitro, which was partially reversed by miR-155-5p mimic transfection. JPX knock-in significantly increased XIST expression and inhibited HepG2 cell growth in vitro or tumor formation in vivo in a XIST dependent manner. JPX and XIST play a suppressive role in HCC. JPX increases expression levels of XIST in HCC cells, which suppresses HCC development by sponging the cancer promoting miR-155-5p.


Evaluation of reproductive compatibility of interstrain matings among plum curculio populations in the eastern United States.
Reproductive compatibility of interstrain matings in plum curculio, Conotrachelus nenuphar (Herbst), was studied during the summers of 2004 and 2006. There was a unidirectional incompatibility in the cross-matings along a rough north to south transect of the range of plum curculio (4 x 4 two-factorial design). There was significantly lower fertility in West Virginia males mated with New York and Virginia females (40 and 29%, respectively), and Florida males had a significantly lower fertility with Virginia and West Virginia females (46 and 37%, respectively), but Florida females were compatible with males of all four populations. Three northern populations were compatible with each other in all cross-mating combinations (New York, Massachusetts, and New Jersey; 3 x 3 two-factorial design). There was a unidirectional reproductive incompatibility in the combination of New Jersey males with Florida females (47%) and a bi-directional incompatibility between Florida and West Virginia reciprocal cross-mating (26 and 21%, respectively). The pattern of the reproductive incompatibility among geographic populations could help us to distinguish plum curculio strains and to clarify their strain distribution range to enrich our knowledge on their population ecology and biosystematics.


Diphtheria outbreak in Thailand, 2012; seroprevalence of diphtheria antibodies among Thai adults and its implications for immunization programs.
An age distribution shift in diphtheria cases during a 2012 outbreak in northeastern of Thailand suggests adults are increasingly at risk for infection in Thailand. Data regarding immunity against diphtheria among the adult Thai population is limited. We review a 2012 diphtheria outbreak in Thailand and conducted a nationwide seroepidemiological survey to determine the prevalence of diphtheria antibodies among Thai adults in order to inform immunization programs. A total of 41 confirmed cases, 6 probable cases and 101 carriers of diphtheria were reported from northeastern and upper southern Thailand. The diphtheria outbreak in northeastern Thailand occurred among adults aged > or =15 years; sporadic cases occurred among children from upper southern Thailand. We conducted a seroepidemiological survey of 890 Thai adults from 4 age groups (20-29, 30-39, 40-49 and 50-59 years) in 7 different geographical areas of Thailand (Chiang Mai, Ratchaburi, Chon Buri, Nakhon Si Thammarat, Phitsanulok, Khon Kaen and Songkhla). Diptheria toxin antibody levels were measured with a commercially available ELISA test. The seroprotection rate ranged from 83% to 99%, with the highest in eastern Thailand (Chon Buri, 99%) and the lowest in northern Thailand (Chiang Mai, 83%). Diphtheria antibodies declined with increasing age. We recommend one doseof diphtheria-tetanus toxoid (dT) vaccine once after 20 years of age in order to boost the antibody and revaccinations every 10 years to prevent future outbreaks.


Effects of Beetroot Supplementation on Recovery After Exercise-Induced Muscle Damage: A Systematic Review.
Beetroots have antioxidant and anti-inflammatory properties, which may help attenuate inflammation and oxidative stress, enhancing recovery from exercise-induced muscle damage (EIMD). To evaluate the effects of beetroot supplementation on oxidative stress, inflammation, and recovery after EIMD. SPORTDiscus, PubMed, Web of Science, and Scopus databases were searched, and hand-searching was performed by looking to relevant studies that were cited in other studies. For a study to be included in this review, the following inclusion criteria had to be met: (1) research conducted with human participants, (2) original articles in peer-reviewed publications, (3) original studies that had investigated beetroot supplementation intervention on muscle damage and recovery, (4) research conducted with 1 control/placebo group, and (5) articles published from inception to October 2020. Systematic review using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Level 3. Two of the 4 authors independently extracted data and assessed the methodological quality of the articles with the PEDro scale. All discrepancies were resolved through a consensus meeting. A total of 9 studies were included in this review. The methodological quality of the included studies ranged from moderate to high. Most of the studies found a better recovery of functional variables and muscle soreness, but improvements in markers of muscle damage, inflammation, and oxidative stress were not reported. The existing evidence suggests that a short-term beetroot supplementation has the potential to accelerate recovery of functional measures and muscle soreness, but further research is needed to clarify if a longer supplementation period (with some days before exercise and some days after) could also promote recovery of markers of muscle damage, inflammation, and oxidative stress.


Prognostic significance of systemic immune-inflammation index in patients with intrahepatic cholangiocarcinoma undergoing hepatic resection.
The prognosis of intrahepatic cholangiocarcinoma (ICC) patients following surgical resection remains poor. It is necessary to investigate effective biomarkers or prognostic models for ICC patients. To investigate the prognostic effect of systemic immune-inflammation index (SII) to predict long-term outcomes in ICC patients with undergoing hepatic resection. Consecutive ICC patients who underwent initial hepatectomy with curative intent from January 2009 to September 2017 were retrospectively reviewed. Receiver-operating characteristic (ROC) curves were used to determine the optimal cut-off values of SII. Kaplan-Meier curves and Cox proportional hazards regression were performed to evaluate the discriminative ability of preoperative SII in predicting overall survival (OS) and recurrence-free survival (RFS). A total of 530 patients were included and randomly divided into derivation (n = 265) and validation cohort (n = 265). The optimal cut-off value for SII was 450. At a median follow-up of 18 mo (range, 1-115.4 mo), 317 (59.8%) patients died and 381 (71.9%) patients experienced tumor relapse. Low SII level was associated with better OS and RFS (both P < 0.05). Multivariate analyses identified multiple tumors, node invasion and high SII level as independent risk factors for OS, while multiple tumors, node invasion and high SII level were identified as independent risk factors for RFS. Validation cohort confirmed the findings of derivation cohort. The present study demonstrated the feasibility of preoperative SII as a prognostic indicator for ICC. Patients with increased SII level were associated with worse OS and earlier tumor recurrence. Elevated SII level was an independent risk factor for OS and RFS in patients with ICC after hepatectomy. In the future, the SII could help stratifying patients with ICC, thus guiding therapeutic choices, especially in immunotherapy.


Standardized mortality ratios by region of residence, Israel, 1987-1994: a tool for public health policy.
Standardized mortality ratios (SMRs) are used internationally to compare health status across regions and to identify high risk areas for investigation of specific diseases, for funding determination, and for planning purposes. To ascertain regional differences in SMRs by sub-District in Israel for 1987-1994. The indirect method of standardization of mortality rates with adjustment for age, gender, and continent of birth was used to calculate SMRs by major cause of death, by sub-District of residence for the Jewish population of Israel. SMRs for all causes of death ranged from regions with low rates (Petah Tikva, Sharon, Rehovot, Ashkelon, and Jerusalem) to those with high rates (Zefat/Golan, Hadera, Yizreel, Ramla, Haifa, Tel Aviv, and Be'er Sheva) (all p<0.0001). Zefat's SMRs are elevated for acute myocardial infarction, stroke, diabetes, and motor vehicle accidents (MVAs). Haifa's SMRs are high for all cardiovascular diseases, liver disease, MVAs, and lung cancer. Be'er Sheva residents had high SMRs for diabetes, liver disease, MVAs, some categories of cardiovascular disease, cervical cancer, and homicide. Yizreel had high SMRs for diabetes, hypertension, stroke, liver disease, and MVAs. Tel Aviv had elevated SMRs for septicemia, acute MI, perinatal causes, and colon, lung and breast cancer. Jerusalem (p<0.0001) and Kinneret residents (p<0.05) had low SMRs for everything except congenital anomalies. Regional SMR differences, adjusted for age, gender, and ethnicity, may be due to socioeconomic, nutritional, environmental, occupational, or health care factors. SMRs provide a tool to identify regions for epidemiological investigation and priorities for preventive interventions. Regional health monitoring should be undertaken routinely on mortality data, as well as other national databases, as part of national health monitoring.


Evidence-based prevent catheter-associated urinary tract infections guidelines and burn-injured patients: a pilot study.
The objective of this pilot study was to describe effectiveness of an evidence-based guideline designed to prevent catheter-associated urinary tract infection (CA-UTI) in reducing CA-UTI in the burn-injured patient population. The study used a pre- and post-bundle implementation comparison design. Inclusion criteria included burn-injured patients of all ages with an indwelling urinary catheter. Patient demographic data were collected by medical record review when informed of a CA-UTI. The Rosswurm-Larrabee Model six-step process model guided implementation of practice change. The sample included eight burn-injured patients (7-88 years). Catheter day range was 1 to 27 days. Each patient had a clear indication for an indwelling urinary catheter; the need for accurate urinary output measurement in a critically injured patient. Four patients had a catheter placed twice during the stay. Nurses reported using a bladder scanner to assess bladder volume for post-operative patients with urinary retention avoiding use of an indwelling urinary catheter in some cases. Integration of evidence-based guidelines in practice resulted in a reduced CA-UTI rate, reduced catheter days, increased days between CA-UTI, and outperformance of the national benchmark statistic. In 2013, the burn unit reduced catheter days by about 75% and reduced infection incidence by >90% in three quarters after implementation of the practice changes. The unit was able to sustain a CA-UTI rate of zero for 248 days.


Atypical mycoplasmas from sheep in Great Britain and Australia identified as Mycoplasma ovipneumoniae.
Representative strains of "lacy-colony" mycoplasmas isolated from sheep in Great Britain and Victoria (Australia) were classified as M ovipneumoniae following comparison with strain Y98 of this species. The taxonomic description of M ovipneumoniae is extended and Y98 is proposed as the type strain. A brief description is given of the isolation of M ovipneumoniae from sheep in East Anglia.


CHARACTERISTICS OF INFECTIOUS PANCREATIC NECROSIS VIRUS.
Malsberger, R. G. (Lehigh University, Bethlehem, Pa.), and C. P. Cerini. Characteristics of infectious pancreatic necrosis virus. J. Bacteriol. 86:1283-1287. 1963.-Infectious pancreatic necrosis virus of trout is an ether-stable virus unable to cause hemagglutination or hemadsorption. During multiplication, the latent period was 5 hr and was followed by a logarithmic phase of virus release terminating at 12 hr postinfection. The virus yield per infected cell averaged 300 tcid(50). Autointerference was demonstrated on serial passage of undiluted seed virus. Infectivity was maintained on storage at 4 C for approximately 5 weeks after which the loss of infectivity became exponential. At -70 C, the decrease in infectivity was exponential through 36 weeks with a total loss of approximately 0.5 log(10) units. The virus is antigenic, and cross-neutralization occurred between the original isolate and a feral strain isolated from tissue cultures of apparently normal trout. The reported characteristics, together with the known size of 30 mmu, are all consistent with the characteristics of the Picornavirus group.


Reflection of tolerance to alcohol in the structure of the sleep wakefulness cycle.
The purpose of the present work was to study the effects of tolerance to ethanol on the sleep-wakefulness cycle (SWC) structure. Experiments were carried out in chronic conditions on the adult cats (n=5). The following methods were used: the stereotaxic - for implanting electrodes; polysomnographic - for EEG registration of the SWC structure. Alcoholisation (0.2-2.5 g/kg 25% ethanol solution) was conducted by intraperitoneal injections that lasted for two weeks. The obtained results were processed statistically and significance of the changes was determined by the Student t-test. Low single doses of ethanol (0.2 - 0.5 g/kg) did not induce any significant changes in the structure of the SWC. While using doses of 0.6 g/kg it was noted only increasing of the latent period of the onset of sleep. However, the structure of the SWC recovered within 1-2 hours after injection. Increasing the dose to 1 g/kg caused severe intoxication. This was reflected in a behavioral (anxiety, tremor, vocalizations) and autonomic (vomiting and frequent urination) signs. Against the background of restless behavioral wakefulness synchronization of the characteristic of light slow-wave sleep developed. The volume of deep slow-wave sleep was statistically significantly decreased and the latent period of the onset of paradoxical sleep was increased. The structure of sleep was fragmented, due to frequent awakenings. For the fifth-eighth day of alcoholization the structure of the SWC restored, behavioral and vegetative signs of intoxication disappeared, which must indicate the development of tolerance to this dose of ethanol. The obtained results signify that development of tolerance to ethanol can be reflected in the alteration of the structure of SWC. Alcoholization disturbs the subtle mechanisms of the sleep due to destruction of brain homeostasis.


Resolution of racemic carbocyclic analogues of purine nucleosides through the action of adenosine deaminase. Antiviral activity of the carbocyclic 2'-deoxyguanosine enantiomers.
The action of adenosine deaminase on racemic carbocyclic analogues of 6-aminopurine nucleosides was investigated. When either racemic carbocyclic adenosine [(+/-)-C-Ado] or the racemic carbocyclic analogue [(+/-)-C-2,6-DAP-2'-dR] of 2,6-diaminopurine 2'-deoxyribofuranoside was incubated with this enzyme, approximately half of the material was deaminated rapidly. From the resulting solution, the D isomers of the deaminated carbocyclic analogues (D-carbocyclic inosine, D-C-Ino, or D-carbocyclic 2'-deoxyguanosine, D-2'-CDG) and the L isomers of the undeaminated carbocyclic analogues were isolated. At higher concentrations of the enzyme, deamination of L-C-Ado and L-C-2,6-DAP-2'-dR proceeded slowly, thus also making the other enantiomers accessible. In tests in vitro against herpes simplex virus, types 1 and 2, D-2'-CDG was as active and potent as (+/-)-2'-CDG, whereas L-2'-CDG displayed only modest activity. In contrast to the previously reported high activity and potency of (+/-)-C-2,6-DAP-2'-dR against these two viruses, L-C-2,6-DAP-2'-dR was inactive.


Oxidative stress of vanadium-mediated oxygen free radical generation stimulated by aluminium on human erythrocytes.
It has been suggested that aluminium stimulates vanadium-mediated superoxide radical generation. The oxidative stress of generated superoxide radicals on antioxidant enzyme activity, oxidation of NADH and NADPH, membrane lipid peroxidation and osmotic fragility in human red blood cells (RBC) was investigated. RBC were incubated with varying concentrations of vanadium and aluminium ions at 37 degrees C for 2 h. RBC incubated with vanadium ions showed significantly increased superoxide dismutase and catalase activities, and oxidized NADH and NADPH concentrations compared with control RBC preparations. Erythrocyte lipid peroxidation was assessed by measuring thiobarbituric acid reactivity. RBC incubated with elevated levels of vanadium showed significantly increased membrane lipid peroxidation when compared with control RBC; it increased further on addition of aluminium. A significant positive correlation was observed between the extent of vanadium induced membrane lipid peroxidation and the osmotic fragility of treated RBC. In the presence of vanadium, aluminium stimulates superoxide dismutase and catalase activities. NADH and NADPH oxidation and membrane lipid peroxidation, as well as increasing osmotic fragility of human erythrocytes. The stimulatory effect of aluminium was dependent on concentration. These results may have implications for the mechanism of toxicity of aluminium and vanadium in haemodialysis patients.


Deaths caused by medication in persons not using illicit narcotic drugs: An autopsy study from Western Denmark.
Information regarding deaths caused by poisoning or adverse effects of medication in Danish persons not using illicit narcotic drugs (PNUIDs) is sparse. To characterize aetiology, demographics, and death scene, we reviewed all legal autopsies performed at Aarhus University from 2017 to 2019 and isolated 96 deaths caused by medications in PNUIDs. Suicides caused by medication overdose accounted for 38%. Opioids and psychotropic medications were the main cause of death in 48% and 35% of the 96 cases, respectively. Morphine, tramadol, and quetiapine were the most commonly involved individual medications. A single medication caused death in 50% of cases, and multiple substances were involved in 50%. The median total number [interquartile range] of detected medications was 5 [4-6], with a higher number in females (5 [4-7]) than males (4 [2-5]), p = 0.009. Median age was 51 [42.5-61.5] years, and 57% were female. Scene of death most frequently involved a body on a bed or couch in the decedent's own home (72%). In conclusion, opioids and psychotropic medications dominated by morphine, tramadol and quetiapine most frequently caused medication-related deaths in PNUIDs. Monitoring this type of death may yield important knowledge to direct prophylactic initiatives regarding medication use and prescription.


Preferential production of IgG2 anti-hapten antibody by immunization with hapten-conjugated Escherichia coli.
It is well-known that immunization of guinea pigs with hapten-protein conjugates induces concomitant production of IgG1 and IgG2 anti-hapten antibodies. However, the synthesis of antibody to 2, 4-dinitrophenyl groups (DNP) was found to be restricted to one of the IgG antibodies (IgG2 antibody) when guinea pigs were immunized through repeated intraperitoneal injections of 0.1 mg of 2, 4-dinitrophenylated Escherichia coli (DNP-E coli). This selective induction of IgG2 anti-DNP antibody formation occurred both in the presence and absence of Freund's adjuvants, whereas a trace of IgG1 anti-DNP antibody was produced concomitantly on increasing the immunizing dose of DNP-E. coli (3.0 mg) in Freund's complete adjuvant (FAC).


Simple devices for the application of samples as narrow streaks for thin-layer chromatography.
The construction and use of devices, based on the design of Achaval and Ellefson, for the application of samples as 1-12 cm streaks at the origin of thin-layer chromatograms is described. These devices are simple to make, and rapid and quantitative in their operation.


Multiscale regeneration scaffold in vitro and in vivo.
Biocompatible scaffolds play an important role in modulating tissue growth. A gelatin and sodium alginate scaffold with a unique structure produced by a combination of 3-D printing, electrospinning, and vacuum freeze-drying has been developed for tissue engineering. The scaffold is composed of a macrostructure, a honeycomb microporous surface morphology, and nanofibers. This structure meets the design criteria for an ideal tissue engineering scaffold. The scaffold degrades and has low cytotoxicity. The biocompatibility of the scaffold is improved by the favorable cell-matrix interaction; cells attach to the scaffold well and secrete large amounts of extracellular matrix in vitro. Rats with the scaffold implanted survived without signs of complications and the host cells infiltrated the interior of the scaffold. After 2 months in vivo, the scaffold was vascularized and contained collagen fibers. This multiscale regeneration scaffold may be suitable for tissue engineering because of its unique structure, degradation, mechanical properties, and lower cytotoxicity, which support cell infiltration and growth, and promote vascularization and generation of granulation tissue in vivo. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1218-1225, 2018.


Migrational responses of Hymenolepis diminuta to surgical alteration of gastro-intestinal secretions.
The effects of the direction of gut flow, of injections of glucose and saline into different regions of the small intestine and of surgical re-routing or ligature of gastric, biliary and pancreatic secretions into the small intestine have been correlated with changes in the migratory response of the rat tapeworm Hymenolepis diminuta. Reversing the normal anterior to distal flow of luminal contents in the small intestine did not affect worm migration following feeding. Injections of a glucose-saline solution into the duodenum did not initiate a migratory response; similar injections into the mid- and posterior regions of the small intestine resulted in migrational responses similar to those following intragastric glucose feeding. Re-routing gastric secretions to the distal duodenum inhibited anterior migration of the worms beyond the new point of entry of gastric juices. Results following re-routing and ligation of the biliary and pancreatic secretions suggest that there is a potent cue to anteriad migration in the pancreatic secretions. Biliary secretions also appear to contain an additional migratory cue to worm migration. In order of importance the factors stimulating/inhibiting worm migration are pancreatic greater than gastric greater than biliary greater than glucose. The results support the hypothesis that the factors affecting worm distribution in the small intestine are interactive and synergistic, involve other luminal factors, such as 5-hydroxytryptamine and the physico-chemical gradients, and are of a regional nature such that the migratory response of a particular worm is directly related to its position in the small intestine when the cues to relocation are received.


Bacteriophages and food safety: An updated overview.
Despite significant advances in pathogen survival and food cleaning measures, foodborne diseases continue to be the main reason for hospitalization or other fatality globally. Conventional antibacterial techniques including pasteurization, pressurized preparation, radioactivity, as well as synthetic antiseptics could indeed decrease bacterial activity in nutrition to variable levels, despite their serious downsides like an elevated upfront outlay, the possibility of accessing malfunctions due to one corrosiveness, as well as an adverse effect upon those the foodstuffs' organoleptic properties and maybe their nutritional significance. Greatest significantly, these cleansing methods eliminate all contaminants, including numerous (often beneficial) bacteria found naturally in food. A huge amount of scientific publication that discussed the application of virus bioremediation to treat a multitude of pathogenic bacteria in meals spanning between prepared raw food to fresh fruit and vegetables although since initial idea through using retroviruses on meals. Furthermore, the quantity of widely viable bacteriophage-containing medicines licensed for use in health and safety purposes has continuously expanded. Bacteriophage bio-control, a leafy and ordinary technique that employs lytic bacteriophages extracted from the atmosphere to selectively target pathogenic bacteria and remove meaningfully decrease their stages meals, is one potential remedy that solves some of these difficulties. It has been suggested that applying bacteriophages to food is a unique method for avoiding bacterial development in vegetables. Because of their selectivity, security, stability, and use, bacteriophages are desirable. Phages have been utilized in post-harvest activities, either alone or in combination with antimicrobial drugs, since they are effective, strain-specific, informal to split and manipulate. In this review to ensure food safety, it may be viable to use retroviruses as a spontaneous treatment in the thread pollution of fresh picked fruits and vegetables, dairy, and convenience foods.


Porphyrins are endogenous ligands for the mitochondrial (peripheral-type) benzodiazepine receptor.
"Peripheral-type" benzodiazepine receptors are localized to the outer mitochondrial membrane. We have identified potent competitive inhibitors of these receptors and purified them from human blood and from several rat organs. TLC analysis of the purified inhibitor from erythrocytes displays a single peak of inhibitory activity with an absorbance spectrum identical to hemin. All of the inhibitory activity in extracts of several tissues can be accounted for by their porphyrin and metalloporphyrin content. Pure hemin and protoporphyrin IX competitively inhibit mitochondrial benzodiazepine binding with Ki values of 41 and 15 nM, respectively, and are less active by a factor of 1000 at central-type benzodiazepine receptors. Thus, porphyrins appear to be endogenous ligands for mitochondrial benzodiazepine receptors.


In vitro microleakage study of a condensable and flowable composite resin.
The aim of this study was to evaluate the in vitro microleakage of a condensable composite resin recommended for Class II restorations with and without a flowable composite resin as a liner. There were statistically significant differences between all groups and between individual groups (p < 0.05). The results showed significantly less microleakage in teeth restored with flowable composite resin underneath a condensable composite resin.


Bioadhesive hydrogel comprising bilirubin/β-cyclodextrin inclusion complexes promote diabetic wound healing.
Chronic non-healing diabetic wound therapy is an important clinical challenge. Manipulating the release of bioactive factors from an adhesive hydrogel is an effective approach to repair chronic wounds. As an endogenous antioxidant, bilirubin (BR) has been shown to promote wound healing. Nonetheless, its application is limited by its low water solubility and oxidative degradation. This study developed a bilirubin-based formulation for diabetic wound healing. Bilirubin was incorporated into β-CD-based inclusion complex (BR/β-CD) which was then loaded into a bioadhesive hydrogel matrix (BR/β-CD/SGP). Scratch wound assays were performed to examine the in vitro pro-healing activity of BR/β-CD/SGP (25 μg/mL of BR). Wounds of diabetic or non-diabetic rats were covered with BR or BR/β-CD/SGP hydrogels (1 mg/mL of BR) and changed every day for a period of 7 or 21 days. Histological assays were conducted to evaluate the in vivo effect of BR/β-CD/SGP. Compared to untreated (18.7%) and BR (55.2%) groups, wound closure was more pronounced (65.0%) in BR/β-CD/SGP group. In diabetic rats, the wound length in BR/β-CD/SGP group was smaller throughout the experimental period than untreated groups. Moreover, BR/β-CD/SGP decreased TNF-α levels to 7.7% on day 3, and elevated collagen deposition and VEGF expression to 11.9- and 8.2-fold on day 14. The therapeutic effects of BR/β-CD/SGP were much better than those of the BR group. Similar observations were made in the non-diabetic model. BR/β-CD/SGP promotes wound healing and tissue remodelling in both diabetic and non-diabetic rats, indicating an ideal wound-dressing agent.


Ethanol and High-Value Terpene Co-Production from Lignocellulosic Biomass of Cymbopogon flexuosus and Cymbopogon martinii.
Cymbopogon flexuosus, lemongrass, and C. martinii, palmarosa, are perennial grasses grown to produce essential oils for the fragrance industry. The objectives of this study were (1) to evaluate biomass and oil yields as a function of nitrogen and sulfur fertilization, and (2) to characterize their utility for lignocellulosic ethanol compared to Panicum virgatum (switchgrass). Mean biomass yields were 12.83 Mg lemongrass ha-1 and 15.11 Mg palmarosa ha-1 during the second harvest year resulting in theoretical biofuel yields of 2541 and 2569 L ethanol ha-1 respectively compared to reported 1749-3691 L ethanol ha-1 for switchgrass. Pretreated lemongrass yielded 198 mL ethanol (g biomass)-1 and pretreated palmarosa yielded 170 mL ethanol (g biomass)-1. Additionally, lemongrass yielded 85.7 kg essential oil ha-1 and palmarosa yielded 67.0 kg ha-1 with an estimated value of USD $857 and $1005 ha-1. These data suggest that dual-use crops such as lemongrass and palmarosa may increase the economic viability of lignocellulosic biofuels.


Prediction of response to haloperidol dose reduction by Span of Apprehension measures for treatment-refractory schizophrenic patients.
Thirteen treatment-refractory schizophrenic patients participated in a haloperidol reduction study. Two of the subjects were unable to tolerate medication reduction. These subjects were comparable to the other patients in terms of initial clinical variables but were outliers on baseline accuracy and reaction time measures from the Span of Apprehension. The results suggest that aspects of basic visual processing and motor response speed may identify patients who require higher neuroleptic doses.


RNA-templated DNA origami structures.
Using the RNA transcript as a template, RNA-templated DNA origami structures were constructed by annealing with designed DNA staple strands. RNA-templated DNA origami structures were folded to form seven-helix bundled rectangular structures and six-helix bundled tubular structures. The chemically modified RNA-DNA hybrid origami structures were prepared by using RNA templates containing modified uracils.