Effects of NGS-based PGT-a for idiopathic recurrent pregnancy loss and implantation failure: a retrospective cohort study.
To clarify the effect of next-generation sequencing (NGS)-based preimplantation genetic testing for aneuploidy (PGT-A) combined with trophectoderm (TE) biopsy on the pregnancy outcomes of idiopathic recurrent pregnancy loss (iRPL) and idiopathic recurrent implantation failure (iRIF), we conducted a retrospective cohort study of 212 iRPL couples and 66 iRIF couples who underwent PGT-A or conventional in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment. The implantation rate (IR) per transfer (64.2%), clinical pregnancy rate (CPR) per transfer (57.5%), and live birth rate (LBR) per transfer (45%) of iRPL couples of the PGT-A treatment group were significantly higher (p < 0.05) than those of the conventional IVF/ICSI group (IR per transfer,38.2%; CPR per transfer,33.3%; LBR per transfer, 28.4%), whereas the pregnancy loss rate (PLR) per transfer was similar between the two groups. These effects were also significant (p < 0.05) in iRPL couples with advanced maternal age (AMA, ≥35 years), whereas no significant differences were found in clinical outcomes between the PGT-A and conventional IVF/ICSI groups in younger iRPL couples (<35 years). The cumulative clinical outcomes of iRPL couples were comparable between the PGT-A and conventional IVF/ICSI groups. No significant differences were found in any clinical outcomes between the PGT-A and conventional IVF/ICSI groups for young or AMA couples with iRIF. In conclusion, NGS-based PGT-A involving TE biopsy may be useful for iRPL women to shorten the time to pregnancy and reduce their physical and psychological burden, especially for iRPL women with AMA; however, couples with iRIF may not benefit from PGT-A treatment. Considering the small sample size of the iRIF group, further investigations with a larger sample size are needed to verify our findings.


[Experimental study on a novel affinity adsorbent for removal of endotoxin in plasma].
In this paper, the adsorbent properties of Polymyxin B immobilized polystyrene microbeads to remove endotoxin from plasma were studied and the factors that affected the absorption of endotoxin were discussed. The rat models of endotoxemia were established, which were used in hemoperfusion. The experiment results indicated that the novel affinity adsorbent could remove endotoxin from plasma effectively. Moreover, the results also showed that Polymyxin B immobilized polystyrene microbeads was a fine biomaterial of hemoperfusion as well as exhibited a satisfactory blood compatibility.


Contents of bioelements and toxic metals in a Polish population determined by hair analysis. Part 2. Young persons aged 10-20 years.
The aim of this study was to define referential values of 5 basic bioelements (Ca, Mg, Zn, Cu, Fe) in the hair of Polish young persons aged 10-20 years, based on the research conducted from 1991 to 2004 on a group of over 3420 healthy young persons. Mean concentrations of two toxic metals (Pb and Cd) in over 2000 young men were also investigated. The results of biochemical tests were analyzed with the program STATISTICA 7.0 (StatSoft PL). Significant differences between girls' and boys' hair Ca, Mg and Zn in the same age group were observed (p = 0.0000). It was determined that boys have smaller concentrations of hair Ca, Mg and Zn than girls. No significant differences were observed between concentrations of Cu and Fe in the hair of girls and boys of the same age in the tested period. Significantly greater amounts of Pb and Cd characterize boys. Analyses of correlations confirm significance (p < 0.05000) of synergistic interactions between bioelements: Ca-Mg (r = +0.80), Ca-Zn (r = +0.52), Ca-Cu (r = +0.14), Mg-Zn (r = +0.50), Mg-Cu (r = +0.13), Zn-Cu (r = +0.11), Cu-Fe (r = +0.04). Significance (p < 0.05000) of antagonistic interactions of bioelements with toxic metals: Zn-Pb (r = -0.30), Mg-Pb (r = -0.20), Ca-Pb (r = -0.18) and Zn-Cd (r = -0.07) was confirmed. Significance (p < 0.05000) of synergistic effects with toxic elements: Pb-Cd (r = +0.34), Fe-Pb (r = +0.22), Fe-Cd (r = +0.13) was determined. Compatibility of the statistically mapped basic characteristics of young persons' developmental age with the functions of concentrations in tested hair bioelements was confirmed. Young persons whose concentrations of selected hair bioelements showed values outside the reference ranges and who had higher concentrations of toxic metals should undergo further diagnostic tests since the results of previous tests could be a sign of disturbances leading to various diseases. Analyses of the concentrations of bioelements and toxic metals in humans based on hair analysis can be useful as a convenient, non-invasive and painless method in the diagnosis of pathological states. Combined with other analytical data, this method can be used by practising physicians as a complementary diagnostic procedure.


Membrane fusion and immune evasion by the spike protein of SARS-CoV-2 Delta variant.
The Delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has outcompeted previously prevalent variants and become a dominant strain worldwide. We report here structure, function and antigenicity of its full-length spike (S) trimer in comparison with those of other variants, including Gamma, Kappa, and previously characterized Alpha and Beta. Delta S can fuse membranes more efficiently at low levels of cellular receptor ACE2 and its pseudotyped viruses infect target cells substantially faster than all other variants tested, possibly accounting for its heightened transmissibility. Mutations of each variant rearrange the antigenic surface of the N-terminal domain of the S protein in a unique way, but only cause local changes in the receptor-binding domain, consistent with greater resistance particular to neutralizing antibodies. These results advance our molecular understanding of distinct properties of these viruses and may guide intervention strategies.


Induction of an immune network cascade in cancer patients treated with monoclonal antibodies (ab1). I. May induction of ab1-reactive T cells and anti-anti-idiotypic antibodies (ab3) lead to tumor regression after mAb therapy?
The antitumor effector functions of unconjugated monoclonal antibodies in cancer therapy are complex. Direct cytotoxic mechanisms such as antibody-dependent cellular cytotoxicity, complement-dependent cytolysis and apoptosis have been suggested. Induction of anti-idiotypic (ab2) and anti-anti-idiotypic (ab3) antibodies as well as T cell (T2 and T3 respectively) responses have also been proposed to be of clinical importance. In this study induction of an immune network cascade in patients with colorectal carcinoma, treated with mAb 17-1A (ab1) was assessed. All patients developed anti-idiotypic antibodies (ab2) of the IgG class after treatment with ab1 and four of nine patients showed induction of mouse Ig reactive T cells [a proliferative response to F(ab')2 fragments of ab1]. Patients with such a T cell response developed anti-anti-idiotypic antibodies (ab3), while those lacking the T cell reactivity failed to mount an ab3 response. Three of four patients with a T cell response achieved a tumor response to mAb therapy. Thus, all responding patients belonged to the group of individuals developing ab3. Induction of mAb(ab1)-reactive T cells as well as an immune network cascade might be important antitumor effector functions of mAb and should be considered in the future design of mAb-based therapy protocols in cancer patients.


Transcranial Doppler to Detect Right to Left Communication: Evaluation Versus Transesophageal Echocardiography in Real Life.
We compared transcranial Doppler (TCD) with transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) for the detection of right to left communication (RLC) in the heart. All patients explored from 2013 to 2016 in a vascular medicine unit to detect RLC by TCD were included. Right to left communication was detected by TCD monitoring for microembolic signals after intravenous injection of agitated 5% glucose and air. One hundred one patients were explored for RLC by TCD, 64 by TEE (not possible in 10, bubble injection in 51), and 93 by TTE because of unexplained stroke or arterial thrombosis (51 males, 50 females, age 51.0 ± 15.8 years) (bubble injection in 35). Fifty-three patients were positive after TCD (TEE: 4 negative, TTE: 7 negative). Of the negative patients after TCD, none was positive for TEE and 1 was positive for TTE with no evidence of patent foramen ovale. Transcranial Doppler was sensitive to detect RLC, even in patients with negative TTE or TTE. A negative TEE did not exclude RLC demonstrated by TCD. Transcranial Doppler might be proposed as first line to detect RLC.


Weight management in patients on peritoneal dialysis.
In summary, patients on PD, along with their health care providers, can be taught tools to manage weight. These techniques include, but are not limited to, judicious use of dialysis solution to provide adequate dialysis and ultrafiltration with the least exposure to glucose, careful attention to diet including salt and calories consumed, and physical activity.


Lung ultrasound: a useful tool in the assessment of the dyspnoeic patient in the emergency department. Fact or fiction?
Patients with respiratory distress present a frequent and challenging dilemma for emergency physicians (EPs). The accurate diagnosis and treatment of the underlying pathology is vitally important in these sick patients to ensure the best outcome and minimise harm from unnecessary treatments. Within the last decade, studies have shown lung ultrasonography (LU) to be valuable in the accurate diagnosis of a variety of lung pathologies, including cardiogenic pulmonary oedema, pleural effusion, pneumothorax, haemothorax and pneumonia. However, despite advances in techniques and the evidence for the use of LU in the diagnosis of respiratory pathology, it remains poorly understood and rarely used by EPs. This clinical review article provides an overview of LU and its relevance as a diagnostic aid to the detection of respiratory pathology in the Emergency Department (ED).


Antidepressant prescribing practices of outpatient psychiatrists.
The authors examined recent changes in the number and proportion of patients prescribed antidepressants by psychiatrists in outpatient private practice and characterized antidepressant prescription patterns by patient age, sex, race, payment source, and clinical diagnosis. The authors analyzed physician-reported data from the 1985 and 1993-1994 National Ambulatory Medical Care Survey, focusing on visits to physicians specializing in psychiatry. Logistic regressions were used to examine associations between survey year and antidepressant prescription, adjusting for the presence of other variables. The proportion of outpatient psychiatric visits in which an antidepressant was prescribed increased from 23.1% (95% confidence interval [CI], 19.7%-26.5%) in 1985 to 48.6% (95% CI, 47.5%-49.7%) in 1993-1994. After controlling for several patient variables, psychiatric patients were approximately 2.3 (95% CI, 1.8-2.9) times more likely to receive an antidepressant in 1993-1994 than in 1985. In 1993-1994, selective serotonin reuptake inhibitors accounted for approximately half of the psychiatric visits with an antidepressant prescription. Increases in the rate of antidepressant prescription were particularly evident for children and young adults; whites; new patients; and patients with adjustment disorders, personality disorders, depression not otherwise specified or dysthymia, and some anxiety disorders. During the late 1980s and early 1990s, there was a significant increase in the prescription of antidepressants by office-based psychiatrists. This increase was greatest for patients with less severe psychiatric disorders.


Positive transcriptional feedback at the bvg locus controls expression of virulence factors in Bordetella pertussis.
Regulation of the genes coding for virulence factors in Bordetella pertussis is controlled by the bvg locus, which encodes one putative sensory protein (BvgS) and one positive regulator of transcription (BvgA). We have studied the transcription of the bvg locus and found that this is controlled by a 350-base-pair DNA fragment, which contains five promoters, three of which transcribe the bvg locus, one transcribes an antisense RNA, and one transcribes a virulence-associated gene. Under noninducing conditions, only the promoter P2 is active and this is responsible for the production of low amounts of regulatory proteins. Upon induction, the other four promoters become active and, by a mechanism that may involve transcriptional and translational regulation, cause a 50-fold increase of the transcriptional activator BvgA. A model of the autoregulation of the bvg locus is presented.


NSAID-avoidance education in community pharmacies for patients at high risk for acute kidney injury, upstate New York, 2011.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently associated with community-acquired acute kidney injury (AKI), a strong risk factor for development and progression of chronic kidney disease. Using access to prescription medication profiles, pharmacists can identify patients at high risk for NSAID-induced AKI. The primary objective of this analysis was to evaluate the effectiveness of a community pharmacy-based patient education program on patient knowledge of NSAID-associated renal safety concerns. Patients receiving prescription medications for hypertension or diabetes mellitus were invited to participate in an educational program on the risks of NSAID use. A patient knowledge questionnaire (PKQ) consisting of 5 questions scored from 1 to 5 was completed before and after the intervention. Information was collected on age, race, sex, and frequency of NSAID use. A total of 152 participants (60% women) completed both the pre- and post-intervention questionnaire; average age was 54.6 (standard deviation [SD], 17.5). Mean pre-intervention PKQ score was 3.3 (SD, 1.4), and post-intervention score was 4.6 (SD, 0.9) (P = .002). Participants rated program usefulness (1 = not useful to 5 = extremely useful) as 4.2 (SD, 1.0). In addition, 48% reported current NSAID use and 67% reported that the program encouraged them to limit their use. NSAID use was common among patients at high risk for AKI. A brief educational intervention in a community pharmacy improved patient knowledge on NSAID-associated risks. Pharmacists practicing in the community can partner with primary care providers in the medical home model to educate patients at risk for AKI.


XPS analysis by exclusion of a-carbon layer on silicon carbide nanowires by a gold catalyst-supported metal-organic chemical vapor deposition method.
Silicon carbide (SiC) nano-structures would be favorable for application in high temperature, high power, and high frequency nanoelectronic devices. In this study, we have deposited cubic-SiC nanowires on Au-deposited Si(001) substrates using 1,3-disilabutane as a single molecular precursor through a metal-organic chemical vapor deposition (MOCVD) method. The general deposition pressure and temperature were 3.0 x 10(-6) Torr and 1000 degrees C respectively, with the deposition carried out for 1 h. Au played an important role as a catalyst in growing the SiC nanowires. SiC nanowires were grown using a gold catalyst, with amorphous carbon surrounding the final SiC nanowire. Thus, the first step involved removal of the remaining SiO2, followed by slicing of the amorphous carbon into thin layers using a heating method. Finally, the thinly sliced amorphous carbon is perfectly removed using an Ar sputtering method. As a result, this method may provide more field emission properties for the SiC nanowires that are normally inhibited by the amorphous carbon layer. Therefore, exclusion of the amorphous carbon layer is expected to improve the overall emission properties of SiC nanowires.


Establishment of prognostic model of bladder cancer based on apoptosis-related genes, in which P4HB promotes BLCA progression.
A variety of apoptosis genes have been confirmed to be related to the occurrence and development of bladder cancer patients, but few studies have paid attention to their significance in the prognosis of bladder cancer. Therefore, this study explored the value of apoptosis-related genes in the prognosis of BLCA by using the data in TCGA database. We downloaded the mRNA expression profiles and corresponding clinical data of bladder cancer patients from TCGA database, and obtained 2411 apoptosis-related genes from Deathbase database. Screening out differentially expressed apoptosis-related genes. Cox regression was used to determine the prognostic value of apoptosis-related genes, and then a prognostic risk model was developed. A nomogram based on risk model was constructed to predict the prognosis of bladder cancer patients. At the same time, immune infiltration correlation analysis of genes in the prognosis model. A prognostic model composed of 12 apoptosis-related genes was constructed. According to the risk score calculated by the model, patients were divided into high-risk group and low-risk group. There are significant differences in the expression of immune cells, immune function and immune checkpoint molecules between high-risk group and low-risk group. P4HB may promote bladder cancer progression. Based on the differential expression of apoptosis-related genes, we established a risk model to predict the prognosis of bladder cancer patients, in which P4HB promotes BLCA progression.


Significant increase in the stability of rare gas hydrides on insertion of beryllium atom.
Chemical binding between a rare gas atom with other elements leading to the formation of stable chemical compounds has received considerable attention in recent years. With an intention to predict highly stable novel rare gas compounds, the process of insertion of beryllium atom into rare gas hydrides (HRgF with Rg=Ar, Kr, and Xe) has been investigated, which leads to the prediction of HBeRgF species. The structures, energetic, and charge distributions have been obtained using MP2, density functional theory, and CCSD(T) methods. Analogous to the well-known rare gas hydrides, HBeRgF species are found to be metastable in nature; however, the stabilization energy of the newly predicted species has been calculated to be significantly higher than that of HRgF species. Particularly, for HBeArF molecule, it has been found to be an order of magnitude higher. Strong chemical binding between beryllium and rare gas atom has also been found in the HBeArF, HBeKrF, and HBXeF molecules. In fact, the basis set superposition error and zero-point energy corrected Be-Ar bond energy calculated using CCSD(T) method has been found to be 112 kJ/mol, which is the highest bond energy ever achieved for a bond involving an argon atom in any chemically bound neutral species. Vibrational analysis reveals a large blueshift (approximately 200 cm(-1)) of the H-Be stretching frequency in HBeRgF with respect to that in BeH and HBeF species. This feature may be used to characterize these species after their preparation by the laser ablation of Be metal along with the photolysis of HF precursor in a suitable rare gas matrix. An analysis of the nature of interactions involved in the present systems has been performed using theory of atoms in molecules (AIM). Geometric as well as energetic considerations along with the AIM results suggest a substantial covalent nature of Be-Rg bond in these systems. Thus, insertion of a suitable metal atom into rare gas hydrides is a promising way to energetically stabilize the HRgX species, which eventually leads to the formation of a new class of insertion compounds, viz., rare gas metallohydrides.


An integrated risk model stratifying seizure risk following brain tumor resection among seizure-naive patients without antiepileptic prophylaxis.
The natural history of seizure risk after brain tumor resection is not well understood. Identifying seizure-naive patients at highest risk for postoperative seizure events remains a clinical need. In this study, the authors sought to develop a predictive modeling strategy for anticipating postcraniotomy seizures after brain tumor resection. The IBM Watson Health MarketScan Claims Database was canvassed for antiepileptic drug (AED)- and seizure-naive patients who underwent brain tumor resection (2007-2016). The primary event of interest was short-term seizure risk (within 90 days postdischarge). The secondary event of interest was long-term seizure risk during the follow-up period. To model early-onset and long-term postdischarge seizure risk, a penalized logistic regression classifier and multivariable Cox regression model, respectively, were built, which integrated patient-, tumor-, and hospitalization-specific features. To compare empirical seizure rates, equally sized cohort tertiles were created and labeled as low risk, medium risk, and high risk. Of 5470 patients, 983 (18.0%) had a postdischarge-coded seizure event. The integrated binary classification approach for predicting early-onset seizures outperformed models using feature subsets (area under the curve [AUC] = 0.751, hospitalization features only AUC = 0.667, patient features only AUC = 0.603, and tumor features only AUC = 0.694). Held-out validation patient cases that were predicted by the integrated model to have elevated short-term risk more frequently developed seizures within 90 days of discharge (24.1% high risk vs 3.8% low risk, p < 0.001). Compared with those in the low-risk tertile by the long-term seizure risk model, patients in the medium-risk and high-risk tertiles had 2.13 (95% CI 1.45-3.11) and 6.24 (95% CI 4.40-8.84) times higher long-term risk for postdischarge seizures. Only patients predicted as high risk developed status epilepticus within 90 days of discharge (1.7% high risk vs 0% low risk, p = 0.003). The authors have presented a risk-stratified model that accurately predicted short- and long-term seizure risk in patients who underwent brain tumor resection, which may be used to stratify future study of postoperative AED prophylaxis in highest-risk patient subpopulations.


Normal placental function and fetoplacental blood circulation in advanced abdominal pregnancy.
Normal levels of unconjugated estriol and human placental lactogen hormone in the maternal serum and a normal, reactive pattern of non-stress test cardiotocography were recorded in a case of advanced abdominal pregnancy with surviving newborn. The placenta was inserted at the base and side walls of fossa Douglas. Fetal, umbilical and retroplacental arterial Doppler ultrasound examinations revealed normal velocity waveforms. These findings indicated that the trophoblast invasion to the retroplacental arteries also occurs when the placenta has an extra-uterine insertion, and this can result in a normal placental blood supply and function.


Interleukin-25-Mediated-IL-17RB Upregulation Promotes Cutaneous Wound Healing in Diabetic Mice by Improving Endothelial Cell Functions.
Diabetic foot ulcer (DFU) frequently leads to non-traumatic amputation and finally even death. However, the mechanism of DFU is not fully understood. Interleukin 25 (IL-25), an alarmin cytokine that responds to tissue injury, has been reported to participate in tissue regeneration and maintaining glucose homeostasis. However, the role of IL-25 in diabetic wound healing remains unknown. Here, we showed that interleukin 17 receptor B (IL-17RB), the functional receptor of IL-25, was significantly inhibited in the wound skin of both diabetic patients with DFU and streptozotocin (STZ)-induced diabetic mice. Topical administration of recombinant IL-25 protein improved angiogenesis and collagen deposition in the wound bed and thus ameliorated delayed diabetic wound healing. IL-25 increased endothelial-specific CD31 expression in diabetic wounds and exogenous IL-25 protected endothelial cells from high glucose-impaired cell migration and tube formation in vitro. We further revealed that IL-25-mediated-IL-17RB signaling rescued the downregulation of Wnt/β-catenin pathway both in vivo in diabetic mice and in vitro in HUVECs and induced the phosphorylation of AKT and ERK 1/2 in HUVECs under high glucose conditions. This study defines a positive regulatory role of IL-25-mediated-IL-17RB signaling in diabetic wound healing and suggests that induction of IL-25-mediated-IL-17RB signaling may be a novel therapeutic strategy for treating poor healing diabetic wounds.


The contribution of ischaemia and deformation to the conduction block generated by compression of the cat sciatic nerve.
The pattern of conduction block induced in cat peripheral nerve by compression has been investigated electrophysiologically by recording unitary action potentials. A degree of compression, associated with chronic compression disorders in man, was applied to the cat sciatic nerve and resulted in a conduction block typified by early failure of the slow conducting myelinated axons. By contrast, a greater degree of compression, a degree more likely to result in acute compression lesions, produced a different pattern of effect, inducing early conduction failure in the fast conducting myelinated axons. These results are related to earlier studies which have shown that nerve deformation during compression has a differential action upon fast myelinated axons, while nerve ischaemia has a differential action upon slow myelinated axons.


The use of psychiatric drugs and worsening body mass index among inpatients with schizophrenia.
The aim of the present study was to investigate the relationship between 10 psychotropic agents and worsening BMI from overweight to obesity among inpatients with schizophrenia. A total of 138 patients with schizophrenia were recruited in this retrospective study. We included 23 patients with worsening BMI, from overweight (24≤BMI<27 kg/m²) to obesity (BMI≥27 kg/m²), as the case group and 115 patients without a worse BMI as the control group. Data were analyzed to assess the relationships between psychiatric drug use and BMI that worsened from overweight to obesity. Of the 138 patients, 60.9% were men. Their mean age was 47.2±9.7 years, mean age of onset of disease was 32.2±10.4 years, and the mean length of illness 15.0±6.5 years. Valproic acid was found to have a significant impact on the worsening of BMI from overweight to obesity (P<0.05). Age at onset of disease, length of illness, and duration of hospitalization were not associated significantly with worsening of BMI from overweight to obesity. These results call for caution in using valproic acid in schizophrenic inpatients with BMIs indicating overweight or obesity.


Inter- and Intraobserver Agreement of 18F-FDG PET/CT Image Interpretation in Patients Referred for Assessment of Cardiac Sarcoidosis.
Recent studies have reported the usefulness of 18F-FDG PET in aiding with the diagnosis and management of patients with cardiac sarcoidosis (CS). However, image interpretation of 18F-FDG PET for CS is sometimes challenging. We sought to investigate the inter- and intraobserver agreement and explore factors that led to important discrepancies between readers. Methods: We studied consecutive patients with no significant coronary artery disease who were referred for assessment of CS. Two experienced readers masked to clinical information, imaging reports, independently reviewed 18F-FDG PET/CT images. 18F-FDG PET/CT images were interpreted according to a predefined standard operating procedure, with cardiac 18F-FDG uptake patterns categorized into 5 patterns: none, focal, focal on diffuse, diffuse, and isolated lateral wall or basal uptake. Overall image assessment was classified as either consistent with active CS or not. Results: One hundred scans were included from 71 patients. Of these, 46 underwent 18F-FDG PET/CT with a no-restriction diet (no-restriction group), and 54 underwent 18F-FDG PET/CT with a low-carbohydrate, high-fat and protein-permitted diet (low-carb group). There was agreement of the interpretation category in 74 of 100 scans. The κ-value of agreement among all 5 categories was 0.64, indicating moderate agreement. For overall clinical interpretation, there was agreement in 93 of 100 scans (κ = 0.85). When scans were divided into the preparation groups, there was a trend toward higher agreement in the low-carb group versus the no-restriction group (80% vs. 67%, P = 0.08). Regarding the overall clinical interpretation, there was also a trend toward greater agreement in the low-carb group versus the no-restriction group (96% vs. 89%, P = 0.08). Conclusion: The interobserver agreement of cardiac 18F-FDG uptake image patterns was moderate. However, agreement was better regarding overall interpretation of CS. Detailed prescan dietary preparation seemed to improve interobserver agreement.


Rapid transport of biologically intact insulin through cultured endothelial cells.
Mono A14-[125I]-iodoinsulin was incubated with cultured endothelial cells derived from bovine pulmonary arteries at physiologic conditions. The processing of the cell-bound A14-[125I]-iodoinsulin was evaluated by trichloroacetic acid precipitation, gel filtration and high performance liquid chromatography. In contrast to insulin processing in many other cell types, approximately 95% of cell bound insulin was dissociated from the cells in less than 15 minutes, and biologically intact insulin rapidly passed through the endothelial cells. The unique location of endothelial cells coupled with the ability of rapid transport of intact insulin are consistent with an endothelial role for either the transport of insulin out of the bloodstream or as an extra-pancreatic storage area for insulin.


Tracheal rupture as a result of coughing.
Tracheal rupture is mostly traumatic or iatrogenic. A few cases of spontaneous tracheal rupture have been reported in literatüre and all of them have been described posterior membraneous wall which is the weakest portion of trachea. In most of such cases, predisposing factors that weaken the tracheal structure were present. We presented the first case of spontaneous anterolateral tracheal rupture as a result of coughing that caused no respiratory distress and that spontaneously recovered without any complications. A 24 year old male presented to the emergency department with sore throat. After eating chicken shawarma, the patient felt a lump in his throat and coughed. After coughing, a tearing like and severe pain developed at his neck's front region radiating to his shoulders and back. On past medical history, the patient had no known diseases and had no history of use of medications. Physical examination findings were unremarkable except for neck tenderness. Pneumomediastinum, free air within the cervical fascias and a 4mm tracheal mural defect on the left anterolateral side at the level superior to the manubrium was observed in computerised tomography scan of neck and chest. The patient had no shortness of breath and therefore urgent surgery was not considered. Increase in free air was not seen in the control x-rays 6 hours later. The patient with a foriegn nationality left the emergency at his own will. He was contacted one month later via telephone. The patient said that his neck pain subsided and had no other complaints.


A cost effective analysis of a laparoscopic versus an open left lateral sectionectomy in a liver transplant unit.
This study aimed to assess the cost effectiveness of a laparoscopic left lateral sectionectomy (LLLS) compared with an open (OLLS) procedure and its role as a training operation as well as the learning curve associated with a laparoscopic approach. Between 2004 and 2013, a prospectively maintained database was reviewed. LLLS were compared with age- and sex-matched OLLS. In addition, the outcomes of LLLS with a consultant as the primary surgeon were compared with those performed by trainees. Forty-three LLLS were performed during the study period. LLLS was a significantly cheaper operation compared with OLLS (P = 0.001, £3594.14 versus £5593.41). The median hospital stay was shorter in the laparoscopic group (P = 0.002, 3 versus 7 days). No difference was found in outcomes between a LLLS performed by a trainee or consultant (operating time, morbidity or R1 resection rate). The procedure length was significantly shorter during the later half of the study period [120 versus 129 min (P = 0.045)]. LLLS is a significantly cost effective operation compared with an open approach with a reduction in hospital stay. In addition, it is suitable to use as a training operation.


Evaluating the Ecological Validity of the Dutch Eating Behavior Questionnaire Among Obese Adults Using Ecological Momentary Assessment.
This study evaluated the ecological validity (i.e., accurate measurement of a construct as experienced in naturalistic settings) of the self-report Dutch Eating Behavior Questionnaire (DEBQ). Obese adults (N = 50) completed the DEBQ, followed by a 2-week ecological momentary assessment protocol that included measures of eating episodes and associated intrapersonal contextual factors. Results revealed that DEBQ Emotional Eating was associated with greater negative affect and less positive affect at both pre- and post-eating episode, as well as post-eating ratings of feeling driven to eat. DEBQ External Eating was positively associated with pre-eating expectations about enjoying the taste of food, but was unrelated to actual enjoyment reported post-eating; External Eating was positively associated with the post-eating ratings of feeling driven to eat. DEBQ Dietary Restraint was positively associated with pre-eating intentions to eat less to lose/avoid gaining weight. Overall, results provide some support for the ecological validity of the DEBQ.


Somatic APC mosaicism and oligogenic inheritance in genetically unsolved colorectal adenomatous polyposis patients.
Germline variants in the APC gene cause familial adenomatous polyposis. Inherited variants in MutYH, POLE, POLD1, NTHL1, and MSH3 genes and somatic APC mosaicism have been reported as alternative causes of polyposis. However, ~30-50% of cases of polyposis remain genetically unsolved. Thus, the aim of this study was to investigate the genetic causes of unexplained adenomatous polyposis. Eight sporadic cases with >20 adenomatous polyps by 35 years of age or >50 adenomatous polyps by 55 years of age, and no causative germline variants in APC and/or MutYH, were enrolled from a cohort of 56 subjects with adenomatous colorectal polyposis. APC gene mosaicism was investigated on DNA from colonic adenomas by Sanger sequencing or Whole Exome Sequencing (WES). Mosaicism extension to other tissues (peripheral blood, saliva, hair follicles) was evaluated using Sanger sequencing and/or digital PCR. APC second hit was investigated in adenomas from mosaic patients. WES was performed on DNA from peripheral blood to identify additional polyposis candidate variants. We identified APC mosaicism in 50% of patients. In three cases mosaicism was restricted to the colon, while in one it also extended to the duodenum and saliva. One patient without APC mosaicism, carrying an APC in-frame deletion of uncertain significance, was found to harbor rare germline variants in OGG1, POLQ, and EXO1 genes. In conclusion, our restrictive selection criteria improved the detection of mosaic APC patients. In addition, we showed for the first time that an oligogenic inheritance of rare variants might have a cooperative role in sporadic colorectal polyposis onset.


Diabetes Care in Brazil: Program to Improve Primary Care Access and Quality-PMAQ.
This article describes the primary health care offered to 8118 service users with diabetes in Brazil based on data from the PMAQ (Program to Improve Primary Care Access and Quality) first survey. Structure, access, service organization and management, and clinical care quality were analyzed. Prevalence of self-reported receipt of appropriate treatment was 14.3% (95% confidence interval [CI]: 13.4-15.2). Following adjustment, it was 26% higher (prevalence ratio [PR] = 1.26; 95% CI: 1.04-1.54) when primary health care centers had all the structure items investigated, it was 13% higher (PR = 1.13; 95% CI: 1.00-1.29) when the teams' work process for service organization and management was adequate and it was 14% higher (PR = 1.14; 95% CI: 1.00-1.30) when the teams' clinical practice was adequate.


Collagen crosslinking impacts stromal wound healing and haze formation in a rabbit phototherapeutic keratectomy model.
The purpose of this study was to evaluate the elastic modulus, keratocyte-fibroblast-myocyte transformation, and haze formation of the corneal stroma following combined phototherapeutic keratectomy (PTK) and epithelium-off UV-A/riboflavin corneal collagen crosslinking (CXL) using an in vivo rabbit model. Rabbits underwent PTK and CXL, PTK only, or CXL 35 days before PTK. Rebound tonometry, Fourier-domain optical coherence tomography, and ultrasound pachymetry were performed on days 7, 14, 21, 42, 70, and 90 post-operatively. Atomic force microscopy, histologic inflammation, and immunohistochemistry for α-smooth muscle actin (α-SMA) were assessed post-mortem. Stromal haze formation following simultaneous PTK and CXL was significantly greater than in corneas that received PTK only and persisted for more than 90 days. No significant difference in stromal haze was noted between groups receiving simultaneous CXL and PTK and those receiving CXL before PTK. Stromal inflammation did not differ between groups at any time point, although the intensity of α-SMA over the number of nuclei was significantly greater at day 21 between groups receiving simultaneous CXL and PTK and those receiving CXL before PTK. The elastic modulus was significantly greater in corneas receiving simultaneous CXL and PTK compared with those receiving PTK alone. We showed that stromal haze formation and stromal stiffness is significantly increased following CXL, regardless of whether it is performed at or before the time of PTK. Further knowledge of the biophysical cues involved in determining corneal wound healing duration and outcomes will be important for understanding scarring following CXL and for the development of improved therapeutic options.


Metabolic surgery in China: present and future.
Obesity and its related complications comprise a serious public health problem worldwide, and obesity is increasing in China. Metabolic surgery is a new type of treatment with unique advantages in weight loss and obesity-related metabolic complications. The pathogenesis of obesity is complex and not yet fully understood. Here, we review the current efficacy and safety of metabolic surgery, as well as recent progress in mechanistic studies and surgical procedures in China. The exciting and rapid advances in this field provide new opportunities for patients with obesity and strike a balance between long-term effectiveness and safety.


Structure-Function Analysis of Nonarteritic Anterior Ischemic Optic Neuropathy and Age-Related Differences in Outcome.
The optic nerve head is vulnerable to ischemia leading to anterior ischemic optic neuropathy (AION), the most common acute optic neuropathy in those older than 50 years of age. We performed a cross-sectional study of 55 nonarteritic anterior ischemic optic neuropathy (NAION) eyes in 34 patients to assess clinical outcome and perform structure-function correlations. The peak age of NAION onset was between 50 and 55 years. Sixty-seven percent of patients presented with their first event between the ages of 40 and 60 years, and 32% presented at ≤50 years. Those with NAION onset at age ≤50 years did not have significantly better visual outcome per logMAR visual acuity, automated perimetric mean deviation (PMD) or optical coherence tomography (OCT) measurements. Kaplan-Meier survival curve and multivariate Cox proportional regression analysis showed that age >50 years at NAION onset was associated with greater risk of second eye involvement, with hazard ratio of 20. Older age at onset was significantly correlated with greater thinning of the ganglion cell complex (GCC) (P = 0.022) but not with logMAR visual acuity, PMD, or thinning of retinal nerve fiber layer (RNFL). Using area under receiver operating characteristic curve analyses, we found that thinning of RNFL and GCC was best able to predict visual outcome, and that mean RNFL thickness >65 μm or macular GCC thickness >55 μm significantly correlated with good visual field outcome. We showed that NAION onset at age >50 years had a greater risk of second eye involvement. Patients with OCT mean RNFL thickness >65 μm and mean macular ganglion cell complex thickness >55 μm had better visual outcomes.


Symptom-dependent taste aversion induced by an anticoagulant rodenticide in the brown rat (Rattus norvegicus).
In a series of 3 experiments with different experimental paradigms, feeding patterns of laboratory rats (Rattus norvegicus) were monitored in 2-choice feeding tests after intubation with a sublethal dose of an anticoagulant rodenticide. We report for the first time that contrary to accepted wisdom, anticoagulants can induce taste aversions. Furthermore, we report behavioral symptoms within the 1st day after dosing. Our data suggest that the taste aversion is induced through an inhibition of the vitamin K cycle and is transient, attenuating over the same period as the levels of vitamin K-dependent proteins return to normal. Because the taste aversion is expressed most strongly when symptoms are most pronounced and is not expressed after symptoms have disappeared, we term this novel form of control symptom-dependent taste aversion.


Disordered speech production in aphasic and normal speakers.
Two empirical studies are presented which seek to extend the parallels between disordered speech production in aphasia and in normals. Study 1 compares the rate and distribution of some theoretically interesting error types in a jargon aphasic and a normal error corpus. Study 2 is an investigation of how the error pattern of normal speakers evolves as utterances become more practiced. On the basis of these studies, we offer a hypothesis about the nature of the variation between more and less disordered systems. Our claim, which is developed in the context of spreading activation models of production, is that such variation is tied to the ability of the system to deliver activation to intended units, relative to that of unintended units, within the time required by the task at hand.


O-GlcNAcylation regulates phosphorylation of tau: a mechanism involved in Alzheimer's disease.
Microtubule-associated protein tau is abnormally hyperphosphorylated and aggregated into neurofibrillary tangles in brains of individuals with Alzheimer's disease (AD) and other tauopathies. Tau pathology is critical to pathogenesis and correlates to the severity of dementia. However, the mechanisms leading to abnormal hyperphosphorylation are unknown. Here, we demonstrate that human brain tau was modified by O-GlcNAcylation, a type of protein O-glycosylation by which the monosaccharide beta-N-acetylglucosamine (GlcNAc) attaches to serine/threonine residues via an O-linked glycosidic bond. O-GlcNAcylation regulated phosphorylation of tau in a site-specific manner both in vitro and in vivo. At most of the phosphorylation sites, O-GlcNAcylation negatively regulated tau phosphorylation. In an animal model of starved mice, low glucose uptake/metabolism that mimicked those observed in AD brain produced a decrease in O-GlcNAcylation and consequent hyperphosphorylation of tau at the majority of the phosphorylation sites. The O-GlcNAcylation level in AD brain extracts was decreased as compared to that in controls. These results reveal a mechanism of regulation of tau phosphorylation and suggest that abnormal hyperphosphorylation of tau could result from decreased tau O-GlcNAcylation, which probably is induced by deficient brain glucose uptake/metabolism in AD and other tauopathies.


Fast determination of salicylic acid in pharmaceuticals by using a terbium-sensitized luminescent SIA optosensor.
In this article, we report the coupling of sequential injection analysis (SIA) and solid phase lanthanide-sensitized luminescence as a detection technique; in this technique, the energy absorbed by the analyte (retained on a solid support) is transferred to the lanthanide ion, which finally emits the luminescence signal. By using this automatic system, the determination of salicylic acid (SA) is easily, rapidly, and selectively achieved. Microspheres of commercial solid support, Sephadex-QAE A-25, are used to fill the flow-through cell and retain analyte and terbium ions; after the signal from SA-terbium complex is obtained, the solid support is easily regenerated by using an ethylenediaminetetraacetic acid disodium salt 2-hydrate (EDTA) solution. Over 200 determinations can be carried out without replacing the resin microbeads. The proposed method shows a 0.045 microg mL(-1) detection limit, with an R.S.D. lower than 3% and a sampling frequency up to 30 samples per hour. The system has been applied to the determination of SA in pharmaceuticals obtained from the Spanish Pharmacopoeia, with satisfactory results; an additional recovery study has been carried out with recoveries close to 100%.


Marine Submicron Aerosols from the Gulf of Mexico: Polluted and Acidic with Rapid Production of Sulfate and Organosulfates.
We measured submicron aerosols (PM1) at a beachfront site in Texas in Spring 2021 to characterize the "background" aerosol chemical composition advecting into Texas and the factors controlling this composition. Observations show that marine "background" aerosols from the Gulf of Mexico were highly processed and acidic; sulfate was the most abundant component (on average 57% of total PM1 mass), followed by organic material (26%). These chemical characteristics are similar to those observed at other marine locations globally. However, Gulf "background" aerosols were much more polluted; the average non-refractory (NR-) PM1 mass concentration was 3-70 times higher than that observed in other clean marine atmospheres. Anthropogenic shipping emissions over the Gulf of Mexico explain 78.3% of the total measured "background" sulfate in the Gulf air. We frequently observed haze pollution in the air mass from the Gulf, with significantly elevated concentrations of sulfate, organosulfates, and secondary organic aerosol associated with sulfuric acid. Analysis suggests that aqueous oxidation of shipping emissions over the Gulf of Mexico by peroxides in the particles might potentially be an important pathway for the rapid production of acidic sulfate and organosulfates during the haze episodes under acidic conditions.


Solid state characterization of commercial crystalline and amorphous atorvastatin calcium samples.
Atorvastatin calcium (ATC), an anti-lipid BCS class II drug, is marketed in crystalline and amorphous solid forms. The objective of this study was to perform solid state characterization of commercial crystalline and amorphous ATC drug samples available in the Indian market. Six samples each of crystalline and amorphous ATC were characterized using X-ray powder diffractometry (XRPD), differential scanning calorimetry (DSC), thermogravimetric analysis, Karl Fisher titrimetry, microscopy (hot stage microscopy, scanning electron microscopy), contact angle, and intrinsic dissolution rate (IDR). All crystalline ATC samples were found to be stable form I, however one sample possessed polymorphic impurity, evidenced in XRPD and DSC analysis. Amongst the amorphous ATC samples, XRPD demonstrated five samples to be amorphous 'form 27', while, one matched amorphous 'form 23'. Thermal behavior of amorphous ATC samples was compared to amorphous ATC generated by melt quenching in DSC. ATC was found to be an excellent glass former with T(g)/T(m) of 0.95. Residual crystallinity was detected in two of the amorphous samples by complementary use of conventional and modulated DSC techniques. The wettability and IDR of all amorphous samples was found to be higher than the crystalline samples. In conclusion, commercial ATC samples exhibited diverse solid state behavior that can impact the performance and stability of the dosage forms.


Myosin Ib modulates the morphology and the protein transport within multi-vesicular sorting endosomes.
Members of at least four classes of myosin (I, II, V and VI) have been implicated in the dynamics of a large variety of organelles. Despite their common motor domain structure, some of these myosins, however, are non processive and cannot move organelles along the actin tracks. Here, we demonstrate in the human pigmented MNT-1 cell line that, (1) the overexpression of one of these myosins, myosin 1b, or the addition of cytochalasin D affects the morphology of the sorting multivesicular endosomes; (2) the overexpression of myosin 1b delays the processing of Pmel17 (the product of murine silver locus also named GP100), which occurs in these multivesicular endosomes; (3) myosin 1b associated with endosomes coimmunoprecipitates with Pmel17. All together, these observations suggest that myosin 1b controls the traffic of protein cargo in multivesicular endosomes most probably through its ability to modulate with actin the morphology of these sorting endosomes.


Leishmania braziliensis replication protein A subunit 1: molecular modelling, protein expression and analysis of its affinity for both DNA and RNA.
Replication factor A (RPA) is a single-strand DNA binding protein involved in DNA replication, recombination and repair processes. It is composed by the subunits RPA-1, RPA-2 and RPA-3; the major DNA-binding activity resides in the subunit 1 of the heterotrimeric RPA complex. In yeast and higher eukaryotes, besides the three basic structural DNA-binding domains, the RPA-1 subunit contains an N-terminal region involved in protein-protein interactions with a fourth DNA-binding domain. Remarkably, the N-terminal extension is absent in the RPA-1 of the pathogenic protozoan Leishmania (Leishmania) amazonensis; however, the protein maintains its ability to bind ssDNA. In a recent work, we identify Leishmania (Viannia) braziliensis RPA-1 by its specific binding to the untranslated regions of the HSP70 mRNAs, suggesting that this protein might be also an RNA-binding protein. Both rLbRPA-1 purified by His-tag affinity chromatography as well as the in vitro transcribed L. braziliensis 3' HSP70-II UTR were used to perform pull down assays to asses nucleic acid binding properties. Also, homology modeling was carried out to construct the LbRPA-1 tridimensional structure to search relevant amino acid residues to bind nucleic acids. In this work, after obtaining the recombinant L. braziliensis RPA-1 protein under native conditions, competitive and non-competitive pull-down assays confirmed the single-stranded DNA binding activity of this protein and demonstrated its interaction with the 3' UTR from the HSP70-II mRNA. As expected, this protein exhibits a high affinity for ssDNA, but we have found that RPA-1 interacts also with RNA. Additionally, we carried out a structural analysis of L. braziliensis RPA-1 protein using the X-ray diffraction structure of Ustilago maydis homologous protein as a template. Our results indicate that, in spite of the evolutionary divergence between both organisms, the structure of these two RPA-1 proteins seems to be highly conserved. The LbRPA-1 protein is a ssDNA binding protein, but also it shows affinity in vitro for the HSP70 mRNA; this finding supports a possible in vivo role in the HSP70 mRNA metabolism. On the other hand, the three dimensional model of Leishmania RPA-1 serves as a starting point for both functional analysis and its exploration as a chemotherapeutic target to combat leishmaniasis.


Mucosal prolapse changes in Hirschsprung's disease.
The aim of this study was to ascertain the incidence of mucosal prolapse changes in Hirschsprung's disease. Twenty-three random, consecutive resection specimens for this condition were analysed for the histological features of prolapse. Eight cases showed histological evidence suggesting mucosal prolapse at the junction between ganglionic and aganglionic bowel. Thickening and splaying of the muscularis mucosae with extension into the lamina propria, and the presence of metaplastic or hyperplastic tubules with goblet cell and cryptal hypertrophy were the dominant histological features found in the eight cases. In addition, an increase in elastic fibres in the lamina propria and diamond-shaped glands were seen to varying degrees in all eight cases. Mucosal prolapse was more prominent in the older patients and is, therefore, related to duration of symptoms. Differential pressures in ganglionic and aganglionic segments of bowel, together with faecal stream and straining are likely to be of pathogenetic significance.


Tunable whispering gallery mode emission from quantum-dot-doped microspheres.
We describe the synthesis of quantum-dot (QD) doped silica microspheres and a method by which it is possible to fine-tune the position of the whispering gallery modes (WGMs) produced by the fluorescence emission of CdSe@ZnS doped silica microspheres (5.06 mum in diameter). The method is based on small perturbations to the sphere's refractive index caused by adsorption of thin layers of polyelectrolytes and modification of the radial position of the nanocrystals within the microsphere by means of deposited silica shells.


Integrated primary care and behavioral health services for Latinos: a blueprint and research agenda.
Disparities in Latino utilization of mental health services have been documented for some years. Factors such as stigma, low rates of health insurance, paucity of culturally competent providers, and linguistic inaccessibility have contributed to this underutilization. The documented tendency of many Latinos to experience the mind and body as a unified whole, often referred to as "non-dualism"; provides a unique opportunity to address these disparities in utilization. This article advocates a specific model of engagement of Latinos into a continuum of needed behavioral health services via the primary care clinic, and suggests a variety of clinical and administrative outcome measures for evaluating the effectiveness of the model. The model centers on the inclusion of a behavioral health specialist who is "nested" within the primary care team. The preparation and perspectives of clinically trained social workers make them ideal for this role.


[Ulterior observations on the use of C3 in acute myocardial infarction: 105 patients were treated within the 1st 6 hours after the symptoms started].
Two homogeneous groups of patients with acute myocardial infarction were observed within the first six hours from the coronary attack. On admittance and for ten days, 105 patients were treated with C3: the mortality rate resulted in 13.3%. The control group of 108 patients showed a mortality of 18.5%. Strict criteria of randomization were followed in allocating patients to the two groups. Although the difference is not statistically significant it is however interesting since it confirms a previous research. Statistically significant differences between the two groups were observed in all surviving patients in the injury signs regression time and in the cardiac volume in favour of the group treated with C3.


Surveillance and diagnostic algorithm for hepatocellular carcinoma proposed by the Liver Cancer Study Group of Japan: 2014 update.
Surveillance and diagnostic algorithms for hepatocellular carcinoma (HCC) have already been described in guidelines published by the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver and the European Organisation for Research and Treatment of Cancer (EASL-EORTC), and the Japan Society of Hepatology (JSH), but the content of these algorithms differs slightly. The JSH algorithm mainly differs from the other two algorithms in that it is highly sophisticated and considers the functional imaging techniques of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI (EOB-MRI) and Sonazoid contrast-enhanced ultrasound (CEUS) to be very important diagnostic modalities. In contrast, the AASLD and EASL-EORTC algorithms are less advanced and suggest that a diagnosis be made based solely on hemodynamic findings using dynamic CT/MRI and biopsy findings. A consensus meeting regarding the JSH surveillance and diagnostic algorithm was held at the 50th Liver Cancer Study Group of Japan Congress, and a 2014 update of the algorithm was completed. The new algorithm reaffirms the very important role of EOB-MRI and Sonazoid CEUS in the surveillance and diagnosis of liver cancer and is more sophisticated than those currently used in the United States and Europe. This is now an optimized algorithm that can be used to diagnose early-stage to classical HCC easily and highly accurately.


Defining the transcriptional signature of skeletal muscle stem cells.
Satellite cells, the main source of myoblasts in postnatal muscle, are located beneath the myofiber basal lamina. The myogenic potential of satellite cells was initially documented based on their capacity to produce progeny that fused into myotubes. More recently, molecular markers of resident satellite cells were identified, further contributing to defining these cells as myogenic stem cells that produce differentiating progeny and self-renew. Herein, we discuss aspects of the satellite cell transcriptional milieu that have been intensively investigated in our research. We elaborate on the expression patterns of the paired box (Pax) transcription factors Pax3 and Pax7, and on the myogenic regulatory factors myogenic factor 5 (Myf5), myogenic determination factor 1 (MyoD), and myogenin. We also introduce original data on MyoD upregulation in newly activated satellite cells, which precedes the first round of cell proliferation. Such MyoD upregulation occurred even when parent myofibers with their associated satellite cells were exposed to pharmacological inhibitors of hepatocyte growth factor and fibroblast growth factor receptors, which are typically involved in promoting satellite cell proliferation. These observations support the hypothesis that most satellite cells in adult muscle are committed to rapidly entering myogenesis. We also detected expression of serum response factor in resident satellite cells prior to MyoD expression, which may facilitate the rapid upregulation of MyoD. Aspects of satellite cell self-renewal based on the reemergence of cells expressing Pax7, but not MyoD, in myogenic cultures are discussed further herein. We conclude by describing our recent studies using transgenic mice in which satellite cells are traced and isolated based on their expression of green fluorescence protein driven by regulatory elements of the nestin promoter (nestin-green fluorescence protein). This feature provides us with a novel means of studying satellite cell transcriptional signatures, heterogeneity among muscle groups, and the role of the myogenic niche in directing satellite cell self-renewal.


Racial differences in the relationship between tobacco, alcohol, and squamous cell carcinoma of the head and neck.
Tobacco and alcohol use are well-known risk factors for squamous cell carcinoma of the head and neck (SCCHN), but there has been little examination of disparities in SCCHN and racial patterns of tobacco and alcohol use, especially for African-Americans. The Carolina Head and Neck Cancer Study, a population-based case-control study, was utilized to determine whether relationships between tobacco and alcohol use and SCCHN differed by race. Using a rapid case ascertainment system, cases were recruited from 46 contiguous counties in North Carolina from 2002 to 2006. Controls, selected from motor vehicle records, were frequency-matched to cases on age, sex, and race. This analysis was based on 989 white and 351 African-American cases and 1,114 white and 264 African-American controls. Analyses were performed using unconditional logistic regression, adjusting for age, sex, race, education, and fruit and vegetable consumption. The association between SCCHN and ever tobacco use among African-Americans (odds ratio (OR), 9.68; 95 % confidence interval (CI), 4.70, 19.9) was much greater than that observed in whites (OR, 1.94; 95 % CI, 1.51, 2.50). Smaller differences were observed when examining ever alcohol use (African-Americans: OR, 3.71; CI, 1.65, 8.30, and Whites: OR, 1.31: CI 0.96, 1.78). African-Americans consistently had greater effect measure estimates when examining common levels of duration and intensity metrics of tobacco and alcohol use, both independently and jointly. No racial differences in the effects of environmental (passive) tobacco smoke were observed. These findings suggest racial differences in SCCHN are not solely explained by differences in consumption patterns, and tobacco and alcohol may have greater impact in African-Americans.


Identification of potential targets for thylakoid oxidoreductase AtVKOR/LTO1 in chloroplasts.
The Arabidopsis thylakoid membrane bimodular oxidoreductase, AtVKOR, could catalyze disulfide bond formation, and its direct functional domain (thioredoxin-like domain) is located in the thylakoid lumen according to the topological structure. Many proteins have one or several disulfide bonds in the thylakoid lumen, including photosynthetic chain components. A yeast two-hybrid assay was used to identify potential targets for the AtVKOR, and a Trx-like domain was constructed into a BD vector as bait. Twenty-two thylakoid lumenal proteins with disulfides were selected. The cDNAs encoding these proteins were constructed into an AD vector. Eight proteins were identified from the hybrid results to interact with AtVKOR, including HCF164, cytochrome c6A, violaxanthin deepoxidase, embryo sac development arrest 3 protein (EDA3), two members pentapeptide repeat proteins (TL17 and TL20.3), and two FK-506 binding proteins (FKBP13 and FKBP20-2). The BIACORE system was used to demonstrate that the recombinant HCF164 and Trx-like domain of AtVKOR could interact directly in vitro. The KD value for binding HCF164 to AtVKOR was calculated as 2.5×10(-6) M. These results suggest that AtVKOR can interact with partial thylakoid lumenal proteins and indicates AtVKOR plays an important role in regulating the thylakoid lumen redox.


TRIF signaling stimulates translation of TNF-alpha mRNA via prolonged activation of MK2.
The adapter protein TRIF mediates signal transduction through TLR3 and TLR4, inducing production of type I IFNs and inflammatory cytokines. The present study investigates the mechanisms by which TRIF signaling controls TNF-alpha biosynthesis. We provide evidence that, in LPS-stimulated murine dendritic cells, TRIF stimulates TNF-alpha biosynthesis selectively at the posttranscriptional level by promoting mRNA translation. In the absence of functional TRIF, the production of TNF-alpha protein was severely impaired, whereas TNF-alpha mRNA levels and stability, as well as transcriptional activity of the Tnfa gene, were not affected. Similarly, TRIF was required for production of LPS-induced TNF-alpha protein, but not of mRNA, in bone marrow-derived macrophages. In peritoneal macrophages, however, TRIF was also required for normal induction of TNF-alpha mRNA, suggesting cell type-related functions of TRIF. The influence of TRIF on dendritic cell TNF-alpha production was independent of type I IFNs. TRIF was required for prolonged activation of MAPKs in LPS-stimulated dendritic cells but was dispensable for the activation of NF-kappaB. Inhibition of late p38 activity attenuated LPS-stimulated elevation of TNF-alpha protein but not mRNA levels. The p38 effector kinase MK2 was directly activated through the TRIF pathway of TLR4. Importantly, stimulation of Mk2(-/-) cells through TLR3 or TLR4 severely impaired TNF-alpha protein production but did not affect TNF-alpha mRNA induction. Together, these results indicate that the TRIF signaling pathway promotes TNF-alpha mRNA translation through activation of the protein kinase MK2.


Current practice compared with the international guidelines: endoscopic surveillance of Barrett's esophagus.
To describe the current practice for the surveillance of patients with Barrett's esophagus, to compare this practice with the national guidelines published by the French Society of Digestive Endoscopy in 1998 and to identify the factors associated with the compliance to guidelines. To determine the attitudes of French hepatogastroenterologists to screening for Barrett's oesophagus, a postal anonymous questionnaire survey was undertaken. It was sent to 246 hepatogastroenterologists in the Rhone-Alpes area. We defined eight criteria allowed to assess the conformity of practices with the guidelines. We created three topics composed of several criterion. The topics analysed were 'Biopsies', 'Surveillance' and the diagnosis of high grade dysplasia. We studied the factors which could be associated with the compliance with the guidelines. The response rate was 81.3%. For 58.0% of the gastroenterologists, endoscopic biopsy sampling were made according to French guidelines (four-quadrant biopsies at 2 cm intervals). Agreement was 78.0% regarding the interval of surveillance for no dysplasia (every 2 or 3 years) and 78.5% regarding the low-grade dysplasia (every 6 or 12 months). For the management of high-grade dysplasia, 28.6% actually confirm the diagnosis by a second anatomopathologist and 42.0% treated by proton pump inhibitor during 2 months. Concerning the biopsies, the young gastroenterologists and gastroenterologists practising in university hospitals had a better adherence to the guidelines (Relative Risk: 2.22, 95% CI 1.25-3.95 and 3.74, 95% CI 1.04-13.47, respectively). The other factors of risk were not statistically significant. The endoscopic follow-up is mostly realized in accordance with the national guidelines. However, there is a wide variability in individual current practice.


Study of tensioactive properties of casein signal peptides and their interactions with phospholipids.
The high degree of sequence conservation in casein signal peptides reflects their unique functional properties. A series of casein signal peptides and derivatives was synthesized in order to study their insertion in phospholipidic mono- and bilayer structures. Most of these amphiphilic peptides were found to be highly tensio-active. Their conformations differ and are solvent dependent. Fluorescence anisotropy measurements showed that all the peptides of the series could interact with dimyristoylphosphatidyl -choline and -glycerol when mixed with the lipids prior to hydration of the liposomes. The most soluble peptide, P6, was selected for insertion experiments in multilamellar vesicles. Its interaction with liposomes is efficient and rapid, being temperature dependent. On the one hand, the physico-chemical measures of interactions of signal peptides of casein beta and alpha s2 confirm their mutual genetic relationship, and on the other hand they show the divergence of casein beta and alpha s2 from casein kappa signal peptide.


Nursing ethics: current state of the art.
... The essays in this issue of the Journal highlight the types of insights that nursing ethics brings to health care ethics, in general, and attempt to address questions about the adequacy of the conceptual and theoretical foundations of bioethics for a practice discipline like nursing. The essays are written by nurses and non-nurses and bring a surprising balance to the discussion of important issues in nursing ethics from several perspectives. The essays do not represent the full scope of philosophical thought and normative judgements in nursing ethics at the present time, but they do provide a view of nursing ethics through the lens of nursing ethics research, past and present. [Introductions follow to essays by Joy H. Penticuff, Joan Liaschenko and Anne J. Davis, Nancy S. Jecker and Donnie J. Self, Betty J. Winslow and Gerald R. Winslow, Robert J. Connelly, Patricia A. Roth and Janet K. Harrison, and Kevin Wildes].


Preparation of fluffy bimodal conjugated electrospun poly(lactic acid) air filters with low pressure drop.
Electrospun nanofiber membranes have been extensively studied as air filters. However, their limited filtration efficiency for submicron inhalable particulate matter (PM), high resistance to filtration, and limited capacity to hold dust have hindered their widespread use. The majority of materials come from petroleum, and the use of organic solvents during the spinning process has a significant negative impact on the environment. In this work, a sustainable method has been proposed for producing filters using poly(lactic acid) (PLA) with a bimodal diameter distribution through conjugated electrospinning. This technique allows for the continuous production of interconnected micro/nano hybrid porous membranes, resulting in reduced resistance and improved dust holding capacity. The filtration efficiency, pressure drop, long-term filtration performance, and actual performance of the conjugated bimodal membrane (CBM) were extensively investigated. The results indicate that the filter has a high capacity for retaining particles, with filtration efficiencies of 99.94% for PM 0.3 and 99.96% for PM 2.5. It also demonstrates a high quality factor (0.078 Pa-1 for PM 0.3 and 0.084 Pa-1 for PM 2.5), long-term stability (a decrease of 2.35% for PM 0.3 and 0.05% for PM 2.5 over a period of 60 days) and outstanding dust holding capacity (9.17 g m-2). The conjugated bimodal membrane (CBM) shows a 22.64% decrease in resistance compared to the non-conjugated bimodal membrane (BM). In general, the approach outlined in this work provides valuable insights into the development of high-performance biodegradable air filters. These filters have improved filtration efficiency and reduced resistance.


Density functional study of structure and dynamics in liquid antimony and Sbn clusters.
Density functional/molecular dynamics simulations have been performed on liquid antimony (588 atoms and six temperatures between 600 K and 1300 K) and on neutral Sb clusters with up to 14 atoms. We study structural patterns (coordination numbers, bond angles, and ring patterns, structure factors, pair distribution functions) and dynamical properties (vibration frequencies, diffusion constants, power spectra, dynamical structure factors, viscosity) and compare with available experimental results and with the results of our previous simulations on Bi. Three short covalent bonds characteristic of pnictogens are common in the clusters, and higher temperatures lead in the liquid to broader bond angle distributions, larger total cavity volumes, and weaker correlations between neighboring bond lengths. There are clear similarities between the properties of Sb and Bi aggregates.


Carpal tunnel syndrome: surgical and nonsurgical treatment.
A retrospective study was performed to evaluate treatment for carpal tunnel syndrome. Two hundred sixty-five patients were treated over a 4 1/2-year period. Only patients in whom studies showed abnormal nerve conduction (a median nerve sensory latency greater than 3.6 msec or a median distal motor latency greater than 4.3 msec) were included in the evaluation. Nonsurgical treatment consisted of patient education, wrist splinting, B vitamins, nonsteroidal anti-inflammatory medication, steroid injections, and job change or modification when possible. A follow-up history, physical examination, and repeat nerve conduction studies were performed at 3- to 9-month intervals, depending on the severity of symptoms and the degree of abnormal latencies. Surgery was performed on 77 patients and 95 hands. The remaining 188 patients were treated nonsurgically. Both surgically and nonsurgically treated patients considered the results to be satisfactory.


Diabetes cognitive impairments and the effect of traditional chinese herbs.
The problem of cognitive impairment resulting from diabetes is gaining more acceptance and attention. Both type 1 and type 2 diabetes mellitus have been proved to be associated with reduced performance on numerous domains of cognitive function. Although the exact mechanisms of cognitive impairments in diabetes have not been completely understood, hyperglycemia and insulin resistance seem to play significant roles. And other possible risk factors such as hypoglycemia, insulin deficiency, vascular risk factors, hyperactive HPA axis, depression, and altered neurotransmitters will also be examined. In the meanwhile, this review analyzed the role of the active ingredient of Chinese herbal medicine in the treatment of diabetes cognitive impairments.


Incidence and risk factors of preoperative venous thromboembolism and pulmonary embolism in patients with ovarian cancer.
To determine the incidence and predisposing factors of preoperative venous thromboembolism (VTE), especially pulmonary embolism (PE) in patients with ovarian cancer. This retrospective study included 387 patients with primary ovarian cancer, whose preoperative work up included both ultrasonography of lower extremity vein and spiral computed tomography pulmonary angiogram, from September 2013 to November 2016. SPSS 22 was used for statistical analyses. The incidence of preoperative VTE and PE was 13.4% (52 patients), 9.3%(36 patients), respectively. Both the univariate and multivariate analyses revealed that D-dimer (DDI) level, age, and massive ascites were associated with preoperative VTE. Moreover, DDI level (odds ratio [OR] 3.133, 95% confidence interval [CI] 1.193-8.225, p = .02), massive ascites (OR 9.972, 95% CI 3.687-26.968, p < .001), and preoperative deep vein thrombosis (OR 5.977, 95% CI 2.073-17.228, p = .001) were independent predictors for preoperative PE. Additionally, the incidence of preoperative VTE and PE increased with increasing DDI levels (p < .001). DDI level < 1.5 μg/ml has 100% negative predictive value and 100% sensitivity for diagnosis of preoperative VTE and PE; however, DDI >5 μg/ml, the incidence of preoperative VTE and PE were 18.4% and 14.2% respectively. Moreover, DDI value was significantly correlated with preoperative PE volume (r = 0.746, p < .001). Preoperative VTE and PE are common events in patients with ovarian cancer. DDI level is a useful parameter for diagnosing and evaluating preoperative VTE and PE.


Molecular Functionalization of Two-Dimensional MoS2 Nanosheets.
Molybdenum disulfide (MoS2 ) nanosheets have attracted great scientific interest for their remarkable electronic and optical properties. During the last few years significant progress on exfoliation methods of such nanosheets allowed the development of surface functionalization in covalent or noncovalent fashion. Markedly, the chemical modification allows tailoring and tuning the optical and electronic characteristics of MoS2 , opening new avenues for the potentiality of MoS2 -based hybrids in diverse technological fields. Physisorption of organic molecules onto MoS2 through the development of numerous van der Waals interactions is the most widely approach employed for the surface noncovalent immobilization of organic species onto MoS2 nanosheets. Conversely, developed strategies for the edge and in-plane covalent functionalization of MoS2 mainly concern chemistry at S vacancies, direct C-S bond formation, and coordination of S edges at metal centers. Herein, we focus into the most representative molecular doping strategies and material designing of MoS2 -based hybrid nanostructures carrying photo- and/or electro-active components. Key points related with the exfoliation routes, the surface functionalization approaches and their impact on the electronic properties of the functionalized nanosheets are comprehensively discussed, offering a toolbox for scientists of different disciplines interested in putting a step forward in the field of transition-metal dichalcogenide-based materials.


Purely positive or discriminatorily positive? The development of two-factor attitudes toward lesbians and gay men scales.
Unidimensional bipolar scales based on prejudice against homosexuality neglect the effect of preference for heterosexuality on attitudes toward homosexuality. Additionally, the term "homosexuality" used in these scales may compromise their validity. The current study uses person-centered and variable-centered approaches to examine the structure and classes of attitudes toward lesbians and gay men. In Study 1, we developed the Two-factor Attitudes toward Lesbians and Gay Men Scales, which have acceptable reliability and validity. The results obtained through variable-centered approaches suggested that a model comprising two factors (prejudice against homosexuality and preference for heterosexuality) was ideal. In Study 2, we explored the classes of attitudes toward lesbians and gay men through latent class analysis. The results supported a model containing three classes (purely positive, discriminatorily positive, and negative). This study validates a two-factor structure of attitudes toward lesbians and gay men and distinguishes between purely positive and discriminatorily positive attitudes, providing an important reference for future research and interventions to promote public attitudes toward lesbians and gay men.


Hybrid zinc oxide nanoparticles for biophotonics.
A novel Zinc oxide (ZnO)-Hydrogel fluorescent colloidal semiconductor nanomaterials system is presented for potential bio-medical applications such as cell and tissue imaging. ZnO nanoparticles (NPs) synthesized using arc discharge technique has been conjugated to bio-compatible Poly N-isopropylacrylamide (PNIPAM) based hydrogel polymer matrix. The stability and fluorescence of ZnO nanoparticles are significantly enhanced using hydrogel colloidal dispersion. Photoluminescence spectroscopy indicates approximately 10 times enhancement in fluorescence in ZnO-Hydrogel colloidal system compared to ZnO-Water system, confirming the surface modification of ZnO nanoparticles by hydrogel polymer matrix. Femtosecond time resolved fluorescence measurement demonstrates that the fluorescence is due to the enhancement in absorption by the ZnO nanoparticles due to scattering by PNIPAM nanospheres.


Energy consumption and innovation-environmental degradation nexus in BRICS countries: new evidence from NARDL approach using carbon dioxide and nitrous oxide emissions.
The BRICS nations-Brazil, Russia, India, China, and South Africa-have grown significantly in importance over the past few decades, playing a vital role in the development and growth of the global economy. This expansion has not been without cost, either, since these countries' concern over environmental deterioration has risen sharply. Both researchers and decision-makers have focused a lot of attention on the connection between economic growth and ecological sustainability. By using nonlinear autoregressive distributed lag (NARDL) approach, the complex relationships were analyzed between important economic indicators-such as gross domestic product (GDP), ecological innovations (EI), energy consumption (ENC), institutional performance (IP), and trade openness (TOP)-and their effect on carbon emissions and nitrous oxide emissions in the BRICS countries from 1990 to 2021, this study seeks to contribute to this important dialog. Principal component analysis is formed for technological innovations and institutional performance using six (ICT service exports as a percentage of service exports, computer communications as a percentage of commercial service exports, fixed telephone subscriptions per 100 people, internet users as a percentage of the population, number of patent applications, and R&D expenditures as a percentage of GDP) and twelve (government stability, investment profile, socioeconomic conditions, internal conflict, external conflict, military in politics, control of corruption, religious tensions, ethnic tensions, law and order, bureaucracy quality, and democratic accountability) distinct indicators, respectively. The results of nonlinear autoregressive distributed lag estimation show that increase in economic growth would increase carbon dioxide and nitrous oxide emissions. The positive and negative shocks in trade openness have positive and significant impact on carbon dioxide and nitrous oxide emissions in BRICS countries. Furthermore, the positive shock energy consumptions have positive and significant effect on Brazil and India when carbon dioxide and nitrous oxide emissions are used. However, EKC exists in BRICS countries when carbon dioxide and nitrous oxide emissions are used. According to long-term estimation, energy consumption and technological innovations in the BRICS countries show a strong and adverse link with nitrous oxide and a favorable relationship with carbon dioxide emissions. In the long run, environmental indicators are seen to have a major and unfavorable impact in BRICS nations. Finally, it is proposed that BRICS nations can assure environmental sustainability if they support creative activities, enhance their institutions, and support free trade policies.


Detection of Verticillium species in Swedish soils using real-time PCR.
Verticillium species are soilborne plant pathogens, responsible for big yield losses worldwide. Here, we report improved procedures to generate DNA from Verticillium species imbedded in farm soils. Using new genomic sequence information, primers for V. dahliae, V. albo-atrum, V. tricorpus, and V. longisporum were designed. In a survey of 429 samples from intensively farmed soil of two Swedish regions, only V. dahliae and V. longisporum were identified. A bias towards V. longisporum (40%) was seen in the south, whereas V. dahliae was more frequent in the western region (19%). Analyses of soil and leaf samples from 20 sugar beet fields, where foliar wilting had been observed, revealed V. dahliae DNA in all leaf and soil samples and V. longisporum in 18 soil samples, illustrating host choice and longevity of the V. longisporum microsclerotia. This study demonstrates the applicability of new molecular diagnostic tools that are important for growers of variable crops.


Unilateral favre-racouchot disease: evidence for the etiological role of chronic solar damage.
Favre-Racouchot disease commonly presents as comedones, cysts and elastosis in the periocular region of older men. Its etiology has been linked to several exogenous factors. Here we present 2 patients with strictly unilateral manifestation of the disease and a corresponding history of predominantly one-sided chronic occupational sun exposure and smoking, making the case for the causative role of these two factors.


A simple one step synthesis of magnetic-optical dual functional ZIF-8 in a sodalite phase for magnetically guided targeting bioimaging and drug delivery.
Functionalized metal-organic frameworks (MOFs) that integrate targeted tumor imaging and drug delivery are expected to significantly enhance the therapeutic efficacy of cancer. However, the complicated synthesis process has greatly limited their utilization in clinical application. Herein, a one-step simple method was used to construct novel multifunctional MOFs by co-loading doxorubicin (DOX) and Fe3O4 into the ZIF-8 with sodalite topology. DOX serves as a fluorescence imaging reagent and an anticancer drug and Fe3O4 is used as a magnetic resonance imaging and magnetic targeting anticancer reagent. The fabricated DOX/Fe3O4@ZIF-8 nanocomposite showed excellent fluorescence and magnetic resonance imaging performances in tumors. Moreover, DOX/Fe3O4@ZIF-8 can be accumulated in tumors via a magnetic targeting effect and tumor growth could be inhibited in vivo due to the release of DOX. Additionally, the apoptosis process of DOX/Fe3O4@ZIF-8 on HepG2 cells is well investigated. Overall, DOX/Fe3O4@ZIF-8 synthesized in simple one step can be used for simultaneous targeted bioimaging and cancer therapy.


Viscosity of human bile sampled from the common bile duct.
Cholestasis is a frequent gastroenterological problem, which is tackled by endoscopic procedures. Little is known about bile viscosity, a major determinant of its flow. We measured the viscosity of bile from the common bile duct during endoscopic retrograde cholangiography. Bile was aspirated immediately after cannulation of the papilla and deep-frozen. Viscosity was measured with a rotational viscometer at 37 degrees C and a broad range of shear rates (0.08-69.5 s(-1)). The majority of the 138 patients (64.5%) had bile viscosities between water (0.7 mPa.s) and the lower limit of plasma (1.1 mPa.s). In 20 patients (14.5%) it was above that of plasma (>1.4 mPa.s), and showed a non-Newtonian behaviour, i.e. the viscosity increased exponentially with decreasing shear rate. Cholecystectomized patients had a lower bile viscosity. Bile viscosities did not differ between patient groups with either choledocholithiasis, sludge, cholangitis, biliary pancreatitis, pancreatic carcinoma, or cholangiocarcinoma. We conclude that bile viscosity in the common bile duct is usually lower than that of plasma, in 15% it is higher and increases exponentially with decreasing flow rate, which may lead to a vicious cycle.


Preclinical evaluation of an MRI-compatible pneumatic robot for angulated needle placement in transperineal prostate interventions.
To evaluate the targeting accuracy of a small profile MRI-compatible pneumatic robot for needle placement that can angulate a needle insertion path into a large accessible target volume. We extended our MRI-compatible pneumatic robot for needle placement to utilize its four degrees-of-freedom (4-DOF) mechanism with two parallel triangular structures and support transperineal prostate biopsies in a closed-bore magnetic resonance imaging (MRI) scanner. The robot is designed to guide a needle toward a lesion so that a radiologist can manually insert it in the bore. The robot is integrated with navigation software that allows an operator to plan angulated needle insertion by selecting a target and an entry point. The targeting error was evaluated while the angle between the needle insertion path and the static magnetic field was between -5.7° and 5.7° horizontally and between -5.7° and 4.3° vertically in the MRI scanner after sterilizing and draping the device. The robot positioned the needle for angulated insertion as specified on the navigation software with overall targeting error of 0.8 ± 0.5mm along the horizontal axis and 0.8 ± 0.8mm along the vertical axis. The two-dimensional root-mean-square targeting error on the axial slices as containing the targets was 1.4mm. Our preclinical evaluation demonstrated that the MRI-compatible pneumatic robot for needle placement with the capability to angulate the needle insertion path provides targeting accuracy feasible for clinical MRI-guided prostate interventions. The clinical feasibility has to be established in a clinical study.


Alteration of cardiac autonomic function in patients with newly diagnosed epilepsy.
The aim of the study was to determine if heart rate variability (HRV) showed any changes in patients with newly diagnosed epilepsy in comparison with controls. Sixty-five patients with epilepsy (38 males and 27 females), aged 30-50 years, who had never previously received treatment with antiepileptic drugs were eligible for inclusion in this study. Resting electrocardiogram (ECG) at spontaneous respiration was recorded for 5 min in supine position. Time-domain analysis, frequency-domain analysis, and Poincare plot of HRV were recorded from ECG In time-domain measures, the square root of the mean of the sum of the squares of differences between adjacent RR intervals (RMSSD) and percentage of consecutive RR intervals that differ by more than 50 msec (pNN50) were significantly less in patients with epilepsy. In frequency-domain measures, high frequency [(HF) msec(2)], HF (nu), and low frequency [LF (msec(2))] were significantly less in patients with epilepsy while LF (nu) and LF/HF were significantly high in patients with epilepsy. In Poincare plot, standard deviation perpendicular to line of Poincare plot (SD1) and standard deviation along the line of entity in Poincare plot (SD2) were significantly less in patients with epilepsy. Our results suggest that epileptic patients have an impact on the cardiac autonomic function as measured by HRV.


Insulin action in cultured HTC and H35 rat hepatoma cells: receptor binding and hormone sensitivity.
Insulin receptors and several biological effects of insulin were measured in H35 and HTC cells, two rat hepatoma lines in permanent cell culture that have been employed previously to study glucocorticoid action. In H35 cells, insulin at concentrations as low as 1 pM both enhanced tyrosine amino-transferase activity and stimulated [3H]uridine incorporation into RNA. In this cell line, the binding of approximately 10 molecules of insulin/cell was sufficient to elicit these two biological responses. In contrast, in HTC cells, much higher concentrations of insulin (3 nM or greater) were needed to stimulate both tyrosine aminotransferase activity and other biological functions. When insulin receptors were measured, both cell types had a major insulin-binding site with a Kd of approximately 20 nM. H35 cells, however, had approximately 6 times more receptors per cell than HTC cells. In both cell types, insulin degradation was minimal. These findings indicate that several biological functions in H35 cells are extremely sensitive to insulin in vitro. In contrast, HTC cells are much less sensitive to the hormone. This lack of sensitivity in HTC cells most likely reflects a decrease in the number of insulin receptors present. In addition, the very large differences in responsiveness suggest that postreceptor alterations are also operative.


Primary omentum extraskeletal osteosarcoma in a dog: case report.
A rescued male mixed-breed dog, approximately nine years old, was evaluated due to progressive weight loss and an enlarged abdomen. An ultrasound revealed a large, indeterminate mass with mineral-like margins visible on the radiographs. The animal underwent an exploratory laparotomy, and the mass was excised. Histopathological analysis revealed characteristics consistent with a primary omentum extraskeletal osteosarcoma. This rare neoplasm, originating from mesenchymal cell proliferation and bone matrix production, is highly malignant. It often results in death due to metastasis and local recurrence or necessitates euthanasia post-diagnosis in certain cases.


Progressive myoclonic epilepsies: recent genetic advances.
The progressive myoclonic epilepsies are a rare group of debilitating epileptic encephalopathies characterized by myoclonic seizures, progressive neurological dysfunction and dementia. In the past year advances in gene mapping have isolated gene loci for the majority of progressive myoclonic disorders, paving the way for specific diagnosis, more accurate prognosis and risk calculation, as well as opening the potential for prenatal and pre-symptomatic diagnosis in at risk families.


Radionuclide imaging of primary tumors and tumor-like conditions of the liver.
The unique information provided by radionuclide techniques allows the noninvasive characterization of primary tumors and tumor-like conditions of the liver. A thorough knowledge of the mechanisms of radiopharmaceutical localization and the histologic abnormalities present in each condition is required to optimally use these techniques. A review of this subject is presented.


Right Ring Finger Volar Mass in a 14-Year-Old Boy.
A trigger digit is relatively uncommon in adolescents and often has a different etiology in that age group vs adults. In the pediatric population, trigger digits frequently arise from a variety of underlying anatomic situations, including thickening of the flexor digitorum superficialis or flexor digitorum profundus tendons, an abnormal relationship between the flexor digitorum superficialis and flexor digitorum profundus tendons, a proximal flexor digitorum superficialis decussation, or constriction of the pulleys. In addition, underlying conditions such as mucopolysaccharidosis, juvenile rheumatoid arthritis, Ehlers-Danlos syndrome, and central nervous system disorders such as delayed motor development have been associated with triggering. Less commonly, triggering secondary to intratendinous or peritendinous calcifications or granulations has been described, which is what occurred in the current case. This report describes a case of tenosynovitis with psammomatous calcification treated with excision of the mass from the flexor digitorum superficialis tendon and release of both the A1 and palmar aponeurosis pulleys in an adolescent patient. [Orthopedics. 2017; 40(5):e918-e920.].


Congenital syphilis re-emergence in Winnipeg, Manitoba.
Infectious syphilis rates have been increasing in Winnipeg, Manitoba among individuals during their childbearing years. Untreated or inadequately treated prenatal infection often results in congenital syphilis, with devastating consequences to fetal health and survival. The objective of this study was to review public health surveillance data regarding congenital syphilis incidence and birthing parent risk factors in Winnipeg from 2018 to 2020. Data extracted from a population-based surveillance database maintained by the Winnipeg Regional Health Authority Public Health investigations for all 2018-2020 probable or confirmed cases of early congenital syphilis or syphilitic stillbirth were reviewed. Rates of congenital syphilis were calculated per 1,000 live births. Descriptive analyses were performed to describe birthing parent age, neighbourhood of residence, intravenous substance use, Child and Family Services involvement, access to prenatal care and obtainment of adequate prenatal treatment. There were eight cases of confirmed/probable congenital syphilis in 2018, 22 cases in 2019 and 30 cases in 2020. Average birthing parent age was 26.5-27.0 years. The majority (66.7%) of birthing parents lived in inner city neighbourhoods with known infectious syphilis outbreaks. Over 50% of birthing parents did not receive any prenatal care, or the care received consisted of inadequate treatment or follow-up. Reinfection among birthing parents who did receive prenatal care was suspected in an additional 23.3% of cases. Congenital syphilis rates in Winnipeg have increased dramatically. Public health and healthcare provider efforts to address the needs of the community are vital for promoting access to safe and effective prenatal care.


[Management of genitourinary trauma].
Urogenital trauma often occurs in the context of polytrauma patients. In this article, aimed at primary care practitioners and emergency physicians, we summarise the epidemiology and aetiology of these traumas as well as their management. The goal is to allow primary healthcare professionals to become acquainted with diagnostic and therapeutic strategies in genitourinary trauma patients.


Monoclonal antibodies and prostate-specific membrane antigen.
Efforts are increasing to identify and evaluate diagnostic and therapeutic markers for prostate cancer patients. One of these, prostate-specific membrane antigen (PSMA), a transmembrane protein highly expressed in all types of prostatic tissue (eg, benign epithelium, benign prostatic hyperplasia, prostatic intra-epithelial neoplasia and adenocarcinomas, with increased binding affinity for malignant cells), is becoming an increasingly important diagnostic and therapeutic marker, not only for prostate cancer, but possibly for other malignant lesions. Recent studies have demonstrated PSMA expression in endothelial cells of tumor-associated neovasculature (including carcinoma of the colon, breast, bladder, pancreas, kidney and melanoma), thus greatly expanding its possible beneficial role, especially as new anti-PSMA mAbs continue to be developed and refined. Future diagnostic and therapeutic interventions utilizing these antibodies will become increasingly important in not only prostate cancer but perhaps many other different malignancy types.


[Long-term mechanical circulatory support for terminal cardiac insufficiency refractory to medical treatment].
Constant progress has been made over the years in order to improve the performance of mechanical circulatory support devices. After the introduction of portable blood pump systems into clinical practice, we now study the performance characteristics of totally implantable mechanical circulatory support systems which do not require percutaneous drive lines or percutaneous electrical wiring. As a matter of fact, transcutaneous energy transfer is now achieved by induction, and pump controller performance read-out and pump parameter adjustment is performed by telemetry. The indication for clinical use of such devices has to be evaluated carefully. Mainly patients in need of a heart transplant but having contraindications to move forward (advanced age, former neoplasm, persistent antibodies) have benefits from such devices as destination therapy.


Diagnostic and clinical significance of Crohn's disease-specific anti-MZGP2 pancreatic antibodies by a novel ELISA.
We developed a new IgA and IgG anti-MZGP2 antibody ELISAs based on recombinant isoform-4 of human zymogen granule protein-2 (GP2), which is the major autoantigen of Crohn's disease (CrD)-specific pancreatic autoantibodies and assessed their clinical relevance in the largest inflammatory bowel disease (IBD) cohort tested to date. 832 sera were studied, including 617 consecutive IBD patients from 323 CrD and 294 ulcerative colitis (UC) follow-up in a tertiary centre, and 112 pathological and 103 normal controls. Sensitivity of IgA anti-MZGP2 for CrD in the IBD population was 15% and specificity was 98% (95, 99), while the sensitivity and specificity of IgG anti-MZGP2 were 27% and 97%. IgA and IgG anti-MZGP2 combined testing led to a sensitivity of 31% and a specificity of 96%. Positivity for either ASCA (IgA or IgG) or anti-MZGP2 (IgA or IgG) showed a sensitivity of 75% (70, 80) and a specificity of 84% (79, 89). IgA anti-MZGP2 antibodies were more prevalent in CrD patients with early disease onset (p=0.011). Also, anti-MZGP2 positive patients more frequently had extensive disease with ileal involvement. Patients with longer disease duration were more likely to have IgG anti-MZGP2 antibodies. Our novel ELISA confirms the high specificity of anti-MZGP2 antibodies for CrD and their association with disease severity phenotypes.