Pediatric to adult transition: a personal experience.
Transitioning from pediatric to adult transplant programs presents various challenges to the patient, his or her family, and the healthcare staff. In this personal, retrospective account of the issues associated with transitioning, a patient and a nephrologist provide insights into some of the problems they confronted.


Shape-control of CeF3 nanocrystals by doping polyoxometalates: syntheses, characterization and tunable photoluminescence.
A series of CeF3 nanocrystals with uniform morphologies have been synthesized by introducing various polyoxometalates as dopants and shape modifiers. The results indicate that the shape and photoluminescence of the CeF3 nanocrystals could be finely tuned by changing the component and amount of the polyoxometalates.


Molecular dynamics simulations of salicylate effects on the micro- and mesoscopic properties of a dipalmitoylphosphatidylcholine bilayer.
Salicylate, an amphiphilic molecule and a popular member of the nonsteroidal anti-inflammatory drug family, is known to affect hearing through reduction of the electromechanical coupling in the outer hair cells of the ear. This reduction of electromotility by salicylate has been widely studied, but the molecular mechanism of the phenomenon is still unknown. In this study, we investigated one aspect of salicylate's action, namely the perturbation of electrical and mechanical membrane properties by salicylate in the absence of cytoskeletal or membrane-bound motor proteins such as prestin. In particular, we simulated the interaction of salicylate with a dipalmitoylphosphatidylcholine (DPPC) bilayer via atomically detailed molecular dynamics simulations to observe the effect of salicylate on the microscopic and mesoscopic properties of the bilayer. The results demonstrate that salicylate interacts with the bilayer by associating at the water-DPPC interface in a nearly perpendicular orientation and penetrating more deeply into the bilayer than either sodium or chloride. This association has several affects on the membrane properties. First, binding of salicylate to the membrane displaces chloride from the bilayer-water interface. Second, salicylate influences the electrostatic potential and dielectric properties of the bilayer, with significant changes at the water-lipid bilayer interface. Third, salicylate association results in structural changes, including decreased headgroup area per lipid and increased lipid tail order. However, salicylate does not significantly alter the mechanical properties of the DPPC bilayer; bulk compressibility, area compressibility, and bending modulus were only perturbed by small, statistically insignificant amounts by the presence of salicylate. The observations from these simulations are in qualitative agreement with experimental data and support the conclusion that salicylate influences the electrical but not the mechanical properties of DPPC membranes.


Chest wall reconstruction using biomaterials.
Skeletal chest wall reconstruction can be a challenge, depending on the indication, location, and health of the patient; various materials are available. Recently, biomaterials that are remodelable (bovine pericardium patch; Veritas, Synovis Life Technologies Inc, St Paul, MN) or absorbable (polylactic acid [PLA] bar; BioBridge, Acute Innovations, Hillsboro, OR) have been introduced for reconstruction procedures. We performed a retrospective review of all patients who underwent chest wall stabilization or reconstruction between July 1, 2009, and March 31, 2011. Biomaterials were used in 25 of 112 patients (22%) who underwent chest wall stabilization or reconstruction, and they form the basis of this review. Indication for reconstruction was malignant disease in 17 patients (68%). Overall, 10 (40%) resection sites were infected preoperatively. Reconstruction was performed with a combination of bovine pericardium and PLA bars in 11 patients (44%), bovine pericardium alone in 10, and PLA bars alone in 4; muscle flaps were interposed in 7 patients (28%). There were no operative deaths. Complications occurred in 6 patients (24%). Median follow-up was 12 months (range, 6 to 27 months). Three patients required removal of their biomaterials. Two bovine pericardial patches were removed prophylactically at the time of debridement of a partially necrotic muscle flap, and 1 PLA bar was removed because of an inflammatory reaction. None of the patients with an infected resection site required removal of their biomaterial. Chest wall reconstruction with biomaterials is a valuable option in the management of patients with chest wall abnormalities. Early results are promising. Biomaterials may be the preferred method of reconstruction for infected chest wall sites.


Self-immolative prodrugs: candidates for antibody-directed enzyme prodrug therapy in conjunction with a nitroreductase enzyme.
The synthesis and properties of some prodrug candidates for antibody-directed enzyme prodrug therapy (ADEPT) are described. These compounds have been designed to generate the corresponding active drug upon interaction with a bacterial nitroreductase that can be conjugated to antibodies that recognize tumor-selective antigens. The active drugs included in the study are actinomycin D, mitomycin C, doxorubicin, 4-[bis(2-chloroethyl)amino]aniline and 4-[bis(2-chloroethyl)amino]phenol. The prodrugs were all 4-nitrobenzyloxycarbonyl derivatives of these drugs, which upon enzymatic reduction, generated the drug through self-immolation of the 4-(hydroxyamino)benzyloxycarbonyl group. In the case of actinomycin D, the ratio of the dose required between drug and prodrug to give the same cytotoxicity was greater than 100. The prodrug was also much less toxic (20-100x) than actinomycin D to mice in vivo. Therefore this self-immolative prodrug has a potential application in the treatment of cancer using an ADEPT-type approach.


[Magnetic Resonance Imaging for Diagnosis of Idiopathic Pediatric Meningiomas].
Objective To analyze the radiological features of idiopathic pediatric meningiomas and explore their relationships with pathological grading,misdiagnoses,and blood loss during surgery.Methods We retrospectively reviewed 29 cases of pathologically confirmed pediatric meningiomas with pre-operative magnetic resonance imaging in Beijing Tiantan Hospital from November 2014 to July 2018.We assessed the imaging features to explore their relationships with pathological grading,misdiagnoses,and blood loss during surgery. Results Among the 29 cases,7 intraparenchymal meningiomas,5 extraparenchymal meningiomas,4 ventricular meningiomas,and 1 transcranial meningioma were misdiagnosed.Tumor location was significantly associated with possibility of misdiagnoses(P=0.021),and intraparenchymal tumors were most likely to be misdiagnosed.Twelve patients had positive dural tail sign,and 4 of them were misdiagnosed;16 patients did not have dural tail sign,and 12 of them were misdiagnosed.Fisher exact test showed that positive dural tail sign was associated with decreased possibility of misdiagnoses(one-sided P=0.034).Univariable regression analysis showed that the feature of tumor surrounding arteries or interfering with veins(P=0.020)and the tumor maximum diameter(P=0.001)had positively linear relationships with blood loss volume during surgery.Combining these two variables,the multivariable regression model showed better fitting performance($R_{ad}^2$=0.468).Conclusions Pediatric meningiomas are extremely rare,with scarce radiological characteristics.They are hard to diagnose,and the intraparenchymal meningiomas are very likely to be misdiagnosed and therefore should be treated with extra caution.Among all the radiological features,tumor surrounding arteries or interfering with veins and tumor maximum diameter were associated with increased blood loss during surgery.


Liver transplantation and the use of KAVA: Case report.
Self-medication and the belief that herbal products are free of health risks are common in Brazil. The kava (Piper methysticum), known for its anxiolytic action, has a widespread popular use. Hepatotoxicity of kava is reported, including cases of liver transplantation and death. The kava had its use prohibited or restricted in countries like Germany, France, among others. Toxicity may be related to overdosage; however, factors such as botanical characteristics of the plant, the harvesting, storage, and production process may be associated with the development of hepatotoxic substances, such as triggering idiosyncratic reactions. In this case, there is a suspicion that the toxicide is intrinsic to the drug; however, the possibility of adulterants and contaminants must be ruled out. This study reports the case of a patient who, after using the herbal kava for 52 days, evolved into acute liver failure and liver transplantation. The data were collected directly with the patient and compared with their clinical records. Causality was determined through the RUCAM algorithm. In addition, a phytochemical analysis of the drug used was performed. According to the patient's report, there is no evidence of overdosage. Results from RUCAM algorithm infer causality between liver damage and the use of kava. The analysis chemical constituents did not find any possible contaminants and major changes in the active compounds. Seven months after transplantation, the patient is well and continues to be followed up by a medical team. Our investigation indicates that there was kava-induced hepatotoxicity at standard dosages. In Brazil, self-medication by herbal medicines is frequent and many patients and health professionals do not know the risks associated with their use. Diagnosing and notifying cases in which plants and herbal medicine induce liver damage is of paramount importance to increase the knowledge about DILI and to prevent or treat similar cases quickly.


[The family of calsyntenins: learning and memory related genes].
Calsyntenins (Cst) comprise a family of transmembrane proteins with the unique potential to link extracellular proteolytic activity with intracellular Ca2+ signaling. It is a molecular class of calcium binding protein, which can bind calcium ion and being involved in signal transduction and cell communication. It contains three members, calsyntenin-1, calsyntenin-2 and calsyntenin-3, which are postsynaptic membrane proteins and predominantly expressed in brain neurons. Each of the three calsyntenins exhibits a distinct neuronal mRNA expression pattern. The three calsyntenins exhibit the highest degree of structural diversity. The calsyntenin-1 is located in the postsynaptic membrane of CNS synapses and a proteolytically processed protein of the postsynaptic membrane with a calcium-binding cytoplasmic domain. Calsyntenin-1 is a dynamic modulator of postsynaptic calcium by extracellular proteolysis. Calsyntenin-1 may modulate Ca2+ transients locally either beneath the postsynaptic membrane or around intracellular Ca2+ stores, such as LTP and LTD. Recent studies showed that impairment of the coordinated metabolic regulation of APP and calsyntenins and the consequent loss of the reciprocal regulation by APP and calsyntenins in the gene transactivation could lead to neural disorders and disease progression in AD. This is important to disclose the mechanism of AD and develop new drugs for treating AD.


Co-production of hydrogen and ethanol from glucose in Escherichia coli by activation of pentose-phosphate pathway through deletion of phosphoglucose isomerase (pgi) and overexpression of glucose-6-phosphate dehydrogenase (zwf) and 6-phosphogluconate dehydrogenase (gnd).
Biologically, hydrogen (H2) can be produced through dark fermentation and photofermentation. Dark fermentation is fast in rate and simple in reactor design, but H2 production yield is unsatisfactorily low as <4 mol H2/mol glucose. To address this challenge, simultaneous production of H2 and ethanol has been suggested. Co-production of ethanol and H2 requires enhanced formation of NAD(P)H during catabolism of glucose, which can be accomplished by diversion of glycolytic flux from the Embden-Meyerhof-Parnas (EMP) pathway to the pentose-phosphate (PP) pathway in Escherichia coli. However, the disruption of pgi (phosphoglucose isomerase) for complete diversion of carbon flux to the PP pathway made E. coli unable to grow on glucose under anaerobic condition. Here, we demonstrate that, when glucose-6-phosphate dehydrogenase (Zwf) and 6-phosphogluconate dehydrogenase (Gnd), two major enzymes of the PP pathway, are homologously overexpressed, E. coli Δpgi can recover its anaerobic growth capability on glucose. Further, with additional deletions of ΔhycA, ΔhyaAB, ΔhybBC, ΔldhA, and ΔfrdAB, the recombinant Δpgi mutant could produce 1.69 mol H2 and 1.50 mol ethanol from 1 mol glucose. However, acetate was produced at 0.18 mol mol-1 glucose, indicating that some carbon is metabolized through the Entner-Doudoroff (ED) pathway. To further improve the flux via the PP pathway, heterologous zwf and gnd from Leuconostoc mesenteroides and Gluconobacter oxydans, respectively, which are less inhibited by NADPH, were overexpressed. The new recombinant produced more ethanol at 1.62 mol mol-1 glucose along with 1.74 mol H2 mol-1 glucose, which are close to the theoretically maximal yields, 1.67 mol mol-1 each for ethanol and H2. However, the attempt to delete the ED pathway in the Δpgi mutant to operate the PP pathway as the sole glycolytic route, was unsuccessful. By deletion of pgi and overexpression of heterologous zwf and gnd in E. coli ΔhycA ΔhyaAB ΔhybBC ΔldhA ΔfrdAB, two important biofuels, ethanol and H2, could be successfully co-produced at high yields close to their theoretical maximums. The strains developed in this study should be applicable for the production of other biofuels and biochemicals, which requires supply of excessive reducing power under anaerobic conditions.


A pH-indicating intelligent packaging composed of chitosan-purple potato extractions strength by surface-deacetylated chitin nanofibers.
The goal of the study is to develop a novel pH-indicating intelligent packaging by using purple potato extractions (PPE), chitosan and surface-deacetylated chitin nanofibers (CN). Since the major pH-sensitive pigment of PPE was anthocyanin (24.3 mg/g), whether anthocyanins could be loaded on a solid phase to prevent its color fading was further tested. The results of Fourier transform infrared spectrophotometry (FT-IR) and differential scanning calorimetry (DSC) indicated that PPE was efficiently attached into the chitosan film. Meanwhile, adding CN (0.450%, w/v) into chitosan film could significantly enhance the tensile strength (TS), the water-resistant ability and the roughness of chitosan film. Whereas higher content of CN (0.600%, w/v) did not further improve mechanical properties and CN would distribute unevenly due to aggregation in the films. In addition to pH-indicating ability, CS-CN-PPE exhibited the extraordinary antioxidant activities and this provides another advantage of packaging readily oxidizable substances. Taken together, the current study provided a novel and biocompatible packaging with strengthened mechanical property and intelligent pH indicator.


Barley bread containing lactic acid improves glucose tolerance at a subsequent meal in healthy men and women.
In the present study, we evaluated whether a low glycemic index (GI) breakfast with lactic acid bread had an effect on glucose tolerance and insulinemia at a subsequent high GI lunch meal. A barley bread containing lactic acid and a reference barley bread were consumed in the morning after an overnight fast in random order by 10 healthy men and women. Four hours after the breakfasts, the subjects ate a standardized high GI lunch, and the blood glucose and insulin responses were measured for the next 3 h. Significant lowerings of the incremental glycemic area (-23%, P = 0.033) and of the glucose response at 95 min were found after the lunch meal when the barley bread with lactic acid was given as a breakfast. At 45 min after the lunch meal, the insulin level was significantly lower (-21%, P = 0.045) after the lactic acid bread breakfast, compared with the barley bread breakfast without lactic acid. We concluded that barley bread containing lactic acid eaten at breakfast has the potential to improve second-meal glucose tolerance at a high GI lunch meal 4 h later.


Comparison of the genetic variability of Blastocystis subtypes between human carriers from two contrasting climatic regions of México.
Blastocystis sp. is an anaerobic intestinal microorganism commonly identified in the feces of several animals, including humans. Blastocystis exhibits high genetic polymorphism and at least 17 subtypes (ST) have been identified; ST1-ST3 are frequently found in the Americas. Furthermore, in vitro assays have shown that temperature and humidity can affect the viability of Blastocystis cysts. In this study, we describe the genetic variability and genetic differentiation among and within Blastocystis STs in adults and children from the cities of Hermosillo and Morelia cities, which represent arid and humid subtropical climatic regions of México, respectively. Phylogenetic and genetic diversity was assessed by analyzing a region of the small subunit ribosomal DNA (SSU rDNA) gene as a marker. Blastocystis ST3 and ST1 were associated with children from Hermosillo and Morelia, respectively. An analysis of the nucleotide diversity (π) and haplotype polymorphism (θ) indexes showed that they were similar within each ST, but different between ST1 and ST3. Interestingly, the group of symptomatic carriers from Hermosillo showed scarce mean nucleotide diversity compared to the asymptomatic carriers (0.0039±0.0030 and 0.0329±0.0286, respectively). Furthermore, the gene flow and genetic differentiation indexes between the children and adults suggested that the Blastocystis haplotypes in the adult carriers were "highly mobile" among humans, while the haplotypes found in the children were more isolated and genetically differentiated between them.


[Midwives in Switzerland: a study of the work and recruitment status].
The aim of this study was an analysis of the working conditions for midwives in- and outside of obstetric clinics. The study is based on a representative survey carried out among Swiss midwives in 1991 and on statistics of the Swiss Red Cross and the Swiss Federal Statistical Office. It could be shown that there is a high degree of professional satisfaction especially among midwives working on their own; of the negative aspects, the irregular work load and an inadequate income were among the most often named problems. Recruitment problems were evident, as there is a clear lack between the available places in the Swiss schools for midwifery and the need for midwives in this country, at least during periods of a relatively favorable economic situation.


Conduction disturbance after isolated surgical aortic valve replacement in degenerative aortic stenosis.
Conduction disturbances are common in patients with aortic stenosis. We investigated the incidence, reversibility, and prognosis of conduction disorders requiring permanent pacemaker implantation in patients with degenerative aortic stenosis after isolated aortic valve replacement. This was a retrospective study conducted at a tertiary care center. We evaluated the incidence of conduction disturbances in patients who underwent isolated surgical aortic valve replacement for aortic stenosis between January 2005 and May 2015. Relevant clinical information was obtained from the patients' medical records. We reviewed results of 663 patients with pathologically proven degenerative aortic stenosis (bicuspid aortic valve, n = 285 [43.0%]) who underwent isolated aortic valve replacement (mechanical valve, n = 310 [46.8%]). Patients' mean age was 67.1 ± 8.1 years, and 362 were male (54.6%). Immediate postoperative intraventricular conduction disorders occurred in 56 patients (8.4%), and atrioventricular block occurred in 68 patients (10.3%). Ten patients with symptomatic second-degree or third-degree atrioventricular block underwent permanent pacemaker implantation within 30 days of aortic valve replacement. During the mean follow-up period of 1288 ± 1122 days, 64 patients (9.7%) developed irreversible conduction disorders (bundle branch block n = 24 and first-degree atrioventricular block n = 42). Of the 10 patients requiring permanent pacemakers, 4 remained depend on the permanent pacemaker during follow-up. Beyond 30 days after aortic valve replacement, 1 patient underwent permanent pacemaker implantation for de novo conduction disturbance 44 months postoperatively. After isolated aortic valve replacement, permanent pacemaker implantation for conduction disturbance is rare (n = 10/663, 1.5%). Isolated aortic valve replacement for degenerative aortic stenosis has a low risk of conduction disturbances during long-term follow-up.


Hyponatremia in small cell lung cancer. Mechanisms not involving inappropriate ADH secretion.
A 62-year-old man with small cell carcinoma (oat cell type) of the lung who had hyponatremia and renal sodium loss with inappropriate antidiuresis is reported. Plasma levels of arginine vasopressin (AVP) were not elevated inappropriately. Plasma levels of atrial natriuretic peptide (ANP), however, were high, and increased after water loading and hypertonic saline infusion. The renin-aldosterone axis was normal, as were adrenal, thyroid, and renal functions. Water restriction to 500 to 700 ml/d resulted in a rise in serum sodium. Analysis of the tumor tissue failed to demonstrate the presence of AVP or ANP. The findings (1) suggest that hyponatremia and renal sodium loss with inappropriate antidiuresis observed in the patient is due to an antidiuretic substance distinct from AVP, and (2) point to the possibility that hypersecretion of ANP may play a role in the pathophysiology.


Working conditions of bipolar radiofrequency on human articular cartilage repair following thermal injury during arthroscopy.
The thermal injury during bipolar radiofrequercy results in chondrocyte death that limits cartilage repair. The purpose was to determine the effects of various factors of bipolar radiofrequency on human articular cartilage after thermal injury, offering suitable working conditions for bipolar radiofrequency during arthroscopy. Osteochondral explants from 28 patients undergoing total knee arthroplasty (TKA) in Department of Orthopaedic, Peking University Reople's Hospital from October 2013 to May 2014, were harvested and treated using bipolar radiofrequency in a light contact mode under the following conditions: various power setting of levels 2, 4 and 6; different durations of 2 seconds, 5 seconds and 10 seconds; irrigation with fluids of different temperatures of 4°C, 22°C, and 37°C; two different bipolar radiofrequency probes ArthroCare TriStar 50 and Paragon T2. The percentage of cell death and depth of cell death were quantified with laser confocal microscopy. The content of proteoglycan elution at different temperatures was determined by spectrophotometer at 530 nm. Chondrocyte mortality during the treatment time of 2 seconds and power setting of level 2 was significantly lower than that with long duration or in higher level groups (time: P = 0.001; power: P = 0.001). The percentage of cell death after thermal injury was gradually reduced by increasing the temperature of the irrigation solutions (P = 0.003), the depth of dead chondrocytes in the 37°C solution group was significantly less than those in the 4°C and 22°C groups (P = 0.001). The proteoglycan elution was also gradually reduced by increasing the temperature (P = 0.004). Compared with the ArthroCare TriStar 50 group, the percentage of cell death in the Paragon T2 group was significantly decreased (P = 0.046). Thermal chondroplasty with bipolar radiofrequency resulted in defined margins of chondrocyte death under controlled conditions. The least cartilage damage during thermal chondroplasty could be achieved with lower power, shorter duration, suitable temperature of irrigation solutions and chondroprotective probes. The recommendations for the use of bipolar radiofrequency to minimize cartilage damage could be achieved with a power setting of level 2, treatment duration of 2 seconds, suitable fluid temperature (closer to body temperature of 37°C) and chondroprotective Paragon T2 probes.


Mechanism for the Excited-State Multiple Proton Transfer Process of Dihydroxyanthraquinone Chromophores.
The single and dual cooperated proton transfer dynamic process in the excited state of 1,5-dihydroxyanthraquinone (1,5-DHAQ) was theoretically investigated, taking solvent effects (ethanol) into account. The absorption and fluorescence spectra were simulated, and dual fluorescence exhibited, which is consistent with previous experiments. Analysis of the calculated IR and Raman vibration spectra reveals that the intramolecular hydrogen bonding interactions (O20-H21···O24 and O22-H23···O25) are strengthened following the excited proton transfer process. Finally, by constructing the potential energy surfaces of the ground state, first excited singlet state, and triplet state, the mechanism of the intramolecular proton transfer of 1,5-DHAQ can be revealed.


Increased expression of TREM2 in peripheral cells from mild cognitive impairment patients who progress into Alzheimer's disease.
Neuroinflammation plays a role in the aetiopathogenesis of Alzheimer's disease (AD). Triggering receptor expressed on myeloid cells 2 (TREM2), a cell surface receptor of the immunoglobulin superfamily, seems to have protective anti-inflammatory activity in AD. Triggering receptor expressed on myeloid cells 2 expression was analysed in peripheral blood mononuclear cells from healthy subjects (CT) and from patients with either AD or mild cognitive impairment (MCI). MCI patients were re-evaluated at a 2-year follow-up to investigate their progression to AD (MCI-AD) or lack thereof (MCI-MCI). Triggering receptor expressed on myeloid cells 2 gene expression was higher in AD than CT patients, but was highest in MCI. At recruitment TREM2 levels were higher in MCI-AD than in MCI-MCI, and in MCI-AD were higher initially than at follow-up. TREM2 displayed a moderate degree of sensitivity and specificity for identifying MCI-AD in all MCI patients. Our data showed higher TREM2 levels in allele ε4 of apolipoprotein E (ApoE ε4) carriers than non-carriers in MCI and particularly in MCI-AD. These data seem to confirm the protective role of TREM2 in the pre-clinical stage of AD. Upregulation of TREM2 in MCI-AD could be a mechanism to counteract the activation of neuroinflammatory processes. It is possible that TREM2 and ApoE ε4 interact synergistically in the pre-clinical stage of AD. Therefore, TREM2 may be useful as an early peripheral biomarker for the development of AD.


Combined treatment of XIAP-targeting shRNA and celecoxib synergistically inhibits the tumor growth of non‑small cell lung cancer cells in vitro and in vivo.
X-linked inhibitor of apoptosis protein (XIAP) has been shown to be highly expressed in lung cancer, but not in normal lung tissue, which makes it an attractive target for lung cancer treatment. Celecoxib (CXB), a cyclooxygenase-2 inhibitor, is in wide clinical use for the treatment and prevention of non-small cell lung cancer (NSCLC). Therefore, in our study, we combined short hairpin RNA (shRNA) targeted to XIAP (XIAP-shRNA) with CXB and tested the effects of this combination on lung cancer cells to identify more effective therapeutics against lung cancer. An XIAP-shRNA plasmid was constructed and transfected into the A549 NSCLC cell line. The cells were then treated with CXB and XIAP-shRNA alone or in combination for indicated time periods, and the treatments were assessed for their effects on cell proliferation, apoptosis, migration, invasion and receptor signaling using the MTT, TUNEL, wound healing and Matrigel invasion assays and western blotting, respectively. In addition, an NSCLC xenograft model was prepared to observe tumor growth. It was found that both CXB and XIAP‑shRNA significantly inhibited cell proliferation, migration and invasion, and induced cell apoptosis in vitro, as well as suppressed tumor growth in vivo. Moreover, the combination of the agents significantly enhanced these effects compared to the single agent treatments. We also found that the combination treatment significantly suppressed constitutive phosphorylation of PI3K and AKT, which may contribute to the inhibition of tumor growth. These findings suggest that the combination of XIAP‑shRNA and CXB is a promising drug candidate for the treatment of NSCLC.


Demodulated low frequency currents from electrosurgical procedures.
Low frequency currents produced incidental to electrosurgical procedures are usually only a minor threat unless they are coupled directly into the heart through a catheter or a thoracic surgical procedure. However, should the low frequency blocking capacitors in the electrosurgical generator fail in the conducting state, extremely dangerous low frequency currents of many milliamperes may flow into the patient. Even with properly functioning capacitors, low frequencies up to several milliamperes may be produced by some generators. The results of this study show that the coagulation mode of operation produces greater amounts of low frequency currents than the "pure cutting" mode at the same power setting. These results also demonstrate that the higher the generator power output, the higher the magnitude of the low frequency currents.


Catastrophic Thermal Corneoscleral Injury Treated with Transplantation of Donor Scleral Graft.
The aim of this study is to report a patient with senile cataract developing severe thermal corneoscleral injury during phacoemulsification, which was treated with a donor scleral graft. Severe thermal corneoscleral injury occurred during phacoemulsification in the right eye of a 74-year-old male. His medical history was prostate hypertrophy. Visual acuity was hand motion and the intraocular pressure was 3 mm Hg OD. There was heavy corneal stromal opacity with intraocular fluid leakage. The patient underwent transplantation of a donor scleral graft to the burn site. Histologically, the injured sclera showed coagulation necrosis without inflammatory cell infiltration. An intraocular lens was eventually fixed in the ciliary sulcus 7 months later. His visual acuity remains at 2/20 OD. Transplantation of the donor scleral grafts is useful to close the wound in catastrophic thermal injury.


Investigation of colloidal stability and insulation characteristics of magnetic oils.
Superparamagnetic iron-oxide (SPIO) particles were synthesized by the co-precipitation method and the oleic acid-coated SPIO (OA-SPIO) was then obtained by a surface grafting procedure. A stock sample of magnetic oil (MO) with 1.6% particle volume fraction (VF) was obtained by dispersing the OA-SPIO in insulating naphthenic oil. The MO stock sample was diluted in the same naphthenic oil to yield MO with 0.1, 0.04, 0.02, and 0.01% VF. Moreover, the 0.04% VF MO sample was manipulated to yield MO samples with water content of 26, 37, and 63 mg L(-1). The spinel structure of OA-SPIO was assessed by XRD and the average diameter of 8.3 nm was provided by TEM analysis. The saturation magnetization at room temperature (RT) was 70 emu/g and no remanence or coercivity was observed. The average hydrodynamic diameter (D(H)) of the colloidal particles suspended within the 0.04% VF MO sample was 58 nm. After aging for 30 days at RT no change was observed for the lowest water content MO sample (26 mg L(-1)). However, D(H) equals to 270 nm was observed for the highest water content MO sample (63 mg L(-1)). The MO samples with 26 mg L(-1) water content were found stable under heating at 90 degrees C for all VF investigated. We found the insulation resistance dropping significantly as VF and temperature increases. The lowest value found was 11 GOhms for the 0.1% VF at 60 degrees C, which is an acceptable value for MO.


Disruption within brain default mode network in postpartum women without depression.
Previous studies have demonstrated that cognitive dysfunction is associated with neurophysiological changes in postpartum period. This study aimed to investigate the intrinsic functional connectivity (FC) pattern within the default mode network (DMN) and its associations with cognitive dysfunction in postpartum women without depression revealed by resting-state functional magnetic resonance imaging (fMRI).Resting-state fMRI scans were acquired from 21 postpartum women and 21 age- and education-matched nulliparous women. The posterior cingulate cortex (PCC) was selected as the seed region to detect the FC patterns and then determine whether these changes were related to specific cognitive performance.Compared with the nulliparous women, postpartum women had a significantly decreased FC between the PCC and the left medial prefrontal cortex (mPFC). After correcting for age and education, the reduced FC between the PCC and the left mPFC was positively correlated with the poorer Clock-Drawing Test (CDT) scores in postpartum women (r = 0.742, P < .001).The present study mainly demonstrated decreased resting-state FC pattern within the DMN regions that was linked with impaired cognitive function in postpartum women. These findings illustrated the potential role of the DMN in postpartum women that will provide novel insight into the underlying neuropathological mechanisms in postpartum period.


Teaching bioinformatics in concert.
Can biology students without programming skills solve problems that require computational solutions? They can if they learn to cooperate effectively with computer science students. The goal of the in-concert teaching approach is to introduce biology students to computational thinking by engaging them in collaborative projects structured around the software development process. Our approach emphasizes development of interdisciplinary communication and collaboration skills for both life science and computer science students.


There and back again: the impact of adult HIV prevalence on national life expectancies.
Worldwide we have seen dramatic increases in HIV prevalence and decreases in life expectancy over the last decade. The aim of this study was to determine the association between HIV prevalence and life expectancy. A strong negative association between adult HIV prevalence and life expectancy was observed for 137 countries. Because high adult HIV prevalence poses the greatest threat to countries with limited health resources, our study supports increased efforts to provide antiretrovirals in these countries.


Solvothermal synthesis of four polyoxometalate-based coordination polymers including diverse Ag(I)···π interactions.
Four 3D POM-based silver coordination polymers, namely, [Ag17(ptz)11(PW12O40)2]n (1), [Ag17(ptz)11(PMo12O40)2]n (2), [Ag12(ptz)6(CN)2(SiW12O40)]n (3), and [Ag19(ptz)8(H2ptz)(H3ptz)(AgP5W30O110)·7H2O]n (4), have been obtained by solvothermal reaction of AgNO3 and 5-phenyl-1H-tetrazole (Hptz) ligand in the presence of four types of polyoxometalates. Structural analysis shows that four types of Ag(I)···π interactions, m-η(1), m/p-η(2), o/m-η(2), and o/m/p-η(3), were observed in compounds 1-4, depending on the polyoxometalates used. The in situ generated CN(-) ion in compound 3 shows unprecedented mixed σ and π bonding modes, similar to the C2(2-) ion in well-studied silver acetylides. For 4, the Na(+) ion in the Preyssler heteropolyoxoanion, [NaP5W30O110](14-), was exchanged by Ag(I) under solvothermal conditions, generating a novel [AgP5W30O110](14-) anion. In addition, the photoluminescence behavior of 1-4 was also investigated.


Lack of association between Vitamin D receptor FokI polymorphism and alopecia areata.
Vitamin D receptor (VDR) is expressed in the hair follicle and the lack of it leads to alopecia. In this study, we investigated whether there was a relationship between VDR FokI gene polymorphism and alopecia areata (AA). This is the first study investigating the relationship between VDR gene polymorphism and AA. Twenty-five patients with the extensive forms of AA (alopecia totalis; AT, alopecia universalis; AU and AT/AU) and 27 healthy control subjects were genotyped. Their genotypes were determined by a polymerase chain reaction (PCR) and restriction fragment length polymorphism analysis. The genotypes were classified as FF (absence of the FokI site) and ff (presence of the FokI site). Allele frequencies for F and f alleles were 76.0% and 24.0% in the alopecic group and 72.2% and 27.7% in the control group (p > 0.05). The frequencies for the FF, Ff and ff genotypes were 56.0%, 40.0% and 4.0% in the patient group, and 48.1%, 48.1% and 3.7% in the control group, respectively. No statistically significant differences were observed in the frequencies of the VDR FokI genotype between the patient and the control groups. However, to conclude that there is no relationship between VDR gene polymorphism and AA, the VDR FokI polymorphism should be further studied in other populations, larger groups, and the distribution of other VDR polymorphisms such as BsmI, Tru9I, ApaI, TaqI and polyA.


Transition Metal Homeostasis.
This chapter focuses on transition metals. All transition metal cations are toxic-those that are essential for Escherichia coli and belong to the first transition period of the periodic system of the element and also the "toxic-only" metals with higher atomic numbers. Common themes are visible in the metabolism of these ions. First, there is transport. High-rate but low-affinity uptake systems provide a variety of cations and anions to the cells. Control of the respective systems seems to be mainly through regulation of transport activity (flux control), with control of gene expression playing only a minor role. If these systems do not provide sufficient amounts of a needed ion to the cell, genes for ATP-hydrolyzing high-affinity but low-rate uptake systems are induced, e.g., ABC transport systems or P-type ATPases. On the other hand, if the amount of an ion is in surplus, genes for efflux systems are induced. By combining different kinds of uptake and efflux systems with regulation at the levels of gene expression and transport activity, the concentration of a single ion in the cytoplasm and the composition of the cellular ion "bouquet" can be rapidly adjusted and carefully controlled. The toxicity threshold of an ion is defined by its ability to produce radicals (copper, iron, chromate), to bind to sulfide and thiol groups (copper, zinc, all cations of the second and third transition period), or to interfere with the metabolism of other ions. Iron poses an exceptional metabolic problem due its metabolic importance and the low solubility of Fe(III) compounds, combined with the ability to cause dangerous Fenton reactions. This dilemma for the cells led to the evolution of sophisticated multi-channel iron uptake and storage pathways to prevent the occurrence of unbound iron in the cytoplasm. Toxic metals like Cd2+ bind to thiols and sulfide, preventing assembly of iron complexes and releasing the metal from iron-sulfur clusters. In the unique case of mercury, the cation can be reduced to the volatile metallic form. Interference of nickel and cobalt with iron is prevented by the low abundance of these metals in the cytoplasm and their sequestration by metal chaperones, in the case of nickel, or by B12 and its derivatives, in the case of cobalt. The most dangerous metal, copper, catalyzes Fenton-like reactions, binds to thiol groups, and interferes with iron metabolism. E. coli solves this problem probably by preventing copper uptake, combined with rapid efflux if the metal happens to enter the cytoplasm.


[Churg-Strauss syndrome. Personal caseload and review of the literature].
Churg-Strauss syndrome (CSS) is a disease characterised by hypereosinophilia and systemic vasculitis occurring in patients with asthma and allergic rhinitis. In the course of CSS three phases may be distinguished. The prodromal phase, which may persist for many years, consists of allergic disease. The second phase is characterised by peripheral blood eosinophilia and eosinophilic tissue infiltrates that produce a clinical picture diagnosed as Loeffler's syndrome, chronic eosinophilic pneumonia or eosinophilic gastroenteritis. The third phase is dominated by systemic vasculitis in which skin, cardiovascular system, gastrointestinal tract and peripheral nervous system are frequently involved. Renal disease in CSS is less common and generally less severe than that classical polyarteritis nodosa and Wegener's granulomatosis. Genitourinary tract may be involved, too. In the postvaculitic phase, allergic rhinitis and asthma usually persist and clinical picture is characterised by the consequences of the vasculitic illness, most commonly in form of neuropathy and hypertension. The pathogenesis of CSS is unknown but its association with asthma and allergic rhinitis may indicate an abnormal immune reactivity. The recently reported association with antineutrophil cytoplasmic antibodies with antimyeloperoxidase specificity may suggest a their role in the pathogenesis of the disease. An important role may be played by eosinophils, too. The main therapy is that with corticosteroids, possibly in association with immunosuppressive drugs.


Profiles of amino acids and biogenic amines in the plasma of Cri-du-Chat patients.
Cri-du-chat syndrome (CDCS) is a rare innate disease attributed to chromosome 5p deletion characterized by a cat-like cry, craniofacial malformation, and altered behavior of affected children. Metabolomic analysis and a chemometric approach allow description of the metabolic profile of CDCS as compared to normal subjects. In the present work, UHPLC/MS was employed to analyze blood samples withdrawn from CDCS carriers (n=18) and normal parental subjects (n=18), all aged 0-34 years, aiming to set up a representative CDCS profile constructed from 33 targeted amino acids and biogenic amines. Methionine sulfoxide (MetO) was of particular concern with respect to CDCS redox balance. Increased serotonin (3-fold), methionine sulfoxide (2-fold), and Asp levels, and a little lower Orn, citrulline, Leu, Val, Ile, Asn, Gln, Trp, Thr, His, Phe, Met, and creatinine levels were found in the plasma of CDCS patients. Nitrotyrosine and Trp did not differ in normal and CDCS individuals.The accumulated metabolites may reflect, respectively, disturbances in the redox balance, deficient purine biosynthesis, and altered behavior, whereas the amino acid abatement in the latter group may affect the homeostasis of the urea cycle, citric acid cycle, branched chain amino acid synthesis, Tyr and Trp metabolism and amino acid biosynthesis. The identification of enzymatic deficiencies leading to the amino acid burden in CDCS is further required for elucidating its molecular bases and eventually propose specific or mixed amino acid supplementation to newborn patients aiming to balance their metabolism.


Further characterisation of forms of haemosiderin in iron-overloaded tissues.
The biochemical and biophysical properties of isolated haemosiderins have been compared to that of another iron-containing protein, termed prehaemosiderin, which sediments through chaotropic potassium iodide only after 20 h of ultracentrifugation, in contrast to that of haemosiderin which is recovered after 2 h of ultracentrifugation. The iron/protein ratio and iron/phosphate ratio were less that that of the corresponding haemosiderin, while the elemental composition was also reduced in many of the prehaemosiderin samples. Mossbauer spectroscopy and electron diffraction identified the predominant presence of ferrihydrite in prehaemosiderin species even though the secondary haemochromatosis haemosiderin iron cores were essentially goethite-like. The majority of the prehaemosiderins isolated showed the presence of an additional peptide band at 17 kDa in addition to that at 21 kDa. Further Mossbauer studies of haemosiderin isolated from untreated secondary haemochromatosis patients showed that goethite was the predominant form of iron present, thereby indicating that the presence of this form of ferrihydrite was not wholly attributable to chelation therapy.


Histone deacetylase inhibitor enhances the anti-leukemic activity of an established nucleoside analogue.
Interest in histone deacetylase (HDAC) inhibitors as antineoplastic agents has been accelerating over the last several years and increasing number of compounds are in or entering clinical trials in humans. Recently, attention has been focused on the ability of HDAC inhibitors to induce perturbations in cell cycle regulatory proteins (e.g. p21CIP1), down regulation of survival signaling pathways (e.g. Raf/MAPkinase/ERK), and disruption of cellular redox state (e.g. reactive oxygen species, ROS). In April 2004 issue of Cancer Research, Maggio et al. report that pre-treatment of human leukemic cells with a histone deacetylase inhibitor, MS-275 significantly enhances the abrogative capacity of an established nucleoside analogue, fludarabine. The study indicates that apart from promoting acetylation of histones and regulation of genes involved in differentiation and apoptosis, MS-275 also induces multiple perturbations in signal transduction, survival and cell cycle regulatory pathways that increase the fludarabine-mediated cell death.


Peptide fragmentation caused by Ar cluster ions depending on primary ion energy.
Time-of-flight secondary ion mass spectrometry (TOF-SIMS) with an Ar cluster ion beam as a primary ion source provides useful information in terms of peptide analysis. It is, however, difficult to interpret the spectra. The ToF-SIMS peptide spectra obtained with Ar clusters having different energies have been investigated in order to classify the secondary ions into the peptide fragment ions and those related to contaminants or the substrate. Three peptides having different molecular weights from 600 to 1300 u were measured with Ar cluster beams having different energies per atom from 4 to 40 eV/atom. In the spectra normalized to a geometric average of all the spectra, the amino acid fragment ions are distinguished from other secondary ions. In the mass range above 600 u, the peptide fragment ions increase with mass while those not related to the peptide decrease with mass. Energy-dependence fragmentation helps in understanding the peptide spectra. Specific peptide fragment ions of the larger peptides are likely to be detected under lower energy than energy higher than 10 eV/atom. Although it is difficult to interpret the TOF-SIMS spectra of a peptide obtained with an Ar cluster ion beam, the secondary ions can be classified by comparing those obtained with different energy Ar cluster ion beams.


Comparison of perineal outcomes in Chinese women adopting lateral positions and lithotomy positions during the passive and active phases of the second stage of labour: An observational study.
To compare the effects of the adoption of lateral positions and lithotomy positions during the passive and active phases of the second stage of labour on perineal outcomes. An observational study with prospectively collected data, conducted in three hospitals in China. Attending midwives recorded the perineal outcomes and characteristics of women giving birth between July-November 2020. Binary logistic regression was performed to explore the effects of lateral positions on perineal outcomes during different phases of the second stage of labour. The STROBE guidelines guided the reporting of this study. Among primiparous women, when compared with those who adopted lateral positions during the passive phase of the second stage of labour and changed to lithotomy positions during the active phase, women who assumed lateral positions during both the passive and active phases had a higher rate of intact perineum/first-degree perineal tears and a reduced risk of episiotomy, and episiotomy/second-degree perineal tears. No significant difference was found in perineal outcomes between those who assumed lithotomy positions during the passive and active phases and those who adopted lateral positions during the passive phase and changed to lithotomy positions during the active phase. No significant difference was found in perineal outcomes among multiparous women, regardless of different positions adopted at the passive and/or the active phase. Lateral positions during the active phase may have protective effects on the perineum in primiparous women. However, adopting lateral positions only during the passive phase did not promote better perineal outcomes, regardless of parity. This study will provide a further reference for the use of lateral positions during different phases of the second stage of labour among primiparous and multiparous women in clinical practice, contributing to the perineal protection during childbirth.


Analysis of HLA-DRB and -DQB gene RFLPs in DR7 homozygous cell lines: associations with Dw11, Dw17 and DB1.
The DR7-associated Dw specificities, Dw11, Dw17 and DB1 were investigated with regard to DRB- and DQB-gene polymorphism, as revealed by RFLP analysis using the restriction enzyme TaqI. In the 22 DR7 homozygous cell lines investigated, each of these Dw specificities was found to correlate to one specific RFLP defined DR-DQ haplotype. In addition, a clear linkage disequilibrium to a specific HLA-B locus allele for each Dw specificity was noted, indicating that the Dw subtypes of DR7 often are associated with a conserved HLA-B-DR-DQ haplotype. Only one genetically homozygous cell line, PLH, deviated from these correlations. This cell line, notably derived from an individual with a deletion of the 21-hydroxylase B-gene (21-OHB), caries the HLA haplotype Bw47, DR7, DQw2, DB1, but displayed a DRB RFLP otherwise found in association with Dw17.


Improved contrast for high frame rate imaging using coherent compounding combined with spatial matched filtering.
The concept of high frame rate ultrasound imaging (typically greater than 1000 frames per second) has inspired new fields of clinical applications for ultrasound imaging such as fast cardiovascular imaging, fast Doppler imaging and real-time 3D imaging. Coherent plane-wave compounding is a promising beamforming technique to achieve high frame rate imaging. By combining echoes from plane waves with different angles, dynamic transmit focusing is efficiently accomplished at all points in the image field. Meanwhile, the image frame rate can still be kept at a high level. Spatial matched filtering (SMF) with plane-wave insonification is a novel ultrafast beamforming method. An analytical study shows that SMF is equivalent to synthetic aperture methods that can provide dynamic transmit-receive focusing throughout the field of view. Experimental results show that plane-wave SMF has better performance than dynamic-receive focusing. In this paper, we propose integrating coherent plane-wave compounding with SMF to obtain greater image contrast. By using a combination of SMF beamformed images, image contrast is improved without degrading its high frame rate capabilities. The performance of compounded SMF (CSMF) is evaluated and compared with that of synthetic aperture focusing technique (SAFT) beamforming and compounded dynamic-receive-focus (CDRF) beamforming. The image quality of different beamforming methods was quantified in terms of contrast-to-noise ratio (CNR). Our results show that the new SMF based plane-wave compounding method provides better contrast than DAS based compounding method. Also CSMF can obtain a similar contrast level to dynamic transmit-receive focusing with only 21 transmit events.


Thoracoscopic removal of an intrapulmonary foreign body in a child.
A 9-year-old boy presented to our institution 6 months after falling on a needle that pierced his left chest wall. He presented to us after multiple unsuccessful attempts to have this foreign body removed at other hospitals. A thoracoscopic removal was successfully undertaken aided by fluoroscopy. This report shows how the needle's position and location were precisely defined by fluoroscopy, despite the needle being invisible on thoracoscopy.


Descemet Membrane Detachment Due to Laser Application in Femtosecond Laser-Assisted Cataract Surgery: Incidence and Risk Factors.
To assess the incidence and risk factors of Descemet membrane detachment due to laser application in femtosecond laser-assisted cataract surgery (FLACS). In this retrospective case series, all patients who underwent FLACS with the LenSx system (Alcon Laboratories, Inc) were eligible to participate. The medical records were reviewed to collect data regarding potential risk factors related to Descemet membrane detachment, including patients' demographics, laser parameters, and ocular measurements. The eyes were separated into two groups based on the clinical diagnosis of Descemet membrane detachment as the femto-second laser was performing the corneal incisions. Five hundred ten eyes (304 patients) were included. Descemet membrane detachment occurred in 20 (3.9%) eyes of 16 (5.3%) patients. Four (1.3%) patients had a detachment in both eyes. In 16 (3.1%) eyes, the Descemet membrane detachment occurred in the secondary incision site. The eyes that had a detachment had a statistically lower mean endothelial cell density (2,193.40 ± 313.37 versus 2,385.08 ± 357.80 cells/ mm2; P = .019), and a statistically higher prevalence of corneal guttata (25.0% versus 8.8%; P = .015). None of the other analyzed variables statistically differed between the groups (P > .05). The risk of having Descemet membrane detachment was statistically higher among eyes with guttata (odds ratio = 3.47; P = .015) and in those with an endothelial cell density of less than 2,000 cells/mm2 (odds ratio = 3.26; P = .014). The incidence of Descemet membrane detachment due to laser application in FLACS was 3.9%, with the associated risk factors being endothelial cell density of less than 2,000 cells/mm2 and corneal guttata. [J Refract Surg. 2021;37(7):466-471.].


Assessment of surgical performance of laparoscopic benign hiatal surgery: a systematic review.
Operative skills correlate with patient outcomes, yet at the completion of training or after learning a new procedure, these skills are rarely formally evaluated. There is interest in the use of summative video assessment of laparoscopic benign foregut and hiatal surgery (LFS). If this is to be used to determine competency, it must meet the robust criteria established for high-stakes assessments. The purpose of this review is to identify tools that have been used to assess performance of LFS and evaluate the available validity evidence for each instrument. A systematic search was conducted up to July 2017. Eligible studies reported data on tools used to assess performance in the operating room during LFS. Two independent reviewers considered 1084 citations for eligibility. The characteristics and testing conditions of each assessment tool were recorded. Validity evidence was evaluated using five sources of validity (content, response process, internal structure, relationship to other variables, and consequences). There were six separate tools identified. Two tools were generic to laparoscopy, and four were specific to LFS [two specific to Nissen fundoplication (NF), one heller myotomy (HM), and one paraesophageal hernia repair (PEH)]. Overall, only one assessment was supported by moderate evidence while the others had limited or unknown evidence. Validity evidence was based mainly on internal structure (all tools reporting reliability and item analysis) and content (two studies referencing previous papers for tool development in the context of clinical assessment, and four listing items without specifying the development procedures). There was little or no evidence supporting test response process (one study reporting rater training), relationship to other variables (two comparing scores in subjects with different clinical experience), and consequences (no studies). Two tools were identified to have evidence for video assessment, specific to NF. There is limited evidence supporting the validity of assessment tools for laparoscopic foregut surgery. This precludes their use for summative video-based assessment to verify competency. Further research is needed to develop an assessment tool designed for this purpose.


The Gengnianchun recipe attenuates insulin resistance-induced diminished ovarian reserve through inhibiting the senescence of granulosa cells.
Insulin resistance (IR) is found in patients with polycystic ovary syndrome (PCOS), but the effects and mechanisms of IR on diminished ovarian reserve (DOR) remain unclear. This study set out to investigate the effects of IR on ovarian reserve; to explore the effects of high concentrations of insulin on the function of ovarian cells in vitro; and to validate the hypothesis that the Gengnianchun recipe (GNC) helps to attenuate DOR caused by IR through reducing the senescence of granulosa cells. Estrus cycle, follicle count, and sex hormone levels were detected to evaluate ovarian function in mice with IR caused by feeding a high-fat diet (HFD). In addition, KGN cells (human granulosa cell line) were treated with high concentrations of insulin. The staining for senescence-associatedβ-galactosidase (SA-β-gal), cell cycle, and expression levels of mRNA and gene proteins related to cell aging were detected in KGN cells treated with high concentrations of insulin. Mice treated with an HFD were fed metformin, GNC, or saline solution for 6 weeks by oral gavage. HOMA-IR, the area under the curve (AUC) of the oral glucose tolerance test (OGTT), levels of fasting blood glucose (FBG), and fasting serum insulin (FINS) were examined to confirm the IR status. Then estrus cycle, follicle count, and sex hormone levels were detected to evaluate ovarian function. Expression levels of mRNA and gene proteins related to cell aging were detected in the ovarian tissue of mice in each group. The results demonstrated that IR reduced murine ovarian reserves, and high doses of insulin caused granulosa cells to senesce. There was a considerable improvement in HFD-induced IR status in the metformin (Met) and GNC treatment groups. In addition, the expression levels of aging-associated biomarkers were much lower in GNC mice than Met mice; and both the latter groups had considerably lower levels than the HFD group. Moreover, higher follicle counts in different stages and shorter diestrus in the Met or GNC groups compared to the HFD group indicated that ovarian aging could be largely reversed. This work showed that: IR impaired ovarian reserve; high concentrations of insulin induced granulosa cell aging; and GNC attenuated ovarian function through inhibiting IR-induced cell aging.


Prognostic significance of HLA class I expression in osteosarcoma defined by anti-pan HLA class I monoclonal antibody, EMR8-5.
With the goal of establishing efficacious peptide-based immunotherapy for patients with bone and soft tissue sarcomas, we previously identified the cytotoxic T lymphocyte-defined osteosarcoma antigenic gene Papillomavirus binding factor. The present study was designed to determine the status of HLA class I expression in osteosarcoma and other bone and soft tissue sarcomas. Seventy-four formalin-fixed paraffin-embedded specimens of various bone and soft tissue sarcomas, including 33 osteosarcomas, were stained with the anti-HLA class I monoclonal antibody EMR8-5, which we recently generated. The expression of HLA class I was lost or downregulated in 46 of these specimens (62%). With respect to osteosarcoma, loss or downregulation of HLA class I expression was seen in 13 (52%) of 25 primary tumors and seven (88%) of eight metastatic tumors. In six of 11 HLA class I-negative osteosarcoma specimens, the expression of beta-2 microglobulin was also lost. Subsequently the prognostic significance of HLA class I expression was analyzed in 21 patients with osteosarcoma who had completed multidrug neoadjuvant chemotherapy and undergone adequate surgery. Patients with osteosarcoma highly expressing HLA class I showed significantly better overall and event-free survival than those with HLA class I-negative osteosarcoma. In contrast, such prognostic significance of HLA class I expression was not found in 15 patients with malignant fibrous histiocytoma of soft tissue. These findings suggest that the class I-restricted cytotoxic T lymphocyte pathway plays a major role in immune surveillance of patients with osteosarcoma.


Lupus-like eruption as the presenting sign of acute myeloblastic leukemia.
Cutaneous manifestations are often the presenting sign of internal malignancies. Up to 50% of patients with acute myeloblastic leukemia (AML) have skin findings. Connective tissue disease, particularly dermatomyositis and, rarely, lupus, have been reported as a paraneoplastic syndrome to various internal malignancies, but seldom with leukemias. We report the case of a middle-aged woman ultimately diagnosed with acute myeloblastic leukemia, who presented initially with a malar eruption, joint pains, and diffuse rash on the upper and lower extremities, with pathology consistent with lupus erythematosus and negative autoimmune serology. There are no prior reports of cutaneous lupus as the presenting sign of AML, and this case highlights the importance of considering paraneoplastic phenomena with presentations of connective tissue disease in older patients, especially with negative serology.


Analysis of NMR J couplings in partially protected galactopyranosides.
[carbohydrate structure: see text] Hydrogen bond mediated NMR J couplings offer additional structural information. The interpretation of these usually small (h)J couplings are, however, not necessarily straightforward. In the present case of a carbohydrate system, a four-bond classical W coupling, (4)J(HO4,H5), is more reasonable on the basis of, in particular, density functional theory calculations of spin-spin coupling constants at the UB3LYP/6-311G** level of theory.


Co-carrying an object by robot in cooperation with humans using visual and force sensing.
Human-robot collaboration poses many challenges where humans and robots work inside a shared workspace. Robots collaborating with humans indirectly bring difficulties for accomplishing co-carrying tasks. In our work, we focus on co-carrying an object by robots in cooperation with humans using visual and force sensing. A framework using visual and force sensing is proposed for human-robot co-carrying tasks, enabling robots to actively cooperate with humans and reduce human efforts. Visual sensing for perceiving human motion is involved in admittance-based force control, and a hybrid controller combining visual servoing with force feedback is proposed which generates refined robot motion. The proposed framework is validated by a co-carrying task in experiments. There exist two phases in experimental processes: in Phase 1, the human hand holds one side of the box object, and the robot gripper of the Baxter robot automatically approaches to the other side of the box object and finally holds it; in Phase 2, the human and the Baxter robot co-carry the box object over a distance to different target positions. This article is part of the theme issue 'Towards symbiotic autonomous systems'.


Identification of the flame retardant decabromodiphenyl ethane in the environment.
The brominated flame retardant decabromodiphenyl ethane, DeBDethane, is marketed as an alternative to decabromodiphenyl ether, BDE209. There are currently no data available about the presence of DeBDethane in the environment. In this study, DeBDethane was positively identified by high-resolution mass spectrometry and quantified by low-resolution mass spectrometry with electron capture negative ionization in sewage sludge, sediment, and indoor air. It was found in 25 of the 50 Swedish sewage treatment plants investigated, with estimated levels up to about 100 ng/g dry weight. The concentration of DeBDethane in sediment from Western Scheldt in The Netherlands was 24 ng/g dry weight, and in an air sample from a Swedish electronics dismantling facility it was 0.6 ng/m3. DeBDethane was also found together with nonabromodiphenyl ethanes in water piping insulation. All samples contained BDE209 in higher concentrations as compared to DeBDethane (DeBDethane/BDE209 ratios ranging from 0.02 to 0.7), probably reflecting the higher and longer usage of BDE209. There is an ongoing risk assessment within the European Union regarding BDE209. Since DeBDethane has similar applications, it is important to investigate its environmental behavior before using it to replace BDE209.


BAZ2A-mediated repression via H3K14ac-marked enhancers promotes prostate cancer stem cells.
Prostate cancer (PCa) is one of the most prevalent cancers in men. Cancer stem cells are thought to be associated with PCa relapse. Here, we show that BAZ2A is required for PCa cells with a cancer stem-like state. BAZ2A genomic occupancy in PCa cells coincides with H3K14ac-enriched chromatin regions. This association is mediated by BAZ2A-bromodomain (BAZ2A-BRD) that specifically binds H3K14ac. BAZ2A associates with inactive enhancers marked by H3K14ac and repressing transcription of genes frequently silenced in aggressive and poorly differentiated PCa. BAZ2A-mediated repression is also linked to EP300 that acetylates H3K14ac. BAZ2A-BRD mutations or treatment with inhibitors abrogating BAZ2A-BRD/H3K14ac interaction impair PCa stem cells. Furthermore, pharmacological inactivation of BAZ2A-BRD impairs Pten-loss oncogenic transformation of prostate organoids. Our findings indicate a role of BAZ2A-BRD in PCa stem cell features and suggest potential epigenetic-reader therapeutic strategies to target BAZ2A in aggressive PCa.


Keratinocyte interleukin-10 expression is upregulated in tape-stripped skin, poison ivy dermatitis, and Sezary syndrome, but not in psoriatic plaques.
Despite the highly diverse reaction patterns of benign and malignant skin diseases involving T lymphocytes, polymerase chain reaction analysis of cytokine mRNAs present in biopsy samples has revealed that many cutaneous responses can be categorized into essentially two discrete groups. One group exemplified by psoriasis is characterized by consistently detectable mRNAs for IL-2, IFN-gamma, and TNF-alpha, but not IL-4, IL-5, IL-10, thereby closely resembling the murine Th1-type cell-mediated response. The second group exemplified by tape-stripped skin, poison ivy dermatitis, and Sezary syndrome contains predominantly IL-4, IL-5, and IL-10 mRNAs resembling the Th2-type cytokine profile. Because of the growing interest in the immunoregulatory role of IL-10, which can suppress IFN-gamma production and inhibit cell-mediated reactions, we produced a rabbit antiserum that was used to immunohistochemically localize IL-10 in a total of 27 biopsies. The results revealed that in Th2-type skin diseases, IL-10 was predominantly identified throughout all levels of epidermis in the cytoplasm of keratinocytes (KCs), with accentuation of their membranes in upper level cells. In Sezary syndrome, T cells were also immunoreactive for IL-10, which was confirmed using the HUT 78 T cell line derived from a Sezary syndrome patient. While normal skin was devoid of IL-10 expression, KCs began expressing it as early as 6 hr following tape stripping or application of poison ivy antigen and became strongly and diffusely positive by 18-24 hr. In contrast, psoriatic plaques contained no IL-10 immunoreactivity in either the parakeratotic scale or the epidermal KCs. These results confirm the earlier IL-10 mRNA analysis using whole skin samples and immunolocalize IL-10 to epidermal KCs in the Th2 diseases.


Method to Measure Surface Tension of Microdroplets Using Standard AFM Cantilever Tips.
Surface tension is a physical property that is central to our understanding of wetting phenomena. One could easily measure liquid surface tension using commercially available tensiometers (e.g., Wilhelmy plate method) or by optical imaging (e.g., pendant drop method). However, such instruments are designed for bulk liquid volumes on the order of milliliters. In order to perform similar measurements on extremely small sample volumes in the range of femtoliters, atomic force microscope (AFM) is considered as a promising tool. It was previously reported that by fabricating a special "nanoneedle"-shaped cantilever probe, a Wilhelmy-like experiment can be performed with AFM. By measuring the capillary force between such special probes and a liquid surface, surface tension could be calculated. Here, we carried out measurements on microscopic droplets with AFM, but instead, using standard pyramidal cantilever tips. The cantilevers were coated with a hydrophilic polyethylene glycol-based polymer brush in a simple one-step process, which reduced its contact angle hysteresis for most liquids. Numerical simulations of a liquid drop interacting with a pyramidal or conical geometry were used to calculate surface tension from the experimentally measured force. The results on micrometer-sized drops agree well with bulk tensiometer measurement of three test liquids (mineral oil, ionic liquid, and glycerol), within a maximum error of 10%. Our method eliminates the need for specially fabricated "nanoneedle" tips, thus reducing the complexity and cost of measurement.


A case of Nocardia asteroides infection in a patient with HIV/AIDS diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).
We report a 45-year-old man with HIV/AIDS who developed mediastinal lymphadenopathy caused by Nocardia asteroides infection that was diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). He was an untreated HIV-infected man who was admitted to our hospital because of Pneumocystis pneumonia and Cytomegalovirus pneumonia. After treatment for pneumonia, cough and fever recurred and chest computed tomography revealed subcarinal lymphadenopathy with rim enhancement. To identify the etiology, we performed EBUS-TBNA and obtained purulent exudates which contained N. asteroides. EBUS-TBNA is a useful and safe technique for the diagnosis of mediastinal infectious lymphadenopathy of unknown origin.


Ethnicity estimation using family naming practices.
This paper examines the association between given and family names and self-ascribed ethnicity as classified by the 2011 Census of Population for England and Wales. Using Census data in an innovative way under the new Office for National Statistics (ONS) Secure Research Service (SRS; previously the ONS Virtual Microdata Laboratory, VML), we investigate how bearers of a full range of given and family names assigned themselves to 2011 Census categories, using a names classification tool previously described in this journal. Based on these results, we develop a follow-up ethnicity estimation tool and describe how the tool may be used to observe changing relations between naming practices and ethnic identities as a facet of social integration and cosmopolitanism in an increasingly diverse society.


Physical training in insulin-resistant states.
It is the scope of this review to summarize animal experimentation carried out to investigate the effects of changes in habitual physical activity on glucose tolerance. Various studies in normal rats and in obese Zucker rats have demonstrated that physical training of mild intensity can partially revert or prevent the development of insulin resistance, glucose intolerance, and skeletal muscle insulin insensitivity. The molecular basis for these phenomena remains to be elucidated. Nevertheless, these observations strongly suggest the possibility to use physical exercise programmes in order to improve glucose tolerance in patients with maturity-onset type diabetes mellitus, especially if associated with obesity.


Earlier trabeculectomy.
This is a preliminary report of a collaborative, prospective, randomised trial of management of primary open angle glaucoma where conventional management using medical therapy followed by trabeculectomy only in unsuccessful cases (Group A) was compared with trabeculectomy as the primary form of treatment supplemented where necessary by medical therapy (Group B). Using one eye of each patient 40 eyes were available at one year and 14 eyes at two years after entry to the trial. The two groups were comparable for age, sex, intraocular pressure before treatment, visual acuity, visual fields and other features. Seven of the 22 eyes in Group A (31 per cent) had required operation in the first year and two of the 18 eyes in Group B (11 per cent) had required supplementary medical therapy in the same period. Trabeculectomy was more effective in lowering intraocular pressure than medical treatment. No statistically significant differences in visual function or disc appearances are yet detectable but there is a trend in favour of trabeculectomy as a primary procedure (Group B).


Reactive Oxygen Species Generated by Cold Atmospheric Plasmas in Aqueous Solution: Successful Electrochemical Monitoring in Situ under a High Voltage System.
Many investigations are dedicated to the detection and quantification of reactive oxygen and nitrogen species (RONS), particularly when generated in liquids exposed to cold atmospheric plasmas (CAPs). CAPs are partially ionized gases that can be obtained by applying a high electric field to a gas. A challenge is to get better insights on the plasma-liquid interactions in order to understand the induced effects on different targets (liquid, cells, tissues, etc.). As RONS are biochemically reactive, the difficulty lies in finding efficient methods to get both dynamic and quantitative data. Herein, we developed an innovative setup aimed at performing an in situ electrochemical monitoring of redox species generated by CAPs in a physiological buffer (PBS, pH 7.4). The challenge was to apply millivolt-potential variations and measure nanoampere Faradaic currents in the presence of ionization waves generated by micropulsed electric fields of some 10 kV·cm-1 amplitude and ampere-transient currents. This was fulfilled by using dedicated working ultramicroelectrodes (Pt-black UMEs) and protecting them, as well as the reference and counter electrodes, within insulated-earthed containers. In this condition, we succeeded in performing both cyclic voltammetry and chronoamperometry in situ, with a resolution equivalent to working in a static solution (subnanoampere currents). Thus, we monitored the accumulation over time of species (H2O2, NO2-) generated by CAPs in PBS and observed the mean dynamic of RONS chemistry during and after plasma exposition, particularly through the detection of a short-living species.


Spectroscopic Investigation of the Formation and Disruption of Hydrogen Bonds in Pharmaceutical Semicrystalline Dispersions.
We recently found that indomethacin (IMC) can effectively act as a powerful crystallization inhibitor for polyethylene glycol 6000 (PEG) despite the fact that the absence of interactions between the drug and the carrier in the solid state was reported in the literature. However, in the present study, we investigate the possibility of drug-carrier interactions in the liquid state to explain the polymer crystallization inhibition effect of IMC. We also aim to discover other potential PEG crystallization inhibitors. Drug-carrier interactions in both liquid and solid state are characterized by variable temperature Fourier transform infrared spectroscopy (FTIR) and cross-polarization magic angle spinning 13C nuclear magnetic resonance spectroscopy (CP/MAS NMR). In the liquid state, FTIR data show evidence of the breaking of hydrogen bonding between IMC molecules to form interactions of the IMC monomer with PEG. The drug-carrier interactions are disrupted upon storage and polymer crystallization, resulting in segregation of IMC from PEG crystals that can be observed under polarized light microscopy. This process is further confirmed by 13C NMR since in the liquid state, when the IMC/PEG monomer units ratio is below 2:1, IMC signals are undetectable because of the loss of cross-polarization efficiency in the mobile IMC molecules upon attachment to PEG chains via hydrogen bonding. This suggests that each ether oxygen of the PEG unit can form hydrogen bonds with two IMC molecules. The NMR spectrum of IMC shows no change in solid dispersions with PEG upon storage, indicating the absence of interactions in the solid state, hence confirming previous studies. The drug-carrier interactions in the liquid state elucidate the crystallization inhibition effect of IMC on PEG as well as other semicrystalline polymers such as poloxamer and Gelucire. However, hydrogen bonding is a necessary but apparently not a sufficient condition for the polymer crystallization inhibition. Screening of crystallization inhibitors of semicrystalline polymers discovers numerous candidates that exhibit the same behavior as IMC, demonstrating a general pattern of polymer crystallization inhibition rather than a particular case. Furthermore, the crystallization inhibition effect of drugs on PEG is independent of the carrier molecular weight. These mechanistic findings on the formation and disruption of hydrogen bonds in semicrystalline dispersions can be extended to amorphous dispersions and are of significant importance for preparation of solid dispersions with consistent and reproducible physicochemical properties.


Loss of highly branched arabinans and debranching of rhamnogalacturonan I accompany loss of firm texture and cell separation during prolonged storage of apple.
Growth and maturation of the edible cortical cells of apples (Malus domestica Borkh) are accompanied by a selective loss of pectin-associated (1-->4)-beta-D-galactan from the cell walls, whereas a selective loss of highly branched (1-->5)-alpha-L-arabinans occurs after ripening and in advance of the loss of firm texture. The selective loss of highly branched arabinans occurs during the overripening of apples of four cultivars (Gala, Red Delicious, Firm Gold, and Gold Rush) that varied markedly in storage life, but, in all instances, the loss prestages the loss of firm texture, measured by both breaking strength and compression resistance. The unbranched (1-->5)-linked arabinans remain associated with the major pectic polymer, rhamnogalacturonan I, and their content remains essentially unchanged during overripening. However, the degree of rhamnogalacturonan I branching at the rhamnosyl residues also decreases, but only after extensive loss of the highly branched arabinans. In contrast to the decrease in arabinan content, the loss of the rhamnogalacturonan I branching is tightly correlated with loss of firm texture in all cultivars, regardless of storage time. In vitro cell separation assays show that structural proteins, perhaps via their phenolic residues, and homogalacturonans also contribute to cell adhesion. Implications of these cell wall modifications in the mechanisms of apple cortex textural changes and cell separation are discussed.


The relationship between the living arrangements of university students and their identity development.
One of the developmental challenges facing the emerging adult is to live independently of his/her family of origin. Research has shown that the living arrangements of late adolescents/young adults also affect aspects of their personal development. This study examined the relationship between university students' living arrangements, their identity development status, the degree of life difficulties experienced, and the manner in which they coped with their difficulties. In general, it was found that those who did not reside in their parents' home had greater levels of problems but also used more direct, problem-focused coping strategies than did those who resided at home. Individuals residing away from their parents were also more likely to have established an adult identity, whereas those who resided with their parents were more likely to be still in the process of developing an adult identity.


Novel cathepsin C mutation in a Brazilian family with Papillon-Lefèvre syndrome: case report and mutation update.
Papilion-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder that involves palmoplantar keratosis (PK) and severe aggressive periodontitis. Cathepsin C (CTSC) gene mutations are etiologic for PLS, with more than 60 different mutations reported in different ethnic groups worldwide. The purpose of this study was to report a novel cathepsin C mutation in a Brazilian patient. A 4-year-old boy presented with aggressive periodontitis, recession, missing teeth, and hyperkeratosis of the palms of hands and soles. Peripheral blood samples were obtained from family members for genomic DNA isolation. The coding region and exon/intron boundaries of the CTSC gene were amplified and sequenced. The patient had a PLS phenotype, which included PK and early-onset severe periodontitis. Sequence analysis showed a novel CTSC mutation (c.267-268del) present in the homozygous state. This report described a novel mutation in a family with Brazilian Papillon-Lefèvre syndrome and presented a review of all cathepsin C (65) mutations reported to date.


Genomic profiling of oral squamous cell carcinoma by array-based comparative genomic hybridization.
We designed a study to investigate genetic relationships between primary tumors of oral squamous cell carcinoma (OSCC) and their lymph node metastases, and to identify genomic copy number aberrations (CNAs) related to lymph node metastasis. For this purpose, we collected a total of 42 tumor samples from 25 patients and analyzed their genomic profiles by array-based comparative genomic hybridization. We then compared the genetic profiles of metastatic primary tumors (MPTs) with their paired lymph node metastases (LNMs), and also those of LNMs with non-metastatic primary tumors (NMPTs). Firstly, we found that although there were some distinctive differences in the patterns of genomic profiles between MPTs and their paired LNMs, the paired samples shared similar genomic aberration patterns in each case. Unsupervised hierarchical clustering analysis grouped together 12 of the 15 MPT-LNM pairs. Furthermore, similarity scores between paired samples were significantly higher than those between non-paired samples. These results suggested that MPTs and their paired LNMs are composed predominantly of genetically clonal tumor cells, while minor populations with different CNAs may also exist in metastatic OSCCs. Secondly, to identify CNAs related to lymph node metastasis, we compared CNAs between grouped samples of MPTs and LNMs, but were unable to find any CNAs that were more common in LNMs. Finally, we hypothesized that subpopulations carrying metastasis-related CNAs might be present in both the MPT and LNM. Accordingly, we compared CNAs between NMPTs and LNMs, and found that gains of 7p, 8q and 17q were more common in the latter than in the former, suggesting that these CNAs may be involved in lymph node metastasis of OSCC. In conclusion, our data suggest that in OSCCs showing metastasis, the primary and metastatic tumors share similar genomic profiles, and that cells in the primary tumor may tend to metastasize after acquiring metastasis-associated CNAs.


Serum Ceramide Kinase as a Biomarker of Cognitive Functions, and the Effect of Using Two Slimming Dietary Therapies in Obese Middle Aged Females.
Highlighting the impact of obesity on mental and cognitive functions using serum ceramide kinase enzyme concentration as a biomarker for cognitive evaluation in the middle aged females, and also targeting to control the obesity and simultaneously postponing the deterioration of the cognitive functions, by implementing two slimming dietary therapies each incorporating different functional ingredients known to boost cognition. Ninety six obese middle aged females, divided into two groups volunteered to follow a low caloric balanced diet combined with two bread supplements composed essentially of barley flour and wheat germ mixed with either 5% turmeric, group (A); or with 5% ginger, group (B) for 4 weeks, phase (1); to be followed by the hypocaloric diet alone for another 4 weeks, phase (2). By the end of phase (1), the biochemical analysis showed a positive response of the levels of C-peptide and modified homeostatic model assessment of insulin resistance; also increased levels of the serum ceramide kinase enzyme, coupled with improved cognitive functions tests. Improvement of the relevant metabolic profile, fasting blood glucose, blood pressure and the anthropometric measurements was detected. Using dietary therapy supported by special formulas which contain active ingredients succeeded in reducing weight and improving both the metabolic profile and the cognitive functions.


Aflatoxin content of foods served to a population with a high incidence of hepatocellular carcinoma.
During three seasons, 36 samples of foods served to mentally retarded clients with a high incidence of hepatocellular carcinoma were analyzed for aflatoxin. Aflatoxin was not detected (less than 5 ppb) by thin-layer liquid chromatography in 35 food samples containing peanuts, corn, wheat or milk. One peanut butter sample contained 20 ppb aflatoxin. Aflatoxin content of these foods was at or below the level permitted by the Food and Drug Administration. Aflatoxin is probably not responsible for liver disease in this population.


Cigarette smoking: Evidence to guide measurement.
Smoking cessation programs measure outcomes in terms of abstinence from or reduction in smoking. These outcomes can be measured through self-report by the smoker, through measurement with a biological marker of smoking, or through a combination of both. Consideration of the relative advantages of self-report and biomarker approaches is important in the selection of measurement strategies to evaluate outcomes in smoking cessation interventions. In this article both ways of measuring smoking behavior, self-report and biomarkers of carbon monoxide, cotinine, nicotine, thiocyanate, and alkaloids of nicotine, are explored. Measurement approaches are discussed in light of research evidence and their physiologic bases.


A new IRES-mediated truncated Cx32 isoform inhibits global mRNA translation to suppress glioblastoma.
Glioblastoma (GBM) is the most lethal malignant primary brain tumor. Although multimodal therapy has been applied for GBM, the median survival time remains less than 16 months. Thus, better therapeutic targets in GBM are urgently needed. Herein, we first identified five new N-terminal-truncated Cx32 isoforms (GJB1-28k, GJB1-22k, GJB1-20k, GJB1-15k, and GJB1-13k) and further demonstrated that they were generated via cap-independent internal translation through internal ribosome entry sites (IRESs) in the coding sequence of GJB1 mRNA. Among these isoforms, GJB1-13k inhibited proliferation, promoted apoptosis, and limited cell cycle progression in GBM cells by inhibiting global mRNA translation. In vivo experiments further confirmed the antitumor activity of GJB1-13k against GBM cells. In addition, TSR3, a ribosomal maturation factor, was demonstrated to directly interact with GJB1-13k. Moreover, GBM cells with high TSR3 expression exhibited low sensitivity to GJB1-13k treatment, while GJB1-13k sensitivity was restored by TSR3 knockdown. Our work identifies a new IRES-mediated protein, GJB1-13k, and suggests that overexpression of GJB1-13k in GBM cells with low TSR3 expression or combined targeting of GJB1-13k and TSR3 in GBM cells with high TSR3 expression constitutes a potential therapeutic strategy for GBM.


Percutaneous endovenous intervention versus anticoagulation in the treatment of lower extremity deep vein thrombosis: a systematic review and meta-analysis.
Deep vein thrombosis (DVT) of the lower extremity (LE) might lead to pulmonary embolism (PE) and post-thrombolytic syndrome (PTS). Recently, percutaneous endovenous intervention (PEVI) has been advocated for early removal of thrombus clot and restoration of venous patency. This study aims to review the safety and efficacy outcomes of PEVI versus anticoagulation in the treatment of acute LE-DVT. We searched the databases of PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) comparing catheter-directed thrombolysis (CDT) and/or pharmacomechanical thrombectomy (PMT) versus anticoagulation for acute proximal LE-DVT, published before August 2022. Efficacy outcomes were PTS and venous patency. Safety outcomes included recurrent thromboembolism, bleeding complications, and PE. Overall, 1,266 patients were included from 6 RCTs. The overall risk of bias was small due to enrolled high-quality RCTs. Compared to anticoagulation, PEVI moderately reduced PTS incidence [odds ratio (OR) 0.47, 95% confidence interval (CI) 0.23-0.99], obviously inhibited moderate-to-severe PTS (OR 0.60, 95% CI: 0.40-0.88), significantly decreased PE (OR 0.16, 95% CI: 0.05-0.48), and substantially increased venous patency (OR 7.95, 95% CI: 1.00-63.16). There was no significant difference in recurrent thromboembolism between PEVI and anticoagulation (OR 0.76, 95% CI: 0.34-1.73). Bleeding events did not differ statistically between PEVI and anticoagulation (OR 1.36, 95% CI: 0.87-2.11). We conducted single-arm meta-analysis of the PEVI or anticoagulation. Pooled proportion of PTS was less after PEVI (0.295, 95% CI: 0.123-0.505) than after anticoagulation (0.459, 95% CI: 0.306-0.616). Pooled proportion of moderate-to-severe PTS was lower after PEVI (0.098, 95% CI: 0.033-0.191) than after anticoagulation (0.183, 95% CI: 0.126-0.247). Pooled proportion of PE was smaller after PEVI (0.006, 95% CI: 0.00-0.020) as compared to anticoagulation (0.075, 95% CI: 0.038-0.122). Pooled proportion of recurrent thromboembolism was similar between PEVI (0.095, 95% CI: 0.054-0.146) and anticoagulation (0.124, 95% CI: 0.061-0.206). Pooled proportion of bleeding was not different statistically between PEVI (0.026, 95% CI: 0.00-0.131) and anticoagulation (0.008, 95% CI: 0.00-0.094). PEVI, consisting of PMT and/or CDT, is an extremely effective and feasible approach for patients with acute LE-DVT. In comparison to therapeutic anticoagulation, PEVI restores venous patency, inhibits the PTS development, reduces the PE occurrence, does not markedly increase the bleeding risk, but does not reduce recurrent thromboembolism.


Designing Internal Hierarchical Porous Networks in Polymer Monoliths that Exhibit Rapid Removal and Photocatalytic Degradation of Aromatic Pollutants.
This paper describes the preparation of 3D polymer monoliths containing internal hierarchical porosity. The porous networks are fabricated based on Pickering high-internal-phase emulsions (HIPEs) stabilized by microporous β-cyclodextrin-based polymer particles (CDPs) as the emulsifier; CDPs are facilely synthesized by the polyaddition reactions without the need for catalysts. The designed Pickering agents enable to form a bicontinuous internal phase in 8:2 cyclohexane-water v/v, and the oil droplets in the continuous water phase is found to be fairly stable up to 1 month. Furthermore, the addition of acrylamide and N,N'-methylenebis(acrylamide) results in polymer networks after in situ thermal polymerization at 60 °C in the water phase, and the monoliths include both interconnected macropores from the HIPE template and micro- and mesopores from the CDPs embedded at the interface. The porous monoliths rapidly absorb a variety of solvents taking advantage of multiscale porosity and amphiphilicity. Furthermore, the materials can be efficiently used for the removal of aromatic pollutants and then reused after washing and drying without the deterioration of performance. Also, they exhibit high photocatalytic capability and good recyclability as being used as a catalytic support when embedded with titanium dioxide (TiO2 ).


Paper- or Web-Based Questionnaire Invitations as a Method for Data Collection: Cross-Sectional Comparative Study of Differences in Response Rate, Completeness of Data, and Financial Cost.
Paper questionnaires have traditionally been the first choice for data collection in research. However, declining response rates over the past decade have increased the risk of selection bias in cross-sectional studies. The growing use of the Internet offers new ways of collecting data, but trials using Web-based questionnaires have so far seen mixed results. A secure, online digital mailbox (e-Boks) linked to a civil registration number became mandatory for all Danish citizens in 2014 (exemption granted only in extraordinary cases). Approximately 89% of the Danish population have a digital mailbox, which is used for correspondence with public authorities. We aimed to compare response rates, completeness of data, and financial costs for different invitation methods: traditional surface mail and digital mail. We designed a cross-sectional comparative study. An invitation to participate in a survey on help-seeking behavior in out-of-hours care was sent to two groups of randomly selected citizens from age groups 30-39 and 50-59 years and parents to those aged 0-4 years using either traditional surface mail (paper group) or digital mail sent to a secure online mailbox (digital group). Costs per respondent were measured by adding up all costs for handling, dispatch, printing, and work salary and then dividing the total figure by the number of respondents. Data completeness was assessed by comparing the number of missing values between the two methods. Socioeconomic variables (age, gender, family income, education duration, immigrant status, and job status) were compared both between respondents and nonrespondents and within these groups to evaluate the degree of selection bias. A total 3600 citizens were invited in each group; 1303 (36.29%) responded to the digital invitation and 1653 (45.99%) to the paper invitation (difference 9.66%, 95% CI 7.40-11.92). The costs were €1.51 per respondent for the digital group and €15.67 for paper group respondents. Paper questionnaires generally had more missing values; this was significant in five of 17 variables (P<.05). Substantial differences were found in the socioeconomic variables between respondents and nonrespondents, whereas only minor differences were seen within the groups of respondents and nonrespondents. Although we found lower response rates for Web-based invitations, this solution was more cost-effective (by a factor of 10) and had slightly lower numbers of missing values than questionnaires sent with paper invitations. Analyses of socioeconomic variables showed almost no difference between nonrespondents in both groups, which could imply that the lower response rate in the digital group does not necessarily increase the level of selection bias. Invitations to questionnaire studies via digital mail may be an excellent option for collecting research data in the future. This study may serve as the foundational pillar of digital data collection in health care research in Scandinavia and other countries considering implementing similar systems.


Stevens rearrangement of thioethers with arynes: a facile access to multi-substituted β-keto thioethers.
An effective method for the synthesis of multi-substituted β-keto thioethers via Stevens rearrangement of simple β-keto thioethers with arynes has been developed. In these reactions, successive C-S/C-H/C-C bonds were formed in one pot under mild and transition-metal free conditions to afford multi-substituted β-keto thioethers in moderate to good yields.


In Vivo Microvascular Pattern of Solitary Juxtapapillary Capillary Hemangioma on OCT Angiography.
Juxtapapillary capillary hemangioma (JCH) is a vascular hamartoma. Fluorescein fundus angiography aids in diagnosis. The vascular morphology of this tumor has not been documented with optical coherence tomography angiography (OCTA), a new, noninvasive diagnostic modality that provides high-resolution images of vascular pattern based on blood flow in the retina and choroid. Although mainly a clinical diagnosis, OCTA helps in studying the intrinsic vascularity of the tumor and helps in differentiating it from other vascular tumors. The authors report the case of a young male with unilateral solitary JCH and its microvascular pattern, as seen on OCTA. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:592-595.].


A breath of fresh air for lung transplant recipients.
Lung transplantation is a definitive therapy for the treatment of many end-stage lung diseases. However, because of donor-related morbidities, only 15% of donor lungs are suitable for transplantation, which leads to an increased risk of death for prospective patients waiting for this lifesaving procedure. A technique reported by Keshavjee's group in this issue of Science Translational Medicine may help address this problem, not only by repairing donor lungs before transplant, but also by possibly preventing lung injury after transplantation.


The management of bilateral cryptorchidism in the adult man: report of two cases.
Undescended testis or cryptorchidism is a pathology usually presenting in the newborn or during childhood, rarely diagnosed in the adult man. This article pretends to perform a review of its management in the adulthood. We present two cases of man with bilateral congenital cryptorchidism diagnosed in the adult. We made a review of the management of this condition in the adult male, based in a research performed in PubMed database. With the use of laparoscopy in the management of men with cryptorchidism, the diagnostic and therapeutic approach in this pathology doesn't differ from that used in childhood. Surgical management is based in the localization of the testis in physical exploration, the risk of testicular cancer and the viability of the gonad in its exploration. Hormonal replacement therapy and fertility preservation techniques should be offered in selected cases to optimize patient health and desires.