Free tubulin modulates mitochondrial membrane potential in cancer cells.
Formation of the mitochondrial membrane potential (ΔΨ) depends on flux of respiratory substrates, ATP, ADP, and Pi through voltage-dependent anion channels (VDAC). As tubulin promotes single-channel closure of VDAC, we hypothesized that tubulin is a dynamic regulator of ΔΨ, which in cultured cancer cells was assessed by confocal microscopy of the potential-indicating fluorophore tetramethylrhodamine methylester (TMRM). Microtubule destabilizers, rotenone, colchicine, and nocodazole, and the microtubule stabilizer paclitaxel increased and decreased cellular free tubulin, respectively, and in parallel decreased and increased ΔΨ. Protein kinase A (PKA) activation by cAMP analogues and glycogen synthase kinase 3β (GSK-3β) inhibition decreased ΔΨ, whereas PKA inhibition hyperpolarized, consistent with reports that PKA and GSK-3β decrease and increase VDAC conductance, respectively. Plasma membrane potential assessed by DiBAC(4)(3) was not altered by any of the treatments. We propose that inhibition of VDAC by free tubulin limits mitochondrial metabolism in cancer cells.


Microbial growth at reduced water activities: some physicochemical properties of compatible solutes.
The water activities (aw) of solutions of D-arabitol (a major compatible solute in yeasts grown at reduced aw) and also of related polyols (L-arabitol, xylitol and ribitol) were determined at 25 degrees C. The aw of saturated solutions of L-proline and monopotassium L-glutamate (solutes which accumulate in bacterial cells at reduced aw) were also determined. The viscosities of L-proline, monopotassium L-glutamate and D-arabitol solutions were measured at 25, 30, 35 and 40 degrees C for various concentrations up to high molalities. The relative viscosity curves were described using a theoretical model for the concentration dependence of viscosity. No relationship of viscosity of the electrolytes to effectiveness as 'compatible solutes' were evident, neither were the compatible solutes particularly effective 'structure makers' or 'structure breakers.'


The stigma of wrongful conviction differs for White and Black exonerees.
Black people are disproportionately targeted and disadvantaged in the criminal legal system. We tested whether Black exonerees are similarly disadvantaged by the stigma of wrongful conviction. In Experiment 1, we predicted that the stigma of wrongful conviction would be greater for Black than White exonerees. After finding the opposite pattern, we conducted two experiments to investigate the psychological underpinnings of this counterintuitive effect-specifically, whether it was driven by attempts to appear unprejudiced and/or beliefs regarding the legal system bias that Black and White exonerees face. In Experiment 1, we unobtrusively measured non-Black participants' behavioral reactions to an anticipated meeting with a Black or White exoneree or businessman. In Experiment 2, participants completed measures that assessed their motivation to appear unprejudiced and then, in a separate session, evaluated a Black or White exoneree and reported their beliefs about the legal system bias faced by the exoneree. Experiment 3 was a partial replication of Experiment 2. In Experiments 2 and 3, we examined data from both non-Black and Black participants. Non-Black participants in Experiment 1 stigmatized the White exoneree, d = -0.31, 95% confidence interval (CI) [-0.72, 0.10], but not the Black exoneree, d = 0.44, 95% CI [0.04, 0.83]. Experiments 2 and 3 replicated this finding, showing that the effect was mediated by the belief that Black exonerees faced greater legal system bias than White exonerees (Experiment 2: B = 0.21, SE = 0.06, 95% CI [0.11, 0.33]; Experiment 3: B = 0.35, SE = 0.09, 95% CI [0.19, 0.55]). Our results also suggested that Black individuals react more favorably to Black than White exonerees, potentially because of their beliefs regarding legal system bias. People may react more favorably to Black than White exonerees because of the belief that Black exonerees face greater injustices within the legal system. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


[Hearing loss in patients with Fabry disease].
Fabry disease is an X-linked lysosomal storage disease involving deficient activity of alpha-galactosidase A, which leads initially to pain, and later to renal insufficiency, cardiomyopathy and stroke. Until now few details are available on hearing impairment in patients with Fabry disease, and especially few relating to female patients. We examined 43 female and 29 male patients. In this study we looked into the question of whether and to what extent patients of both genders are affected by hearing impairment. Hearing loss is characteristic being more severe at high frequencies frequencies. Overall, 22 female and 15 male patients were found to have suffered a hearing loss. Patients with severe symptoms of Fabry disease usually demonstrate more prominent hearing losses. Both men and women with Fabry disease are affected by hearing impairment. It seems that the hearing loss is less marked in female than in male patients. Children with Fabry disease complain of tinnitus more frequently than other children and quite early in the course of the disease.


Antibody titers to Toxoplasma gondii in renal transplant patients.
Of 70 renal transplant patients submitted to the indirect immunofluorescence reaction test for toxoplasmosis, 16 (23%) had titers higher than 1/4,000, as compared to 0/41 for chronic hemodialysis patients and 0/50 for blood donors. The indirect immunofluorescence reaction titers in the renal transplant patients correlated with time since initiation of immunosuppressive therapy. Six percent (2/33) of the patients had been on immunosuppressors for less than one year, 30.7% (4/13) for 1 to 2 years, and 41.6% (10/24) for 2 or more years. The frequency of negative titers among the immunosuppressed patients was similar to that observed for blood donors and chronic hemodialysis patients. Fifty percent (8/16) of the patients with higher immunofluorescence reaction titers also had significantly high (greater than or equal to 320) positive titers in the complement fixation test. The results indicate that: 1) the immunosuppressive scheme used for the transplant patients may favor the reactivation of infection from latent Toxoplasma gondii foci, and 2) even though the patients were immunosuppressed, their antitoxoplasma antibody levels were high enough to be detected by the serologic test.


Self-inflicted genital ulcer: An intriguing case report.
Self inflicted genital ulcer due to penile constriction injury is a rare clinical entity, which requires urgent management to prevent its devastating outcomes such as penile gangrene and auto amputation. Although this is common, definitely, it is of interest because of the genital involvement. Here, we present a case report on an unusual case of rubber band induced penile constriction injury.


A randomized controlled trial examining the effectiveness of a STOMA psychosocial intervention programme on the outcomes of colorectal patients with a stoma: study protocol.
To report a study protocol that evaluates the effects of a psychosocial intervention on patients with a newly formed stoma. With the loss of a significant body function and distorted body image, stoma patients experience physical, psychological and social challenges. Nurses have an important role in helping patients' make a smooth transition to living with their stoma. Limited studies have examined the effects of psychosocial interventions on improving stoma-related health outcomes. A randomized controlled trial is planned. Eighty-four patients with newly formed stoma in a tertiary hospital in Singapore (Research Ethics Committee approval obtained in January 2013) will be recruited. Participants will be randomly assigned to either a control group who receive routine care or an intervention group who receive STOMA psychosocial intervention besides routine care. Outcome variables include stoma care self-efficacy, days to stoma proficiency, length of hospital stay, acceptance of stoma, anxiety and depression and quality of life. Data will be collected at four time points: before randomization and intervention (baseline), on the day of discharge (mid-intervention), at 4 weeks after discharge (postintervention 1) and at 4 months after discharge (postintervention 2). This study will develop a psychosocial intervention programme, which may improve patients' stoma-related outcomes. The findings will provide direction to health professionals about education and the type of support that could be offered to patients concerning stoma care in the hospital setting, which will eventually improve their quality of life.


I-FiBH trial: intravenous fluids in benign headaches-a randomised, single-blinded clinical trial.
Many emergency physicians use an intravenous fluid bolus as part of a 'cocktail' of therapies for patients with headache, but it is unclear if this is beneficial. The objective of this study was to determine if an intravenous fluid bolus helps reduce pain or improve other outcomes in patients who present to the ED with a benign headache. This was a randomised, single-blinded, clinical trial performed on patients aged 10-65 years old with benign headaches who presented to a single ED in Las Vegas, Nevada, from May 2017 to February 2019. All patients received prochlorperazine and diphenhydramine, and they were randomised to also receive either 20 mL/kg up to 1000 mL of normal saline (the fluid bolus group) or 5 mL of normal saline (the control group). The primary outcome was the difference between groups in mean pain reduction 60 min after the initiation of treatment. Secondarily, we compared groups with regards to pain reduction at 30 min, nausea scores, the use of rescue medications and disposition. We screened 67 patients for enrolment, and 58 consented. Of those, 35 were randomised to the fluid bolus group and 23 to the control group. The mean pain score dropped by 48.3 mm over 60 min in the fluid bolus group, compared with 48.7 mm in the control group. The between groups difference of 0.4 mm (95% CI -16.5 to 17.3) was not statistically significant (p=0.96). Additionally, no statistically significant difference was found between groups for any secondary outcome. Though our study lacked statistical power to detect small but clinically significant differences, ED patients who received an intravenous fluid bolus for their headache had similar improvements in pain and other outcomes compared with those who did not. NCT03185130.


Serotonin receptor binding affinities of several hallucinogenic phenylalkylamine and N,N-dimethyltryptamine analogues.
Hallucinogenic phenylalkylamine and N,N-dimethyltryptamine analogues are known to affect serotonergic systems both in vivo and in vitro. Using a rat stomach fundus model, the 5-HT receptor binding affinities of several of these analogues were determined and compared. The most behaviorally potent analogues examined, DOB, DOM, and 5-methoxy-N,N-dimethyltryptamine, were found to possess rather high affirmities (pA2 = 7.35, 7.12, and 7.08, respectively) for the 5-HT receptors of the model system.


Nosocomial bloodstream infections caused by Streptococcus pneumoniae.
A retrospective study of Streptococcus pneumoniae bacteraemia among adult patients in two large teaching hospitals in Spain identified 108 (10.6%) of 1,020 episodes as nosocomial pneumococcal bloodstream infections (NPBIs). Seventy-seven clinical records with sufficient data were available for analysis. The interval between admission and a positive blood culture was 3--135 days (median 17 days; interquartile range 8--27). The main underlying and predisposing conditions for NPBI were malignancy (31%), chronic obstructive pulmonary disease (28.6%), heart failure (16.9%), chronic renal failure (15.6%), liver cirrhosis (13%) and infection with human immunodeficiency virus (13%). Overall, 31.2% of patients developed severe sepsis, 11.7% septic shock, and 3.9% multi-organ failure. The main portals of entry were pneumonia (70.1%), meningitis (5.2%) and primary peritonitis (5.2%). Of the responsible serogroups, 78% were included in the 23-valent polysaccharide vaccine. Thirty-five (45.5%) patients died, with death considered to be related to the NPBI in 21 (27.3%) cases. Following multivariate analysis, factors that independently predicted death after adjusting for age were: ultimately fatal underlying disease (OR, 8.9; 95% CI, 0.8--94.3; p<0.001); rapidly fatal underlying disease (OR, 15.0; 95% CI, 2.8--81.3; p<0.001); heart failure (OR, 8.11; 95% CI, 1.1--60.8; p<0.03); inadequate empirical therapy (OR, 10.6; 95% CI, 1.2--97; p<0.003); a severe sepsis score (OR, 9.5; 95% CI, 1.9--47.0; p<0.001); and septic shock or multi-organ failure (OR, 63.7; 95% CI, 4.9--820.7; p<0.001). Adequate empirical therapy was an independent protective factor (OR, 0.05; 95% CI, 0.04--0.58; p<0.005), but the use of more than one antimicrobial agent was not.


Dynamics of compartmented and reticulate food webs in relation to energetic flows.
Using simple food webs, we address how the interactions of food web structure and energetic flows influence dynamics. We examine the effect of food web topologies with equivalent energetics (i.e., trophic interactions are equivalent at each trophic level), following which we vary energetic flows to include weak and strong interactions or nonequivalent energetics. In contrast to some work (Pimm 1979), we find that compartmented webs are more stable than reticulate webs. However, we find that nonequivalent energetics can stabilize previously unstable reticulate structures. It is not only weak flows that can be stabilizing but also the arrangement of the flows that emphasizes stabilizing mechanisms. We find that the main stabilizing mechanism is asynchrony, where structures and energetic arrangements that decrease synchrony such as internal segregation or competition will stabilize dynamics. Since compartments allow prey dynamics to behave somewhat independently, compartmentation readily promotes stability. In addition, these results can be scaled from simple food webs to more complex webs with many interacting subsystems so that linking weak subsystems to strong ones can stabilize dynamics. We show that food web dynamics are determined not only by topology but also the arrangement of weak and strong energetic flows.


The reproductive phenotype in polycystic ovary syndrome.
The symptoms of women with polycystic ovary syndrome (PCOS) include hirsutism and irregular menstrual bleeding due to ovarian androgen excess and chronic anovulation. Typically, these features emerge late in puberty or shortly thereafter. The proposed mechanism(s) responsible for increased ovarian androgen production include heightened theca cell responsiveness to gonadotropin stimulation, increased pituitary secretion of luteinizing hormone, and hyperinsulinemia. The cause of ovulatory dysfunction is not well understood, but is linked to abnormal follicle growth and development within the ovary. As a result, infertility is common among women with PCOS and, in many instances, is the initial presenting complaint. Insulin resistance and obesity are frequently associated with PCOS and probably contribute to the severity of symptoms. The polycystic ovary that accompanies the syndrome has recently been defined as having 12 or more follicles per ovary or an ovarian volume greater than 10 ml as determined by ultrasonography. In addition, there is an increased number of growing follicles in the polycystic ovary. Despite this distinctive appearance, the cause and development of the polycystic ovary are completely unknown.


Oral treatment with gallic acid and quercetin alleviates lindane-induced cardiotoxicity in rats.
Lindane is a man-made organochlorine pesticide used for agricultural purposes. Since lindane-induced toxicity is mediated by free radical generation, this investigation was carried out to study the protective effects of gallic acid and quercetin against lindane-induced cardiotoxicity. Lindane (100 mg·(kg body mass)(-1)) was administered orally to rats for 30 days. Histological analysis revealed pathological changes in the heart of lindane-treated rats. Biochemical analysis of the lindane-treated animals showed elevated activity for serum marker enzymes, lipid peroxidation (LPO), and membrane-bound Ca(2+) ATPase, with a concomitant decrease in the level of non-enzymic antioxidant (GSH), enzymic antioxidants such as superoxide dismutase, catalase, glutathione peroxidase (GPx), and glutathione-S-transferase (GST), and membrane-bound ATPases like Na(+)/K(+) ATPase and Mg(2+) ATPase in heart tissue. The results suggest that gallic acid and quercetin offer protection against lindane-induced myocardial damage, possibly through maintaining levels of endogenous antioxidant enzymes and membrane bound ATPase activity, as well as inhibiting lipid peroxidation.


Brain-region-specific changes in neurons and glia and dysregulation of dopamine signaling in Grin2a mutant mice.
A genetically valid animal model could transform our understanding of schizophrenia (SCZ) disease mechanisms. Rare heterozygous loss-of-function (LoF) mutations in GRIN2A, encoding a subunit of the NMDA receptor, greatly increase the risk of SCZ. By transcriptomic, proteomic, and behavioral analyses, we report that heterozygous Grin2a mutant mice show (1) large-scale gene expression changes across multiple brain regions and in neuronal (excitatory and inhibitory) and non-neuronal cells (astrocytes and oligodendrocytes), (2) evidence of hypoactivity in the prefrontal cortex (PFC) and hyperactivity in the hippocampus and striatum, (3) an elevated dopamine signaling in the striatum and hypersensitivity to amphetamine-induced hyperlocomotion (AIH), (4) altered cholesterol biosynthesis in astrocytes, (5) a reduction in glutamatergic receptor signaling proteins in the synapse, and (6) an aberrant locomotor pattern opposite of that induced by antipsychotic drugs. These findings reveal potential pathophysiologic mechanisms, provide support for both the "hypo-glutamate" and "hyper-dopamine" hypotheses of SCZ, and underscore the utility of Grin2a-deficient mice as a genetic model of SCZ.


Nucleation, aggregative growth and detachment of metal nanoparticles during electrodeposition at electrode surfaces.
The nucleation and growth of metal nanoparticles (NPs) on surfaces is of considerable interest with regard to creating functional interfaces with myriad applications. Yet, key features of these processes remain elusive and are undergoing revision. Here, the mechanism of the electrodeposition of silver on basal plane highly oriented pyrolytic graphite (HOPG) is investigated as a model system at a wide range of length scales, spanning electrochemical measurements from the macroscale to the nanoscale using scanning electrochemical cell microscopy (SECCM), a pipette-based approach. The macroscale measurements show that the nucleation process cannot be modelled as either truly instantaneous or progressive, and that step edge sites of HOPG do not play a dominant role in nucleation events compared to the HOPG basal plane, as has been widely proposed. Moreover, nucleation numbers extracted from electrochemical analysis do not match those determined by atomic force microscopy (AFM). The high time and spatial resolution of the nanoscale pipette set-up reveals individual nucleation and growth events at the graphite basal surface that are resolved and analysed in detail. Based on these results, corroborated with complementary microscopy measurements, we propose that a nucleation-aggregative growth-detachment mechanism is an important feature of the electrodeposition of silver NPs on HOPG. These findings have major implications for NP electrodeposition and for understanding electrochemical processes at graphitic materials generally.


Nonflammable Fluorinated Carbonate Electrolyte with High Salt-to-Solvent Ratios Enables Stable Silicon-Based Anode for Next-Generation Lithium-Ion Batteries.
High energy density and safety are two key factors for the development of next-generation lithium-ion batteries. Recently, silicon (Si) has attracted tremendous interest owing to its high theoretical capacity. However, the fast capacity decay triggered by huge volume change restricts its practical application. Moreover, higher energy density brings about more serious safety issues. To solve these problems, here we propose a safer high salt-to-solvent electrolyte that consisted of nonflammable mixture solvents of di-2,2,2-trifluoroethyl carbonate and fluoroethylene carbonate. It is revealed that this electrolyte could not only enhance the cycling stability toward the silicon nanoparticle (SiNPs) anode but also solve the safety hazards. A high initial reversible capacity of 2644 mAh g-1 and a low capacity fading rate (only 0.064% per cycle) after 300 cycles are delivered. The performance enhancement mechanism is further explored by electrochemical impedance spectroscopy, Fourier transform infrared, and scanning electron microscopy. This study may shed an inspiring light on the development of next-generation high-energy-density batteries.


Neuroimaging evaluation in refractory epilepsy.
To describe the application of neuroimaging analysis, compared to neuropsychological tests and video-electroencephalogram, for the evaluation of refractory epilepsy in a reference centre in Cali, Colombia. Between March 2013 and November 2014, 29 patients, 19 men and 10 women, aged 9-65 years and with refractory epilepsy, were assessed by structural and functional magnetic resonance imaging while performing tasks related to language, verbal and non-verbal memory. Also, volumetric evaluation was performed. A 1.5 Tesla magnetic resonance imaging scanner was used in all cases. Neuroimaging evaluation identified 13 patients with mesial temporal sclerosis. The remaining patients were classified as: 10 patients with neoplastic masses, two patients with cortical atrophy, two patients with scarring lesions and two patients with non-structural aetiology. Among patients with mesial temporal sclerosis, comparison between techniques for lateralising the epileptogenic foci was made; the κ index between functional magnetic resonance imaging and hippocampi volumetry was κ=1.00, agreement between neuroimaging and video-electroencephalogram was good (κ=0.78) and comparison with a neuropsychological test was mild (κ=0.24). Neuroimaging studies allow the assessment of functional and structural damage related to epileptogenic lesions and foci, and are helpful to select surgical treatment, conduct intraoperative neuronavigation techniques, predict surgical deficits and evaluate patient recovery.


Hyperplasia of sebaceous glands in a linear pattern of papules. Report of four cases.
Four cases of a clinically discernible hyperplasia of sebaceous glands in a linear pattern of papules were seen and studied at the Dominican Dermatological Institute in the past 3 years. The condition was found in three men and one woman and was characterized by a linear arrangement of papular lesions situated on the pre- and retroauricular regions, neck, and chin. The histologic features were stereotypic in all cases and consisted of hyperplasia of sebaceous glands.


Measurement of dynamic cell-induced 3D displacement fields in vitro for traction force optical coherence microscopy.
Traction force microscopy (TFM) is a method used to study the forces exerted by cells as they sense and interact with their environment. Cell forces play a role in processes that take place over a wide range of spatiotemporal scales, and so it is desirable that TFM makes use of imaging modalities that can effectively capture the dynamics associated with these processes. To date, confocal microscopy has been the imaging modality of choice to perform TFM in 3D settings, although multiple factors limit its spatiotemporal coverage. We propose traction force optical coherence microscopy (TF-OCM) as a novel technique that may offer enhanced spatial coverage and temporal sampling compared to current methods used for volumetric TFM studies. Reconstructed volumetric OCM data sets were used to compute time-lapse extracellular matrix deformations resulting from cell forces in 3D culture. These matrix deformations revealed clear differences that can be attributed to the dynamic forces exerted by normal versus contractility-inhibited NIH-3T3 fibroblasts embedded within 3D Matrigel matrices. Our results are the first step toward the realization of 3D TF-OCM, and they highlight the potential use of OCM as a platform for advancing cell mechanics research.


[Sarcoidosis of the thyroid: A case report].
To present a case of thyroid sarcoidosis revealed by a multinodular goiter and cervical and mediastinal adenopathies. We summarize the clinical presentation of a thyroid sarcoidosis. A review of literature regarding this topic is also presented. A 48-year-old woman presented dysphagia without dyspnea. Clinical and radiological explorations find a multinodular goiter with cervical and mediastinal adenopathies. The symptomatic side of the goiter and the association with adenopathies justify the surgery. Total thyroidectomy and mediastinal lymphadenectomy are processed. Histopathological examination of the thyroid reveal a goiter without malignity, a vesicular nodule, and non necrotizing granulomas consistent with sarcoidosis, as in the adenopathy. The interest here, is the difficulty to make the diagnostic without histopathology, between a thyroid cancer with lymphadenopathies and extrapulmonary sarcoidosis (involving thyroid and adenopathies).


Spontaneous termination of an induced pseudopregnancy in the Djungarian hamster, Phodopus campbelli.
The mechanisms which underlie the termination of a functional pseudopregnancy and the return to a behavioral estrus in the Djungarian hamster, Phodopus campbelli, were investigated through changes in (1) serum prolactin concentrations; (2) progesterone and estradiol concentrations in the serum and extracted corpus luteum, ovulatory follicle, and non-luteal portion of the ovary; and (3) corpus luteum and non-luteal ovary weight. Females were asynchronous in the timing of resumption of behavioral estrus, ranging between Days 9 and 11 postcoitus with the mode on Day 10. Unlike proestrus of a cycle, mating following a pseudopregnancy was associated with a large surge of progesterone in serum. Early pseudopregnancy was characterized by high pulsatile changes in serum prolactin, stable serum and corpus luteum progesterone, low concentrations of serum and ovarian estradiol, and high, stable corpus luteum weight. Although the day of return to behavioral estrus varied across females, there was synchrony between females in the timing of regression of corpus luteum function and structure. Serum prolactin and progesterone levels significantly decreased by Day 7 but were not followed by a decrease in corpus luteum progesterone content until Day 8. Changes in luteal function were also uncoupled from changes in weight since luteal weight remained high through Day 8 before disappearing from the ovary by Day 9. The pattern and level of prolactin surges during pseudopregnancy is the same as that seen during pregnancy, suggesting that the termination of coitally induced pituitary prolactin surges is spontaneous.


[Reorientational arthrodesis of the ankle joint using four screws].
Arthrodesis of the ankle has gained wide acceptance as a first-line treatment option for painful posttraumatic osteoarthritis. The technique using four to five lag screws for internal osteosynthesis is a safe and biomechanically stable method to obtain a sound ankle fusion with good to excellent long-term results in the majority of patients. Malalignment hazards are minimized by preservation of the ankle mortise. The meticulous resection of all cartilage and sclerotic bone as well as an atraumatic surgical technique are essential for preventing major complications. The need for revision surgery is minimized by correction of talar malalignment, fusion with the foot in a 90 degrees position and preoperative evaluation of the subtalar joint. In a series of 40 ankle fusions fixed with the lag screw technique, 82.5% good to excellent results were obtained after 5.6 (4.8-7.6) years. No infection, stress fracture or non-union was seen. In cases of osteitis, osteonecrosis, osteoporosis, and poor soft-tissue condition, external fixation techniques are preferred. In the presence of severe loss of bone stock at the distal tibia, stability can be achieved by using a compression nail for tibiotalar fusion without additional subtalar arthrodesis.


Son preference, security concerns and crime against women: Expanding the public health discourse in India.
The phenomenon of son preference in India and the declining number of girls due to such a mindset has been an area of concern. While the Preconception and Prenatal Diagnostic Techniques Act and the Beti Bachao and Beti Padhao scheme have been the mainstay of the government's initiative to counter this reproductive injustice, recognizing son preference and crime against women as public health concern opens up a new vista to counter this injustice. This study has identified that the public health system needs to engage with the following aspects to counter the problem: counseling services to women and men around fertility choices; access/availability to contraceptive choices; engaging men and boys in developing a response against violence; gender-sensitive training and capacity building; access to sexual and reproductive rights awareness amongst girls, women, boys, and men; and health insurance for senior citizens.


An Embedded Sensor System for Real-Time Detecting 5-DOF Error Motions of Rotary Stages.
The geometric error motions of rotary stages greatly affect the accuracy of constructed machines such as machine tools, measuring instruments, and robots. In this paper, an embedded sensor system for real-time measurement of two radial and three angular error motions of a rotary stage is proposed, which makes use of a rotary encoder with multiple scanning heads to measure the rotational angle and two radial error motions and a miniature autocollimator to measure two tilt angular errors of the axis of rotation. The assembly errors of the grid disc of the encoder and the mirror for autocollimator are also evaluated and compensated. The developed measuring device can be fixed inside the rotary stage. In the experiments, radial error motions of two points on the axis (h = 5 mm and 60 mm) were measured and calibrated with LVDTs, and the data showed that the radial error motions of the axis were less than 20 μm, and the calibration residual errors were less than 2 μm. When intermittent external forces were applied to the stage, the change of the stage's error motion could also be monitored accurately.


Calcitonin gene-related peptide stimulates carbonic anhydrase activity in trout gill membranes.
The effect of human calcitonin gene-related peptide (hCGRP) on carbonic anhydrase activity in trout branchial membranes was investigated. hCGRP stimulated the carbonic anhydrase activity, 5-fold over the basal value. This effect was specific: in the presence of sCT only a 2.4-fold increase was observed. Rat amylin that has a 43% homology with hCGRP had no effect on carbonic anhydrase activity. On the other hand hCGRP(8-37), which is a partial antagonist, inhibited the hCGRP-stimulated carbonic anhydrase activity. This effect was observed at low hormonal concentration and suggests the involvement of hCGRP in regulating carbonic anhydrase activity in this important target organ for CO2 exchange.


Cortical malformations: a significant cause of paediatric neurological morbidity.
Disorders of cortical development are a significant cause of epilepsy, developmental delay and congenital neurological deficits in children of all ages. Disruption of neuronal proliferation, differentiation, migration and organization during the middle trimester are recognized as the basis of most of these disorders. With advances in magnetic resonance imaging and increasing recognition of the characteristic radiological appearance of these lesions, a variety of lesions are now described. Furthermore, detailed clinical and genetic studies have lead to the recognition of clinicopathological syndromes of cortical maldevelopment with specific modes of inheritance. Our understanding of these disorders is increasing rapidly and will continue to do so with improvements in neuroimaging, advances in developmental neurobiology and heightened clinician awareness.


3-Methoxytyrosine as an indicator of dopaminergic manipulation in equine plasma.
The use of catechol-O-methyltransferase inhibitors may mask doping agents, primarily levodopa, administered to racehorses and prolong the stimulating effects of dopaminergic compounds such as dopamine. It is known that 3-methoxytyramine is a metabolite of dopamine and 3-methoxytyrosine is a metabolite of levodopa thus these compounds are proposed to be potential biomarkers of interest. Previous research established a urinary threshold of 4,000 ng/mL for 3-methoxytyramine to monitor misuse of dopaminergic agents. However, there is no equivalent biomarker in plasma. To address this deficiency a rapid protein precipitation method was developed and validated to isolate target compounds from 100 µL equine plasma. A liquid chromatography-high resolution accurate mass (LC-HRAM) method using an IMTAKT Intrada amino acid column provided quantitative analysis of 3-methoxytyrosine (3-MTyr) with lower limit of quantification of 5 ng/mL. Reference population profiling (n = 1129) investigated the expected basal concentrations for raceday samples from equine athletes and showed a right-skewed distribution (skewness = 2.39, kurtosis = 10.65) which resulted from large variation (RSD = 71%) within the data. Logarithmic transformation of the data provided a normal distribution (skewness = 0.26, kurtosis = 3.23) resulting in the proposal of a conservative threshold for plasma 3-MTyr of 1,000 ng/mL at a 99.995% confidence level. A 12-horse administration study of Stalevo® (800 mg L-DOPA, 200 mg carbidopa, 1600 mg entacapone) revealed elevated 3-MTyr concentrations for 24-hours post-administration.


Correlates of sedentary behavior in the general population: A cross-sectional study using nationally representative data from six low- and middle-income countries.
Sedentary behavior (SB) is associated with adverse health outcomes independent of levels of physical activity. However, data on its correlates are scarce from low- and middle-income countries (LMICs). Thus, we assessed the correlates of SB in six LMICs (China, Ghana, India, Mexico, Russia, South Africa) using nationally representative data. Cross-sectional, community-based data on 42,469 individuals aged ≥18 years from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. Self-reported time spent sedentary per day was the outcome. High SB was defined as ≥8 hours of SB per day. The correlates (sociodemographic and health-related) of high SB were estimated by multivariable logistic regression analyses. The overall prevalence (95%CI) of high SB was 8.3% (7.1-9.7%). In the overall sample, the most important sociodemographic correlates of high SB were unemployment and urban residence. Physical inactivity, morbid obesity (BMI≥30.0 kg/m2), higher number of chronic conditions, poor self-reported health, higher disability levels, and worse health status in terms of mobility, pain/discomfort, affect, sleep/energy and cognition were associated with high SB. Several between-country differences were found. The current data provides important guidance for future interventions across LMICs to assist sedentary people to reduce their SB levels.


The chronic rhinosinusitis practice parameter.
The Allergy-Immunology Joint Task Force on Practice Parameters has published the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines for the medical management of chronic rhinosinusitis with nasal polyposis (CRSwNP). The practice parameter provides evidence-based guidelines on the use of intranasal corticosteroids (INCS) and biologics for CRSwNP, and aspirin therapy after desensitization (ATAD) for the management of aspirin-exacerbated respiratory disease (AERD). Evidence on surgery was not assessed. Overall, the guidelines suggest INCS rather than no INCS (conditional recommendation, low certainty of evidence), biologics rather than no biologics (conditional recommendation, moderate certainty of evidence), and ATAD rather than no ATAD (conditional recommendation, moderate certainty of evidence). Patient-important outcomes are compared across the various INCS delivery modalities and across the different biologics and ATAD. Specific consideration points for shared decision making with patients are detailed in the guideline. These include delivery method and small treatment effect sizes for INCS, disease burden at presentation, variability in efficacy among biologics, cost issues for biologics, and adverse effects of aspirin and risks related to desensitization for ATAD. The guidelines also identify a need for randomized control trials directly comparing treatment modalities and further investigation into which outcomes are important for patients.


Association of 49245A>G (rs868) polymorphism in the 3'UTR of donor TGFBR1 gene with course of hepatitis C following orthotopic liver transplantation.
Terminal hepatitis C is one of the leading indications for orthotopic liver transplantation (OLT). However, hepatitis C virus (HCV) reinfection occurs in almost all recipients and usually leads to progressive fibrosis and graft failure. Transforming growth factor-b (TGF-β) plays a part in transplanted liver cirrhosis, but nothing is known about the possible role of genetic diversity of TGF-β receptor system. Therefore, the aim of our study was to investigate whether genetic variation in 3' untranslated region (3'UTR) of TGF-β receptor type I (TGFBR1) gene is associated with recurrence and severity of hepatitis C and liver fibrosis following OLT in HCV-infected patients. The study group included 95 chronic hepatitis C patients following OLT. The recipients and donors were genotyped for 49245A>G (rs868) and 51976G>A (rs334349) single nucleotide polymorphisms (SNP). Donor rs868 AA genotype was strongly associated with worse clinical course of recurrent hepatitis C. The rs868 AA group displayed more severe symptoms of hepatitis C during the follow-up and the fibrosis score in this group was significantly higher 3 years after OLT. Clinical course of hepatitis C after OLT may depend on donor rs868 SNP located in TGFBR1 3'UTR.


[Sairei-to inhibits the production of endothelin-1 by nephritic glomeruli(2): alisols, possible candidates as active compounds].
We have previously reported that Sairei-to (TJ-114), a Japanese herbal medicine, prevented the production of endothelin-1 in anti-GBM nephritic rats, and that Alismatis Rhizoma (Takusha in Japanese), one of the twelve herbs composing TJ-114, might be responsible for the action. In order to further clarify the antinephritic components of TJ-114, we investigated the effects of Takusha extracts on various parameters, including endothelin-1 production of glomeruli in vitro and in vivo using anti-GBM nephritic rats. MeOH-100% MeOH and MeOH-50% MeOH fractions (31.3 microgram/ml or higher) strongly inhibited an increase in endothelin-1 concentration in culture medium when they were added to a culture of glomerular cells derived from nephritic rats. In addition, oral administration of the MeOH-100% MeOH fraction (30 mg/kg) ameliorated the proteinuria, increase in systolic blood pressure and changes in histopathological parameters in nephritic rats. Oral administration of the MeOH-100% MeOH fraction inhibited increase in endothelin-1 expression in the glomeruli of nephritic rats and in endothelin-1 production by a culture of glomerular cells derived from the nephritic rats. Alisols A and B, the main constituents of the MeOH-100% MeOH fraction, inhibited in vitro endothelin-1 production by glomerular cells derived from the nephritic rats. Oral administration of alisol B (30 mg/kg) prevented the endothelin-1 expression by glomeruli and the increase in endothelin-1 production by cultured nephritic glomerular cells. Oral administration of alisol B also ameliorated the proteinuria, the increase in systolic blood pressure and the changes in histopathological parameters in the nephritic rats. These results indicate that the antinephritic action of TJ-114, resulting from the inhibition of endothelin-1 production, may be attributed to the alisols in Takusha.


Five HLA-B22 group alleles in Japanese.
HLA-B22-group alleles in Japanese were identified using PCR-single-strand conformation polymorphism (SSCP) and sequence analyses. We analyzed genomic DNAs obtained from Japanese individuals positive for HLA-B22 group antigens (HLA-B54, B55, B56) including two locally proposed splits (B55.2, and B22N). In the SSCP analysis of both exons 2 and 3, we discriminated five different B22-group alleles. Each allelic pattern corresponded to each serological split antigen. Direct sequencing analysis of exon 2 and exon 3 showed that alleles encoding B54, B55.1 and B56 antigens in Japanese are encoded by B*5401, B*5502 and B*5601, respectively, and those encoding B55.2 and B22N antigens are previously unidentified alleles, B*5504 and B*5603, respectively. Full-length cDNA sequencing showed that the B*5603 sequence is identical to those of B*5501, B*5502, B*5601, and B*5602 in exons 1 to 2 except for a synonymous substitution at nucleotide position 165 in exon 2. On the other hand, the sequence of exons 3 to 7 was identical to those of some B15 and B46 alleles, suggesting that B*5603 was generated by a recombination event between one of the B55 and B56 alleles and one of the B15 and B46 alleles in intron 2. As for B*5504, the entire exon 1 to 7 sequence is identical to that of B*5502 except that the 5'-half of the exon 3 sequence is identical to those of some B7, B27, B40 and B48 alleles, suggesting that an event such as gene conversion, segmental exchange, or double recombination occurred in this region.


Accounting for Differential Item Functioning Using Bayesian Approximate Measurement Invariance.
The main thesis of the present study is to use the Bayesian structural equation modeling (BSEM) methodology of establishing approximate measurement invariance (A-MI) using data from a national examination in Saudi Arabia as an alternative to not meeting strong invariance criteria. Instead, we illustrate how to account for the absence of measurement invariance using relative compared to exact criteria. A secondary goal was to compare latent means across groups using invariant parameters only and through utilizing exact and relative evaluative-MI protocol suggested equivalence of the thresholds using prior variances equal to 0.10. Subsequent differences between groups were evaluated using effect size criteria and the prior-posterior predictive p-value (PPPP), which proved to be invaluable in attesting for differences that are beyond zero, some meaningless nonzero estimate, and the three commonly used indices of effect sizes described by Cohen in 1988 (i.e., .20, .50, and .80). Results substantiated the use of the PPPP for evaluating mean differences across groups when utilizing nonexact evaluative criteria.


Mechanisms underlying the beneficial effects of physical exercise on multiple sclerosis: focus on immune cells.
Multiple sclerosis (MS) is a prevalent neuroimmunological illness that leads to neurological disability in young adults. Although the etiology of MS is heterogeneous, it is well established that aberrant activity of adaptive and innate immune cells plays a crucial role in its pathogenesis. Several immune cell abnormalities have been described in MS and its animal models, including T lymphocytes, B lymphocytes, dendritic cells, neutrophils, microglia/macrophages, and astrocytes, among others. Physical exercise offers a valuable alternative or adjunctive disease-modifying therapy for MS. A growing body of evidence indicates that exercise may reduce the autoimmune responses triggered by immune cells in MS. This is partially accomplished by restricting the infiltration of peripheral immune cells into the central nervous system (CNS) parenchyma, curbing hyperactivation of immune cells, and facilitating a transition in the balance of immune cells from a pro-inflammatory to an anti-inflammatory state. This review provides a succinct overview of the correlation between physical exercise, immune cells, and MS pathology, and highlights the potential benefits of exercise as a strategy for the prevention and treatment of MS.


[A new model for disease control and prevention driven by big data in healthcare].
With the rapid development of Internet technology and the continuous advancement of medical informatization, big data in healthcare has gradually become an important resource to innovate health management and meet the growing health needs of people and the application of big data in healthcare has been one of the indispensable parts of national big data strategy in China. Based on the established healthcare big data platform and the application of big data technology, Yinzhou district has made innovative efforts to explore a new model driven by big data for the prevention and control of communicable and non-communicable diseases and the management of vaccination programs. It is expected that the "Internet plus healthcare" model will strengthen the disease prevention and control and public health management in local area, create a new business form and provide strong support for Healthy China 2030. This article introduces this new model driven by big data in Yinzhou and discusses the preliminary efficiency of this model in public health practice.


Auranofin versus penicillamine in rheumatoid arthritis. One-year results from a prospective clinical investigation.
Forty patients with definite or classical active rheumatoid arthritis were stratified by the minimization procedure to auranofin (6 mg/day) or penicillamine (go slow and low regime). This investigation is a prospective planned 3 year patient and 'doctor-open' as well as 'doctor-blind' clinical trial. This article describes the results after 12 months. Both drugs decreased disease activity and improved the functional capacity in a similar way. Two patients in the auranofin group and 5 in the penicillamine group stopped treatment due to major side effects. Four other patients in the auranofin group left treatment: 2 due to death from unrelated cause and 2 according to the Helsinki II Declaration. After one year a further patient in the auranofin group and 2 in the penicillamine group stopped treatment due to lack of clinical effect. Side effects due to auranofin were statistically more frequent distal in the gastrointestinal tract (loose stools/diarrhoea) than with penicillamine. In contrast, penicillamine produced significantly more side effects in the oral cavity (mainly taste disturbances) than auranofin. Other side effects were about equal in the two groups, but 2 cases of severe proteinuria and one with obstructive lung disease were observed in the penicillamine group. Only 3 patients did not complain of any untoward effect during the 12-month period. We conclude that on the basis of this one year investigation it is an open question whether one should select auranofin or penicillamine for the treatment of clinical active rheumatoid arthritis.


Work Interruption Experienced by Nurses during Medication Administration Process and Associated Factors, Northwest Ethiopia.
During medication administration process, including preparation, administration, and documentation, there is high proportion of work interruption that results in medication administration errors that consequently affect the safety of patients. Thus, the main purpose of this study was to assess the prevalence of work interruption and associated factors during medication administration process. A prospective, observation-based, cross-sectional study was conducted on 278 nurses. Structure observational sheet was utilized to collect data. EPI Info version 3.5.3 and SPSS version 20 software were utilized for data entry and analysis, respectively. Binary and multivariable logistic regression were fitted to identify the associated factors using an odds ratio and 95% CI. The incidence of work interruption was found to be 1,152 during medication administration process. Of this, 579 (50.3%) were major/severe work interruptions. Unit of work, day of the week, professional experience, perceived severity of work interruption, source/initiator of interruption, and secondary tasks were factors significantly associated with major work interruptions at p < 0.05. In this study, more than half of work interruption was major/severe. Thus, the authors suggest raising the awareness of nurses regarding the severity of work interruptions, with special attention to those who have lower work experience, sources of interruption, and secondary tasks by assigning additional nurses who manage secondary tasks and supportive supervision.


Catalpol decreases peroxynitrite formation and consequently exerts cardioprotective effects against ischemia/reperfusion insult.
Peroxynitrite (ONOO(-)) formation triggers oxidative/nitrative stress and contributes to exacerbated myocardial ischemia/reperfusion (MI/R) injury. Catalpol, an iridoid glycoside, abundantly found in the roots of Rehmannia glutinosa L. that is included in the family Phrymaceae in the order Lamiales, endemic to China, was found to have neuroprotective effects. However, the effect of catalpol on MI/R injury has not been identified. This study investigated whether catalpol attenuates oxidative/nitrative stress in acute MI/R. Adult male rats were subjected to 30 min of myocardial ischemia and 3 h of reperfusion and were treated with saline, catalpol (5 mg/kg, i.p., 5 min before reperfusion) or catalpol plus wortmannin (15 µg/kg intraperitoneally injected 15 min before reperfusion). Pretreatment with catalpol significantly improved cardiac functions, reduced myocardial infarction, apoptosis and necrosis of cardiomyocytes after MI/R (all p < 0.05). Meanwhile, ONOO(-) formation was markedly reduced after catalpol treatment (3.01 ± 0.22 vs. 4.66 ± 0.53 pmol/mg protein in vehicle, p < 0.05). In addition, catalpol increased Akt and endothelial nitric oxide synthase phosphorylation, nitric oxide (NO) production, anti-oxidant capacity and reduced MI/R-induced inducible nitric oxide synthase expression and superoxide anion (·O(2)(-)) production in I/R hearts. PI3K inhibitor wortmannin not only blocked catalpol-induced Akt activation, but also attenuated all the beneficial effects of catalpol. Suppression of ONOO(-) formation by either catalpol or an ONOO(-) scavenger uric acid (5 mg/kg) reduced myocardial infarct size in MI/R rats. In conclusion, catalpol affords cardioprotection against MI/R insult by attenuating ONOO(-) formation, which is attributable to increased physiological NO and decreased ·O(2)(-) production.


A radical operation for the Budd-Chiari syndrome associated with obstruction of the inferior vena cava. A report of six patients.
The Budd-Chiari syndrome is caused by an occlusion of the hepatic veins and is often associated with an obstruction in the hepatic portion of the inferior vena cava (IVC). Therefore, the various shunt operations done in an attempt to relieve the portal hypertension are often not effective. By using a radical surgical technique on six patients with Budd-Chiari syndrome, the liver was freed and a wide longitudinal incision was made in the hepatic portion of the IVC. The obstructed hepatic vein was reopened using a Fogarty catheter, and a pericardial patch reinforced with a Teflon prosthesis was secured over the incision. Two patients were still asymptomatic 3 and 4 years after operation. Two patients died postoperatively of pneumonia and hepatic insufficiency. The two other patients were discharged in fair condition, and one died 6 months postoperatively following hepatic failure.


Mechanism of Fluorescence Quenching by Acylamino Twist in the Excited State for 1-(Acylamino)anthraquinones.
Nitrogen-containing anthraquinone derivatives are widely applied in vegetable fiber dyes. In this paper, the fluorescence quenching mechanism by an acylamino group twist in the excited state for the 1-(acylamino)anthraquinones (AYAAQs) derivatives in acetonitrile is investigated by density functional theory (DFT) and time-dependent density functional theory (TD-DFT) methods. The calculated Stokes shift is in good agreement with the experimental data. The energy profiles show that each AYAAQs derivative reveals a barrierless twist process, indicating that the involvement of acylamino group rotation in addition to proton transfer becomes as another important coordinate in the excited state relaxation pathway. The effects of electron-substituted group promote twist process compared with 1-aminoanthraquinone (AAQ). Then, the cross points are searched by the constructed linearly interpolated internal coordinate (LIIC) pathways for AYAAQs, demonstrating that the potential energy curves of the S1 and T2 states intersect each other and are in accord with the El-Sayed rules. So one can conclude that the acylamino group twist and following intersystem crossing (ISC) processes are important nonradiative inactivation channel for the S1 state of the AYAAQs derivatives, which is more prone to proton transfer process and can explain the low fluorescence efficiency. In addition, we have measured the phosphorescence spectra of AAQ, and on this basis, it can be predicted that the phosphorescence may occur for the AYAAQs derivatives.


A conjunctival mass in the deep superior fornix after a long retained hard contact lens in a patient with keloids.
To report a case of an upper eyelid mass induced by a rigid contact lens retained for more than 3 years in the eye of a patient with a general history of keloids and to provide a review of the literature on retained contact lenses. Case report. A 45-year-old woman with an ophthalmologic history of dry eyes and follicular chronic conjunctivitis presented at our department complaining of irritation, mucous discharge, and contact lens intolerance in her left eye. The ophthalmic examination revealed a visual acuity of 20/20 in both eyes and bilateral blepharitis. A pseudoptosis and an impressive mass growing from the superior tarsal conjunctiva with a lot of mucous discharge were present in the left eye. After a delay of 3.5 years with persisting complaints, a double lid eversion revealed the presence of a hard contact lens retained in the deep fornix of the left eye. After removing the lens and a short period of treatment with local corticosteroids, the mass and the symptoms disappeared. In patients who wear or wore contact lenses and present with one-sided chronic irritation and tissue proliferation, the possibility of a retained contact lens should be considered. The previous history of dry eyes and chronic conjunctivitis led us to miss the diagnosis at the first visits, despite persisting complaints. No other cases about the effects of a retained contact lens in a patient with keloids have been previously reported.


[Surgical treatment of pulmonary tuberculosis combined with endobronchial tuberculosis].
To evaluate the experience of surgical treatment of pulmonary tuberculosis with endobronchial tuberculosis. The clinical data of 85 patients with pulmonary tuberculosis and endobronchial tuberculosis undergoing surgical resection from 1967 to 2004 were reviewed retrospectively. Forty-five cases were bronchial stenosis. Four cases were tracheal stenosis. Sixteen cases underwent right upper lobectomy. One case underwent right upper and middle lobectomy. Three cases underwent right middle lobectomy. Five cases underwent right middle and lower lobectomy. Two cases underwent right lower lobectomy. Twelve cases underwent left upper lobectomy. Four cases underwent left lower lobectomy. Eight cases were assisted with sleeve lobectomy. Six cases underwent right pneumonectomy (with partial tracheal resection and tracheal reconstruction in 3 cases). Thirty cases underwent left pneumonectomy. One case underwent left lower lobectomy who underwent left upper lobectomy 2 years ago. Four cases were assisted with sleeve pneumonectomy. Three cases underwent tracheal segment resection and tracheal reconstruction. One case underwent left upper bronchial and pulmonary artery sleeve resection. One case underwent biopsy. No surgical mortality occurred. There was 1 case of bronchopleural fistula and 1 case of empyema in the 35 cases (without sleeve lobectomy) who underwent lobectomy. There were 3 cases of bronchopleural fistula and 4 cases of empyema in the 33 cases (without sleeve pneumonectomy) who underwent pneumonectomy (P < 0.05). There were 5 cases of atelectasis in the 35 cases who underwent lobectomy and 3 cases of atelectasis in the 8 cases who underwent sleeve lobectomy (P < 0.01). In the follow-up of 3 to 10 years, 1 case died due to acute respiratory distress syndrome 7 years postoperatively. It is important to resect all the tissue which has been infected. With the routine anti-tuberculosis chemotherapy during the perioperative period, the effect of surgical treatment is superior to others. Fewer pneumonectomy is also important.


Mucoadhesive microspheres for nasal administration of an antiemetic drug, metoclopramide: in-vitro/ex-vivo studies.
Microparticulate delivery systems designed for the nasal administration of an antiemetic drug, metoclopramide hydrochloride, were prepared. Microspheres composed of sodium alginate, chitosan hydrochloride, or both, were obtained using a spray-drying method; some batches of drug-free microparticles were prepared as a comparison. The morphology, in-vitro swelling behaviour, mucoadhesive properties and drug release from microparticles were evaluated. Ex-vivo drug permeation tests were carried out using sheep nasal mucosa; permeation test of the drug solution was performed as comparison. During ex-vivo permeation tests, transmission electron microscopy (TEM) analyses were carried out on the nasal mucosa to study the morphological changes of epithelial cells and tight junctions, while the change in microsphere morphology was examined using photostereo microscopy (PM). Spray-dried microparticles had a mean diameter (d(vs)) in the range of about 3-10 microm. They showed good in-vitro mucoadhesive properties. In-vitro release profiles and swelling behaviour depended on their composition: the drug release occurred in 1-3 h. Ex-vivo studies showed that drug permeation through the mucosa from microparticles based on chitosan was higher than from those consisting of alginate alone. This can be related to the penetration enhancing properties of chitosan. Complexation of chitosan with alginate led to a control of the drug release. Microscopy observation of microspheres during the permeation tests revealed that microparticles swelled and gelled, maintaining their shape. TEM analyses of the mucosa after exposure to the microparticles consisting of alginate/chitosan showed opened tight junctions. This preliminary study shows that alginate/chitosan spray-dried microspheres have promising properties for use as mucoadhesive nasal carriers of an antiemetic drug.


Predicting Ambulatory Function Based on Infantile Lower Extremity Posture Types in Amyoplasia Arthrogryposis.
Arthrogryposis multiplex congenita (AMC) is a nonprogressive syndrome with multiple rigid joints, fibrotic periarticular tissue, and muscular fibrosis. The most common subgroup is amyoplasia. Ambulation is one of the most significant functions of the lower extremities as it translates to increased functionality and independence in adulthood. There is no predicative scale to determine ambulation at maturity for the infant with amyoplasia. It is believed lower extremity resting position of infants with amyoplasia potentially correlates with ambulation at maturity. The purpose of this study was to classify the infantile position of lower extremities and muscle strength to predict ambulation potential at maturity. Children with amyoplasia were retrospectively reviewed and classified into groups based on infantile position of hip-knee alignment and limb muscle function. Sitting, standing, and walking skills from infancy into adulthood were evaluated. The ambulation function was correlated with the infantile position of the lower extremities. Amyoplasia cases were sorted into 5 types and correlated with ambulatory potential. Type I: mild ambulatory impairment with infantile position of flexed knees and hips but full range of motion. At maturity, all were community ambulators. Type II: moderate ambulatory impairment having infantile position of hip flexion, hip external rotation, and knee flexion contractures. Hip abductors and external rotators had antigravity strength. All stood and walked during the first decade of life with knee ankle foot orthoses. Type III: severe ambulatory impairment having infantile position of hip flexion, abduction, external rotation, and knee flexion contractures but lacked hip muscle recruitment. All used wheelchairs at maturity. Type IV: mild ambulatory impairment with infantile position of extended knees and flexed dislocated hips. At maturity, 90% were community ambulators. Type V: variable ambulatory impairment having asymmetric hip and knee alignment with unilateral hip dysplasia with extended knee and opposite limb flexed. Ambulation skill varied at maturity with 27% full-time wheelchair users. Amyoplasia can be sorted by infantile position of lower extremities and muscle strength into 5 types to predict ambulatory function. Level III-Prognostic Study.


Protein profile of tax-associated complexes.
Infection with human T-cell leukemia virus type 1 (HTLV-1) results in adult T-cell leukemia and HTLV-1-associated myelopathy/tropical spastic paraparesis. Tax, a 40-kDa protein, regulates viral and cellular transcription, host signal transduction, the cell cycle, and apoptosis. Tax has been shown to modulate cellular CREB and NFkappaB pathways; however, to date, its role in binding to various host cellular proteins involved in tumorigenesis has not been fully described. In this study, we describe the Tax-associated proteins and their functions in cells using several approaches. Tax eluted from a sizing column mostly at an apparent molecular mass of 1800 kDa. Following Tax immunoprecipitation, washes with high salt buffer, two-dimensional gel separation, and mass spectrometric analysis, a total of 32 proteins was identified. Many of these proteins belong to the signal transduction and cytoskeleton pathways and transcription/chromatin remodeling. A few of these proteins, including TXBP151, have been shown previously to bind to Tax. The interaction of Tax with small GTPase-cytoskeleton proteins, such as ras GAP1m, Rac1, Cdc42, RhoA, and gelsolin, indicates how Tax may regulate migration, invasion, and adhesion in T-cell cancers. Finally, the physical and functional association of Tax with the chromatin remodeling SWI/SNF complex was assessed using in vitro chromatin remodeling assays, chromatin remodeling factor BRG1 mutant cells, and RNA interference experiments. Collectively, Tax is able to bind and regulate many cellular proteins that regulate transcription and cytoskeletal related pathways, which might explain the pleiotropic effects of Tax leading to T-cell transformation and leukemia in HTLV-1-infected patients.


Are diamond nanoparticles cytotoxic?
Finely divided carbon particles, including charcoal, lampblack, and diamond particles, have been used for ornamental and official tattoos since ancient times. With the recent development in nanoscience and nanotechnology, carbon-based nanomaterials (e.g., fullerenes, nanotubes, nanodiamonds) attract a great deal of interest. Owing to their low chemical reactivity and unique physical properties, nanodiamonds could be useful in a variety of biological applications such as carriers for drugs, genes, or proteins; novel imaging techniques; coatings for implantable materials; and biosensors and biomedical nanorobots. Therefore, it is essential to ascertain the possible hazards of nanodiamonds to humans and other biological systems. We have, for the first time, assessed the cytotoxicity of nanodiamonds ranging in size from 2 to 10 nm. Assays of cell viability such as mitochondrial function (MTT) and luminescent ATP production showed that nanodiamonds were not toxic to a variety of cell types. Furthermore, nanodiamonds did not produce significant reactive oxygen species. Cells can grow on nanodiamond-coated substrates without morphological changes compared to controls. These results suggest that nanodiamonds could be ideal for many biological applications in a diverse range of cell types.


Effectiveness of Intraluminal Air Decompression on Postcolonoscopic Pain According to Reinsertion Site.
Colonoscopy is a very effective and essential examination to diagnose colorectal cancer; however, many patients experience discomfort due to post-examination abdominal pain, which reduces colonoscopy compliance. This study was conducted to determine methods for reducing post-colonoscopic abdominal pain. We conducted a randomized controlled study of 405 male and female adults who visited Hana General Hospital in Cheongju. We surveyed general characteristics, history of colonoscopy, and other related factors, then categorized examinees into 5 groups (0-5) according to the site of scope reinsertion. Pain was measured using a numeric rating scale (NRS). The mean age of examinees in this study was 47.8 years, and 210 participants had prior experience of colonoscopy. No significant difference was observed between variables, with the exception of reinsertion duration (P=0.005). Pain scores were different between performing physicians (P=0.006), and were higher when the subjective level of procedure difficulty was low (P=0.026) in univariate analysis. Pain scores decreased as the reinsertion site became closer to the proximal colon (P<0.001), but there was no significant difference between groups 3 and 4. The results of multiple logistic regression analysis, including univariate analysis, showed that group 1 had 0.48 times, group 2 had 0.38 times, group 3 had 0.09 times, and group 4 had 0.03 times odds ratio (moderate-to-severe pain, NRS ≥4) than control group 0. Air decompression by scope reinsertion is an effective way to reduce abdominal pain after colonoscopy. Removing air when the reinserted scope approaches the hepatic flexure seems to be the most effective method to reduce post-colonoscopic pain.


Sinonasal pathophysiology of SARS-CoV-2 and COVID-19: A systematic review of the current evidence.
The ongoing pandemic of coronavirus disease (2019 coronavirus disease [COVID-19]), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus, is highly contagious with high morbidity and mortality. The role of the nasal and paranasal sinus cavities is increasingly recognized for COVID-19 symptomatology and transmission. We therefore conducted a systematic review, synthesizing existing scientific evidence about sinonasal pathophysiology in COVID-19. Systematic review. Systematic searches were performed of all indexed studies in PubMed/Medline and Cochrane databases through 28 March 2020 and studies searchable on preprints.com (including ArXiv and Scilit repositories) through 30 March 2020. Data extraction focused on sinonasal pathophysiology in COVID-19. A total of 19 studies were identified. The sinonasal cavity may be a major site of infection by SARS-CoV-2, where susceptibility genes required for infection are expressed at high levels and may be modulated by environmental and host factors. Viral shedding appears to be highest from the nose, therefore reflecting a major source for transmission. This has been highlighted by multiple reports of health care-associated infection (HAI) during rhinologic procedures, which are now consequently considered to be high risk for SARS-CoV-2 transmission to health care workers. While sinonasal symptomatology, such as rhinorrhea or congestion, appears to be a rarer symptom of COVID-19, anosmia without nasal obstruction is reported as highly specific predictor of COVID-19+ patients. Sinonasal pathophysiology is increasingly important in our understanding of COVID-19. The sinonasal tract may be an important site of infection while sinonasal viral shedding may be an important transmission mechanism-including HAI. Anosmia without nasal obstruction may be a highly specific indicator of COVID-19. 2a.


Modelling and eliciting organisational and information system requirements for medical information systems.
In this paper an outline of a modelling technique will be presented that allows for the encapsulation and analysis of the social and technical aspects of an organisational information system. This notation is used to construct and analyse both the static and dynamic models of organisations and organisational behaviour. The construction and analysis is achieved through the use of concepts such as role and responsibility. The conceptual modelling framework is then applied to a case study. This case study is based upon an accident and emergency department of an inner city hospital situated within the centre of Dublin, Ireland.


How are base excision DNA repair pathways deployed in vivo?
Since the discovery of the base excision repair (BER) system for DNA more than 40 years ago, new branches of the pathway have been revealed at the biochemical level by in vitro studies. Largely for technical reasons, however, the confirmation of these subpathways in vivo has been elusive. We review methods that have been used to explore BER in mammalian cells, indicate where there are important knowledge gaps to fill, and suggest a way to address them.


Decisional control preference among Chinese patients with advanced kidney disease: the role of mastery, perceived social support and self-efficacy.
Although previous studies have shown a correlation between mastery, self-efficacy, and perceived social support among Chinese patients with advanced kidney disease, few studies have examined their relationship pathways. This study aimed to examine decisional control preference and the relationship between mastery, perceived social support, and self-efficacy among patients with advanced chronic kidney disease. A cross-sectional survey was conducted, and 350 participants were investigated using Control Preference Scale, Personal Mastery Scale, Perceived Social Support Scale, and Self-efficacy Scale. The mediating relationships were determined via structural equation modeling. Results showed that education and economic status were demographic factors influencing patients' decisional control preference. The model showed that mastery and self-efficacy had a direct effect on decisional control preference while perceived social support had an indirect effect mediated via mastery and self-efficacy. Therefore, improving self-efficacy can increase patient willingness to involve in medical decision-making. This study provides new interventions and future directions for promoting decisional control preference.


De Novo Construction of Chiral Aminoindolines by Cu-Catalyzed Asymmetric Cyclization and Subsequent Discovery of an Unexpected Sulfonyl Migration.
Searching for efficient strategies to access structurally novel aminoindolines is of great significance for drug discovery. However, catalytic asymmetric de novo construction of aminoindoline scaffolds with functionality primed for diversification still remains elusive. Here, we report a Cu-catalyzed asymmetric cyclization of ethynyl benzoxazinones with amines, producing chiral 3-aminoindolines in good yield and with high enantioselectivity (up to 97% yield and 98:2 er). Moreover, a radical-mediated sulfonyl migration of these products was unexpectedly found, further affording new chiral 3-aminoindolines bearing alkenyl sulfonyl groups with retained enantiopurity (up to 84% yield and 98:2 er). Bioactivity evaluations indicate that these 3-aminoindolines show notable antitumor activities and chirality is proven to have a significant impact on their antitumor activity.


Torque Contribution to Haptic Rendering of Virtual Textures.
Despite the fact that conventional haptic interfaces and rendering algorithms commonly approximate interactions with force only, the dynamic effects of even simple tasks, e.g., writing on a paper, involve both forces and torques. To extend previous algorithms as well as to investigate the effects of torque feedback on human roughness perception, we deployed a novel haptic platform with two probes, fingertip and penhandle. Three torque conditions were examined: 1) Slope Torque, which orients the probe perpendicular to the surface, 2) No Torque, where no active torque is provided by the device, and 3) Stiff Torque, where torque feedback is provided to keep the probe upright. A conventional magnitude estimation experiment was performed. The results indicated that both the torque signals and grasp type mediate human perception of virtual textures. Slope Torque led to greater perceived roughness when the fingertip was used, and the fingertip led to higher roughness ratings than the penhandle with the Slope Torque condition. The Slope Torque algorithm appears to be advantageous for generating rougher surfaces compared to the force-based algorithms which are typically limited by the system stability and actuator saturation.


[Use of the western blot method for detecting antibodies against proteins of various rotavirus strains].
The aim of this work was to adapt the Western blot method to analyse the humoral response to proteins of rotavirus strains having various antigens. 10 serum samples from animals immunized with SA11, 18 serum samples from hospitalized children with rotavirus infections and 17 serum samples from healthy adults were examined for rotavirus antibodies using Western blot. Antibodies against all structural rotavirus proteins were detected. The examined sera reacted differently with rotavirus proteins depending on the strain used. The highest IgG reactivity was observed for Wa and SA11, while the lowest was noted for DS-1. At the same time a different level of cross-reactivity of human sera with specific proteins of antigenically varying rotaviruses was observed. The sera taken from adults showed a lower reactivity with proteins of antigens used compared with sera from children. The exception was VP6 of the Ito strain for which the reactivity of adult sera was statistically higher. Essential differences in the reactivity of children's and adult sera were found mainly in the case of VP2 and VP4 belonging to the SA11 strain and VP4 and VP7 of the Ito strain. From these investigations we can conclude that the Western blot method may be useful in assessing immune response caused by rotaviruses. The results of reactivity of some human sera with proteins of strains used indicates that the persons had previously been infected by antigenically varied rotaviruses.


Can advising lead to meaningful relationships?
Schools have increasingly implemented advising programs as a means of linking students with caring adults. Although this approach is promising, its success depends on adequate funding; the full commitment of administration, staff, and parents; and a thoughtful definition of the procedures for achieving the goals.


Detecting the Majorana fermion surface state of 3He-B through spin relaxation.
The Majorana fermion, which can be useful for topological quantum computation, has eluded detection. (3)He-B, recently shown to be a time-reversal invariant topological superfluid, has a gapless Majorana fermion surface state. We show here that an electron spin relaxation experiment can detect this surface state--its Majorana nature through the Zeeman field direction dependence of the relaxation time 1/T(1) proportional, proportional to sin(2)theta, where theta is the angle between the field and the surface normal. We propose an experimental setup where an electron inside a nanobubble is injected below the (3)He liquid surface.


Effects of local pressure and vibration on muscle pain from eccentric exercise and hypertonic saline.
In human subjects the triceps surae of one leg was exercised eccentrically by asking subjects to walk backwards on an inclined treadmill. Before the exercise controlled local pressure, applied to the muscle with an electromagnet, produced mild soreness, which was reduced when the pressure was combined with vibration. When delayed-onset muscle soreness (DOMS) had set in, 24-48 h after the exercise, vibration increased pain from local pressure. Vibrating at different frequencies suggested 80 Hz as the optimal frequency. During 2-h testing post-exercise, evidence of a change in character of the effects of vibration was first detected at 6 h. It persisted up to 72 h post-exercise. When muscle pain was generated in an unexercised triceps by injection of hypertonic (5%) saline, controlled local pressure applied to the sore area increased pain levels by 32% while pressure plus vibration reduced this to 11%. In a subject with DOMS, local pressure again increased pain from saline by 32% but combining it with vibration increased pain further by an additional 20%. The effect of vibration on DOMS could be abolished with a large nerve fibre block applied to the sciatic nerve. It is concluded that the vibration effects are the result of stimulation of large-diameter mechanoreceptive afferents in the muscle which, it is speculated, play a role in generating DOMS.


Selective determination of COXIBs in environmental water samples by mixed-mode solid phase extraction and liquid chromatography quadrupole time-of-flight mass spectrometry.
The development and performance evaluation of a method for the simultaneous determination of six pharmaceuticals belonging to the class of non-steroidal anti-inflammatory drugs (NSAIDs) which present high selectivity for the cyclooxygenase (COX)-2 isoform of COX (COXIBs) in environmental waters are presented. The method involves an off-line mixed mode (reversed-phase and strong anionic exchange) solid phase extraction (SPE) for the selective concentration of COXIBs in combination with liquid chromatography (LC) quadrupole time-of-flight (QTOF) mass spectrometry (MS). The use of a strong anionic exchange sorbent (Oasis MAX) led to a significant reduction of matrix effects, during electrospray ionization (ESI), in comparison with results obtained for mixed mode weak anionic exchange sorbent (Oasis Wax) and polymeric reversed phase sorbents (Oasis HLB and Strata X). The developed method attained limits of quantification (LOQs) between 0.01 and 0.20 ng L(-1) for river water and effluent wastewater and, for influent wastewater this limits were ranged between 0.03 and 0.45 ng L(-1). Among the pharmaceuticals investigated, two of them (celecoxib and etoricoxib) were detected at low levels (ppt) in real samples of treated and raw wastewaters, and two metabolites were also found; the carboxylated celecoxib and the hydroxylated etoricoxib.


Tendon transfers in traumatic foot.
A clinical review was performed of 11 cases of traumatic foot treated by tendon transfer. Among 11 patients, there were eight males and three females, ranging from four to 36 years of age. The anterior tibial tendon was used in six cases for tendon transfer and among these, split anterior tibial tendon was used in three cases in children. The posterior tibial tenodn was used in two cases and the extensor digitorum longus tendon of the foot was in three cases. In six cases of soft tissue injury where tendon transfer was impossible, microvascular free cutaneous flap transplantation was combined with the tendon transfer. Follow-up results were obtained from 25 months to nine years. Excellent results were obtained in eight cases and satisfactory results in three cases. For the correction of function loss in traumatic foot, tendon transfere were a useful method for the recovery of active motion of the foot. For the restoration of function loss in the traumatic foot, there are several methods of treatment such as tendon transfer, arthrodesis and tenodesis, but for recovery of the active motion of the foot, tendon transer is the only useful method.


Cellular immune responses to acute stress in female caregivers of dementia patients and matched controls.
This study investigated whether the stress of caregiving alters cellular immune responses to acute psychological stressors. Twenty-seven women caring for a spouse with a progressive dementia (high chronic stress) and 37 controls matched for age and family income performed a 12-min laboratory stressor. Cellular immune function was assessed by both functional and quantitative measures taken before (low acute stress), immediately after (high acute stress), and 30 min after (recovery from stress) exposure to the laboratory stressors. The laboratory challenges were associated with diminished proliferative responses but elevated natural killer (NK) cell cytotoxicity; however, subsequent analyses suggested that this elevated cytotoxicity was largely attributable to an increase in the number of NK cells in peripheral blood. The results suggest that although the stress of caregiving diminishes cellular immune function, caregiving appears to have little effect on cellular immune responses to or recovery from brief psychological challenges.


U.S. Department of Justice Investigation of a State Psychiatric Hospital.
The Department of Justice investigation of state psychiatric hospitals is nothing like investigation by more familiar regulatory agencies such as The Joint Commission or Centers for Medicare and Medicaid Services (CMS). For one, it comes with the threat of serious legal consequences for both the state psychiatric hospital under investigation and the state in general. Although little has been written about this topic, much of what has been written describes a negative, painful, and expansive experience affecting every aspect of the hospital system. Using an example of a state psychiatric hospital that has been investigated by the DOJ, this article examines this portrayal and explores whether there are positive aspects of such investigations that have been overlooked.


Hopping Down the Main Street: Eastern Grey Kangaroos at Home in an Urban Matrix.
Most urban mammals are small. However, one of the largest marsupials, the Eastern Grey Kangaroo Macropus giganteus, occurs in some urban areas. In 2007, we embarked on a longitudinal study of this species in the seaside town of Anglesea in southern Victoria, Australia. We have captured and tagged 360 individuals to date, fitting each adult with a collar displaying its name. We have monitored survival, reproduction and movements by resighting, recapture and radio-tracking, augmented by citizen science reports of collared individuals. Kangaroos occurred throughout the town, but the golf course formed the nucleus of this urban population. The course supported a high density of kangaroos (2-5/ha), and approximately half of them were tagged. Total counts of kangaroos on the golf course were highest in summer, at the peak of the mating season, and lowest in winter, when many males but not females left the course. Almost all tagged adult females were sedentary, using only part of the golf course and adjacent native vegetation and residential blocks. In contrast, during the non-mating season (autumn and winter), many tagged adult males ranged widely across the town in a mix of native vegetation remnants, recreation reserves, vacant blocks, commercial properties and residential gardens. Annual fecundity of tagged females was generally high (≥70%), but survival of tagged juveniles was low (54%). We could not determine the cause of death of most juveniles. Vehicles were the major (47%) cause of mortality of tagged adults. Road-kills were concentrated (74%) in autumn and winter, and were heavily male biased: half of all tagged males died on roads compared with only 20% of tagged females. We predict that this novel and potent mortality factor will have profound, long-term impacts on the demography and behavior of the urban kangaroo population at Anglesea.


Budd-Chiari syndrome in Behçet's disease.
A 36-year-old man was admitted to the emergency department due to a 30-day history of abdominal distention and epigastralgia. He had described a non-intentional 10kg weight loss, dry cough, and fever 6 months before his admission. He had a history of tobacco and cocaine abuse and reported recurrent oral and genital ulcers. Physical examination showed an extensive area of venous collateral circulation on the abdominal wall, hepatomegaly, signs of a moderate ascites, and lower limb edema. Liver and renal function tests were normal. The ascitic fluid analysis did not show an inflammatory or infectious pattern. Upper flexible endoscopy revealed esophageal fine-caliber varices and colonoscopy showed an isolated terminal ileal ulcer. Abdominal imaging revealed hepatomegaly, voluminous ascites, and thrombosis of hepatic veins, inferior and superior vena cava (Figure 1). Infections and coagulation or lymphoproliferative disorders were excluded. Thereafter, the diagnosis of Budd-Chiari Syndrome in Behçet disease was established and immunosuppression treatment was started with good initial clinical evolution.


Antidiuretic effects of dibutyryl-cyclic AMP microinjected into the hypothalamic supraoptic nucleus in water-loaded and ethanol-anesthetized rats.
Effects of dibutyryl-cyclic AMP (db-cAMP) and cyclic AMP (cAMP) microinjected into the hypothalamic supraoptic nucleus (SON) which contains the neurons synthesizing and releasing antidiuretic hormone upon the outflow and the osmotic pressure of urine and the other visceral functions were investigated in water-loaded rats anesthetized with ethanol. When microinjected into the SON the dibutyryl analog of cAMP induced dose-dependent antidiuretic effects without significant effects on any other visceral functions. Dibutyryl-cAMP was much more effective than cAMP; The ED50 value for db-cAMP was approx. 200 nmol versus more than 500 nmol for cAMP. The time course of the antidiuretic effects was relatively slow with minimal urine outflow appearing only after more than 1/2 hour post-injection. The effects induced by db-cAMP demonstrated tachyphylaxis and were partially inhibited by pretreatment with atropine or theophylline, which suggests that the antidiuretic effects were mediated through muscarinic and adenosine receptors present in the nucleus.


Tests of linearity in the responses of eye-movement-sensitive vestibular neurons to sinusoidal yaw rotation.
The rotational vestibulo-ocular reflex in primates is linear and stabilizes gaze in space over a large range of head movements. Best evidence suggests that position-vestibular-pause (PVP) and eye-head velocity (EHV) neurons in the vestibular nuclei are the primary mediators of vestibulo-ocular reflexes for rotational head movements, yet the linearity of these neurons has not been extensively tested. The current study was undertaken to understand how varying magnitudes of yaw rotation are coded in these neurons. Sixty-six PVP and 41 EHV neurons in the rostral vestibular nuclei of 7 awake rhesus macaques were recorded over a range of frequencies (0.1 to 2 Hz) and peak velocities (7.5 to 210°/s at 0.5 Hz). The sensitivity (gain) of the neurons decreased with increasing peak velocity of rotation for all PVP neurons and EHV neurons sensitive to ipsilateral rotation (type I). The sensitivity of contralateral rotation-sensitive (type II) EHV neurons did not significantly decrease with increasing peak velocity. These data show that, like non-eye-movement-related vestibular nuclear neurons that are believed to mediate nonlinear vestibular functions, PVP neurons involved in the linear vestibulo-ocular reflex also behave in a nonlinear fashion. Similar to other sensory nuclei, the magnitude of the vestibular stimulus is not linearly coded by the responses of vestibular neurons; rather, amplitude compression extends the dynamic range of PVP and type I EHV vestibular neurons.


Neutrophil Ratio of White Blood Cells as a Prognostic Predictor of Clostridioides difficile Infection.
A leukocyte count ≥15,000 cells/mL and serum creatinine of >1.5 mg/dL have been reported as two important predictors of severe CDI. However, the association of the differential ratios of blood leukocytes, and the prognosis of Clostridioides difficile infection (CDI) is not clear. A clinical study was conducted at medical wards of Tainan Hospital, Ministry of Health and Welfare in southern Taiwan between January 2013 and April 2020. Hospitalized adults (aged ≥20 years) with hospital-onset CDI (ie, symptom onset after at least 48 hours of admission) were included. A total of 235 adults with an average age of 75.7 years and female predominance (51.5%), including 146 (62%) adults with non-severe CDI and 87 (38%) severe CDI, were included for analysis. Patients with severe CDI had a higher crude in-hospital mortality rate than patients with non-severe CDI (35.6% vs 18.5%, P = 0.005). Multivariate analysis revealed no association between a leukocyte count >15,000 cell/mL at the onset of CDI and in-hospital mortality (odds ratio [OR] 1.66, P = 0.21). In contrast, a neutrophil ratio >75% (OR 2.65, P = 0.02), serum creatinine >1.5 mg/L (OR 3.42, P = 0.03), and CDI caused by isolates harboring the tcdC gene (OR 3.54, P = 0.02) were independently associated with in-hospital mortality. Patients with a neutrophil ratio >85%, 80-85%, or 75-80% of serum leukocytes had a higher mortality rate (34.8%, 30.3%, or 34.4%, respectively) than patients with a neutrophil ratio of 70-75% or ≤75% (12.5% or 13.9%, respectively). Serum creatinine >1.5 mg/L, a high neutrophil ratio of blood leukocytes (>75%), and the causative C. difficile harboring the tcdC gene was independent prognostic predictors in hospitalized adults with CDI.


[Estrus induction in the goat after pulsatile administration of LHFSHRH].
In this experiment we used nine goats to which we administered GnRH in fractioned doses at a pulse like rhythm in order to obtain follicular growth and oestrus. The average length of treatment was 5.5 days; the animals were injected with a daily amount of 0.05 mg of GnRH subdivided in three doses (0.017 mg each). All the 9 experimental goats came into oestrus and became pregnant. The GnRH treatment in fractioned and repeated daily doses proves a valid method to induce follicular growth and ovulation in anoestrus goats.


An intercostal-phrenic inhibitory reflex in human newborn infants.
An effect of phasic distortion of the rib cage on inspiratory time was studied in thirty sleeping newborn infants. Distortion was produced by both manual compression of various rib cage diameters, and by occluding the airway at functional residual capacity, allowing diaphragmatic contraction to alter rib cage shape. With rapid distortion produced by these maneuvers, inspiration was often terminated prematurely. The effect was dependent upon there being a rapid rate of distortion, and was most readily elicited when inward motion involved the lower lateral rib cage. The results indicate a potent inspiratory inhibitory reflex, originating most probably from the spindles of intercostal muscles. This reflex acts to decrease tidal volume and ventilation when rates of rib cage retraction are high during spontaneous breathing.


Rescue of proximal failure of endovascular abdominal aortic aneurysm repair with standard and fenestrated grafts.
This study aimed to assess the outcomes of standard and fenestrated grafts to treat proximal failure of previous endovascular aneurysm repair (EVAR) in a tertiary referral center. All patients undergoing elective implantation of a standard or fenestrated graft after proximal failure of a previous EVAR between April 2010-November 2018 were included. Data were collected prospectively. Fifty procedures were performed in 49 patients (45 male; mean age 74.6±7 years). A fenestrated proximal cuff was used in 24 (48%) cases, a composite bifurcated configuration in 21 (42%) cases, and EVAR in 5 (10%) cases. Technical success was achieved in all 5 EVAR cases and 41 of 45 FEVAR cases (91.1%). Iliac artery access problems due to the presence of the previous graft were encountered in eight (16%) procedures and renal artery catheterization difficulties in grafts with suprarenal fixation in seven (15.6%) procedures. There was one (2%) early death due to retroperitoneal bleeding. Early major complications occurred in three (6%) patients. Median follow-up was 26 months (range 1-77). Late occlusion occurred in two (1.3%) of the 151 targeted vessels. One patient needed permanent dialysis. Nine patients died during follow-up, one (2%) of them aneurysm-related. Ten (20.4%) patients presented with major complications during follow-up of which nine (18.4%) needed reintervention. Estimated freedom from reintervention at 1 and 3 years was 89.3±5.1% and 78.8±7.3%, respectively. Repair with fenestrated grafts represents a safe and effective treatment option. Increased technical challenges are to be expected due to the previous graft.


Effects of soil C:N:P stoichiometry on biomass allocation in the alpine and arid steppe systems.
Soil nutrients strongly influence biomass allocation. However, few studies have examined patterns induced by soil C:N:P stoichiometry in alpine and arid ecosystems. Samples were collected from 44 sites with similar elevation along the 220-km transect at spatial intervals of 5 km along the northern Tibetan Plateau. Aboveground biomass (AGB) levels were measured by cutting a sward in each plot. Belowground biomass (BGB) levels were collected from soil pits in a block of 1 m × 1 m in actual root depth. We observed significant decreases in AGB and BGB levels but increases in the BGB:AGB ratio with increases in latitude. Although soil is characterized by structural complexity and spatial heterogeneity, we observed remarkably consistent C:N:P ratios within the cryic aridisols. We observed significant nonlinear relationships between the soil N:P and BGB:AGB ratios. The critical N:P ratio in soils was measured at approximately 2.0, above which the probability of BGB:AGB response to nutrient availability is small. These findings serve as interesting contributions to the global data pool on arid plant stoichiometry, given the previously limited knowledge regarding high-altitude regions.


Genome Analysis Identified Novel Candidate Genes for Ascochyta Blight Resistance in Chickpea Using Whole Genome Re-sequencing Data.
Ascochyta blight (AB) is a fungal disease that can significantly reduce chickpea production in Australia and other regions of the world. In this study, 69 chickpea genotypes were sequenced using whole genome re-sequencing (WGRS) methods. They included 48 Australian varieties differing in their resistance ranking to AB, 16 advanced breeding lines from the Australian chickpea breeding program, four landraces, and one accession representing the wild chickpea species Cicer reticulatum. More than 800,000 single nucleotide polymorphisms (SNPs) were identified. Population structure analysis revealed relatively narrow genetic diversity amongst recently released Australian varieties and two groups of varieties separated by the level of AB resistance. Several regions of the chickpea genome were under positive selection based on Tajima's D test. Both Fst genome- scan and genome-wide association studies (GWAS) identified a 100 kb region (AB4.1) on chromosome 4 that was significantly associated with AB resistance. The AB4.1 region co-located to a large QTL interval of 7 Mb∼30 Mb identified previously in three different mapping populations which were genotyped at relatively low density with SSR or SNP markers. The AB4.1 region was validated by GWAS in an additional collection of 132 advanced breeding lines from the Australian chickpea breeding program, genotyped with approximately 144,000 SNPs. The reduced level of nucleotide diversity and long extent of linkage disequilibrium also suggested the AB4.1 region may have gone through selective sweeps probably caused by selection of the AB resistance trait in breeding. In total, 12 predicted genes were located in the AB4.1 QTL region, including those annotated as: NBS-LRR receptor-like kinase, wall-associated kinase, zinc finger protein, and serine/threonine protein kinases. One significant SNP located in the conserved catalytic domain of a NBS-LRR receptor-like kinase led to amino acid substitution. Transcriptional analysis using qPCR showed that some predicted genes were significantly induced in resistant lines after inoculation compared to non-inoculated plants. This study demonstrates the power of combining WGRS data with relatively simple traits to rapidly develop "functional makers" for marker-assisted selection and genomic selection.


Rupture of inferior phrenic artery aneurysm. An unusual complication of mesenteric arteritis due to postcoarctectomy syndrome.
Postcoarctectomy syndrome was developed in a boy with Williams syndrome. Angiogram revealed widespread changes of visceral arteries and extravasation of the contrast material from the right inferior phrenic artery. Emergency laparotomy was successful. This unusual complication makes clear that the mesenteric arteritis after coarctectomy can cause aneurysm with a risk of rupture.