Micro-carrier-test: evaluating disinfectants for HIV.
To determine the effect of disinfectants against viruses in vitro, I devised the Micro-Carrier-Test of dry-fixed virus-infected cells. Human immunodeficiency virus type 1-infected Molt-4 cells (1 x 10(5) cells in 5 microliters of 10% fetal bovine serum) were dry-fixed at the bottom of each well of a 96-well flat-bottomed microtiter plate for 120 minutes at room temperature. Disinfectants were added and allowed to remain for designated times and the wells were washed three times with PBS. Uninfected Molt-4 cells (1 x 10(4) cells/well) were inoculated and cultured for 4 weeks. The culture supernatant was harvested to measure reverse transcriptase activity by non-radioisotopic reverse transcriptase assay every week. Residual cytotoxicity of the disinfectant was determined by cytotoxicity assay. To evaluate the new method, the virucidal efficacy of several well-known disinfectants was reevaluated. Dose- and time-dependent effects of the disinfectants were determined. The minimal effective concentrations after 5 minutes of contact were 20% ethanol, 0.01% glutaraldehyde and 0.1% sodium hypochlorite. These results are almost the same as those reported previously, but there are some discrepancies. The differences between the present and previous protocols are discussed. This Micro-Carrier-Test promises to be useful in the screening of disinfectants.


Molecular detection of parapoxvirus in Ixodidae ticks collected from cattle in Corsica, France.
Several viruses belonging to the family Poxviridae can cause infections in humans and animals. In Corsica, livestock farming (sheep, goats, pigs, and cattle) is mainly mixed, leading to important interactions between livestock, wildlife, and human populations. This could facilitate the circulation of zoonotic diseases, and makes Corsica a good example for studies of tick-borne diseases. To gain understanding on the circulation of poxviruses in Corsica, we investigated their presence in tick species collected from cattle, sheep, horses, and wild boar, and characterized them through molecular techniques. Ticks were tested using specific primers targeting conserved regions of sequences corresponding to two genera: parapoxvirus and orthopoxvirus. A total of 3555 ticks were collected from 1549 different animals (687 cattle, 538 horses, 106 sheep, and 218 wild boars). They were tested for the presence of parapoxvirus DNA on one hand and orthopoxvirus DNA on the other hand using Pangeneric real-time TaqMan assays. Orthopoxvirus DNA was detected in none of the 3555 ticks. Parapoxvirus DNA was detected in 6.6% (36/544) of ticks collected from 23 cows from 20 farms. The remaining 3011 ticks collected from horses, wild boars, and sheep were negative. The infection rate in cow ticks was 8.0% (12/148) in 2018 and 6.0% (24/396) in 2019 (p = 0.57). Parapoxvirus DNA was detected in 8.5% (5/59) of Hyalomma scupense pools, 8.2% (15/183) of Hyalomma marginatum pools, and 6.7% (16/240) of Rhipicephalus bursa pools (p = 0.73). We successfully amplified and sequenced 19.4% (7/36) of the positive samples which all corresponded to pseudocowpox virus. Obviously, further studies are needed to investigate the zoonotic potential of pseudocowpox virus and its importance for animals and public health.


Sex Differences in Dopamine Receptor Signaling in Fmr1 Knockout Mice: A Pilot Study.
Fragile X syndrome (FXS) is an X-chromosome-linked dominant genetic disorder that causes a variable degree of cognitive dysfunction and developmental disability. Current treatment is symptomatic and no existing medications target the specific cause of FXS. As with other X-linked disorders, FXS manifests differently in males and females, including abnormalities in the dopamine system that are also seen in Fmr1-knockout (KO) mice. We investigated sex differences in dopamine signaling in Fmr1-KO mice in response to L-stepholidine, a dopamine D1 receptor agonist and D2 receptor antagonist. We found significant sex differences in basal levels of phosphorylated protein kinase A (p-PKA) and glycogen synthase kinase (GSK)-3β in wild type mice that were absent in Fmr1-KO mice. In wild-type mice, L-stepholidine increased p-PKA in males but not female mice, decreased p-GSK-3 in female mice and increased p-GSK-3 in male mice. Conversely, in Fmr1-KO mice, L-stepholidine increased p-PKA and p-GSK-3β in females, and decreased p-PKA and p-GSK-3β in males.


Severe acute post-streptococcal glomerulonephritis in an infant.
Acute post-streptococcal glomerulonephritis (APSGN) is very rare below the age of two years. We report a 14-month-old girl who presented with frank hematuria and nephrotic syndrome following group A streptococcal pharyngitis (GAS), which was confirmed by laboratory investigations. The patient underwent a renal biopsy to confirm the diagnosis and was treated with prednisolone. The proteinuria and hematuria resolved completely in eight weeks. Our case demonstrates that APSGN should be considered in evaluating hematuria and nephrotic syndrome in infants and children below two years of age.


Shoot Turgor Does Not Limit Shoot Growth of NaCl-Affected Wheat and Barley.
The aim of this work was to test the hypothesis that the reduced growth rate of wheat and barley that results when the roots are exposed to NaCl is due to inadequate turgor in the expanding cells of the leaves. The hypothesis was tested by exposing plants to 100 millimolar NaCl (which reduced their growth rates by about 20%), growing them for 7 to 10 days with their roots in pressure chambers, and applying sufficient pneumatic pressure in the chambers to offset the osmotic pressure of the NaCl, namely, 0.48 megapascals. The results showed that applying the pressure had no sustained effect (relative to unpressurized controls) on growth rates, transpiration rates, or osmotic pressures of the cell sap, in either the fully expanded or currently expanding leaf tissue, of both wheat and barley. The results indicate that the applied pressure correspondingly increased turgor in the shoot although this was not directly measured. We conclude that shoot turgor alone was not regulating the growth of these NaCl-affected plants, and, after discussing other possible influences, argue that a message arising in the roots may be regulating the growth of the shoot.


Analysis of Damage and Permeability Evolution for Mudstone Material under Coupled Stress-Seepage.
Mudstone material in a deep roadway is under the coupled stress-seepage condition. To investigate the permeability change and damage development during rock excavation in roadways, a stress-seepage damage coupling model has been proposed. In this model, damage capacity expansion of mudstone material is considered as the initiation and propagation of micro-cracks and the fracture penetration. A damage variable is introduced into the proposed model based on the principle of minimum energy consumption. As a result, an elastoplastic damage constitutive equation is established. Then, the permeability evolution equation describing the micro-macro hydraulic behavior of mudstone is deduced via percolation theory, which can describe the characteristics of sudden permeability change after rock capacity expansion. Furthermore, a finite element model is established based on commercial finite element software-ABAQUS. The numerical model was firstly verified by comparison between experimental and simulation results. On the basis of it, numerical investigation of the temporal and spatial evolution law of pore pressure, damage and permeability coefficient during roadway excavation is undertaken. The numerical results indicate that with increase of construction time, pore pressure first increases and then decreases, while the damage zone and permeability coefficient increase gradually and finally nearly keep constant. The proposed coupling model and finite element method can describe damage and permeability evolution for mudstone material under coupled stress-seepage well.


A Minimum Set of Physiological Parameters to Diagnose Obstructive Sleep Apnea Syndrome Using Non-Invasive Portable Monitors. A Systematic Review.
Introduction. Despite its high accuracy, polysomnography (PSG) has several drawbacks for diagnosing obstructive sleep apnea (OSA). Consequently, multiple portable monitors (PMs) have been proposed. Objective. This systematic review aims to investigate the current literature to analyze the sets of physiological parameters captured by a PM to select the minimum number of such physiological signals while maintaining accurate results in OSA detection. Methods. Inclusion and exclusion criteria for the selection of publications were established prior to the search. The evaluation of the publications was made based on one central question and several specific questions. Results. The abilities to detect hypopneas, sleep time, or awakenings were some of the features studied to investigate the full functionality of the PMs to select the most relevant set of physiological signals. Based on the physiological parameters collected (one to six), the PMs were classified into sets according to the level of evidence. The advantages and the disadvantages of each possible set of signals were explained by answering the research questions proposed in the methods. Conclusions. The minimum number of physiological signals detected by PMs for the detection of OSA depends mainly on the purpose and context of the sleep study. The set of three physiological signals showed the best results in the detection of OSA.


Gasserian ganglion radiofrequency thermoablation in a patient with aneurysm of the anterior communicating artery -A case report.
Gasserian ganglion radiofrequency thermoablation is a good treatment option for the management of pain in trigeminal neuralgia. We report a case in which the patient of trigeminal neuralgia combined with anterior cerebral artery aneurysm was treated successfully by gasserian ganglion thermoablation without any complication. An 85-year-old female presenting with electric shock like sensation in the gum and molar teeth was diagnosed as trigeminal neuralgia. Carbamazepine medication and trigeminal nerve blockade relieved her pain partially, but severe side effects of carbamazepine occurred. Magnetic resonance angiography of the brain showed saccular aneurysm in inferior aspect of the anterior communicating artery. Gasserian ganglion thermoablation under sedation anesthesia using nicardipine was performed carefully without any rupture of the cerebral aneurysm. Gasserian ganglion thermoablation could be performed safely in a patient with cerebral aneurysm without any inadvertent event.


Alzheimer's disease.
Alzheimer's disease is an extremely prevalent illness that has been more clearly understood in recent years. Although its cause is unknown, it is in some cases genetically transmissable. Symptoms include forgetfulness, memory loss, and confusion early in the illness and culminate in loss of personality and total cognitive degeneration. Diagnosis can be made with certainty only at autopsy, but the clinician must carefully eliminate treatable and partially treatable illnesses that present as dementia. A deficit of choline acetyltransferase seems specific to the disease and has been correlated to the neuropathologic changes in brains of patients with AD as well as to clinical symptomatology. While pharmacologic treatment strategies have attempted to increase brain acetylcholine function, they have not been clinically successful to date. Antipsychotic agents remain the treatment of choice for many AD patients, although helping the family care for such patients may be the most valuable service the physician can provide.


A new method for the synthesis of hydrophobic gold nanotapes.
Protocols for the synthesis of gold nanoparticles are increasingly focusing on controlling the morphology of the nanocrystals. We demonstrate in this article the facile, one-step synthesis of gold nanotapes that are readily dispersible in organic media. This is accomplished by the spontaneous reduction of aqueous chloroaurate ions by hexadecylaniline molecules present in chloroform at the static interface between water and chloroform. The hexadecylaniline molecules cap the gold nanotapes thus formed, rendering them hydrophobic and dispersible in a range on nonpolar and weakly polar organic solvents. Possible reasons for the growth of gold nanotapes are discussed.


Systematic Modeling, Prediction, and Comparison of Domain-Peptide Affinities: Does it Work Effectively With the Peptide QSAR Methodology?
The protein-protein association in cellular signaling networks (CSNs) often acts as weak, transient, and reversible domain-peptide interaction (DPI), in which a flexible peptide segment on the surface of one protein is recognized and bound by a rigid peptide-recognition domain from another. Reliable modeling and accurate prediction of DPI binding affinities would help to ascertain the diverse biological events involved in CSNs and benefit our understanding of various biological implications underlying DPIs. Traditionally, peptide quantitative structure-activity relationship (pQSAR) has been widely used to model and predict the biological activity of oligopeptides, which employs amino acid descriptors (AADs) to characterize peptide structures at sequence level and then statistically correlate the resulting descriptor vector with observed activity data via regression. However, the QSAR has not yet been widely applied to treat the direct binding behavior of large-scale peptide ligands to their protein receptors. In this work, we attempted to clarify whether the pQSAR methodology can work effectively for modeling and predicting DPI affinities in a high-throughput manner? Over twenty thousand short linear motif (SLiM)-containing peptide segments involved in SH3, PDZ and 14-3-3 domain-medicated CSNs were compiled to define a comprehensive sequence-based data set of DPI affinities, which were represented by the Boehringer light units (BLUs) derived from previous arbitrary light intensity assays following SPOT peptide synthesis. Four sophisticated MLMs (MLMs) were then utilized to perform pQSAR modeling on the set described with different AADs to systematically create a variety of linear and nonlinear predictors, and then verified by rigorous statistical test. It is revealed that the genome-wide DPI events can only be modeled qualitatively or semiquantitatively with traditional pQSAR strategy due to the intrinsic disorder of peptide conformation and the potential interplay between different peptide residues. In addition, the arbitrary BLUs used to characterize DPI affinity values were measured via an indirect approach, which may not very reliable and may involve strong noise, thus leading to a considerable bias in the modeling. The R prd 2 = 0.7 can be considered as the upper limit of external generalization ability of the pQSAR methodology working on large-scale DPI affinity data.


Phase Change Transformations with Dynamically Addressable Aminal Metallogels.
Dynamic polymers assembled through hemiaminal and aminal functionalities reversibly fragment upon binding to trivalent metals. Gels produced with these dynamic polymers are broken down to liquids after the addition of metal salts. Nuclear magnetic resonance spectroscopy studies and density functional theory calculations of intermediates reveal that the presence of these metals causes shifts in the energetic landscape of the intermediates in the condensation pathway to render stable nonequilibrium products. These species remain stable in the liquid phase at room temperature but convert to gels upon heating. With thermal activation, the fragmented ligands transform catalytically into closed-ring hexahydrotriazine products, which are macroscopically observable as new gels with distinct physical properties. The interplay between equilibrium and nonequilibrium gels and liquids and the ligands responsible for these transformations has been observed rheologically, giving controlled gel times dictated by the thermodynamics and kinetics of the system. This constitutionally dynamic macromolecular system offers the possibility of harnessing an equilibrium/nonequilibrium system in tandem with its inherent self-healing properties and triggered release functionality.


Differential expression of the metastasis suppressor KAI1 in decidual cells and trophoblast giant cells at the feto-maternal interface.
Invasion of trophoblasts into maternal uterine tissue is essential for establishing mature feto-maternal circulation. The trophoblast invasion associated with placentation is similar to tumor invasion. In this study, we investigated the role of KAI1, an antimetastasis factor, at the maternal-fetal interface during placentation. Mouse embryos were obtained from gestational days 5.5 (E5.5) to E13.5. Immunohistochemical analysis revealed that KAI1 was expressed on decidual cells around the track made when a fertilized ovum invaded the endometrium, at days E5.5 and E7.5, and on trophoblast giant cells, along the central maternal artery of the placenta at E9.5. KAI1 in trophoblast giant cells was increased at E11.5, and then decreased at E13.5. Furthermore, KAI1 was upregulated during the forskolin-mediated trophoblastic differentiation of BeWo cells. Collectively, these results indicate that KAI1 is differentially expressed in decidual cells and trophoblasts at the maternal-fetal interface, suggesting that KAI1 prevents trophoblast invasion during placentation.


Adverse reactions in ten years' general practice, computer analysed.
A total of 167 264 symptoms were recorded in numerical shorthand during a ten years period in a general practice. Computer analysis yielded 1535 adverse reactions with the drug prescribed. Especially prominent were reactions from three antibiotics (13% of all reported reactions), most of which were alimentary symptoms. Ampicillin also induced rashes reported at a rate of 5.2 per thousand prescriptions. Reactions to an oral contraceptive (Minovlar) were the most frequent to a single named drug, being 25.9% of prescriptions for that drug. A worldwide total of around one trillion symptoms seems likely before AD 2000. Computers could be used to detect the unpredictable side effects, as with practolol. Various 'costs' involved are noted, together with wider questions.


Cerebral aneurysms and variations in the circle of Willis.
In order to obtain information about the relationship between variations in the circle of Willis and aneurysms, 44 complete circles of Willis with aneurysm were studied macroscopically. The incidence of variations was significantly higher in the aneurysm series than in the control circles without aneurysm. There was a definite correlation between asymmetric proximal segments of the anterior cerebral artery and aneurysms of the anterior communicating artery, and a tendency to correlation was found in the case of asymmetric posterior communicating arteries and aneurysms on the internal carotid artery-posterior communicating artery junction. In the light of these findings it seems likely that through hemodynamic changes variation in the circle of Willis plays some role in the development of cerebral aneurysms.


Protective Effect of Dalbergia sissoo Extract Against Amyloid-β (1-42)-induced Memory Impairment, Oxidative Stress, and Neuroinflammation in Rats.
The ayurvedic literature reports that Dalbergia sissoo, a common medicinal plant for gastric and skin problems, has brain-revitalizing effects. However, the neuroprotective effect of this herb on an amyloid-β (Aβ) 1-42 model of Alzheimer's disease (AD) is yet unknown. The current study describes the protective effect of ethanolic extracts of D. sissoo leaves (EEDS) against Aβ (1-42)-induced cognitive deficit, oxidative stress, and neuroinflammation in rats. EEDS (300 and 500 mg/kg) was orally administered to rats for 2 weeks prior to intracerebroventricular Aβ (1-42) treatment. The neuroprotective effect of EEDS was assessed by evaluating behavioral, biochemical, and neuroinflammatory parameters in the rat hippocampus. Memory function was assessed via the Morris water maze (MWM) task 2 weeks after Aβ (1-42) administration. After 3 weeks, surgery was performed, all biochemical parameters were evaluated, and histopathological examination of the tissues was carried out. EEDS improved the cognitive ability of Aβ (1-42)-administered rats in the MWM task. It reduced oxidative stress by significantly decreasing nitrite and malondialdehyde levels and increasing catalase activity and glutathione levels in the rat brain. Moreover, EEDS mitigated neuroinflammation in rats by decreasing the concentration of neuroinflammatory markers in a dose-dependent manner. D. sissoo leaf extract has a beneficial role in alleviating cognitive deficits in AD by modulating cholinergic function, oxidative stress, and neuroinflammation.


A case of McKusick-Kaufman Syndrome.
We are reporting a rare case of McKusick- Kaufman Syndrome in a ten-month old female infant from Addis Ababa with difficulty of urination often days duration. Clinical exam revealed supra-pubic mass with tenderness and had left hand postaxial polydactily. Ultrasound and CT scans showed the mass to be hydrometrocolpos posterior to the bladder. Intravenous urography revealed a lower abdomen-pelvic mass displacing and compressing the ureters with bilateral hydronephrosis. Further pelvic exam under anaesthesia revealed hydrometrocolpos with vaginal agenesis. This, to the best knowledge of the authors, is the first ever reported case of the syndrome in Ethiopia.


Array-based comparative genomic hybridization in ulcerative colitis neoplasia: single non-dysplastic biopsies distinguish progressors from non-progressors.
Approximately 10% of ulcerative colitis patients develop colorectal neoplasia. At present, identification of this subset is markedly limited and necessitates lifelong colonoscopic surveillance for the entire ulcerative colitis population. Better risk markers are needed to focus surveillance onto the patients who are most likely to benefit. Using array-based comparative genomic hybridization, we analyzed single, non-dysplastic biopsies from three patient groups: ulcerative colitis progressors (n=9) with cancer or high-grade dysplasia at a mean distance of 18 cm from the analyzed site; ulcerative colitis non-progressors (n=8) without dysplasia during long-term surveillance; and non-ulcerative colitis normal controls (n=2). Genomic DNA from fresh colonic epithelium purified from stroma was hybridized to 287 (low-density) and 4342 (higher-density) feature bacterial artificial chromosome arrays. Sample-to-reference fluorescence ratios were calculated for individual chromosomal targets and globally across the genome. The low-density arrays yielded pronounced genomic gains and losses in 3 of 9 (33%) ulcerative colitis progressors but in none of the 10 control patients. Identical DNA samples analyzed on the higher-density arrays, using a combination of global and individual high variance assessments, distinguished all nine progressors from all 10 controls. These data confirm that genomic alterations in ulcerative colitis progressors are widespread, even involving single non-dysplastic biopsies that are far distant from neoplasia. They therefore show promise toward eliminating full colonoscopic surveillance with extensive biopsy sampling in the majority of ulcerative colitis patients.


Maillard reactions in hyperthermophilic archaea: implications for better understanding of non-enzymatic glycation in biology.
Maillard reactions are an unavoidable feature of life that appear to be damaging to cell and organisms. Consequently, all living systems must have ways to protect themselves against this process. As of 2012, several such defense mechanisms have been identified. They are all enzymatic and were found in mesophilic organisms. To date, no systematic study of Maillard reactions and the relevant defense mechanisms has been conducted in thermophiles (50°C-80°C) or hyperthermophiles (80°C-120°C). This is surprisingly because Maillard reactions become significantly faster and potent with increasing temperatures. This review examines this neglected issue in two well-defined sets of hyperthermophiles. My analysis suggests that hyperthermophiles cope with glycation stress by several mechanisms: • Absence of glycation-prone head groups (such as ethanoalamine) from hyperthermophilic phospholipids • Protection of reactive carbohydrates and labile metabolic intermediates by substrate channeling. • Conversion of excess reactive sugars such as glucose to non-reactive compounds including trehalose, di-myo-inositol-phosphate and mannosylglycerate. • Detoxification of methylglyoxal and other ketoaldehydes by conversion to inert products through a variety of reductases and dehydrogenases. • Scavenging of the remaining carbonyls by nucleophilic amines, including a variety of novel polyamines. Disruption of the Maillard process at its early stages, rather than repair of damage caused by it at later stages, appears to be the preferred strategy in the organisms examined. The most unique among these mechanisms appears to be a polyamine-based scavenging system. Undertaking research of the Maillard process in hyperthermophiles is important in its own right and is also likely to provide new insights for the control of these reactions in humans, especially in diseases such as diabetes mellitus.


[Analysis different transcriptional factors in different phenotype endometrial cancer cells].
To analysis the activity of transcriptional factors in endometrial cancer cell lines with different estrogen receptor subtypes. The mRNA levels of estrogen receptor (ER) was detected by quantitative RT-PCR, and the activity of transcriptional factors was also analysed by 345-channel protein/DNA array in RL-952 (the expression status of ERalpha and ERbeta both positive), HEC-1A [ERalpha (+/-), while ERbeta negative] and HEC-1B (ERalpha and ERbeta both negative). The transcription factors of NFkappaBp65 and p38MAPK with different activity were tested by enzyme-linked immunosorbent assay (ELISA) to confirm the results of protein/DNA array. The mRNA levels of ERalpha in RL-952, HEC-1A and HEC-1B were (6780+/-282), (684+/-84) and (168+/-38) copy/ng, respectively. Among 345 candidate transcriptional factors, there were 28 factors associated with ER status. Compared with RL-952 cells, 13 transcriptional activity factors were concomitantly up-regulation, while 15 concomitantly down-regulation in HEC-1A and HEC-1B cells. Transcriptional activities of TTF (1)-1, NRF-1, TCE were significantly correlated with the high-expression status of ERalpha mRNA (r=0.523, P=0.037), while RFX123 and Ikaros were significantly correlated with the low-expression status of ERalpha mRNA (r=-0.312, P=0.041). Transcriptional factors of TTF (1)-1, NRF-1, TCE may be associated with ER-mediated signal pathway, while RFX123 and Ikaros may be associated with non ER-mediated signal pathway in endometrial cancer.


[Emergency laparoscopic surgery].
The laparoscopic approach has represented a major step forward in general and emergency surgery. Its application in the emergency setting still raises a number of concerns that limit its more widespread use. To assess the true scope of laparoscopic surgery in the acute abdominal setting, we retrospectively evaluated our experience. From February 2003 to June 2007, 314 patients underwent an emergency laparoscopic operation, for low abdominal pain (193 patients), acute cholecystitis (78 patients), bowel obstruction (18 patients), diffuse peritonitis (16 patients), blunt abdominal trauma (6 patients), and acute pancreatitis (3 patients). Laparoscopy yielded a good diagnostic definition in all cases. The conversion rate was 16.6% (52 patients). Mean operative time was 63 +/- 29 minutes. The general major morbidity rate was 1.5% (4 patients) and the mortality rate was 0.4% (1 pt.). The laparoscopic approach in patients with abdominal emergencies is a useful tool that yields a reliable diagnostic definition in uncertain cases and allows minimal access treatment of the causative disease in the majority of cases.


Extended anaesthesia and nasotracheal intubation of a red kangaroo (Macropus rufus).
Anaesthesia requires maintenance of a patent airway. Nasotracheal intubation of a red kangaroo (Macropus rufus) was performed when the inability to open the animal's mouth prevented orotracheal intubation. Nasotracheal intubation was easy to perform, secured the airway and permitted delivery of supplemental oxygen, isoflurane and intermittent positive pressure ventilation.


A Benchmark Protocol for DFT Approaches and Data-Driven Models for Halide-Water Clusters.
Dissolved ions in aqueous media are ubiquitous in many physicochemical processes, with a direct impact on research fields, such as chemistry, climate, biology, and industry. Ions play a crucial role in the structure of the surrounding network of water molecules as they can either weaken or strengthen it. Gaining a thorough understanding of the underlying forces from small clusters to bulk solutions is still challenging, which motivates further investigations. Through a systematic analysis of the interaction energies obtained from high-level electronic structure methodologies, we assessed various dispersion-corrected density functional approaches, as well as ab initio-based data-driven potential models for halide ion-water clusters. We introduced an active learning scheme to automate the generation of optimally weighted datasets, required for the development of efficient bottom-up anion-water models. Using an evolutionary programming procedure, we determined optimized and reference configurations for such polarizable and first-principles-based representation of the potentials, and we analyzed their structural characteristics and energetics in comparison with estimates from DF-MP2 and DFT+D quantum chemistry computations. Moreover, we presented new benchmark datasets, considering both equilibrium and non-equilibrium configurations of higher-order species with an increasing number of water molecules up to 54 for each F, Cl, Br, and I anions, and we proposed a validation protocol to cross-check methods and approaches. In this way, we aim to improve the predictive ability of future molecular computer simulations for determining the ongoing conflicting distribution of different ions in aqueous environments, as well as the transition from nanoscale clusters to macroscopic condensed phases.


Integrated health care in Russia: to be or not to be?
The purpose of this paper is to look at what has happened in Russia during the last ten years in the health care sector from the point of view of integrated care. This country, when it still was the leading subject of the Soviet Union, hosted in 1978 the Alma Ata Conference on Primary Health Care, which in many countries gave a strong boost on the development of multidisciplinary, community based care in a gate-keeper position. In Soviet Russia, PHC became marginalised and identical to poor level of care in remote areas of the country where people had very little choice and did not want to use it. Has the situation changed, and is Russia in practice addressing the problems created by the lack of integration, vertical treatment structures and over specialisation? In addition to the data sources that are referred to in the text, this paper is based on "gray literature" available in project reports and governmental documents, and on the personal experiences of the authors, who have worked for long periods of time in the Russian Federation as international experts dealing with health sector reforms and health policy formulation.


Somatostatin and the dumping syndrome.
Infusion of somatostatin reduced the symptoms of the early dumping syndrome after oral glucose was given and also reduced the associated tachycardia and rise in packed cell volume. It inhibited the secretion of enteroglucagon, neurotensin, and vasoactive intestinal polypeptide, which are raised in patients with the dumping syndrome and may have an aetiological role. It also prevented the reactive hypoglycaemia of late dumping by inhibiting the release of gastric inhibitory polypeptide and insulin. Somatostatin, possibly through its inhibitory effects on hormonal secretion, may have a role in the management of patients with the early and late dumping syndrome.


Oral fucoidan improves muscle size and strength in mice.
Fucoidan is a sulfated polysaccharide found in a range of brown algae species. Growing evidence supports the long-term supplementation of fucoidan as an ergogenic aid to improve skeletal muscle performance. The aim of this study was to investigate the effect of fucoidan on the skeletal muscle of mice. Male BL/6 mice (N = 8-10) were administered a novel fucoidan blend (FUC, 400 mg/kg/day) or vehicle (CON) for 4 weeks. Treatment and control experimental groups were further separated into exercise (CON+EX, FUC+EX) or no-exercise (CON, FUC) groups, where exercised groups performed 30 min of treadmill training three times per week. At the completion of the 4-week treatment period, there was a significant increase in cross-sectional area (CSA) of muscle fibers in fucoidan-treated extensor digitorum longus (EDL) and soleus fibers, which was accompanied by a significant increase in tibialis anterior (TA) muscle force production in fucoidan-treated groups. There were no significant changes in grip strength or treadmill time to fatigue, nor was there an effect of fucoidan or exercise on mass of TA, EDL, or soleus muscles. In gastrocnemius muscles, there was no change in mRNA expression of mitochondrial biogenesis markers PGC-1α and Nrf-2 in any experimental groups; however, there was a significant effect of fucoidan supplementation on myosin heavy chain (MHC)-2x, but not MHC-2a, mRNA expression. Overall, fucoidan increased muscle size and strength after 4 weeks of supplementation in both exercised and no-exercised mice suggesting an important influence of fucoidan on skeletal muscle physiology.


"Emergency Room Evaluation and Recommendations" (ER2) Tool for the Screening of Older Emergency Department Visitors With Major Neurocognitive Disorders: Results From the ER2 Database.
Purpose: The Emergency Room Evaluation and Recommendation (ER2) is an application in the electronic medical file of patients visiting the Emergency Department (ED) of the Jewish General Hospital (JGH; Montreal, Quebec, Canada). It screens for older ED visitors at high risk of undesirable events. The aim of this study is to examine the performance criteria (i.e., sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV], positive likelihood ratio [LR+], negative likelihood ratio [LR-] and area under the receiver operating characteristic curve [AUROC]) of the ER2 high-risk level and its "temporal disorientation" item alone to screen for major neurocognitive disorders in older ED visitors at the JGH. Methods: Based on a cross-sectional design, 999 older adults (age 84.9 ± 5.6, 65.1% female) visiting the ED of the JGH were selected from the ER2 database. ER2 was completed upon the patients' arrival at the ED. The outcomes were ER2's high-risk level, the answer to ER2's temporal disorientation item (present vs. absent), and the diagnosis of major neurocognitive disorders (yes vs. no) which was confirmed when it was present in a letter or other files signed by a physician. Results: The sensitivities of both ER2's high-risk level and temporal disorientation item were high (≥0.91). Specificity, the PPV, LR+, and AROC were higher for the temporal disorientation item compared to ER2's high-risk level, whereas a highest sensitivity, LR-, and NPV were obtained with the ER2 high-risk level. Both area under the receiver operating characteristic curves were high (0.71 for ER2's high-risk level and 0.82 for ER2 temporal disorientation item). The odds ratios (OR) of ER2's high-risk level and of temporal disorientation item for the diagnosis of major neurocognitive disorders were positive and significant with all OR above 18, the highest OR being reported for the temporal disorientation item in the unadjusted model [OR = 26.4 with 95% confidence interval (CI) = 17.7-39.3]. Conclusion: Our results suggest that ER2 and especially its temporal disorientation item may be used to screen for major neurocognitive disorders in older ED users.


Genograms: a psychosocial assessment tool for hospice.
Genograms are a valuable and non-threatening evaluation tool for hospice patients and families. The genogram provides basic information about the family including the role of each member and the family dynamics. As the diagram is drawn, family life cycle issues and relationships between family members become evident. The genogram may go beyond the household to include supportive neighbors, friends, and community resources. Religious and spiritual support is also noted. The information is used to assess family needs and to provide interventions both before the death and during bereavement.


p53 expression in patients with ulcerative colitis - associated with dysplasia and carcinoma: a systematic meta-analysis.
Tumor suppressor gene p53 expression has been reported in patients with ulcerative colitis (UC). However, the correlation between p53 expression and UC remains controversial. The aim of this meta-analysis was to investigate the association between p53 expression and different pathological types of UC. Publications were searched in the PubMed, Embase, EBSCO, Wangfang, and CNKI databases. The overall odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were summarized in this study. Final 19 papers were identified in this meta-analysis, including 1068 patients with UC and 130 normal tissue samples. Immunohistochemical p53 expression was significantly higher in UC without dysplasia and carcinoma (UC group) compared to normal tissue samples (OR = 3.14, P = 0.001), higher in UC with dysplasia than in UC group (OR = 10.76, P < 0.001), and higher in UC with colorectal cancer (CRC) than in UC with dysplasia (OR = 1.69, P = 0.035). Subgroup analysis of ethnicity (UC group vs. normal tissues) showed that p53 expression was correlated with UC in Asians, but not in Caucasians. When UC with dysplasia was compared to UC group, p53 expression was linked to UC with dysplasia among both Asians and Caucasians. When UC-CRC was compared to UC with dysplasia, p53 expression was not associated with UC-CRC in both Caucasians and Asians. p53 expression was closely associated with UC-CRC development. p53 expression showed different ethnic characteristics among different pathological types of UC.


Differences in susceptibility of the European eel (Anguilla anguilla) and the Japanese eel (Anguilla japonica) to the swim-bladder nematode Anguillicola crassus.
The swim-bladder nematode Anguillicola crassus originates from the Far East where it is a parasite of the Japanese eel (Anguilla japonica). After A. crassus was introduced to Europe, it became a predominant parasite of the European eel (Anguilla anguilla). A study performed with experimentally infected eels (98 days, 23 degrees C) revealed significant differences in the susceptibility of the two eel species to this parasite. The recovery rate of 30 administered infective A. crassus larvae (L3) from A. japonica was less than half of that from A. anguilla (33.2% and 13.8%, respectively). Almost 60% of the worms recovered from A. japonica were found as dead, encapsulated and necrotic larvae in the swimbladder wall. In contrast, no dead larvae were found in A. anguilla. Additionally, the development of the worms was shown to be significantly slower in A. japonica compared with A. anguilla. The lower survival rate of the worms, together with their slower development, resulted in a significantly lower adult worm burden (11 and 428 mg wet weight, respectively) and in a decreased reproductive success in A. japonica compared with A. anguilla. These results demonstrate that the original host, A. japonica, possesses more effective defence mechanisms against A. crassus than does the non-adapted host, A. anguilla.


Recurrent pancreatitis in the setting of gallbladder agenesis, ansa pancreatica, Santorinicoele and eventual intraductal papillary mucinous neoplasia (IPMN).
Gallbladder agenesis is a rare condition. Patients with gallbladder agenesis can present with biliary type symptoms and rarely pancreatitis. We present the case of a 35-year-old gentleman who was admitted and treated for recurrent pancreatitis on a background of gallbladder agenesis, ansa pancreatica and Santorinicoele. He has had several admissions with pancreatitis and has had multiple imaging modalities during these admissions which we delineate. We discuss this rare anatomical variant and describe the course and management of his illness leading up to his eventual diagnosis of intraductal papillary neoplasia (IPMN).


Semiautomatic lymph node segmentation in multislice computed tomography: impact of slice thickness on segmentation quality, measurement precision, and interobserver variability.
To determine the impact of slice thickness on semiautomatic lymph node analysis. Thoracic multislice computed tomography (MSCT) of 46 patients with NSCLC were reconstructed at 1.0-, 3.0-, and 5.0-mm slice thickness. Two radiologists independently determined long and short axis diameter and volume of 299 thoracic lymph nodes by semiautomatic segmentation software. Necessity of manual correction (= relative difference between uncorrected and corrected segmented lymph node volume) and relative interobserver differences were determined. The precision of segmentation was expressed by relative measurement deviations (RMD) from the reference standard (mean of 1.0 mm datasets). Statistical analysis encompassed t test and Bland-Altman plots. Necessity of manual correction was significantly higher for 5.0 mm than for 3.0 (P = 0.042) or 1.0 mm (P = 0.0012). The RMD for long and short axis diameter were found to be independent of slice thickness, whereas the RMD for lymph node volume significantly (P = 0.021) increased from 4.0% at 1.0 mm (95% CI: 1.0%-3.5%) to 35% at 5.0 mm (95% CI: 10.5%-60.5%). The relative interobserver differences was consistently low for metric and volumetric parameters (eg, volume 2.3%, 95% CI: -7.4%-10.8% at 5.0 mm) with no difference in any of the slice thicknesses (P > 0.064). Significant deviations in lymph node volume together with excessive manual corrections suggest reconstruction of the data for semiautomatic lymph node assessment at a slice thickness of 1.0 mm but not exceeding 3.0 mm.


Effective down-regulation of signal transducer and activator of transcription 3 (STAT3) by polyplexes of siRNA and lipid-substituted polyethyleneimine for sensitization of breast tumor cells to conventional chemotherapy.
Signal transducer and activator of transcription 3 (STAT3) is a transcription factor that plays a major role in the development of resistance to conventional anti-cancer drugs in many types of cancer, when constitutively activated. Inhibition of STAT3 is considered as a promising strategy for inhibition of tumor growth and overcoming the drug resistance manifested. In this study, the capability of STAT3 knockdown by lipid substituted low molecular weight (2 kDa) polyethyleneimine (PEI2) complexes of STAT3-siRNA was assessed. The efficiency of PEI/STAT3-siRNA polyplexes in the induction of STAT3 associated cell death in wild type and drug-resistant MDA-MB-435 breast cancer cells as monotherapy and upon combination with chemotherapeutic agents, doxorubicin and paclitaxel, was also investigated. Our results identified linoleic acid-substituted (PEI-LA) polymer as the most efficient carrier among different lipid substituted PEI2 for siRNA delivery, leading to most STAT3 associated loss of cell viability in MDA-MB-435 cells. STAT3-siRNA delivery by the PEI-LA polymer resulted in efficient down-regulation of STAT3 at both mRNA and protein levels. Furthermore, pre-treatment of cancer cells with STAT3-siRNA formulation increased the cytotoxic effect of doxorubicin and paclitaxel in both wild type and drug resistant MDA-MB-435 cells. The results of this study point to the potential of PEI-LA polyplexes of STAT3-siRNA as inhibitors of STAT3 expression in breast tumor cells. The results also demonstrate an improved efficacy for chemotherapeutic drugs in combination with lipid-substituted low molecular weight PEI-LA/STAT3-siRNA complexes in comparison to drug therapy alone.


Extramedullary tumor of monoblasts in the central nervous system: presenting feature of simultaneous bone marrow involvement by acute monocytic leukemia.
An extramedullary tumor of monoblasts in the central nervous system has been described in the literature as a single case report, preceding the development of acute monocytic leukemia by 1 year. We report a previously undescribed presentation of acute monocytic leukemia as a left temporal lobe extra-axial mass with concomitant bone marrow involvement. We describe our findings in order to heighten awareness of this entity, which may be encountered in morphologic evaluation of central nervous system masses.


Cutaneous Squamous Cell Carcinoma: The Frontier of Cancer Immunoprevention.
Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer, with its incidence rising steeply. Immunosuppression is a well-established risk factor for cSCC, and this risk factor highlights the critical role of the immune system in regulating cSCC development and progression. Further highlighting the nature of cSCC as an immunological disorder, substantial evidence demonstrates a tight association between cSCC risk and age-related immunosenescence. Besides the proven efficacy of immune checkpoint blockade therapy for advanced cSCC, novel immunotherapy that targets cSCC precursor lesions has shown efficacy for cSCC prevention. Furthermore, the appreciation of the interplay between keratinocytes, commensal papillomaviruses, and the immune system has revealed the possibility for the development of a preventive cSCC vaccine. cSCC shares fundamental aspects of its origin and pathogenesis with mucosal SCCs. Therefore, advances in the field of cSCC immunoprevention will inform our approach to the management of mucosal SCCs and potentially other epithelial cancers.


Prognostic factors for the occurrence of post-operative shoulder stiffness after arthroscopic rotator cuff repair: a systematic review.
Post-operative shoulder stiffness (POSS) is one of the most frequent complications after arthroscopic rotator cuff repair (ARCR). Factors specifying clinical prediction models for the occurrence of POSS should rely on the literature and expert assessment. Our objective was to map prognostic factors for the occurrence of POSS in patients after an ARCR. Longitudinal studies of ARCR reporting prognostic factors for the occurrence of POSS with an endpoint of at least 6 months were included. We systematically searched Embase, Medline, and Scopus for articles published between January 1, 2014 and February 12, 2020 and screened cited and citing literature of eligible records and identified reviews. The risk of bias of included studies and the quality of evidence were assessed using the Quality in Prognosis Studies tool and an adapted Grading of Recommendations, Assessment, Development and Evaluations framework. A database was implemented to report the results of individual studies. The review was registered on PROSPERO (CRD42020199257). Seven cohort studies including 23 257 patients were included after screening 5013 records. POSS prevalence ranged from 0.51 to 8.75% with an endpoint ranging from 6 to 24 months. Due to scarcity of data, no meta-analysis could be performed. Overall risk of bias and quality of evidence was deemed high and low or very low, respectively. Twenty-two potential prognostic factors were identified. Increased age and male sex emerged as protective factors against POSS. Additional factors were reported but do require further analyses to determine their prognostic value. Available evidence pointed to male sex and increased age as probable protective factors against POSS after ARCR. To establish a reliable pre-specified set of factors for clinical prediction models, our review results require complementation with an expert's opinion.


Pneumococcal bacteremia with pneumonia. Mortality in acquired immunodeficiency syndrome.
To compare mortality due to bacteremic pneumococcal pneumonia in patients with acquired immunodeficiency syndrome (AIDS) vs (control) patients without human immunodeficiency virus (HIV) infection. Non-AIDS patients with HIV infection were incidentally tabulated as a separate group. A two-year retrospective study. Inpatients of St. Clare's Hospital, a community hospital in New York City. Forty-nine patients had 50 separate episodes with at least one positive blood culture for Streptococcus pneumoniae (all were penicillin-sensitive) and pneumonia on chest roentgenogram. Twenty-four patients had no HIV infection, 14 patients had AIDS, and 11 patients with 12 bacteremic episodes were HIV-positive without AIDS. Treatment for pneumonia was determined by the patient's individual physician. AIDS patients with pneumonia had a mortality of 57.1 percent (8/14), which was significantly higher than the 25 percent (6/24) seen in patients without HIV infection (p less than 0.025, two-sample test for independent proportions). Septic shock, usually occurring within the first five days of hospitalization, was the primary cause of death, occurring in six of eight AIDS patients and six of six patients without HIV infection. If the mortality in the first five days of hospitalization was excluded, the mortality would drop to 33.3 percent in the AIDS population and 5.3 percent in patients without HIV infection. Eleven HIV-infected patients without AIDS survived 12 episodes of bacteremic pneumococcal pneumonia. Bacteremic pneumococcal pneumonia in the setting of AIDS has a survival rate of less than 50 percent with septic shock as the usual mode of death. This is the highest pneumococcal pneumonia mortality rate ever reported in a large subgroup of patients in the antibiotic era. On the other hand, HIV-infected patients without progression to AIDS have an excellent chance for survival. This may be related in part to young age, absence of many underlying diseases, and a better humoral immune system.


Interaction between mesenchymal stem cells and Ti-30Ta alloy after surface treatment.
In this study, in vitro cytocompatibility was investigated in the Ti-30Ta alloy after two kinds of surfaces treatments: alkaline and biomimetic treatment. Each condition was evaluated by scanning electron microscopy/energy-dispersive X-ray spectroscopy. Cellular adhesion, viability, protein expression, morphology, and differentiation were evaluated with Bone marrow stromal cells (MSCs) to investigate the short and long-term cellular response by fluorescence microscope imaging and colorimetric assays techniques. Two treatments exhibited similar results with respect to total protein content and enzyme activity as compared with alloy without treatment. However, it was observed improved of the biomineralization, bone matrix formation, enzyme activity, and MSCs functionality after biomimetic treatment. These results indicate that the biomimetic surface treatment has a high potential for enhanced osseointegration.


Effort-induced mirror movements. A study of transcallosal inhibition in humans.
During sustained, fatiguing maximal voluntary contraction of muscles of one hand, muscles of the other hand gradually become activated also. Such effort-induced mirror movements indicate a decreased ability of the central nervous system (CNS) to selectively control individual muscles. We studied whether altered transcallosal inhibition (TCI) contributed to this phenomenon. TCI was determined in ten healthy subjects by measuring the ipsilateral silent period (iSP) and the contralateral silent period (cSP) during a sustained contraction of the abductor digiti minimi, induced by focal unihemispheric ipsilateral transcranial magnetic stimulation. Mirror movements occurred in all subjects in response to the effort. There was a bilateral increase in cSPs and a parallel increase in the iSP in the contralateral working muscle. In contrast, the iSP in the mirroring muscle remained unchanged, explained by a balance of increased crossed pyramidal inhibition (cSP) and decreased transcallosal inhibition. In finely tuned unimanual movements, mirroring activity of the contralateral hand is suppressed by TCI originating in the working hemisphere. During sustained, effortful contractions, the outflow of the contralateral hemisphere is increased due to reduced TCI. Effort-induced mirror contractions are thus the result of disinhibition of contralateral crossed projections rather than disinhibition of ipsilateral uncrossed pathways.


Characteristics of alumino-humic flocs in relation to DAF performance.
This paper examines the implications of pretreatment in the context of the likely behaviour of flocs in DAF units. Evidence indicates that the maximum floc size (dmax) of alumino-humic is scaled by the Kolmogorov length (eta) with dmax/eta approximately 1. A larger ratio exists when polymer is present. Data from the literature suggests that velocity gradient in the inlet chamber may exceed 1000 s-1, suggesting eta approximately 40 microns. This view of the response of floc to shear is supported by shear tests carried out on samples of floc withdrawn from flocculators at full scale water treatment works. Using an underwater CCTV camera, coupled with image analysis, it is shown that floc sizes in conventionally designed flocculators are much bigger than the sizes which are likely to exist in DAF units. Circumstantial evidence gained from water treatment works suggests that DAF units perform satisfactorily whatever the size of the incoming floc. From such evidence, the authors question the conventional design of the flocculators in association with DAF units.


Ultra-Fast Image Reconstruction of Tomosynthesis Mammography Using GPU.
Digital Breast Tomosynthesis (DBT) is a technology that creates three dimensional (3D) images of breast tissue. Tomosynthesis mammography detects lesions that are not detectable with other imaging systems. If image reconstruction time is in the order of seconds, we can use Tomosynthesis systems to perform Tomosynthesis-guided Interventional procedures. This research has been designed to study ultra-fast image reconstruction technique for Tomosynthesis Mammography systems using Graphics Processing Unit (GPU). At first, projections of Tomosynthesis mammography have been simulated. In order to produce Tomosynthesis projections, it has been designed a 3D breast phantom from empirical data. It is based on MRI data in its natural form. Then, projections have been created from 3D breast phantom. The image reconstruction algorithm based on FBP was programmed with C++ language in two methods using central processing unit (CPU) card and the Graphics Processing Unit (GPU). It calculated the time of image reconstruction in two kinds of programming (using CPU and GPU).


Early Middle Ordovician evidence for land plants in Argentina (eastern Gondwana).
• The advent of embryophytes (land plants) is among the most important evolutionary breakthroughs in Earth history. It irreversibly changed climates and biogeochemical processes on a global scale; it allowed all eukaryotic terrestrial life to evolve and to invade nearly all continental environments. Before this work, the earliest unequivocal embryophyte traces were late Darriwilian (late Middle Ordovician; c. 463-461 million yr ago (Ma)) cryptospores from Saudi Arabia and from the Czech Republic (western Gondwana). • Here, we processed Dapingian (early Middle Ordovician, c. 473-471 Ma) palynological samples from Argentina (eastern Gondwana). • We discovered a diverse cryptospore assemblage, including naked and envelope-enclosed monads and tetrads, representing five genera. • Our discovery reinforces the earlier suggestion that embryophytes first evolved in Gondwana. It indicates that the terrestrialization of plants might have begun in the eastern part of Gondwana. The diversity of the Dapingian assemblage implies an earlier, Early Ordovician or even Cambrian, origin of embryophytes. Dapingian to Aeronian (Early Silurian) cryptospore assemblages are similar, suggesting that the rate of embryophyte evolution was extremely slow during the first c. 35-45 million yr of their diversification. The Argentinean cryptospores predate other cryptospore occurrences by c. 8-12 million yr, and are currently the earliest evidence of plants on land.


The efficacy of periarticular multimodal drug infiltration in total hip arthroplasty.
Patient-controlled analgesia is a widely used and effective method of controlling pain after THA. This method is associated with substantial undesirable side effects. Local infiltration has been introduced in an attempt to reduce opioid requirements postoperatively, but its ability to reduce pain without complications is still questioned. We evaluated patient-controlled analgesia use, pain and satisfaction scores, complication rates, and ropivacaine levels associated with the use of periarticular multimodal drug infiltration in THA. We randomized 64 patients undergoing THA to receive a periarticular intraoperative multimodal drug injection or to receive no injection. All patients received patient-controlled analgesia for 24 hours after surgery. The final assessment was at 6 weeks. Patients receiving the periarticular injection used less patient-controlled analgesia 6 hours postoperatively. The 24-hour patient-controlled analgesia requirement postsurgery also was less. The visual analog scale score for pain on activity in the postanesthetic care unit was less for patients who received an injection. The visual analog scale satisfaction score was similar in the two groups throughout the followup period. Recorded unbound ropivacaine levels were 2.5 times lower than toxic levels. Periarticular intraoperative injection with multimodal drugs can reduce postoperative patient-controlled analgesia requirements and pain on activity in patients undergoing THA with no apparent increase in risk. Level I, therapeutic study. See the guidelines online for a complete description of level of evidence.


Relationship between Helicobacter pylori infection and serum ferritin level in primary school children of Tehran-Iran.
To determine the relationship between serum Ferritin levels and Helicobacter pylori antibody titer (IgG) in primary school children with H.pylori infection. This cross-sectional study was performed among 6-12 year old healthy primary schoolchildren in Tehran during the academic year 2005-2006. Specimen collection was done by cluster and randomization methods (multistage sampling) Personal information and laboratory results were compiled in questionnaires and data was analyzed by descriptive and analytical statistics via SPSSv.15 software. One thousand six hundred sixty five primary school children (43% boys, 57% girls) with mean age 9.2 +/- 1.5 years were enrolled into the study. H.pylori IgG antibody titer was positive in 26% (432 cases) with mean values of 0.79 +/- 0.42 ISR units in boys and 0.75 +/- 0.39 ISR units in girls, which showed a significant statistical difference (P = 0.004). H.pylori infection was more common among children of large families or those with low economic status (P = 0.002). Twenty nine percent of children (477 cases)had low serum Ferritin levels, which was significantly higher among boys (P > 0.05); 32 82 +/- 33.12 mg/dL in boys and 43.23 +/- 2.5 mg/dL in girls. Out of the children with low serum Ferritin levels, 71% (334 cases) had negative and 28% (132 patients) had positive H.pylori antibody titers (IgG levels). Also, 296 children (25%) with normal Ferritin levels had H.pylori infection. We did not find a significant relationship between H.pylori infection and low serum Ferritin or iron deficiency anaemia.


Effects of clenbuterol treatment on the relaxant response in rat uterus.
Prolonged treatment with the beta(2)-adrenergic agonist clenbuterol (0.25 mg kg(-1) s.c. once daily for 10 days) produced a reduction of the relaxant response and cAMP production mediated by stimulation of beta-adrenoceptors in oestrogen-treated rat uterus. Substantial decreases in the relaxant effect of isoproterenol is observed in uterine rings precontracted with 50 mM KCl from clenbuterol-treated rats. The recovery of the relaxant response was also studied and significant differences were seen between acute and prolonged treatment with clenbuterol (P<0.05 vs control). In contrast the relaxant effect of forskolin and 3-isobutyl-1-methylxanthine was similar in untreated or treated rats. Sodium fluoride also showed a relaxant response which was not affected by the treatment with clenbuterol. The radioligand studies showed a reduction in the number of beta-adrenoreceptors after acute and prolonged treatment with clenbuterol in rat uterus. These results suggest that prolonged treatment with clenbuterol caused a desensitization of the relaxant uterine response through beta(2)-adrenoceptors and also showed differences in the recovery of the relaxant response depending on the duration of treatment.


Lung ultrasound findings in pediatric patients with COVID-19.
During the pandemic caused by the novel coronavirus (COVID-19), lung ultrasound has been used to diagnose and monitor respiratory condition. The aim of the study was to describe lung ultrasound findings in children with a COVID-19 infection. Patients younger than 18 years old and positive for COVID-19, admitted to pediatric tertiary referral hospital were included. They were divided into two groups depending on the presence of respiratory symptoms. Lung ultrasound results were categorized into four degrees according to Soldati et al. score (J Ultrasound Med 39:1-7, 2020) and it was also described the presence and type of consolidation. Sixteen patients were recruited. The median age was 11 years old (IQR 2.8-12). Four children (25%) required admission to the intensive care unit. Six patients (37.5%) presented with respiratory symptoms. Most of them showed S.score of 2 and subpleural consolidations were observed in four cases (66.6%). Ten patients (62.5%) presented with non-respiratory symptoms, lung ultrasound showed S.score from 0 to 2. Three (30%) were diagnosed of multisystem inflammatory syndrome and lung ultrasounds showed S.score of 2 with bilateral pleural effusion.Conclusions: Children with COVID-19 and respiratory symptoms mostly showed a S.score of 2 and 3 with subpleural consolidations, upon the lung ultrasound assessment. What is Known: • Lung ultrasound is a useful tool for monitoring patients with respiratory symptoms in both adults and children. Lung ultrasounds are altered in adult patients with COVID-19. What is New: • Lung ultrasound might improve COVID-19 assessment, it could be a useful tool to diagnose and monitor patients throughout the COVID-19 pandemic. Even COVID-19 patients with non-respiratory symptoms have lung alterations that are visible on lung ultrasound.


Echinoids from the Tesero Member (Werfen Formation) of the Dolomites (Italy): implications for extinction and survival of echinoids in the aftermath of the end-Permian mass extinction.
The end-Permian mass extinction (∼252 Ma) was responsible for high rates of extinction and evolutionary bottlenecks in a number of animal groups. Echinoids, or sea urchins, were no exception, and the Permian to Triassic represents one of the most significant intervals of time in their macroevolutionary history. The extinction event was responsible for significant turnover, with the Permian-Triassic representing the transition from stem group echinoid-dominated faunas in the Palaeozoic to Mesozoic faunas dominated by crown group echinoids. This turnover is well-known, however, the environmental and taxonomic distribution of echinoids during the latest Permian and Early Triassic is not. Here we report on an echinoid fauna from the Tesero Member, Werfen Formation (latest Permian to Early Triassic) of the Dolomites (northern Italy). The fauna is largely known from disarticulated ossicles, but consists of both stem group taxa, and a new species of crown group echinoid, Eotiaris teseroensis n. sp. That these stem group echinoids were present in the Tesero Member indicates that stem group echinoids did not go extinct in the Dolomites coincident with the onset of extinction, further supporting other recent work indicating that stem group echinoids survived the end-Permian extinction. Furthermore, the presence of Eotiaris across a number of differing palaeoenvironments in the Early Triassic may have had implications for the survival of cidaroid echinoids during the extinction event.


Screening for Down's syndrome: experience of two district general hospitals having different screening strategies.
The aim of this retrospective study is to determine the rate of reduction in the number of Down's syndrome babies delivered in two hospitals having different screening strategies. The total number of Down's syndrome babies during the study period was 0.6/1000 births at Birch Hill Hospital and 1.9/1000 births at Oldham Hospital. Antenatal diagnosis of Down's syndrome was made in 1/4 of women (25%) at Birch Hill and 7/19 of women (37%) in Oldham. The reduction rate of Down's syndrome was similar in both hospitals (25 and 26%). This retrospective analysis and comparison between two neighbouring units, highlights the fact that there is little standardisation of screening policies and screening programmes have not resulted in a substantial reduction in Down's syndrome babies.


Paediatric Pain Medicine: Pain Differences, Recognition and Coping Acute Procedural Pain in Paediatric Emergency Room.
Paediatric pain and its assessment and management are challenging for medical professionals, especially in an urgent care environment. Patients in a paediatric emergency room (PER) often undergo painful procedures which are an additional source of distress, anxiety, and pain. Paediatric procedural pain is often underestimated and neglected because of various myths, beliefs, and difficulties in its evaluation and treatment. However, it is very different from other origins of pain as it can be preventable. It is known that neonates and children can feel pain and that it has long-term effects that last through childhood into adulthood. There are a variety of pain assessment tools for children and they should be chosen according to the patient's age, developmental stage, communication skills, and medical condition. Psychological factors such as PER environment, preprocedural preparation, and parental involvement should also be considered. There are proven methods to reduce a patient's pain and anxiety during different procedures in PER. Distraction techniques such as music, videogames, virtual reality, or simple talk about movies, friends, or hobbies as well as cutaneous stimulation, vibration, cooling sprays, or devices are effective to alleviate procedural pain and anxiety. A choice of distraction technique should be individualized, selecting children who could benefit from nonpharmacological pain treatment methods or tools. Nonpharmacological pain management may reduce dosage of pain medication or exclude pharmacological pain management. Most nonpharmacological treatment methods are cheap, easily accessible, and safe to use on every child, so it should always be a first choice when planning a patient's care. The aim of this review is to provide a summary of paediatric pain features, along with their physiology, assessment, management, and to highlight the importance and efficacy of nonpharmacological pain management in an urgent paediatric care setting.


Obesity: long-term management after bariatric surgery.
For many patients, bariatric surgery results in enduring weight loss and comorbidity resolution, but it is not without risk of complications. Complications necessitating possible surgical intervention include small bowel obstruction, internal hernia, intussusception, anastomotic ulcer, and anastomotic leak. Medical complications include dumping syndrome; osteoporosis; substance abuse; nephrolithiasis; high suicide rates; and nutritional deficiencies, some of which can result in neurologic disorders. Patients need to take daily multivitamins with minerals (containing iron, copper thiamine, and folic acid), vitamin D, and calcium to prevent nutritional deficiencies. Patients also need to consume 1 to 1.5 g of protein per kilogram of ideal body weight daily. Vitamin levels should be assessed on a regular basis to monitor for deficiencies and prevent neurologic sequelae.


Spectral characterization of polarization dependent loss of locally pressed fiber Bragg grating.
In this paper, the spectral characterization of polarization dependent loss (PDL) of locally pressed fiber Bragg grating (FBG) is analyzed. The evolution of the PDL response of a FBG as functions of the load magnitude the loaded length of the grating and the position of the load are studied. The physical model is presented and a numerical simulation based on the modified transfer matrix method is also used to calculate the PDL response of the FBG. The theoretical analysis and numerical simulation suggest that the PDL response of the FBG has potential applications for distributed diametric load sensor. Good agreements between experimental results and numerical simulations have been obtained.


Clinical relevance of intracranial microembolic signals in patients with left ventricular assist devices. A prospective study.
The use of left ventricular assist devices has become an established method in bridging patients with end-stage cardiac failure to heart transplantation. Since thromboembolism is one of the major complications, we undertook this study to evaluate the clinical significance of Doppler microembolic signals (MES) in patients with left ventricular assist devices. Six patients with left ventricular assist devices were monitored for MES with transcranial Doppler ultrasonography during the first 30 postoperative days. Additionally, repeated (10 per day and patient) and prolonged (3 hours per patient) monitorings were performed to assess the adequacy of the 30-minute recordings. Three observers evaluated 30 randomly assigned monitorings in a blinded fashion to assess the interobserver variability. The relation between MES counts and clinical, radiological, hemostaseological, and pump flow parameters and the predictive value of MES counts regarding the occurrence of embolic events was evaluated. Ten ischemic cerebrovascular accidents and 2 peripheral thromboembolic events occurred during the observation period of 177 days (total incidence, 6.8%). MES were found in 143 of 170 monitorings (84.1%). Their counts were significantly higher on days with clinically manifest embolic events as compared with event-free days (18.5 [3-74] versus 4 [0-52], respectively, median and 95% CI; P < .001, Mann-Whitney). The predictive value of MES counts above 7 per 30 minutes was high (75%). Significant differences in the incidence and counts of MES as well as in the incidence of clinically manifest embolic events were noted among the six patients (all P < .01) without equal differences in anticoagulant treatment or pump flow. Interobserver agreement was high (p = .78 to .89, unpaired Student's t test). Considerable short- and long-term intrapatient variations of MES counts, without consistent pattern, were noted. Serial monitoring for MES is prognostically superior to single monitorings in patients with left ventricular assist devices. In the future, this new application mode may individually guide anticoagulation strategies and even influence the decision regarding early cardiac transplantation versus long-term use of the assist devices.


Enhancement of Terpenoid Biosynthesis from Mevalonate in a Fraction of the Latex from Euphorbia lathyris.
A latex pellet fraction from Euphorbia lathyris incorporates mevalonate into triterpenols and their fatty acid esters. Conditions for improved incorporation were determined. CaCl(2) or CaCl(2) plus MnCl(2) stimulated biosynthesis, and the metal ion chelator, ethylenebis(oxyethylenenitrilo)tetraacetic acid (EGTA) enhanced stimulation. Ethylenediaminetetraacetic acid was almost as effective as EGTA, but phthalic acid and citric acid were relatively poor stimulators. The concentration of the Ca(2+)-EGTA complex was directly measured, and the incorporation data are best fitted by a curve that shows that the receptor for the complex is saturable. In the presence of the metal-chelate complex, the addition of fructose, 1,6-bisphosphate plus aldolase (triose-P) or malate provided additional stimulation. Incorporation was maximum at 40 micromolar R-mevalonate, and inhibition occurred at higher concentrations. The apparent K(m) for R-mevalonate was 15 micromolar. Under improved reaction conditions, the rate of triterpenoid biosynthesis from mevalonate is 25 times faster than was previously observed (GJ Piazza, EJ Saggese, KM Spletzer [1987] Plant Physiol 83: 177-180).


Structure of type I and type III heterotypic collagen fibrils: an X-ray diffraction study.
The molecular packing arrangement within collagen fibrils has a significant effect on the tensile properties of tissues. To date, most studies have focused on homotypic fibrils composed of type I collagen. This study investigates the packing of type I/III collagen molecules in heterotypic fibrils of colonic submucosa using a combination of X-ray diffraction data, molecular model building, and simulated X-ray diffraction fibre diagrams. A model comprising a 70-nm-diameter D- (approximately 65 nm) axial periodic structure containing type I and type III collagen chains was constructed from amino acid scattering factors organised in a liquid-like lateral packing arrangement simulated using a classical Lennard-Jones potential. The models that gave the most accurate correspondence with diffraction data revealed that the structure of the fibril involves liquid-like lateral packing combined with a constant helical inclination angle for molecules throughout the fibril. Combinations of type I:type III scattering factors in a ratio of 4:1 gave a reasonable correspondence with the meridional diffraction series. The attenuation of the meridional intensities may be explained by a blurring of the electron density profile of the D period caused by nonspecific or random interactions between collagen types I and III in the heterotypic fibril.


[Pulmonary pseudosequestration receiving arterial supply from the right coronary artery: a case report].
A 66-year-old female had been treated by hemodialysis since 1996. She was admitted to our hospital with acute pneumonia in January 2001. During admission, ischemic heart disease was identified. Her condition deteriorated and organic pneumonia of the right middle lobe progressed. She recovered after 6 months and coronary arteriography was performed. A 90% stenosis was detected at the ostium of the right coronary artery. An aberrant tortuous artery arose from the distal sinus node artery, and drained into the lung network, but also partially drained to the right segmental pulmonary artery branch. The diagnosis was significant stenosis of the right coronary artery, and pulmonary pseudosequestration or pulmonary sequestration receiving arterial supply from the sinus node artery. Surgical revascularization, ligation of the aberrant artery, and partial resection of the right middle lobe were performed. However, intraoperative findings did not identify the pulmonary sequestration. This rare case of pulmonary pseudosequestration received the arterial supply from the sinus node artery, originating from the right coronary artery with a significant stenotic lesion, and developed without recurrent pneumonia.


Perceptions and Practice of Preconception Care by Healthcare Workers and High-Risk Women in South Africa: A Qualitative Study.
Preconception care is biomedical, behavioural, and social health interventions provided to women and couples before conception. This service is sometimes prioritised for women at high risk for adverse pregnancy outcomes. Evidence revealed that only very few women in Africa with severe chronic conditions receive or seek preconception care advice and assessment for future pregnancy. Thus, this study aimed to explore the perceptions and practice of preconception care by healthcare workers and high-risk women in Kwa-Zulu-Natal, South Africa. This exploratory, descriptive qualitative study utilised individual in-depth interviews to collect data from 24 women at high risk of adverse pregnancy outcomes and five healthcare workers. Thematic analysis was conducted using Nvivo version 12. Five main themes that emerged from the study include participants' views, patients' access to information, practices, and perceived benefits of preconception care. The healthcare workers were well acquainted with the preconception care concept, but the women had inconsistent acquaintance. Both groups acknowledge the role preconception care can play in the reduction of maternal and child mortality. A recommendation is made for the healthcare workers to use the 'One key' reproductive life plan question as an entry point for the provision of preconception care.


Infantile hepatic hemangioendothelioma in comparison with hepatoblastoma in children: clinical and ultrasound features.
Infantile hepatic hemangioendothelioma (IHH) and hepatoblastoma (HBL) are respectively the most common benign and malignant liver tumors in children. To study the clinical manifestations and the ultrasound features of the pediatric patients for distinguishing IHH from HBL. Between 2002 and 2012, thirteen children with IHH and 38 children with HBL under the age of 10 years were included. We retrospectively reviewed the clinical and the ultrasound features of the two groups, especially including parameters as follows: age at diagnosis, gender, alpha-fetoprotein (AFP) elevation, venous involvement and Doppler ultrasound. Compared with HBL group, the age of IHH group was much younger (5.8 months vs. 35.1 months, P = 0.000), the AFP elevation was less likely to be detected in IHH group (23.1% vs. 89.5%, P = 0.000). Although the color flow were the same commonly observed (61.5% vs. 52.6%, P > 0.05), the spectral Doppler showed IHH was less likely to appear as arterial flow with resistance index (RI) > 0.7(12.5% vs. 75.0%, P < 0.05), characterized by arterial flow with RI < 0.7 and/or venous flow. Combined the clinical features including age (< 6 months) and normal AFP level yielded high capability in differential diagnosis, with sensitivity, specificity and Youden index of 77% (10/13), 95% (36/38), and 0.72, respectively. When combined clinical features (age and AFP) and spectral Doppler as the diagnostic criterion for distinguishing these cases with positive color flow signals, the sensitivity, specificity, accuracy and Youden Index were 88%, 95%, 89% and 0.83, respectively. The clinical features are effective indicators for distinguishing IHH from HBL, and the spectral Doppler may be a useful adjunct parameter for differential diagnosis.


Update: dracunculiasis eradication--Ghana, 1992.
The reported incidence of dracunculiasis (i.e., Guinea worm disease) in Ghana declined substantially during 1992--the third consecutive year in which reports of known cases declined. This report summarizes 1992 surveillance data for Ghana that are being used to monitor progress toward eradication of this disease.


Skew-symmetric Random Effect Models with Application to a Preventive Cohort Study: Improving Outcomes in Low Back Pain Patients.
To investigate the respective contribution of various biologic and psychosocial factors, especially Health Related Quality of Life (HRQOL) as a main outcome, in the natural history of acute low back pain (LBP) and to evaluate the impact of this condition on HRQOL. In a prospective cohort study For 24 weeks, 150 patients were assessed at an outpatient clinic in Korea consulting for low back and confirmed disc herniation duration at inclusion and treated with treatment package comprised of herbal medicines, acupuncture, bee venom acupuncture, and a Korean version of spinal manipulation (Chuna). Study participants were evaluated at baseline and every 4 weeks for 24 weeks. Low back intensity levels were measured on a visual analog scale (0-10), back function was evaluated with the Oswestry Disability Index (0-100), disability assessed by HRQOL assessed by the short form 36 health survey (0-100 in 8 different sub-categories). Out of 150 patients, 128 completed the 24 weeks of traditional therapy. Patients reported improvements SF-36 outcome measures. At the completion of the study, low back pain scores improved by a mean of 3.3 (95% CI = 2.8 to 3.8). According to the results of our modeling, low back intensity level, back function and BMI measures had significant effects on quality of life during study. Interpreting the coefficients of modeling, the impact of the decreasing acute LBP episode on HRQOL by VAS and ODI outcomes, was high and important. This study highlights the large contribution of integrative package therapy as an effective preventive method for improving LBP patient's HRQOL.


A 10-nm Spectral Resolution Hyperspectral LiDAR System Based on an Acousto-Optic Tunable Filter.
Hyperspectral LiDAR (HSL) technology can obtain spectral and ranging information from targets by processing the recorded waveforms and measuring the time of flight (ToF). With the development of the supercontinuum laser (SCL), it is technically easier to develop an active hyperspectral LiDAR system that can simultaneously collect both spatial information and extensive spectral information from targets. Compared with traditional LiDAR technology, which can only obtain range and intensity information at the selected spectral wavelengths, HSL detection technology has demonstrated its potential and adaptability for various quantitative applications from its spectrally resolved waveforms. However, with most previous HSLs, the collected spectral information is discrete, and such information might be insufficient and restrict the further applicability of the HSLs. In this paper, a tunable HSL technology using an acousto-optic tunable filter (AOTF) as a spectroscopic device was proposed, designed, and tested to address this issue. Both the general range precision and the accuracy of the spectral measurement were evaluated. By tuning the spectroscopic device in the time dimension, the proposed AOTF-HSL could achieve backscattered echo with continuous coverage of the full spectrum of 500-1000 nm, which had the unique characteristics of a continuous spectrum in the visible and near infrared (VNIR) regions with 10 nm spectral resolution. Yellow and green leaves from four plants (aloe, dracaena, balata, and radermachera) were measured using the AOTF-HSL to assess its feasibility in agriculture application. The spectral profiles measured by a standard spectrometer (SVC© HR-1024) were used as a reference for evaluating the measurements of the AOTF-HSL. The difference between the spectral measurements collected from active and passive instruments was minor. The comparison results show that the AOTF-based consecutive and high spectral resolution HSL was effective for this application.


Organocobalt Complexes as Sources of Carbon-Centered Radicals for Organic and Polymer Chemistries.
Organocobalt(III) complexes (R-CoIII), defined as cobalt complexes featuring a carbon-cobalt bond, are largely used to produce carbon-centered radicals by homolytic cleavage of their C-Co bond under mild conditions. They are key compounds in cutting-edge developments in the fields of organic chemistry, biochemistry, medical research, radical reactions, and organometallic chemistry. This is the first Review of the use of R-CoIII in both organic and polymer chemistries. Although pioneering works in organic synthesis have largely contributed to the implementation of R-CoIII in polymer design, the two fields have evolved independently, with many breakthroughs on both sides. The main motivation of this Review is to confront both fields to stimulate cross-fertilization. It notably describes the most important synthetic pathways for R-CoIII, the influence of the ligand structure and the environment of the complex on the C-Co bond strength, the modes of formation of the radicals, and the most relevant R-CoIII-promoted radical reactions, with a focus on the main reaction mechanisms.


Neuroendocrine cell hyperplasia of infancy: diagnosis with high-resolution CT.
Neuroendocrine cell hyperplasia of infancy is a form of childhood interstitial lung disease originally reported as persistent tachypnea of infancy. Reports of small series of cases and anecdotal experience have suggested that this disorder may have a consistent CT pattern. The purpose of this study was to review the CT findings in children with neuroendocrine cell hyperplasia of infancy to determine the findings at high-resolution CT, the diagnostic accuracy of CT compared with biopsy, and interrater reliability. Images from 23 CT examinations of children with biopsy-proven neuroendocrine cell hyperplasia of infancy and six CT examinations of children with other childhood interstitial lung diseases were reviewed by two pediatric radiologists with special expertise in thoracic imaging. Identifying digital data were removed, and images were reviewed without clinical data. A CT assessment form was completed for each patient. Ground-glass opacification was the most common finding in patients with neuroendocrine cell hyperplasia of infancy. The right middle lobe and lingula were most commonly involved. Air trapping with a mosaic pattern was the second most common finding. Interrater reliability was very good with a kappa value of 0.93. The sensitivity and specificity of CT in the diagnosis of neuroendocrine cell hyperplasia of infancy were at least 78% and 100%. Neuroendocrine cell hyperplasia of infancy can have a characteristic appearance on high-resolution CT scans, the imaging findings being useful in differentiating neuroendocrine cell hyperplasia of infancy from other types of childhood interstitial lung disease. The appearance aids radiologists in suggesting a specific diagnosis but does not exclude this diagnosis; in 17-22% of cases, the readers in this study did not suggest the diagnosis of neuroendocrine cell hyperplasia of infancy when it was present.


[Antitumor effect of LPS immobilized beads].
The anticancer effects of lipopolysaccharide (LPS) have been investigated, but its strong toxicity has made it difficult to utilize. In order to induce the anticancer effect without toxicity, LPS and its components were immobilized to polystyrene beads. Spleen cells from C3H/HeN mice and SD rats were activated by contact stimulation with immobilized beads. Cytotoxicity tests were measured by 51Cr release assay. Spleen cells stimulated by beads immobilizing a portion of the components constituting LPS led to little cytotoxicity. Spleen cells stimulated by E. coli LPS immobilized beads led to strong cytotoxicity in the murine system. On the other hand, in the SD rat system, cells stimulated with Salmonella LPS immobilized beads led to more stronger cytotoxicity than that of lymphokine activated killer (LAK) cells. These activities were enhanced by culturing within 48 to 72 hours after stimulation. Activated spleen cells were injected into the tumor-bearing mice intralesionally, and suppression of tumor growth and survival elongation of the mice were recognized. Activated cells were injected intravenously into the metastatic lung tumor-bearing rats, and lung metastasis almost vanished. LPS immobilized beads exhibited antitumor effects, and it was considered LPS immobilized beads induced killer cells through cytokines and proper immobilized LPS was different according to the species of animals.


Human bone marrow mesenchymal stem cells transfected with human insulin genes can secrete insulin stably.
Beta-cell replacement therapy by pancreatic islet transplantation has become a promising treatment for type 1 diabetes. However, the limited supply of human islet tissue prevents this therapy from being widely used to treat patients with type 1 diabetes. In order to obtain insulin-secreting cells, retrovirus vector pLNCX was used to transfer the human insulin gene into human bone marrow mesenchymal stem cells (hMSCs). The hMSCs were isolated from bone marrow of healthy volunteers and were expanded in vitro. The reverse transcriptase-polymerase chain reaction (RT-PCR) was used to amplify the insulin DNA fragment from a healthy pancreas sample. The recombinant vector pLNCX-Ins was constructed by cloning the insulin DNA fragment into retrovirus vector pLNCX. After being packaged by BD RetroPack PT67 packaging cells, the virus that contained the insulin gene was used to infect hMSCs. Transcription and expression of the insulin gene in transfected hMSCs were examined by RT-PCR and immunofluorescence. The transfected hMSCs stably secreted insulin into culture media for >3 weeks. Thus, insulin gene-transfected hMSCs can secrete insulin and provide a new way to cope with the shortage of beta cells for therapy of type 1 diabetes.


Performance. Assure thing.
How can PCTs be sure they are on the right path to world class commissioning? We look at the quality assurance system developed by the Department of Health to help clinicians and managers achieve their targets.


Modulation of cis-diamminedichloroplatinum(II) accumulation and sensitivity by forskolin and 3-isobutyl-1-methylxanthine in sensitive and resistant human ovarian carcinoma cells.
We have determined the effect of forskolin, an adenyl cyclase agonist, and 3-isobutyl-1-methylxanthine (IBMX), a phosphodiesterase inhibitor, on the accumulation and cytotoxicity of cisplatin (DDP) in 2008 human ovarian carcinoma cells. In DDP-sensitive 2008 cells, forskolin and IBMX caused 2.1-fold and 2.3-fold increases, respectively, in the short-term accumulation of DDP relative to untreated cells. The inactive analogue, 1,9-dideoxyforskolin, decreased DDP accumulation. Forskolin and IBMX also increased accumulation in A2780 cells. Neither forskolin nor IBMX had any effect on DDP accumulation in DDP-resistant 2008 cells. The effects were detectable as early as 1 min and persisted at 60 min. The concentrations for half-maximal stimulation of DDP accumulation were approximately 0.2 microM for forskolin and 0.2 mM for IBMX. Forskolin caused marked increases in cAMP levels in both sensitive and resistant 2008 cells within 1 min, although there were differences in the subsequent time-courses of the response. Both 2008 cell types had identical cAMP-dependent protein kinase (PKA) activity. These results suggest that there is a target downstream of PKA that is an important participant in DDP accumulation, and that this target is defective or missing in DDP-resistant cells. Following a 1-hr exposure to drugs, forskolin and IBMX at concentrations that were by themselves completely non-toxic increased the slopes of the clonogenic survival vs. DDP concentration curves in 2008 cells 1.9-fold and 3.3-fold, respectively. In DDP-resistant 2008 cells, however, forskolin and IBMX increased the slopes only 1.2 and 2.6-fold, respectively. These effects of forskolin and IBMX on DDP cytotoxicity did not directly correlate with the effects on the 1-hr DDP accumulation which suggested that, in addition to modulating DDP accumulation, these agents increase the cytotoxicity of the intracellular platinum. The results indicate that modulation of cAMP levels can have important effects on DDP accumulation and cytotoxicity in 2008 cells and that these effects are significantly diminished in DDP-resistant cells.


Naturally occurring anti-i/I cold agglutinins may be encoded by different VH3 genes as well as the VH4.21 gene segment.
In the current study, we wished to determine if the V regions encoding the naturally occurring anti-i/I Cold Agglutinins (anti-i/I CA) differ from pathogenic anti-i/I CA that are exclusively encoded by the VH4.21 gene. After EBV transformation of B lymphocytes, we generated one anti-I secreting clone from each of two individuals; clone 4G (individual CM, PBL) and clone Sp1 (individual SC, spleen). Clone 4G expresses a VH3 gene sequence that is 92% homologous to the germline gene WHG26. Clone Sp1 also expresses a VH3 gene that is 98% homologous to the fetally rearranged M85/20P1 gene. Another clone, Sp2 (anti-i specificity), from individual SC is 98% homologous to the germline gene VH4.21. For correlation, we studied anti-i/I CA fractions purified from 15 normal sera and found no or relatively small amounts of 9G4 (VH4.21 related idiotype) reactive IgM. Five cold agglutinin fractions contained large amounts of VH3-encoded IgM (compared to pooled normal IgM) by virtue of their binding to modified protein Staph A (SPA), and absorption of three CA fractions with modified SPA specifically removed anti-i/I binding specificity entirely. Collectively, the data indicate that naturally occurring anti-i/I CA may be encoded to a large extent by non-VH4.21-related genes, and that the VH4.21 gene is not uniquely required for anti-i/I specificity.


Lung Ultrasound in Thoracic Surgery: Confirming Placement of a Pediatric Right Double-Lumen Tube.
In the recent decades, flexible bronchoscopy has replaced lung auscultation to confirm more precisely the placement of a double-lumen endotracheal tube (DLT) for thoracic surgery. However, bronchoscopes are costly and not always available. Lung ultrasound has been described in the literature as an alternative to confirm left DLT placement and lung isolation. In this case report, we describe a pediatric thoracic case in which lung ultrasound was utilized to confirm correct placement of a right-sided DLT.


Link between culture zeta potential homogeneity and Ebp in Enterococcus faecalis.
Enterococcus faecalis, a commensal of the gastrointestinal tract and an opportunistic pathogen, has the ability to adhere to surfaces and form biofilms. It has been shown earlier that only 10 to 20% of an E. faecalis OG1RF culture expresses endocarditis- and biofilm-associated pili (Ebp), which are involved in biofilm formation. Another study revealed that E. faecalis clinical isolates, as well as OG1RF, are heterogeneous with respect to their apparent zeta potential, which was also correlated with increased ability to form biofilm. The aim of this study was to demonstrate that the heterogeneity in the presence of Ebp is correlated to that in apparent zeta potential. Heterogeneous cultures of OG1RF showed two distinct subpopulations with the most (-38 mV) and least (-26 mV) negative zeta potential. Deletion of EbpR, the activator of the ebp operon, or the structural genes ebpABC resulted in homogeneous culture with the most negative zeta potential. Conversely, overexpression of EbpR or the structural genes ebpABC resulted in homogeneous culture with the least negative zeta potential. The results show that ebp operon expression in E. faecalis, as measured by using P(ebp)-gfp promoter fusion, is the cause of heterogeneity in zeta potential and that pilus production causes the cells to behave as the least negative particle in an electric field.


Concomitant frozen elephant trunk procedure and pulmonary embolectomy.
The antegrade stented (frozen) elephant trunk procedure and pulmonary embolectomy are complex cardiac surgical operations for extensive aortic and pulmonary arterial disease, respectively. We report the first known case of concomitant antegrade stented elephant trunk and pulmonary embolectomy in order to highlight pre- and intra-operative management strategies for this uncommon disease combination.


Sulfated polysaccharide, curdlan sulfate, efficiently prevents entry/fusion and restricts antibody-dependent enhancement of dengue virus infection in vitro: a possible candidate for clinical application.
Curdlan sulfate (CRDS), a sulfated 1→3-β-D glucan, previously shown to be a potent HIV entry inhibitor, is characterized in this study as a potent inhibitor of the Dengue virus (DENV). CRDS was identified by in silico blind docking studies to exhibit binding potential to the envelope (E) protein of the DENV. CRDS was shown to inhibit the DENV replication very efficiently in different cells in vitro. Minimal effective concentration of CRDS was as low as 0.1 µg/mL in LLC-MK2 cells, and toxicity was observed only at concentrations over 10 mg/mL. CRDS can also inhibit DENV-1, 3, and 4 efficiently. CRDS did not inhibit the replication of DENV subgenomic replicon. Time of addition experiments demonstrated that the compound not only inhibited viral infection at the host cell binding step, but also at an early post-attachment step of entry (membrane fusion). The direct binding of CRDS to DENV was suggested by an evident reduction in the viral titers after interaction of the virus with CRDS following an ultrafiltration device separation, as well as after virus adsorption to an alkyl CRDS-coated membrane filter. The electron microscopic features also showed that CRDS interacted directly with the viral envelope, and caused changes to the viral surface. CRDS also potently inhibited DENV infection in DC-SIGN expressing cells as well as the antibody-dependent enhancement of DENV-2 infection. Based on these data, a probable binding model of CRDS to DENV E protein was constructed by a flexible receptor and ligand docking study. The binding site of CRDS was predicted to be at the interface between domains II and III of E protein dimer, which is unique to this compound, and is apparently different from the β-OG binding site. Since CRDS has already been tested in humans without serious side effects, its clinical application can be considered.


Effective pain management: lessons from a nursing home research study.
Persistent pain affects at least half of all older adults. The negative consequences of persistent pain are numerous and include depression, anxiety, and lower overall quality of life: However, pain is often underrecognized, underreported, underassessed, and undertreated, and multiple barriers to optimal pain practices exist. Although a solid evidence base exists for optimal pain practices, little progress has been made. This article reviews a study that developed and implemented a multifaceted intervention to improve pain practices in nursing homes and then examines the implications of those study findings for the home healthcare setting.