Photochemical Production of Carbon Monoxide from Dissolved Organic Matter: Role of Lignin Methoxyarene Functional Groups.
Carbon monoxide (CO) is the second most abundant identified product of dissolved organic matter (DOM) photodegradation after CO2, but its formation mechanism remains unknown. Previous work showed that aqueous photodegradation of methoxy-substituted aromatics (ArOCH3) produces CO considerably more efficiently than aromatic carbonyls. Following on this precedent, we propose that the methoxy aromatic groups of lignin act as the C source for the photochemical formation of CO from terrestrial DOM via a two-step pathway: formal hydrolytic demethylation to methanol and methanol oxidation to CO. To test the reasonableness of this mechanism, we investigated the photochemistry of eight lignin model compounds. We first observed that initial CO production rates are positively correlated with initial substrate degradation rates only for models containing at least one ArOCH3 group, regardless of other structural features. We then confirmed that all ArOCH3-containing substrates undergo formal hydrolytic demethylation by detecting methanol and the corresponding phenolic transformation products. Finally, we showed that hydroxyl radicals, likely oxidants to initiate methanol oxidation to CO, form during irradiation of all models. This work proposes an explicit mechanism linking ubiquitous, abundant, and easily quantifiable DOM functionalities to CO photoproduction. Our results further hint that methanol may be an abundant (yet overlooked) DOM photoproduct and a likely precursor of formaldehyde, formic acid, and CO2 and that lignin photodegradation may represent a source of hydroxyl radicals.


Vertebrate Protein CTCF and its Multiple Roles in a Large-Scale Regulation of Genome Activity.
The CTCF transcription factor is an 11 zinc fingers multifunctional protein that uses different zinc finger combinations to recognize and bind different sites within DNA. CTCF is thought to participate in various gene regulatory networks including transcription activation and repression, formation of independently functioning chromatin domains and regulation of imprinting. Sequencing of human and other genomes opened up a possibility to ascertain the genomic distribution of CTCF binding sites and to identify CTCF-dependent cis-regulatory elements, including insulators. In the review, we summarized recent data on genomic distribution of CTCF binding sites in the human and other genomes within a framework of the loop domain hypothesis of large-scale regulation of the genome activity. We also tried to formulate possible lines of studies on a variety of CTCF functions which probably depend on its ability to specifically bind DNA, interact with other proteins and form di- and multimers. These three fundamental properties allow CTCF to serve as a transcription factor, an insulator and a constitutive dispersed genome-wide demarcation tool able to recruit various factors that emerge in response to diverse external and internal signals, and thus to exert its signal-specific function(s).


Human brain short chain L-3-hydroxyacyl coenzyme A dehydrogenase is a single-domain multifunctional enzyme. Characterization of a novel 17beta-hydroxysteroid dehydrogenase.
Human brain short chain L-3-hydroxyacyl-CoA dehydrogenase (SCHAD) was found to catalyze the oxidation of 17beta-estradiol and dihydroandrosterone as well as alcohols. Mitochondria have been demonstrated to be the proper location of this NAD+-dependent dehydrogenase in cells, although its primary structure is identical to an amyloid beta-peptide binding protein reportedly associated with the endoplasmic reticulum (ERAB). This fatty acid beta-oxidation enzyme was identified as a novel 17beta-hydroxysteroid dehydrogenase responsible for the inactivation of sex steroid hormones. The catalytic rate constant of the purified enzyme was estimated to be 0.66 min-1 with apparent Km values of 43 and 50 microM for 17beta-estradiol and NAD+, respectively. The catalytic efficiency of this enzyme for the oxidation of 17beta-estradiol was comparable with that of peroxisomal 17beta-hydroxysteroid dehydrogenase type 4. As a result, the human SCHAD gene product, a single-domain multifunctional enzyme, appears to function in two different pathways of lipid metabolism. Because the catalytic functions of human brain short chain L-3-hydroxyacyl-CoA dehydrogenase could weaken the protective effects of estrogen and generate aldehydes in neurons, it is proposed that a high concentration of this enzyme in brain is a potential risk factor for Alzheimer's disease.


Dynamics and configurational fluctuations of single DNA molecules in linear mixed flows.
We examine the dynamics of DNA molecules in mixed flows where the ratio of vorticity to strain rate may be slightly above or below unity via Brownian dynamics simulation. We find that the chain dynamics in these flows are dramatically different than those found for simple shear flow. When the strain rate exceeds vorticity, the dynamics are found to be driven by the extra amount of straining. For vorticity-dominated flows, a periodicity in chain extension is observed with considerable chain deformation.


Vindesine in the treatment of leukaemia.
Despite lack of cross-resistance with vincristine and a somewhat different toxicity spectrum, the semi-synthetic vinca alkaloid, vindesine, has not yet achieved its expected potential in the treatment of acute leukaemias. The ability of vindesine to induce remissions in vincristine-resistant and relapsed ALL is of particular interest for the development of potentially curative second-line regimens. Vindesine may also have a role in consolidation strategies for de novo ALL, although it will be difficult to demonstrate specific advantages for this agent as part of a multidrug treatment approach. In myeloid leukaemias, while vindesine appears to have a limited role in ANLL, it may be useful for the palliative treatment of CML blast crisis. In the future, new synergistic combinations, incorporating vindesine with for example, methotrexate or edatrexate, may be developed.


Production of slow-released nitrogen fertilizer from urine.
Human excreta, especially urine is rich in nitrogen that can be utilized for agricultural purposes, while the slow-release fertilizer allows effective utilization of nutrients in agricultural production. The direct formation of slow-release fertilizer--methylene urea--from urine was being proposed in this study. The experiments were tried to prove formation of methylene urea from human urine, and to investigate the effect of pH and salt concentration on the reaction rate. The synthetic urine and real urine were used for the urea source of the reaction. As a result, the precipitates were prepared from synthetic urine, while the small molecule fractions generated then they grew into precipitate. The nuclear magnetic resonance, infrared spectroscopy, element analyses showed the precipitates in synthetic urine were the same compound found in the urea solution, which was methylene urea. The reaction rate was high at low pH value. The reaction rate in the buffer solution was lower than the synthetic urine at the same pH, because some salts may work as a catalyst. The urea concentration reduction rate in real urine showed the same trend with synthetic urine at the same pH, while the precipitation was quite similar to methylene urea.


[A case of p-ANCA positive necrotizing vasculitis associated with Graves' disease].
A 22-year-old female who had been suffering from Graves' disease developed p-ANCA positive necrotizing vasculitis. Her Graves' disease has been treated with propylthiouracil (PTI) for 6 years, which failed to improve serum TSH. She developed transient and recurrent polyarthralgia 4 years before. Because of microscopic hematuria and polyarthralgia, She visited our hospital last year. She had hypergammaglobulinemia and microhematuria at that time. But no autoantibody was noted except anti-microsomal antibody at that time. Skin biopsy from her finger subdermal nodule revealed necrotizing vasculitis of small vessels. Serum p-ANCA was positive. She was admitted under the diagnosis of p-ANCA positive necrotizing vasculitis. Renal biopsy revealed mesangium proliferative glomerulonephritis. Since she developed telescoped sediments after admission, predonisolone (PSL) 50 mg daily was started. Clinical and laboratory findings improved quite well. PSL was gradually tapered after 6 weeks. She is being maintained in good condition on tapering doses of both PSL and PTI. The coincidence of Graves' disease and vasculitis is rare. This case may provide some important immunological insights into the study of pathogenesis of necrotizing vasculitis and Graves' disease.


Type and Quantity of Shipborne Garbage at Selected Tropical Beaches.
Marine debris is widely distributed at the coastal area of the global oceans; however, shipborne garbage source studies are still lacking to document the pollution in Malaysia Territorial Water. Thus, this study has adopted a standard method of beach marine debris survey at five beaches and inspected 115 vessels to assess the type and amount of debris from shipping source stranded on the beach. This study found that vessel visiting Malaysian ports observed the MARPOL 73/78 Annex V requirements; however, identified objects from shipping activity (1.3%; 2 items/km) found on the beaches indicate that there are vessels disposing of garbage illegally at sea. Therefore, there is a need to promote the use of biodegradable material and introduce environmental education to increase awareness on the vessel.


The neurology of human immunodeficiency virus infection.
HIV-infected patients are at markedly increased risk for neurological dysfunction, which may occur at any level of the neuraxis (see Table 1). The most common syndromes--AIDS dementia complex, vacuolar myelopathy, and possibly distal symmetric peripheral neuropathy--appear to be related to HIV infection within the nervous system, rather than due to the immunoincompetence caused by HIV. However, the mechanism(s) by which HIV causes these syndromes, e.g., infecting neurons or oligodendroglia directly, interfering with neurotrophic factors, effecting toxic monokine production, etc., is unknown. Early, albeit incomplete, success with azidothymidine is encouraging. Less commonly, neurological syndromes may be secondary to the immunoincompetence produced by HIV. Many different etiologies--most of which are treatable--have been encountered, but a few of these (cerebral toxoplasmosis, cryptococcal meningitis, primary CNS lymphoma, and progressive multifocal leukoencephalopathy) are responsible for most of the opportunistic complications. Marked differences in symptoms and signs between AIDS patients and immunologically normal patients may complicate recognition of some of these diseases (e.g., herpes simplex encephalitis). Finally, some HIV-associated syndromes, e.g., inflammatory demyelinating polyradiculoneuropathy and retinal microvasculopathy, are of unknown etiology.


[Development of intranasal lactocin (oxytocin) drops technology].
Pure oxytocin substance was obtained from posterior part of cattle pituitary gland by high pressure liquid chromatography. Biological activity of the substance--450-500 IU/mg. Chromatographically pure Oxytocin substance was used in developing two different compositions of Lactocin intranasal drops (40 IU/ml). Stability evaluation was performed for 2 year period. The technical documentation was prepared on the basis of the research results. Lactocin is active preparation helping lactation and is indicated for lactostasis treatment and its prophylaxis after delivery.


[Analysis of maternal mortality in the municipality of Ribeirao Preto -- SP-- in 1991-1995].
This study aims at learning about and identifying the causes leading to maternal death. Data were obtained from the Ribeirão Preto Committee for Studies and Prevention of Maternal Death and from obituaries. It is an exploratory study in which 72 maternal deaths occurring in Ribeirão Preto were analyzed from 1991 to 1995. In 1995, the maternal death rate was 60.3 in 100,000 births, with the predominance of avoidable causes, such as hemorrhage (33.3%), other causes (26.4%), hypertension (15.3%), abortion (11.1%), infection (8.3%) and puerperium (5.6%). Maternal death is a public health problem which must be faced by government authorities.


Impact of Pre-Transplantation Psychological Counseling in Improving the Mental Well-Being of Patients on Hemodialysis.
Background: Patients who are on hemodialysis (HD) and are waiting for kidney transplantation encounter various psychological issues. Objective: The current research aimed to compare the effectiveness of regular nursing care with that of nursing care coupled with dedicated psychological counseling in patients who were on HD before they underwent kidney transplantation. Methods: Baseline data were collected 1 month before kidney transplantation in patients of both the control (patients who received general nursing care between August 2011 and June 2015) and intervention (patients who received nursing care and psychological counseling between June 2015 and July 2018) groups. The Mental Status Scale in Non-Psychiatric Settings (MSSNS) was administered to assess and record the psychological status. Clinicodemographic and end-stage renal disease (ESRD)-related details, including duration of dialysis, causes for ESRD, the number of dialysis sessions performed before transplantation, and MSSNS scores, were recorded and compared between the groups. Results: A total of 37 patients were enrolled, including 19 in the control group and 18 in the intervention group. The number of dialysis sessions performed before transplantation was 143 (26, 564) and 227.5 (39, 767), and dialysis duration was 20.4 ± 14.5 and 14.4 ± 12.1 months in the intervention and control groups, respectively. There was no significant difference in baseline negative emotions between the two groups (P > 0.05). The psychological intervention group reported significantly lower anxiety, depression, anger, and loneliness scores than the control group (P < 0.05). Conclusion: Psychological counseling before kidney transplantation in patients on HD could reduce their negative emotions and enhance mental well-being.


Performance of laboratory diagnostics for the detection of influenza A(H1N1)v virus as correlated with the time after symptom onset and viral load.
To diagnose influenza A(H1N1)v virus infection, accurate and rapid detection are important. However, there is scanty data on the performance of various laboratory diagnostics. To compare the performance of rapid antigen test (RAT), viral culture and RT-PCR for the detection of influenza A(H1N1)v virus and to correlate their performance with the time after symptom onset and viral load. From May 1, 2009 to June 25, 2009, respiratory samples were collected from 5740 individuals suspected of having influenza A(H1N1)v infection. The performance of viral culture and RT-PCR were investigated and correlated with the time after symptom onset. The sensitivity of RAT ESPLINE influenza A & B-N (Fujirebio Inc, Tokyo) was evaluated using a subset of 60 samples from patients diagnosed as having influenza A(H1N1)v infection. Using respiratory samples from 587 patients diagnosed with influenza A(H1N1)v infection, comparison of laboratory diagnostics showed viral culture and RT-PCR gave comparable results with overall sensitivity of 93.9% and 98.1%, respectively. For RAT, when testing a subset of 60 samples collected < or =3 days following symptom onset, the sensitivity was 62%. Although viral shedding is prolonged and of higher titre in influenza A(H1N1)v infection, RAT showed a low sensitivity of 62% among patients presenting < or =3 days after symptom onset. Viral culture showed comparable performance with RT-PCR and with sensitivity better than that documented for seasonal influenza.


ACOG committee opinion number 305, November 2004. Influenza vaccination and treatment during pregnancy.
Influenza vaccination is an essential element of prenatal care. The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice supports the Centers for Disease Control and Prevention's expanded recommendation that women who will be pregnant during the influenza season (October through mid May) should be vaccinated. The ideal time to administer the vaccine is October and November; however, it is appropriate to vaccinate patients throughout the influenza season as long as the vaccine supply lasts. This intramuscular inactivated vaccine may be used in all 3 trimesters. Because of the unknown effects of influenza antiviral drugs on pregnant women and their fetuses, the Committee on Obstetric Practice recommends that these antiviral agents should be used during pregnancy only if the potential benefits justify the potential risks.


Early intravenous ibuprofen decreases narcotic requirement and length of stay after traumatic rib fracture.
Pain control after traumatic rib fracture is essential to avoid respiratory complications and prolonged hospitalization. Narcotics are commonly used, but adjunctive medications such as nonsteroidal anti-inflammatory drugs may be beneficial. Twenty-one patients with traumatic rib fractures treated with both narcotics and intravenous ibuprofen (IVIb) (Treatment) were retrospectively compared with 21 age- and rib fracture-matched patients who received narcotics alone (Control). Pain medication requirements over the first 7 hospital days were evaluated. Mean daily IVIb dose was 2070 ± 880 mg. Daily intravenous morphine-equivalent requirement was 19 ± 16 vs 32 ± 24 mg (P < 0.0001). Daily narcotic requirement was significantly decreased in the Treatment group on Days 3 through 7 (P < 0.05). Total weekly narcotic requirement was significantly less among Treatment patients (P = 0.004). Highest and lowest daily pain scores were lower in the Treatment group (P < 0.05). Hospital length of stay was 4.4 ± 3.4 versus 5.4 ± 2.9 days (P = 0.32). There were no significant complications associated with IVIb therapy. Early IVIb therapy in patients with traumatic rib fractures significantly decreases narcotic requirement and results in clinically significant decreases in hospital length of stay. IVIb therapy should be initiated in patients with traumatic rib fractures to improve patient comfort and reduce narcotic requirement.


Structural Characteristics of Glycocins: Unraveling the Role of S-Linked Carbohydrates and Other Structural Elements.
Glycocins are antimicrobial peptides with glycosylations, often an S-linked monosaccharide. Their recent structure elucidation has brought forth questions about their mechanisms of action as well as the impact of S-glycosylation on their structural behavior. Here, we investigated structural characteristics of glycocins using a computational approach. Depending on the peptide's class (sublancin- or glycocin F-like), the sugar changes the peptide's flexibility. Also, the presence of glycosylation is necessary for the lack of structure of Asm1. The C-terminal tail in glycocin F-like peptides influenced their structured regions, acting like a regulator. These findings corroborate the versatility of these post-translational modifications, pointing toward their potential use in molecular engineering.


Anti-cyclic citrullinated peptide antibody-positive rheumatoid arthritis caused by bacterial organizing pneumonia in a patient with Sjogren's syndrome.
A 58-year-old woman with a history of Sjogren's syndrome was admitted to our hospital with cough, decreased right lung breath sounds and arthralgia in both thumbs. Chest computed tomography showed consolidation with air bronchogram in the right lung. Levels of anti-cyclic citrullinated peptide antibody and rheumatoid factor levels were significantly elevated. She was diagnosed with rheumatoid arthritis induced by bacterial organizing pneumonia. Treatment with salazosulfapyridine was added for rheumatoid arthritis and arthralgia gradually improved. This case highlights that respiratory infections could lead to anti-cyclic citrullinated peptide antibody-positive rheumatoid arthritis in patients with Sjogren's syndrome.


The potential use of intrauterine insemination as a basic option for infertility: a review for technology-limited medical settings.
Objective. There is an asymmetric allocation of technology and other resources for infertility services. Intrauterine insemination (IUI) is a process of placing washed spermatozoa transcervically into the uterine cavity for treatment of infertility. This is a review of literature for the potential use of IUI as a basic infertility treatment in technology-limited settings. Study design. Review of articles on treatment of infertility using IUI. Results. Aspects regarding the use of IUI are reviewed, including ovarian stimulation, semen parameters associated with good outcomes, methods of sperm preparation, timing of IUI, and number of inseminations. Implications of the finding in light of the needs of low-technology medical settings are summarized. Conclusion. The reviewed evidence suggests that IUI is less expensive, less invasive, and comparably effective for selected patients as a first-line treatment for couples with unexplained or male factor infertility. Those couples may be offered three to six IUI cycles in technology-limited settings.


An advanced cone-and-plate reactor for the in vitro-application of shear stress on adherent cells.
Endothelial cells (ECs) are permanently exposed to the blood flow and the resulting shear stress, its magnitude varying with the EC site in the blood stream. Along with other mechanical stimuli like vessel wall stretching or hydrostatic blood pressure, this shear stress modulates the endothelial cell function, morphology and gene expression. Here, we describe our improved cone-and-plate reactor that applies up to 10 dyn/cm(2) uniform wall shear stress on a defined, ring-shaped region on a culture dish. At the same time, a hydrostatic pressure of up to 195 mmHg can be applied by increasing the atmospheric pressure in the incubator box. Gas composition can be controlled additionally, used for maintaining CO2-homeostasis or inducing hypoxic conditions. For better comparability, six cone-and-plate systems can be used at the same time at different rotational velocities. The effects on cell morphology, cytoskeleton and cell alignment can be monitored during application using a laser scanning microscope. Flow conditions have been studied and a sufficient area of uniform wall shear stress could be shown. To exceed 10 dyn/cm2, we suggest an increase in medium viscosity.


The mediating role of compassion in the relationship between COVID-19 anxiety syndrome and COVID-19 burnout.
The coronavirus has caused fundamental changes in our way of life, leading to a wave of psychological distress associated with the COVID-19 epidemic, including stress, anxiety, perceived threats, and fear. Considering the psychological consequences of COVID-19, the present study was conducted with the aim of mediating the role of compassion in the relationship between COVID-19 anxiety syndrome and COVID-19 burnout. The design of the present study was descriptive correlation. The present study population included all students of Ahvaz Jundishapur University of Medical Sciences in the academic year 2020. Two hundred and fifty-one students were selected and completed the COVID-19 Anxiety Syndrome Questionnaire, Compassion Scale, and COVID-19 Burnout Scale. Pearson correlation coefficient test and structural equation model were performed using SPSS version 18 and LISREL 8.8. The results showed that COVID-19 burnout had a positive and significant relationship with the overall score of anxiety syndrome (r = 0.42, P = 0.01), while it has a negative and significant relationship with compassion (r = -0.37, P = 0.01). Compassion also has a significant negative relationship with anxiety syndrome (r = -0.35, P = 0.01). In addition, the results of path analysis showed that compassion plays a mediating role in the relationship between COVID-19 anxiety syndrome and COVID-19 burnout. Based on the findings of the present study, it can be said that compassion acts as a protective factor against the negative effects of anxiety syndrome. Therefore, this factor can be considered in the development of prevention and treatment programs for burnout caused by COVID-19.


[Quality of life and working status in patients with coronary artery disease treated by percutaneous coronary angioplasty during long-term observation].
Improvement in the quality of life is nowadays widely acknowledged as an important factor in assessment of the long-term outcome of the actually pursued treatment. Percutaneous transluminal coronary angioplasty (PTCA) has been used in the treatment of coronary disease in ca. 1/3 of patients. The present study aimed to assess the quality of life in 567 patients successfully treated by PTCA in the period 1987-1996. In the observation period spanning 2.5-12 years (5.5 years on average) 26 patients (4.6%) died. A specially designed questionnaire was sent out to the remaining 541 patients, in which they were asked to attempt a subjective assessment of their general health condition and physical fitness, as well as to comment on the quality of their family and social life following angioplasty. The filled-in questionnaire was returned by 447 patients (82.6%). Their functional status, assessed in compliance with the CCS criteria, was perceptibly improved after the procedure and at the end of the observation period 70.5% of patients had no significant coronary complaints. A durable improvement after PTCA was claimed by 85.7% of patients, for 38.2% the result of PTCA turned out to be much better than originally expected, while 47.9% admitted that the procedure actually complied with their expectations. No improvement whatsoever was reported by 11.8%, while 2.3% of patients claimed their condition to have deteriorated since. In their own assessment, normal sexual life after PTCA was still pursued by 63.1% of patients, though men appeared to be more active in that domain than women (68.0% vs. 44.7%, p = 0.0001). Notable improvement was reported by 15.2%, while deterioration was claimed by 17.2%; in both cases it was significantly more frequent in men (improvement 17.0% vs 8.5%, p = 0.042, deterioration 19.5% vs 8.5%, p = 0.012). Angioplasty had no impact on their social relations in 78.8% of patients, while 21.2% of them are commonly perceived as the disabled persons. The need for psychotherapy (counselling) was expressed by 15.9%. The analysis of the key factors determining the actual quality of life in patients, carried out in the sub-groups, did not yield significant differences between the patients with stable and unstable angina, patients below and over 50 years of age, patients with complete and incomplete revascularisation, nor in patients who experienced or not, cardiac events during the follow-up. The significant differences between men and women were encountered only with respect to their sexual life. Diabetics in comparison with non-diabetics significantly more frequently reported improvement in their sexual life, full resumption of their non-occupational activities, generally showed more appreciation for the overall outcome of the PTCA procedure. Diabetics much less frequently experienced improvement in their general physical fitness, generally regarded the need for regular medical check-ups as a hindrance, as well as were more frequently perceived as the disabled persons. The working status of the patients after angioplasty failed to improve, however, as nearly half of them, despite the successfully completed procedure, was granted disability pensions or took advantage of the voluntary retirement schemes. Only 7.2% of the non-working patients well within their statutory employment age successfully returned to their employment, although not on a full-time basis. Patients who had completed their primary or secondary education were found to leave their employment twice more frequently than the ones with academic education. Similarly, patients living in the rural areas or in small towns (less than 40.000 inhabitants) left their employment twice more frequently than the ones living in major cities. Both the functional status of patients and the majority of the analysed factors determining the quality of life--in the subjective assessment of those patients--improved significantly after a successful PTCA. This improvement is irrespective of the patients' age, symptoms of unstable angina during the procedure, extensiveness of revascularisation as well as cardiac events during the follow-up. Nearly half of the working patients tend to leave their employment after a successful percutaneous revascularisation, while the non-working patients are seldom prompted to resume their employment by the successful procedure. Patients with academic education, living in major cities, are usually found to resume their original employment most frequently.


[Effects of allopurinol for oxidative injury of cisplatin-induced nephrotoxicity in mice].
The effects of allopurinol (Allop) on the lipid peroxidation in the nephrotoxicity of an antitumor drug, cisplatin (CDDP) were studied in mice. CDDP was administered intraperitoneally to two groups (CDDP + Allop group and CDDP + CMC-Na group) at single doses of 10 mg/kg, and mice were sacrificed 3 days after CDDP administration. The body weights of the CDDP-administered group gradually decreased to approximately 78% of the values of the control group (saline + Allop group and saline + CMC-Na group) within 3 days. Plasma urea nitrogen and creatinine, especially in the CDDP + Allop group, increased after 3 days. Lipid peroxides in the blood and kidney were monitored by measuring the production of malondialdehyde (MDA), which increased in the CDDP + CMC-Na group. On the other hand, MDA levels in the CDDP + Allop group increased in the kidney but remained unchanged in the blood. Changes were observed in tissue glutathione (reduced form, GSH; oxidized form, GSSG) levels in the CDDP + Allop group but not in the CDDP + CMC-Na group. Histomorphological examination demonstrated the degeneration of the proximal tubuli in the CDDP-administered groups. Especially in the CDDP + Allop group, the increase of mesangium cells in the glomeruli was observed. From these results, it was suggested that Allop was not able to inhibit CDDP-induced lipid peroxidation in the kidney, and the kidney function became more severely impaired by the administration of Allop.


Patterns of lymphokine production by primary antigen-specific/MHC restricted murine helper T cell clones.
In this study we examined a panel of CD4+ antigen specific/MHC restricted T cell clones for their ability to secrete IL-2, IL-4, and IFN-gamma upon stimulation with con A, three lymphokines which are diagnostic for the TH1 and TH2 subtypes of helper T cells. Eight of the twelve clones we analyzed did not fit the classical TH1/TH2 patterns of lymphokine secretion. Seven of these clones secreted both IL-2 and IL-4 and two of these also produced IFN-gamma. The remaining non-classical clone secreted IL-4 and IFN-gamma but not IL-2. Data from the subcloning of the IL-2/IL-4/IFN-gamma triple producers were not consistent with the parental lines being a mixture of TH1 and TH2 cells. The IL-2/IL-4 double producers (IFN-gamma negative) cannot be explained by the parental lines being a mixture of the TH1 and TH2 subtypes. Nevertheless, these double producers were subcloned and the results provided convincing evidence that clones which secrete both IL-2 and IL-4 do exist. Lymphokine loss variants involving IL-2, IL-4 or IFN-gamma were observed among subclones derived from the double and triple producers as well as in several parental lines maintained in continuous culture. We also observed the appearance of inducible IFN-gamma production in some subclones derived from parental clones where production of IFN-gamma was not detectable. The phenotypes of these variants failed to indicate an obvious trend toward the TH1 and TH2 subtypes. Thus, our results suggest that more heterogeneity in the population of CD4+ helper T cells exists than can be explained by the TH1 and TH2 subtypes of these cells.


Povidone-Iodine as a Pre-Procedural Mouthwash to Reduce the Salivary Viral Load of SARS-CoV-2: A Systematic Review of Randomized Controlled Trials.
The use of pre-procedural rinses has been investigated to reduce the number of viral particles and bacteria in aerosols, potentially decreasing the risk of cross-infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during medical and dental procedures. This review aims to confirm whether there is evidence in the literature describing a reduction in salivary load of SARS-CoV-2 when povidone-iodine (PVP-I) is used as a pre-intervention mouthwash. An search of the MEDLINE, Embase, SCOPUS, and the Cochrane library databases was conducted. The criteria used followed the PRISMA® Statement guidelines. Randomized controlled trials investigating the reduction of salivary load of SARS-CoV-2 using PVP-I were included. Ultimately, four articles were included that met the established criteria. According to the current evidence, PVP-I is effective against SARS-CoV-2 in saliva and could be implemented as a rinse before interventions to decrease the risk of cross-infection in healthcare settings.


Sudden cardiac death, implanted defibrillation, and clinical electrophysiology.
A mere 25 years ago, the technique of external defibrillation became the starting point for the development of clinical electrophysiology by permitting routine use of endocavitary programmed electrical stimulation of the heart without undue risk. Major advances in knowledge of clinical arrhythmias and the understanding of their mechanisms were, thus, permitted. Mirowski's implanted defibrillator also constituted a major breakthrough therapeutically; unfortunately, however, some 10 years later, it has not yet induced similarly hoped for consequences in terms of progressing knowledge concerning lethal arrhythmias, largely due to the absence of Holter functions in the implanted devices. As a result of this, in our opinion, better established therapeutic indications are still needed. The reasons for the present situation, we believe, may be partly technical but are conceptual as well. The key point is that even the clear demonstration of the great practical efficacy of a therapeutic tool does not exempt us from the obligation of determining the mechanisms of this effect.


Does thrombin activatable fibrinolysis inhibitor (TAFI) contribute to impairment of fibrinolysis in patients with preeclampsia and/or intrauterine fetal growth retardation?
Thrombin Activatable Fibrinolysis Inhibitor (TAFI) is a relatively recently described glycoprotein (MM 55 KDa) that can be converted into its active form by the thrombin/thrombomodulin complex and potentially inhibits fibrinolysis. Since it represents a link between coagulation and fibrinolysis, TAFI can be expected to play a part in various clinical conditions associated with a thrombotic tendency. Preeclampsia (PE) and intrauterine fetal growth retardation (IUFGR) are fairly common complications of pregnancy that are characterized by hemostatic abnormalities. TAFI antigen and its influence on hemostasis was investigated in 46 women with PE and/or IUFGR and in 16 normal pregnancies. We found a significant decrease of TAFI antigen in the patient group. Using the recently described method Overall Hemostatic Potential (OHP) in plasma we measured clot lysis time (CLT) and overall fibrinolytic potential (OFP). We found that CLT is prolonged and OFP decreased in patients with PE and/or IUFGR. Since OFP did not increase after addition of the specific inhibitor of TAFI (potato tuber carboxypeptidase inhibitor), it seems that TAFI does not contribute to the impairment of fibrinolysis in these patients. Since serum albumin was decreased together with presence of proteinuria and aminotransferases were increased in the patients, it seems that one explanation for the decrease in TAFI could be reduced hepatic synthesis and an increased loss in urine. It an be speculated that this mechanism can prevent more serious thrombotic complications in patients with PE and/or IUFGR.


Effect of HM30181 mesylate salt-loaded microcapsules on the oral absorption of paclitaxel as a novel P-glycoprotein inhibitor.
The purpose of this study was to develop HM30181 mesylate salt (HM30181M)-loaded microcapsules as a novel P-glycoprotein inhibitor for enhancing the oral absorption of paclitaxel. The effect of various carriers including hydrophilic polymers and solvents on the solubility of HM30181M were evaluated. Among the hydrophilic polymers and solvents tested, HPMC and methylene chloride (and ethanol) provided the highest HM30181M solubility. Numerous HM30181M-loaded microcapsules were prepared with HPMC, silicon dioxide and acidifying agents using a spray-drying technique, and their solubility, dissolution and physicochemical properties were evaluated. Furthermore, a pharmacokinetic study was performed after oral administration of paclitaxel alone, simultaneously with HM30181M powder or HM30181M-loaded microcapsules to rats. Among the acidifying agents investigated, phosphoric acid provided the best improvement in the solubility and dissolution of HM30181M. Moreover, the microcapsule composed of HM30181M, HPMC, silicon dioxide and phosphoric acid at a weight ratio of 3:6:3:2 remarkably enhanced the solubility and dissolution of HM30181M compared with the HM30181M powder alone. The microcapsules were spherical in shape, had a reduced particle size of about 7μm, and contained HM30181M in an amorphous state. Furthermore, this microcapsule significantly enhanced HM30181M absorption, making it about 1.7-fold faster and 1.6-fold greater after simultaneous administration, leading to about 70- and 2-fold improved oral bioavailability of paclitaxel compared with paclitaxel alone and the simultaneous administration with HM30181M powder, respectively. Thus, this novel microcapsule could be a potential candidate for effective P-glycoprotein inhibition during oral administration of paclitaxel.


Dysregulated expression of cyclin D1 in normal human mammary epithelial cells inhibits all-trans-retinoic acid-mediated G0/G1-phase arrest and differentiation in vitro.
Overexpression of cyclin D1 protein is observed in the majority of breast cancers, suggesting that dysregulated expression of cyclin D1 might be a critical event in breast cancer carcinogenesis. We investigated whether retroviral-mediated expression of cyclin D1 might affect all-trans-retinoic acid (ATRA)-mediated growth inhibition and differentiation of normal cultured human mammary epithelial cells (HMECs). HMECs treated with 1.0 microM ATRA undergo irreversible growth inhibition starting at 24 h and complete G0/G1-phase arrest by Day 3. Cyclin D1 protein levels are observed to decrease in association with the initiation of growth arrest starting at 24 h and then increase by approximately 35% on Day 3. Concomitant with this observed increase in cyclin D1, HMECs undergo morphologic changes consistent with progression to a more differentiated phenotype, including an increase in cell size, increased cell spreading, increased tonofilaments, and accumulation of cytoplasmic vesicles containing lipid. Dysregulated expression of cyclin D1 in HMECs results in inhibition of G0/G1-phase arrest mediated by ATRA. In addition, HMECs expressing exogenous cyclin D1 are resistant to differentiation by ATRA. Our results suggest that coordinated expression of cyclin D1 may be critical for normal mammary epithelial cell homeostasis, and dysregulated expression of cyclin D1 might result in retinoid resistance and promote mammary carcinogenesis.


Global transcriptome analysis reveals extensive gene remodeling, alternative splicing and differential transcription profiles in non-seed vascular plant Selaginella moellendorffii.
Selaginella moellendorffii, a lycophyte, is a model plant to study the early evolution and development of vascular plants. As the first and only sequenced lycophyte to date, the genome of S. moellendorffii revealed many conserved genes and pathways, as well as specialized genes different from flowering plants. Despite the progress made, little is known about long noncoding RNAs (lncRNA) and the alternative splicing (AS) of coding genes in S. moellendorffii. Its coding gene models have not been fully validated with transcriptome data. Furthermore, it remains important to understand whether the regulatory mechanisms similar to flowering plants are used, and how they operate in a non-seed primitive vascular plant. RNA-sequencing (RNA-seq) was performed for three S. moellendorffii tissues, root, stem, and leaf, by constructing strand-specific RNA-seq libraries from RNA purified using RiboMinus isolation protocol. A total of 176 million reads (44 Gbp) were obtained from three tissue types, and were mapped to S. moellendorffii genome. By comparing with 22,285 existing gene models of S. moellendorffii, we identified 7930 high-confidence novel coding genes (a 35.6% increase), and for the first time reported 4422 lncRNAs in a lycophyte. Further, we refined 2461 (11.0%) of existing gene models, and identified 11,030 AS events (for 5957 coding genes) revealed for the first time for lycophytes. Tissue-specific gene expression with functional implication was analyzed, and 1031, 554, and 269 coding genes, and 174, 39, and 17 lncRNAs were identified in root, stem, and leaf tissues, respectively. The expression of critical genes for vascular development stages, i.e. formation of provascular cells, xylem specification and differentiation, and phloem specification and differentiation, was compared in S. moellendorffii tissues, indicating a less complex regulatory mechanism in lycophytes than in flowering plants. The results were further strengthened by the evolutionary trend of seven transcription factor families related to vascular development, which was observed among four representative species of seed and non-seed vascular plants, and nonvascular land and aquatic plants. The deep RNA-seq study of S. moellendorffii discovered extensive new gene contents, including novel coding genes, lncRNAs, AS events, and refined gene models. Compared to flowering vascular plants, S. moellendorffii displayed a less complexity in both gene structure, alternative splicing, and regulatory elements of vascular development. The study offered important insight into the evolution of vascular plants, and the regulation mechanism of vascular development in a non-seed plant.


Sigmoid volvulus in 16-year-old boy with an associated anomalous congenital band.
Sigmoid volvulus, a condition generally seen in debilitated elderly patients, is extremely rare in the pediatric age group. Frequent predisposing conditions that accompany pediatric sigmoid volvulus include intestinal malrotation, omphalomesenteric abnormalities, Hirschsprung's disease, imperforate anus and chronic constipation. A 16-year-old previously healthy African American male presented with a 12 hour history of sudden onset abdominal pain and intractable vomiting. CT was consistent with sigmoid volvulus. A contrast enema did not reduce the volvulus, but it was colonoscopically reduced. Patient condition initially improved after colonoscopy, but he again became distended with abdominal pain, so he was taken to the operating room. On exploratory laparotomy, a band was discovered where the mesenteries of the sigmoid and small bowel adhered and created a narrow fixation point around which the sigmoid twisted. A sigmoidectomy with primary anastomosis was performed. The diagnosis of sigmoid volvulus may be more difficult in children, with barium enema being the most consistently helpful. Seventy percent of cases do not involve an associated congenital problem, suggesting that some pediatric patients may have congenital redundancy of the sigmoid colon and elongation of its mesentery. The congenital band found in our patient was another potential anatomic factor that led to sigmoid volvulus. Pediatric surgeons, accustomed to unusual problems in children, may thus encounter a condition generally found in the debilitated elderly patient.


Low Ca2+ concentration doping enhances the mechanical properties and ionic conductivity of Na3PS4 superionic conductors based on first-principles.
The mechanical strength and ionic conductivity of sulfide solid electrolytes have received widespread attention for their application in solid sodium batteries. Herein, first-principles calculations are used to determine the properties, including the electronic, mechanical and ionic transport properties, of Na3PS4 sulfide solid electrolytes doped with low and high Ca ion concentrations. Our theoretical results demonstrate that low Ca ion concentrations can be easily doped in tetragonal and cubic phases (t-Na3PS4 and c-Na3PS4) and create a suitable number of Na vacancies based on the formation energy analysis. Furthermore, the calculated density of states and charge density differences indicate that the surrounding electronic environment is changed, and Ca-S ionic bonds are formed in Na3PS4 with Ca-doping. In addition, the improved ductility and mechanical strength of c-Na3PS4 and t-Na3PS4 achieved by low-concentration Ca doping may help suppress dendritic growth and electrode deformation. Finally, sodium ion migration in Ca-doped Na3PS4 is described with the aid of the CI-NEB method, and it is found that the migration energy barriers are less than those of pure Na3PS4, which suggests that the sodium ion conductivity can be effectively improved by doping with low Ca2+ concentrations. The present work improves the understanding of the influence of doping on the performance of solid electrolytes and provides a feasible framework for the future design of high-performance solid electrodes.


Prognostic factors in advanced prostatic carcinoma treated with total androgen blockade. Flutamide with orchiectomy or with LHRH analogues. A Belgian multicentric study of 546 patients.
Prognostic factors were evaluated in advanced loco-regional (M0) or distant metastatic (M1) prostatic carcinoma treated with total androgen blockade (flutamide with either orchiectomy of LHRH-analogues), in 546 patients from a Belgian multicentric study. After a mean follow-up of 16.5 months (maximum 37 months) 113 (21%) patients had progressed (90 were patients with M1 disease (31%)). The estimated median progression-free survival exceeded 37.5 months. The results of a univariate analysis show that the following parameters are important prognostic factors with respect to progression-free survival in these patients: M stage, G grade, ECOG performance status, weight loss, concomitant disease, pain, dysuria and haemoglobin (Lee-Desu test, p < or = 0.01). From a multivariate analysis (Cox regression) the following prognostic factors were indicative of a decrease in progression-free survival: M1 stage, high initial G grade, ECOG performance status > I, high serum PSA, presence of concomitant disease, presence of pain and absence of dysuria. Age did not appear to be a statistically significant prognostic factor.


Chemical attraction of kleptoparasitic flies to heteropteran insects caught by orb-weaving spiders.
Insects of the heteropteran families Pentatomidae (stink bugs) and Coreidae (squash bugs), when being eaten by the orb-weaving spider Nephila clavipes, attract flies of the family Milichiidae. The flies aggregate on the bugs and, as kleptoparasites, share in the spider's meal. Stink bugs and squash bugs typically eject defensive sprays when attacked; they do so when caught by Nephila, but the spray only minimally affects the spider. Evidence is presented indicating that it is the spray of the bugs that attracts milichiids to the spider's catch.


Enhancing Routine HIV Testing in Primary Care With a Continuing Education Intervention.
Since 2006, the Centers for Disease Control and Prevention (CDC) has recommended routine HIV screening in primary care settings for people ages 13 to 64, regardless of individual risk factors. However, an extensive body of research has identified several barriers to primary care providers' (PCPs) adherence to the CDC recommendations. Employing a pre-postintervention design, this study provided an assessment of barriers among 11 PCPs and implemented an evidence-based continuing education program adapted to the specific individual barriers they identified. The study found that PCPs were initially providing HIV testing using risk-based criteria but that the continuing education program increased intentions to perform routine HIV testing (e.g., during annual wellness examinations and new patient visits). Results of the study inform individual quality improvement projects and legislative or policy actions to increase HIV screening in sites providing primary care. [J Contin Educ Nurs. 2018;49(12):563-574.].


AKI and Genetics: Evolving Concepts in the Genetics of Acute Kidney Injury: Implications for Pediatric AKI.
In spite of recent advances in the field of acute kidney injury (AKI) research, morbidity and mortality remain high for AKI sufferers. The study of genetic influences in AKI pathways is an evolving field with potential for improving outcomes through the identification of risk and protective factors at the individual level that may in turn allow for the development of rational therapeutic interventions. Studies of single nucleotide polymorphisms, individual susceptibility to nephrotoxic medications, and epigenetic factors comprise a growing body of research in this area. While promising, this field is still only emerging, with a small number of studies in humans and very little data in pediatric patients.


Impact of diabetes on overall and cancer-specific mortality in colorectal cancer patients.
Diabetes is associated with increased risk of developing colorectal cancer (CRC), but its effect on overall and cancer-specific mortality in CRC patients has been little investigated. The aim of this study was to assess the influence of diabetes on overall and cancer-specific mortality in Italian CRC patients. Cases of adult (≥15 years) CRC, diagnosed in 2003-2005, most followed-up to the end of 2008, were randomly selected from the Italian Cancer Registries database. Diabetic status, sex, age, tumor stage, subsite, treatment, morphology, and grade were obtained by consultation of patient clinical records. Poisson multivariable regression models, adjusted for potential confounding variables, were used to estimate hazard ratios (HRs) for all-cause and CRC-specific mortality, according to diabetic status. A total of 1,039 CRC cases with known fasting glucose or diabetic status, archived in 7 cancer registries, was analyzed. Compared to non-diabetics, diabetics (specific diagnosis or glucose ≥126 mg/dl) were older and less likely to receive adjuvant therapy. Diabetics were at higher risk of all-cause death [HR 1.41; 95 % confidence interval (CI) 1.18-1.70] and CRC death (HR 1.36; 95 % CI 1.11-1.67), with no differences by sex or subsite. Diabetes was significantly associated with increased overall and CRC-specific mortality. Our findings indicate that diabetes is a negative prognostic factor for CRC and suggest that in patients with CRC, diabetes prevention and treatments that stabilize the condition and control its complications might reduce mortality. Further studies are required to ascertain the mechanisms linking diabetes to greater mortality in CRC patients.


Social and Political Trust in a Low Trust Society.
We study the causal relationship between social and political trust in a low trust society, a setting where this topic has received very little attention. We focus on contemporary Chile, a relatively consolidated new democracy lacking many of the conditions that fosters trust such as high socioeconomic equality, weak social divisions, or universal welfare policies. Our empirical analysis is based on a 4-wave panel survey applied to a representative sample of 2000 Chilean adults interviewed face to face each year between 2016 and 2019. Based on statistical models with varying specifications and assumptions, we find support for the institutionalist view that claims that political trust exercises a positive influence over social trust. However, contrary to recent findings for some European democracies (Sønderskov & Dinesen 2016, Seifert 2018), we also find that social trust positively affects political trust. Our results suggest that the positive relationship between both types of trust travels to different political settings, and that there is no minimum threshold required in levels of trust for this relationship to emerge.


A comparison of two U.S. surveys of infant feeding.
This study compares the 1988 National Maternal and Infant Health Survey (NMIHS) and the 1989 Ross Laboratories Mothers Survey with respect to sample characteristics and proportions of women who breastfed. Weighted proportions of women included in the two surveys were compared according to various characteristics to see how well they represented U.S. childbearing women. A z-statistic was produced to test for significant differences in the proportions who breastfed. In 1988-89, 52.2% of American women breastfed according to the Ross survey and 53.4% according to the NMIHS. Despite differences in sample size, sampling technique and the application of sample weights, the difference between the surveys was only 1 percentage point, and most levels of most variables examined were comparable. The Ross survey is a valuable source of data because it is ongoing, and it is generally corroborated by the NMIHS. The NMIHS is probably more representative of the U.S. population of childbearing women, and is a reliable source of data for setting U.S. objectives concerning infant feeding, and for the study of other issues vis-à-vis breastfeeding.


Epidemiology of Abusive Head Trauma Among Children in Saudi Arabia.
To examine abusive head trauma (AHT) trends using data obtained from hospital-based child protection centers (CPCs) and the distribution of age in months among young children in Saudi Arabia. A retrospective study was conducted that includes data obtained from 58 hospital-based CPCs in all 13 regions of Saudi Arabia registered in the National Family Safety Registry from 2010 to 2020. AHT cases (n=106) were identified for inclusion in the registry by a daily review of the emergency department logbooks. Over the 11-year period, there was a sharp increase in the number of cases, specifically after 2014, from seven cases per year in 2010 to 16 cases in 2020. AHT affects predominantly children aged 0-12 months (72.6%), followed by 13-24 months (17.9%), 25-36 months (3.8%), 37-48 months (3.8%), and 49-60 months (1.9%). Victims were characterized by a predominance of crying infants (23.6%), past history of abuse (13.2%), a child's chronic disease and disability (7.6%), and prematurity (2.8%). Different training and educational programs need to be performed to raise awareness of AHT. Enacting the pediatrician's mandatory reporting law will improve the rate of reporting cases.


Prolonged peroneal reaction time in ankle instability.
The peroneal reflex time to sudden ankle inversion and the postural control of 15 athletes with functionally instable ankles were compared with 15 stable controls. A trapdoor produced sudden ankle inversion. Surface electrodes recorded electromyographic activity of the peroneal muscles. Postural sway was expressed by a transverse sway value obtained during single limb stance on a force plate. Increased postural sway was found in subjects with functional instability (p less than 0.01). This is in accordance with previous studies. Functionally instable subjects also displayed an increased peroneal reaction time (p less than 0.01) supporting the theory that functional instability is induced by a proprioceptive reflex defect. Nine of the 15 instable subjects were unilaterally instable and showed lower peroneal reaction time and postural sway values for the stable ankle, but the difference was not significant. There was a high degree of correlation between postural sway and peroneal reaction time (Spearman's rho = .92). In ten functionally instable athletes tested with and without ankle taping, it could not be verified that a reflex enhancing effect of taping occurs through stimulation of cutaneous afferents.


Coronary stenting for ST-elevation myocardial infarction vs. other indications in patients on oral anticoagulation: any difference in in-hospital management and outcome?
The aim of this paper was to compare the in-hospital management and outcome of patients on oral anticoagulation (OAC) undergoing coronary artery stenting (PCI-S) for ST-elevation myocardial infarction (STEMI) vs. other indications. One hundred and sixteen patients on OAC at the time of PCI-S who were prospectively enrolled in a multi-center, observational registry, were evaluated. Patients were segregated according to whether PCI-S was performed for STEMI (group 1) or other indications, such as non ST-elevation acute coronary syndromes, stable angina, silent ischemia, etc. (group 2), and the pharmacological and procedural management, as well as the in-hospital outcome, were compared. No significant differences were observed in vascular access site, sheath size and type of stent implanted, nor was significantly different the use of glycoprotein IIb/IIIa inhibitors, and the use and dose of intravenous unfractionated heparin. Although not statistically different, the in-hospital occurrence of death (3.7% vs. 1.1%; OR 3.3; 95% confidence intervals [CI] 0.2-56.0), stent thrombosis (3.7% vs. 1.1%; OR 3.3; 95% CI 0.2-56.0) and major bleeding (7.4% vs. 2.2%; OR 3.4; 95% CI 0.4-25.9) was consistently about 3-fold higher in group 1. The in-hospital pharmacological and procedural management of OAC patients undergoing PCI-S for STEMI vs. other indications appears not different. Although not significantly different however, the in-hospital occurrence of major bleeding, as well as of death and stent thrombosis, appears substantially higher in patients treated for STEMI, warranting therefore further larger, prospective studies.


Novel brachytherapy drainage tube loaded with double 125I strands for hilar cholangiocarcinoma: A case report.
Hilar cholangiocarcinoma (CC) is a common malignant tumor with high malignancy and poor prognosis. Most patients have lost the opportunity to undergo radical surgery when diagnosed. Although palliative drainage or biliary stent placement is a preferable choice, the tumor cannot be controlled. This study aimed to develop a novel brachytherapy drainage tube for low-dose-rate brachytherapy with an effective drainage, thereby prolonging the survival time of patients. A 54-year-old male patient had undergone choledochal stent implantation due to obstructive jaundice. He was admitted to the hospital because of the recurrence of jaundice. Preoperative imaging and pathological biopsy revealed hilar CC (Bismuth-Corlette type IIIa). First, the patient underwent percutaneous transhepatic cholangial drainage and the symptoms of jaundice gradually relieved. To further treat hilar CC and remove the biliary drainage tube as far as possible, the patient chose to use the novel brachytherapy drainage tube after a multi-disciplinary consultation. After 1 mo of brachytherapy, the re-examination revealed that the obstructive lesions disappeared, and the drainage tube was finally removed. During the following 10 mo of follow-up, the patient's hilar CC did not recur. The novel brachytherapy drainage tube may be a new choice for patients with unresectable hilar CC.


Background adaptation in children with a history of mild retinopathy of prematurity.
In children with a history of mild retinopathy of prematurity (ROP), test the hypothesis that elevation of the parafoveal over peripheral dark-adapted threshold is due to photoreceptor rather than postreceptor dysfunction. A forced choice procedure was used to measure thresholds, for detection of 2 degrees diameter, 50 msec, blue stimuli presented 10 degrees (parafoveal) or 30 degrees (peripheral) eccentric in the dark and in the presence of steady red backgrounds (-4 to +2 log scot td). Four ROP and four control subjects were tested at both eccentricities. A model of the increment threshold function was fit to the data to calculate the eigengrau and dark-adapted threshold. Both ROP subjects with elevated parafoveal thresholds also have elevated parafoveal eigengraus. On the other hand, parafoveal and peripheral eigengraus are equal in ROP subjects without parafoveal threshold elevation. Nevertheless, the dark-adapted thresholds of all ROP subjects are higher than those of any control subject at both sites. The parafoveal threshold elevation is due to rod dysfunction. There is also evidence of peripheral rod photoreceptor involvement in the subjects with ROP.


Amino Acid Uptake into Cultivated Mesophyll Cells from Asparagus officinalis L.
The uptake of threonine, aspartic acid, and isoleucine into cultivated asparagus cells was examined under culture conditions.Transport was linear with time and with the number of cells present in the assay. The upake of the three amino acids obeyed Michaelis-Menten kinetics with apparent affinities in the range of 0.1 to 0.02 millimolar. Azide and 2,4-dinitrophenol caused inhibition of threonine uptake. Reciprocal competitive inhibitions were found between threonine, aspartic acid, and isoleucine. Methionine and lysine competitively inhibited the uptake of these three amino acids. These results and the comparison of apparent affinities and inhibition constants are in favor of only one uptake system for threonine, aspartic acid, isoleucine, methionine, and lysine with different affinities for the different amino acids. All other amino acids with the exception of histidine, arginine, asparagine, and hydroxyproline inhibited threonine uptake. It is most likely that at least one component of the uptake system is shared by all amino acids.


Where are we moving in the classification of idiopathic inflammatory myopathies?
Discoveries of myositis-specific antibodies, transcriptomic signatures, and clinicoseropathological correlation support classification of idiopathic inflammatory myopathies (IIM) into four major subgroups: dermatomyositis, immune-mediated necrotizing myopathy (IMNM), antisynthetase syndrome (ASS), and inclusion body myositis (IBM) whereas leaving polymyositis as a historical nonspecific diagnosis of exclusion. This review summarizes and comments on recent knowledge regarding the major subgroup of IIM. Type 1 interferon (IFN1) pathway activation is the most prominent in dermatomyositis whereas type 2 interferon (IFN2) pathway activation is high in IBM and ASS; neither pathway is distinct in IMNM. Myxovirus-resistant protein A, IFN1 surrogate marker, is now one of definite dermatomyositis muscle biopsy criteria in the new 2018 European Neuromuscular Centre classification of dermatomyositis; the classification emphasizes on different categorization with and without dermatomyositis-specific antibody result. Novel HLA loci associated with anti-TIF1-γ, anti-Mi-2, and anti-Jo-1 antibodies in Caucasian population are identified. Associations of chaperon-assisted selective autophagy (CASA) and complement-mediated autoimmunity in IMNM as well as highly differentiated T cells in IBM are discovered. Current IIM classification requires integrated clinicoseropathological approaches. Additional information, such as transcriptomics, HLA haplotyping, and potential biomarkers help tailoring categorization that may have future diagnostic and therapeutic implications.


Variability in baseball pitching biomechanics among various levels of competition.
The aim of this study was to compare within-individual variability in baseball pitching among various levels of competition. It was hypothesized that variability decreases as level of competition increases. Five fastballs were analysed for 93 healthy male baseball pitchers (20 youth, 19 high school, 20 college, 20 Minor League, and 14 Major League level pitchers). Eleven kinematic, four temporal, and six kinetic parameters were quantified with a 240-Hz automated digitizing system. Three multiple analyses of variance were used to compare individual standard deviations for kinematic, temporal, and kinetic parameters among the five competition levels. There was a significant overall difference in kinematics and in six of the eleven kinematic parameters analysed: foot placement, knee flexion, pelvis angular velocity, elbow flexion, shoulder external rotation, and trunk forward tilt. Individual standard deviations tended to be greatest for youth pitchers, and decreased for higher levels of competition. Thus pitchers who advanced to higher levels exhibited less variability in their motions. Differences in temporal variation were non-significant; thus variability in pitching coordination was not improved at higher levels. Differences in kinetic variation were non-significant, implying no particular skill level has increased risk of injury due to variation in joint kinetics.


Introducing Dendrosomal Nanocurcumin as a Compound Capable of in vitro Eliminating Undifferentiated Stem Cells in Cell Therapy Practices.
One of the major obstacles needed to be overcome before using cell therapy for clinical purposes is the high probability of tumor formation in patients who receive the transplants, as undifferentiated stem cells (SCs) have the potential to form teratomas/teratocarcinoma in xenotransplants. In this study the ability of dendrosomal nanocurcumin (solublized curcumin using a biodegradable non-toxic nano-carrier) to affect undifferentiated/hazardous cell, and hence increasing the safety of cell therapy (particularly in diabetes type I) by mesenchymal stem cells (MSCs) was examined. The results showed that after completion of differentiation of human mesenchymal stem cells (hMSCs) into insulin producing cells (IPCs), the expression level of insulin increases, although there remains a minority of undifferentiated cells which still express nestin (gene which is expressed in progenitor stem cells of IPCs). It indicates the emergence of a heterogeneous population containing undifferentiated and differentiated cells. Furthermore our data demonstrated that the expression level of p53 decreases during differentiation of hMSCs into IPCs which implies a more favorable microenvironment for tumor formation following the transplantation of such a heterogeneous population. After treatment with dendrosomal nanocurcumin, nestin expression eliminated, however no significant effect on the expression and secretion of insulin was observed. Together our data shows that dendrosomal nanocurcumin have the ability to affect residual undifferentiated stem cells after the completion of differentiation of MSCs induced to differentiate into IPCs; while it exerts no significant harmful effect on the survival and function of differentiated cells. With regard to the obtained results in this study, exploiting dendrosomal nanocurcumin, after completion of induced differentiation of stem cells and prior to the transplantation step, can be suggested as a very efficient, safe and cost-effective method to eliminate the residual undifferentiated stem cells in cell therapy practices in order to considerably decrease the risk of tumor development following transplantation.


Implications of the growth of dental education in India.
By influencing the supply of trained human resources, the dental education sector can play a significant role in influencing policy goals of ensuring good quality and equitable access to oral health services in developing countries. Our research goal was to assess quantitatively the size of the Indian dental education sector, its growth over time, and the implications of this growth for equity and quality in oral health care. Information on the location of teaching institutions, the year of establishment, type of ownership, and seat capacity was obtained from government sources, the Dental Council of India, and websites of individual institutions to estimate the growth in the undergraduate dental education sector, including the role of the private sector from 1950 to 2005. Data on location of training capacity and institutions were used to assess the geographical distribution of undergraduate dental education capacity in India. Registration data on dentists, the size of available faculty relative to regulatory requirements, and penalties imposed on offending faculty and education institutions were used to assess the impact of the growing Indian dental education sector on graduate quality and equitable access. Dental colleges and enrollment capacity have grown rapidly over the five decades since 1950, mainly due to a growing private sector. There is regional inequality in the location of dental education schools in India with a bias toward economically better-off regions. The growth in the dental education sector has translated into increased overall access, although accompanied by rising inequality in access and possibly lower quality of dental education.


On the Formation of Nanocrystalline Grains in Metallic Glasses by Means of In-Situ Nuclear Forward Scattering of Synchrotron Radiation.
Application of the so-called nuclear forward scattering (NFS) of synchrotron radiation is presented for the study of crystallization of metallic glasses. In this process, nanocrystalline alloys are formed. Using NFS, the transformation process can be directly observed during in-situ temperature experiments not only from the structural point of view, i.e., formation of nanocrystalline grains, but one can also observe evolution of the corresponding hyperfine interactions. In doing so, we have revealed the influence of external magnetic field on the crystallization process. The applied magnetic field is not only responsible for an increase of hyperfine magnetic fields within the newly formed nanograins but also the corresponding components in the NFS time spectra are better identified via occurrence of quantum beats with higher frequencies. In order to distinguish between these two effects, simulated and experimental NFS time spectra obtained during in-situ temperature measurements with and without external magnetic field are compared.


Synergistic malaria vaccine combinations identified by systematic antigen screening.
A highly effective vaccine would be a valuable weapon in the drive toward malaria elimination. No such vaccine currently exists, and only a handful of the hundreds of potential candidates in the parasite genome have been evaluated. In this study, we systematically evaluated 29 antigens likely to be involved in erythrocyte invasion, an essential developmental stage during which the malaria parasite is vulnerable to antibody-mediated inhibition. Testing antigens alone and in combination identified several strain-transcending targets that had synergistic combinatorial effects in vitro, while studies in an endemic population revealed that combinations of the same antigens were associated with protection from febrile malaria. Video microscopy established that the most effective combinations targeted multiple discrete stages of invasion, suggesting a mechanistic explanation for synergy. Overall, this study both identifies specific antigen combinations for high-priority clinical testing and establishes a generalizable approach that is more likely to produce effective vaccines.


Developing an automatic accreditation support system of health websites.
The annual national quality and accreditation label awarding approach has been used to identify quality health websites since 2002 in Taiwan. Since the accreditation process has resumed great amount of professional manpower every year, this study was designed to simplify the process by using the text categorization and information extraction approach..


Isolation and application of P genome-specific DNA sequences of Agropyron Gaertn. in Triticeae.
Different types of P genome sequences and markers were developed, which could be used to analyze the evolution of P genome in Triticeae and identify precisely wheat- A. cristatum introgression lines. P genome of Agropyron Gaertn. plays an important role in Triticeae and could provide many desirable genes conferring high yield, disease resistance, and stress tolerance for wheat genetic improvement. Therefore, it is significant to develop specific sequences and functional markers of P genome. In this study, 126 sequences were isolated from the degenerate oligonucleotide primed-polymerase chain reaction (DOP-PCR) products of microdissected chromosome 6PS. Forty-eight sequences were identified as P genome-specific sequences by dot-blot hybridization and DNA sequences analysis. Among these sequences, 22 displayed the characteristics of retrotransposons, nine and one displayed the characteristics of DNA transposons and tandem repetitive sequence, respectively. Fourteen of 48 sequences were determined to distribute on different regions of P genome chromosomes by fluorescence in situ hybridization, and the distributing regions were as following: all over P genome chromosomes, centromeres, pericentromeric regions, distal regions, and terminal regions. We compared the P genome sequences with other genome sequences of Triticeae and found that the similar sequences of the P genome sequences were widespread in Triticeae, but differentiation occurred to various extents. Additionally, thirty-four molecular markers were developed from the P genome sequences, which could be used for analyzing the evolutionary relationship among 16 genomes of 18 species in Triticeae and identifying P genome chromatin in wheat-A. cristatum introgression lines. These results will not only facilitate the study of structure and evolution of P genome chromosomes, but also provide a rapid detecting tool for effective utilization of desirable genes of P genome in wheat improvement.


Cdc6 protein activates p27KIP1-bound Cdk2 protein only after the bound p27 protein undergoes C-terminal phosphorylation.
In mammalian cells Cdk2 activity during the G(1)-S transition is mainly controlled by p27(KIP1). Although the amount and subcellular localization of p27 influence Cdk2 activity, how Cdk2 activity is regulated during this phase transition still remains virtually unknown. Here we report an entirely new mechanism for this regulation. Cdc6 the AAA+ ATPase, known to assemble prereplicative complexes on chromosomal replication origins and activate p21(CIP1)-bound Cdk2, also activated p27-bound Cdk2 in its ATPase and cyclin binding motif-dependent manner but only after the p27 bound to the Cdk2 was phosphorylated at the C terminus. ROCK, which mediates a signal for cell anchorage to the extracellular matrix and activates the mTORC1 cascade as well as controls cytoskeleton assembly, was partly responsible for C-terminal phosphorylation of the p27. In vitro reconstitution demonstrated ROCK (Rho-associated kinase)-mediated phosphorylation of Cdk2-bound p27 at the C terminus and subsequent activation of the Cdk2 by Cdc6.


Distribution of secretory inhibitor of platelet microbicidal protein among anaerobic bacteria isolated from stool of children with diarrhea.
To study the secretory inhibitor of platelet microbicidal protein (SIPMP) phenotypes of faecal anaerobic isolates from patients with diarrhea. Faecal isolates of anaerobic bacteria (B. fragilis, n = 42; B. longum, n = 70; A. israelii, n = 21; E. lentum, n = 12) from children with diarrhea were tested. SIPMP production was tested by inhibition of platelet microbicidal protein (PMP) bioactivity against B. subtilis and was expressed as percentage of inhibition of PMP bactericidal activity. Among anaerobic isolates 80% of B. longum strains, 85.7% of A. israelii strains, 50% of E. lentum strains and 92.86% of B. fragilis strains were SIPMP-positive. The isolated anaerobic organisms demonstrated SIPMP production at a mean level of 13.8% +/- 0.7%, 14.7% +/- 1.8%, 3.9% +/- 0.9% (P < 0.05) and 26.8% +/- 7.5% (P < 0.05) for bifidobacteria, A. israelii, E. lentum and B. fragilis, respectively. Data from the present study may have significant implications in understanding the pathogenesis of microecological disorders in the intestine, as well as for future improvement in the prevention and therapy of anaerobe-associated infections.


Dental Treatment Effect on Blood Glucose Level Fluctuation in Type 1 Unbalanced Diabetic Children.
Diabetic patients struggle to maintain their blood glucose near normal levels to avoid the occurrence of hypo- or hyperglycemia discomfort. Dental practitioners must foresee such complications as they can also take place during dental treatment. This study aims to evaluate the impact of the type and duration of dental treatment on the blood glucose level (BGL) fluctuation in type 1 unbalanced diabetic children [hemoglobin A1c (HbA1c) >7]. A cross-sectional approach was conducted on 83 type 1 unbalanced diabetic children (HbA1c) > 7%, aged between 7 years and 12 years, divided into 40 females and 43 males in the Department of Pediatric Dentistry at the Lebanese University in Beirut. For dental treatments, diabetic children were scheduled for morning sessions 60-90 minutes after breakfast intake and a habitual insulin shot. Only patients with a BGL between 70 mg/dL and 300 mg/dL underwent dental treatments. The type, the duration of the dental session, and the BGL at the baseline (T0), and at the end of the session (T1) were recorded. The dental acts were classified into simple (without local anesthesia) and unpleasant with a solution of 2% lignocaine with 1:200,000 epinephrine. Statistical analyses were performed. Fifty of 83 showed a decrease in their BGLs after dental treatments, 20 an increase, and 13 no change. For both genders, in simple acts, a statistical significance was noted (p = 0.0002) for the female and (p = 0.0014) for the males. Treatment unbalanced diabetic children can be safely done by taking some precautions and measures to avoid a hypo- or hyperglycemia episode. Noueiri B, Nassif N. Dental Treatment Effect on Blood Glucose Level Fluctuation in Type 1 Unbalanced Diabetic Children. Int J Clin Pediatr Dent 2021;14(4):497-501.


Peroxisome proliferator-activated receptors in cardiac energy metabolism and cardiovascular disease.
Cardiomyocytes mainly depend on energy produced from the oxidation of fatty acids and mitochondrial oxidative phosphorylation. Shortage of energy or excessive fat accumulation can lead to cardiac disorders. High saturated fat intake and a sedentary life style have a major influence in the development of cardiovascular disease (CVD). Peroxisome proliferator-activated receptors (PPARs), one of the nuclear receptor super family members, play critical role in the metabolism of lipids by regulating their oxidation and storage. Furthermore, they are involved in glucose homeostasis as well. PPARs, mainly alpha (α) and beta/delta (β/δ), have a significant effect on the lipid metabolism and anti-inflammation in endothelial cells (ECs), vascular smooth muscle cells, and also in cardiomyocytes. Pro-inflammatory cytokines, mainly tumour necrosis factor-α, released at the site of inflammation in the sub-ECs of coronary arteries can inactivate the PPARs which can eventually lead to decreased energy production in the myocardium. Various synthetic ligands of PPAR-α and β/δ have many favourable effects in modulating the vascular diseases and heart failure. Despite the adverse effects from therapy using PPAR- gamma ligands, several laboratories are now focused on synthesizing partial activators which may combine their beneficial effects with lowering of undesirable side effects. This review discusses the role of isoforms of PPAR in the cardiomyocytes energy balance and CVD. The knowledge will help in the synthesis of ligands for their partial activation in order to render energy balance and protection from CVD.


What every clinician should know about polysomnography.
Polysomnography studies are an essential tool for the sleep physician and aid in the diagnosis and treatment of sleep disorders. Polysomnography refers to the recording, analysis, and interpretation of multiple physiologic signals collected simultaneously. Rapid advancements in technology have transformed the field from a time when analog studies were collected on paper to computer-assisted collection of digitally transformed studies. Sleep clinicians, whether physicians, respiratory therapists, or sleep technologists, must therefore have an understanding of a broad array of principles underlying the collection of the various signals. In addition, an understanding of basic technical rules in the evaluation of polysomnography studies is necessary for both the scoring and interpretation of such studies. The American Academy of Sleep Medicine published a new manual for the scoring of sleep and associated events in 2007. These changes included modifications to the visual scoring of sleep, the scoring of sleep-disordered breathing events, and movement disorders during sleep. A few early studies have evaluated the effects of the changes in scoring guidelines to the previous Rechtschaffen and Kales (R&K) rules for sleep and the American Academy of Sleep Medicine rules for respiratory events. Some controversy regarding the scoring of respiratory events continues to exist and requires further studies to be performed.


Complications of mitomycin C therapy in 100 eyes with ocular surface neoplasia.
To determine the complications associated with mitomycin C (MMC) in the treatment of ocular surface neoplasia. A retrospective and consecutive study of 100 eyes in 91 patients with ocular surface neoplasia treated with MMC in a single centre between November 1998 and January 2005. Outcome measures included complications of MMC and the treatment required for these complications. One to three 7 day cycles of topical MMC 0.04% four times a day were given to 59 eyes with localised corneal-conjunctival intraepithelial neoplasia (CIN), 19 eyes with diffuse CIN, six eyes with recurrent CIN, one eye with ocular surface squamous cell carcinoma, three eyes with primary acquired melanosis (PAM) with atypia, nine eyes with conjunctival malignant melanoma (MM), two eyes with sebaceous carcinoma with pagetoid spread, and one eye with recurrent atypical fibroxanthoma. Nine patients had bilateral CIN. 31 (34%) cases developed an allergic reaction to MMC and 14 (14%) eyes had epiphora secondary to punctal stenosis at a mean follow up period of 26.5 months. In the largest study looking at complications of topical MMC in the treatment of ocular surface neoplasia, allergic reaction and punctal stenosis are relatively common. Serious complications were not observed suggesting the safe use of MMC in mid-term follow up.


Solution-based evolution and enhanced methanol oxidation activity of monodisperse platinum-copper nanocubes.
Shape-controlled catalysis: High-quality Pt-Cu nanocubes with an average size of about 8 nm (see picture, scale bar = 20 nm) were synthesized from a high-temperature organic solution system in the presence of various capping ligands. These cubic Pt-Cu nanocrystals terminated with {100} facets demonstrated a superior catalytic activity towards methanol oxidation compared to similar sized Pt-Cu and Pt nanospheres.


Role of beta-defensin-1 polymorphisms in mother-to-child transmission of HIV-1.
Mother-to-child transmission (MTCT) of HIV-1, the main source of pediatric AIDS, is multifactorial. Defensins provide microbial barriers and function as effectors of innate immunity. This study investigated the relationship between genetic variants of beta-defensin-1 gene and MTCT of HIV-1. Three hundred children, 118 HIV-1 infected and 182 HIV-1 uninfected, born to HIV-1-infected mothers who had not undergone antiretroviral therapy during pregnancy, and 84 HIV-1-infected mothers were analyzed. The single nucleotide polymorphisms -44C/G (rs1800972) and -52G/A (rs1799946) were genotyped by TaqMan allelic discrimination assay and sequencing. Statistical analyses were performed using SNPStats and Bonferroni correction for multiple tests. In children, the -52GG genotype and the -44G/-52G haplotype had a protective role against HIV-1 infection [odds ratio (OR) = 0.52, 95% confidence interval (CI) 0.31 to 0.86, P = 0.03 and OR = 0.50, 95% CI 0.31 to 0.83, P = 0.014, respectively]. In mothers, the -52GG genotype and the -44G/-52G haplotype were associated with low levels of HIV-1 plasma viremia (<1000 copies/mL) and a lower risk of maternal HIV-1 transmission (OR = 0.14, 95% CI 0.03 to 0.67, P = 0.009 and OR = 0.23, 95% CI 0.08 to 0.66, P = 0.012, respectively). These results demonstrate a significant relationship between genetic variants of beta-defensin-1 gene, viral load, and MTCT of HIV-1, thus supporting a critical role of innate immunity in pediatric HIV-1 infection.


Resolution-dependent estimates of lesion volumes in magnetic resonance imaging studies of the brain in multiple sclerosis.
In this study, we investigated the relationship between multiple sclerosis lesion volumes measured from magnetic resonance imaging scans and image-slice thickness. The lesion volume was computed using a semiautomated thresholding technique from axial scans of the brain of varying slice thickness. Ten patients were studied, and in all cases the computed lesion volume increased with decreasing slice thickness (p = 0.01). Linear extrapolation from our data allowed the lesion volume at very small slice thickness to be estimated; this was found to be on average 20% greater than that obtained using a slice thickness of 5 mm. Furthermore, there were considerable differences in the percentage of change in lesion volume from patient to patient, and it would appear that there is a larger variation with slice thickness for patients with smaller lesions and higher lesion loads.


Analysis of copy number variation using whole genome exon-focused array CGH in Korean patients with primary congenital glaucoma.
Primary congenital glaucoma (PCG) is an autosomal recessive form of glaucoma that manifests within the first year of life and if left untreated, leads to irreversible blindness. Cytochrome P450 1B1 (CYP1B1) is the major gene known to be associated with PCG. The role of the CYP1B1 gene in disease pathogenesis and the relatively low detection rate of CYP1B1 mutations in some populations, especially Asians, remain unexplained. We hypothesized that altered gene dosage of CYP1B1 or anterior segmental dysgenesis causative genes may be involved in the pathogenesis of PCG. We performed whole genome exon-focused array comparative genome hybridization (aCGH) to identify copy number variation (CNV) in 20 Korean PCG patients and their parents. We identified 12 patients with at least one rare gene-containing copy number variation each, corresponding to 25 CNVs (5 deletions and 20 duplications) at frequencies of 5-30% in PCG patients and 0% in controls. The 25 CNVs were not located at known chromosomal loci for PCG, namely GLC3A, which harbors CYP1B1 (2p21), GLC3B (1p36.2-p36.1), or GLC3C (14q23), and did not include any target genes associated with PCG or anterior segmental dysgenesis. Further genetic studies with larger cohorts of patients are necessary to validate our results and to elucidate other genetic mechanisms underlying PCG, because the identified CNVs might be PCG-specific pathogenic variants and may explain the disease pathogenesis of PCG.


Is fluoroscopy necessary for sacroiliac joint injections?
The use of sacroiliac joint injection has been a steadily increasing for therapeutic and diagnostic purposes in the United States. Because of the conceivably easy accessibility of sacroiliac joint and reported low incidence of morbidity, the sacroiliac joint injection is felt to be a procedure that maybe performed easily in the office based setting. While this procedure may be common, the sacroiliac joint injection is not performed accurately without the aide of imaging. Further complicating the issue of sacroiliac joint injections is the lack of specific and reliable diagnostic testing. Clinical evaluation and imaging studies are often unreliable and practitioners often mistakenly assume that pain over the posterior superior iliac spine is pathognomonic for sacral joint pain. In addition, referral patterns are unreliable and bedside testing is often non-diagnostic. Sixty patients undergoing sacroiliac joint injections were studied. Sacroiliac joint injections were placed blindly then examined under fluoroscopy for accurate needle placement. The needle was placed by a single this experienced spinal injectionist. Results of blind needle placement revealed that only 5 of 60 patients were felt to have needle placement approximating a therapeutic point of contact with the sacroiliac joint. Furthermore, the posterior superior iliac spine, was found to be a poor indicator of sacroiliac joint anatomic access. The results of this study show that accurate placement of sacroiliac joint injections is successful without fluoroscopy in only 12% of the patients, even in experienced hands.


[The significance of kinesitherapy for prophylaxis of osteoporosis].
Osteoporosis is a significant public health problem. It is associated with bone fragility resulting mostly from low bone mass and a concomitant increase in the risk for fracture. Physical exercises are commonly prescribed intervention for prophylaxis of osteoporosis. The purpose of the present study is to state the necessity of appliance kynesitherapy under different forms and methods at osteoporosis.


Mental Pain Surrounding Suicidal Behaviour: A Review of What Has Been Described and Clinical Recommendations for Help.
To conduct a comprehensive review of scientific publications related to mental pain and suicide risk in order to deepen relevant aspects to guide clinical interventions. Using a text analysis tool, we collected the terms most frequently linked with that situation in published results of research using various tools to evaluate mental pain or psychache. We propose clinical interventions for the clinical conditions most commonly associated with mental pain.


Semiautomatic sizing software in emergency endovascular aneurysm repair for ruptured abdominal aortic aneurysms.
In emergency endovascular repair (EVAR) of ruptured aneurysms of the aorta (rAAA), anatomical suitability must be determined. Semiautomatic three-dimensional assessment of the aortoiliac arteries has the potential to standardise measurements. This study assesses the fitness for purpose of such a semiautomatic approach for rAAA and determined interobserver agreement on suitability. Interobserver study with six trained observers (4 vascular surgeons, 2 radiologists) blindly assessing preoperative computed tomography angiography scans of 50 consecutive patients with rAAA. A central lumen line (CLL) was generated, and perpendicular diameters, length along the CLL, and EVAR suitability were determined using dedicated sizing software (3mensio; 3mensio Vascular; Bilthoven, The Netherlands). Success of generating a CLL, time of assessment, and interobserver agreement was determined. In the majority of the patients (median 76 %, range 64-78 %), a CLL was semiautomatically generated. The median duration of CLL generation and performance measurements was 7.5 min (interquartile range 5.5-10.6). Agreement on suitability was moderate for the entire group (Fleiss' κ = 0.55, confidence interval 0.48-0.62) and ranged from moderate to good (Cohen's κ = 0.40-0.72) between observer pairs. Assessing EVAR suitability of rAAA patients using dedicated sizing software is possible in the majority of patients. The measurements can be performed in a reasonable amount of time, and the agreement of suitability for EVAR in patients with rAAA is moderate. Improvements and additional research are necessary to replace the current axial measurement.


Characterization of the morphological, growth, and steroidogenic effect of TPA on mouse Y-1 adrenal cortical tumor cells in culture.
The tumor-promoting agent 12-0-tetradecanoyl-phorbol-13-acetate (TPA) caused a time- and dose-dependent morphological change in Y-1 adrenocortical tumor cells. The morphological alteration was apparent 2 hr following addition of 1 microgram/ml TPA to cell cultures and became more striking with longer treatment times. Smaller doses of TPA took a longer time to produce an effect. Cultures grown in the presence of TPA exhibited more rounding and piling up of cells than similar cultures maintained in medium lacking TPA. These TPA-stimulated morphological changes were reversible, and after 24 hr in TPA-free media, the cultured cells began to flatten. After 96 hr in TPA-free media they resembled the control cultures. The reversibility of the morphological change was also dose dependent: cells treated with 1 microgram/ml TPA took a longer time to resume the typical control morphology than did cultures treated with 0.01 microgram/ml TPA. In addition, TPA treatment resulted in a decrease in cell growth rate, an increase in steroid production, and an increase in the localization of free catalytic units of cAMP-dependent protein kinase in the cytoplasm. The steroidogenic effect of ACTH on the cell population was inhibited in cultures maintained in TPA. The results of this study indicate that TPA induces morphological changes in the Y-1 adrenocortical tumor cell population while increasing steroidogenesis and the activation of cAMP-dependent protein kinase and decreasing cell growth rate.


Benchmark investigation of diamondoid-functionalized electrodes for nanopore DNA sequencing.
Small diamond-like particles, diamondoids, have been shown to effectively functionalize gold electrodes in order to sense DNA units passing between the nanopore-embedded electrodes. In this work, we present a comparative study of Au(111) electrodes functionalized with different derivatives of lower diamondoids. Focus is put on the electronic and transport properties of such electrodes for different DNA nucleotides placed within the electrode gap. The functionalization promotes a specific binding to DNA leading to different properties for the system, which provides a tool set to systematically improve the signal-to-noise ratio of the electronic measurements across the electrodes. Using quantum transport calculations, we compare the effectiveness of the different functionalized electrodes in distinguishing the four DNA nucleotides. Our results point to the most effective diamondoid functionalization of gold electrodes in view of biosensing applications.


The end of the line? A case of drug resistance to third-line antiretroviral therapy.
HIV drug resistance has been described in all antiretroviral drug classes and threatens the long-term success of HIV treatment. Here, we describe the first reported case of acquired resistance to the integrase strand transfer inhibitors in South Africa. This case illustrates the dilemma of treatment in the context of inadequate adherence and poor psychosocial support and highlights the potential risk of transmission of multidrug-resistant virus.


Intimal plaque development and oxidative stress in cholesterol-induced atherosclerosis in New Zealand rabbits.
Although oxidative stress is well known in atherogenesis, the origin, nature and kinetics of free radicals involved have not been well described till now. Here, we correlated parameters of oxidative stress with cellular components during induction and stabilization of aortic intimal lesions which were induced in rabbits by feeding a cholesterol-enriched diet for 6 weeks and a normal diet for further 68 weeks. Plasma lipids, aortic plaque size and composition (macrophages, smooth muscle cells, oxidized LDL by morphometry), as well as aortic radical production (by luminol-enhanced chemiluminescence and TEMPO-9AC fluorescence) were measured after various time points. The parameters of oxidative stress were correlated with the different cellular components of the aortic plaques. The plaques increased until week 21, no significant regression was found until week 74, plasma cholesterol was maximal at week 6. Macrophages, oxidized LDL and generation of different species of free radicals were increased during plaque development, yet with different time kinetics. Whereas chemiluminescence correlated only weakly with the amount of intimal macrophages, strong correlations were found between TEMPO fluorescence and smooth muscle cells (r = 0.4778, P < 0.001) and between macrophages and oxidized LDL (r = 0.5896, P < 0.0001). Different indicators of oxidative stress were increased during plaque progression and stabilization. However, the various correlations show, that distinct types of reactive species secreted probably from macrophages and smooth muscle cells contribute to oxidative stress in the different phases of plaque development.


Risk factors and distribution of symptomatic venous thromboembolism in total hip and knee replacements: prospective study.
Venous thromboembolism (VTE) is a common complication of orthopaedic surgery in the industrialised world; though there may be variability between population groups. This study aims to define the incidence and risk factors for symptomatic VTE following primary elective total hip and knee arthoplasty surgery in a single centre in Eastern Europe. This prospective study included 499 adult patients undergoing total hip and knee arthroplasty for symptomatic osteoarthritis over a two-year period at the Clinic of Orthopaedic Surgery and Traumatology, Belgrade. The overall rate of confirmed symptomatic VTE during hospitalisation was 2.6%. According to the univariate logistic regression, an age greater than 75 years (OR = 3.08; 95%CI = 1.01-9.65), a family history of VTE (OR = 6.61; 95% CI = 1.33-32.90), varicose veins (OR = 3.13; 95% CI = 1.03-9.48), and ischemic heart disease (OR = 4.93; 95% CI = 1.61-15.09) were significant risk factors for in-hospital VTE. A family history of VTE and ischemic heart disease were independent risk factors according to multivariate regression analysis. Preoperative initiation of pharmacological thromboprophylaxis (p = 0.03) and a longer duration of thromboprophylaxis (p = 0.001) were protective for postoperative DVT. Though thromboprophylaxis was safe, with very few patients suffering major haemorrhage or heparin-induced thrombocytopenia, there was a general reluctance by our local surgeons to use prolonged thromboprophylaxis. VTE is common following hip and knee arthroplasty surgery. Orthopaedic patients with a family history of VTE, heart failure and coronary heart disease are at a considerable risk of thromboembolic complications in the postoperative period. There may be a role for preoperative thromboprophylaxis in addition to prolonged postoperative treatment.