PdIr Aerogels with Boosted Peroxidase-like Activity for a Sensitive Total Antioxidant Capacity Colorimetric Bioassay.
Metallic aerogels (MAs), imparting the active catalytic properties of nanostructured noble metals to macroscopic aerogels, draw tremendous interest in diverse fields owing to the unique features of three-dimensional interconnected channels, self-supported architectures, and pure metallic backbones. Moreover, flexible manipulation of compositions, high electrical conductivity, and abundant active sites of MAs contribute to the great potential to mimic natural enzymes. However, the cumbersome synthetic process takes a couple of hours to days, and unavoidable impurities usually impede surface electrons/mass transfer, posing the decrease of stability and enzyme-like activity of MAs. Here, a PdIr bimetallic aerogel prepared in the ethanol phase via spontaneous assembly and a surfactant-free strategy is reported. Gelation kinetics of PdIr aerogels in ethanol is increased with 2-4 orders of magnitude compared to the traditional preparation method in water. Owing to the intrinsic physicochemical properties, PdIr aerogels exhibit the high activity of peroxidase mimics using 3,3',5,5'-tetramethylbenzidine as a chromogenic probe. In addition, the PdIr aerogels maintain relatively high activity at an elevated temperature and pH of 3-7, demonstrating their good stability and survivability. Utilizing the exceptional peroxidase-like activity of PdIr aerogels, we realized the quantitative bioassay for H2O2 and total antioxidant capacity, indicating enormous potential in the quality evaluation of real samples.


An update on the management of traumatic brain injury.
The management of traumatic brain injury (TBI) continues to evolve in a number of key areas. In the first instance there have been major advances in clinical information gathering and interpretation such that there are mow sophisticated prognostic models readily available. Secondly, technological advances have allowed the introduction of advanced multimodal monitoring which can provide real time information regarding the complex physiological and biochemical derangements that occur following TBI. Finally recent clinical trials have raised important questions regarding the efficacy or otherwise of important therapeutic options most notably hypothermia and decompressive craniectomy. The aim of this update is to highlight some of the areas where there has been advancement and controversy.


Dietary starch composition and level of energy intake alter nutrient oxidation in "carbohydrate-sensitive" men.
The effect of dietary starch type on components of 24-h energy expenditure (total, sleep, exercise) were examined in 13 hyperinsulinemic and nine control men, aged 28-58 y. Subjects consumed products containing 70% amylopectin or 70% amylose cornstarch for two 14-wk periods in a crossover design. A 10-wk period of starch replacement in the subjects' self-selected diets was followed by a 4-wk controlled feeding period at 100% maintenance energy intake; diets during the last 4 d of the controlled feeding period provided excess energy, i.e., 125% of maintenance energy. Data for insulin, glucose, 24-h energy expenditure and its components, respiratory quotient and nutrient oxidation were analyzed by ANOVA for mixed models. Although insulin and glucose responses to a starch tolerance test remained greater for hyperinsulinemic than for control subjects, both were reduced with high amylose consumption (P < 0.04). No component of energy expenditure was significantly affected by dietary starch or subject type. However, excess energy intake did increase metabolic energy expenditure (P < 0.0001). Protein oxidation increased with excess energy intake when subjects consumed the high amylopectin starch but did not increase in response to excess energy consumption when the high amylose diet was consumed, suggesting increased protein retention. The magnitude of the response in carbohydrate and fat oxidation was blunted in hyperinsulinemic subjects consuming excess levels of the amylose diet. This may be due to an improvement in overall insulin response or to a change in available substrates for oxidation resulting from microbial fermentation.


Localization of Galactolipid Biosynthesis in Etioplasts Isolated from Dark-Grown Wheat (Triticum aestivum L.).
Etioplasts were isolated from leaves of dark-grown wheat (Triticum aestivum L. var Starke II). Galactolipid biosynthesis was assayed in an envelope-rich fraction and in the fraction containing the rest of the etioplast membranes by measuring incorporation of (14)C from uridine-diphospho[(14)C]galactose into monogalactosyl diacylglycerol and digalactosyl diacylglycerol. More than half of the galactolipid biosynthetic capability was found in the fraction of inner etioplast membranes. This fraction was subfractioned into fractions enriched in prolamellar bodies and membrane vesicles (prothylakoids), respectively. All membrane fractions obtained from etioplasts were able to carry out galactolipid biosynthesis, although the activity was very low in prolamellar body-enriched fractions. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed markedly different polypeptide patterns between the different fractions. It is concluded that the capability of galactolipid biosynthesis of etioplasts probably is not restricted to the envelope, but is also present in the inner membranes of this plastid.


Cross-sectional anatomy, computed tomography and magnetic resonance imaging of the head of common dolphin (Delphinus delphis) and striped dolphin (Stenella coeruleoalba).
Computed tomography (CT) and low-field magnetic resonance imaging (MRI) were used to scan seven by-caught dolphin cadavers, belonging to two species: four common dolphins (Delphinus delphis) and three striped dolphins (Stenella coeruleoalba). CT and MRI were obtained with the animals in ventral recumbency. After the imaging procedures, six dolphins were frozen at -20°C and sliced in the same position they were examined. Not only CT and MRI scans, but also cross sections of the heads were obtained in three body planes: transverse (slices of 1 cm thickness) in three dolphins, sagittal (5 cm thickness) in two dolphins and dorsal (5 cm thickness) in two dolphins. Relevant anatomical structures were identified and labelled on each cross section, obtaining a comprehensive bi-dimensional topographical anatomy guide of the main features of the common and the striped dolphin head. Furthermore, the anatomical cross sections were compared with their corresponding CT and MRI images, allowing an imaging identification of most of the anatomical features. CT scans produced an excellent definition of the bony and air-filled structures, while MRI allowed us to successfully identify most of the soft tissue structures in the dolphin's head. This paper provides a detailed anatomical description of the head structures of common and striped dolphins and compares anatomical cross sections with CT and MRI scans, becoming a reference guide for the interpretation of imaging studies.


Systemic and intra-dorsal periaqueductal gray injections of cholecystokinin sulfated octapeptide (CCK-8s) induce a panic-like response in rats submitted to the elevated T-maze.
The neuropeptide cholecystokinin (CCK) has been implicated in fear and anxiety. CCK is found in the CNS in several molecular forms such as the tetrapeptide (CCK-4) and, mainly, the sulfated octapeptide (CCK-8s) fragments. Administration of CCK-4 induces panic attacks in humans and increases the expression of different anxiety-related behaviors in laboratory animals. The effects of CCK-8s on fear and anxiety are less straightforward and seem to be influenced, among other factors, by the route of the peptide administration and the animal model employed. In other to further investigate the role of CCK-8s in fear and anxiety, in the present study we analyzed the effect of CCK-8s in male Wistar rats submitted to the elevated T-maze. This animal model of anxiety was developed in order to separate generalized anxiety (inhibitory avoidance) and panic-like (escape) responses in the same rat. The effect of CCK-8s in this test was also investigated after injection of the peptide into the dorsal periaqueductal gray (DPAG). This brainstem area is rich in CCK receptors and has consistently been implicated in the mediation of fear and anxiety responses. The results showed that both the intraperitoneal and intra-DPAG injections of CCK-8s potentiated one-way escape behavior, suggesting a panicogenic action. In contrast, the injection of the CCK2 receptor antagonist CR2945 inhibited the expression of this behavior, a panicolytic-like effect. Therefore, the elevated T-maze, in contrast to other animal models of anxiety, can detect the anxiety-eliciting effects of CCK-8s both after its systemic and central administration. Also, the results provide further evidence about the involvement of a CCK-mediated mechanism within the DPAG in the regulation of panic-related defensive behaviors.


Nanomaterial Technology and Triple Negative Breast Cancer.
Triple negative breast cancer (TNBC) is a malignant breast cancer subtype that is prone to progression, with high associated metastasis and five-year mortality rates and an overall poor prognosis. Chemotherapy is usually administered to treat TNBC without additional targeted therapies. Novel nanomaterials have a variety of excellent physical and chemical properties and biological functions (including targeting specificity), and contrast agents and drug delivery vectors based on nanotechnology are progressing towards a more accurate and targeted direction. This review discusses the mechanisms of action and prospects for the use of nanotechnology in the treatment of TNBC, thus providing potential new strategies for the diagnosis and treatment of TNBC.


PD-1 (PDCD1) promoter methylation in Merkel cell carcinoma: prognostic relevance and relationship with clinico-pathological parameters.
Merkel cell carcinoma is an aggressive neuroendocrine skin tumor, for which several non-conclusive prognostic factors of adverse clinical behavior have been reported. As promoter methylation of the immune checkpoint receptor CD279/PD-1/PDCD1(mPDCD1) has been shown to be a prognostic factor in different cancers, we investigated its role in Merkel cell carcinoma. mPDCD1was assessed retrospectively in a cohort of 69 Merkel cell carcinoma patients from the University of Bologna, University of Turin and University of Insubria. Kaplan-Meier curves and log-rank tests were calculated for all variables. To assess the influence of mPDCD1, the Cox proportional hazards model and different Royston-Parmar models were evaluated. High PDCD1 methylation (mPDCD1high) was associated with a higher overall mortality at both the univariate analysis (log rank test: χ2 = 5.17, p = 0.023; permutation test: p = 0.023) and the multivariate analysis (HR = 2.111, p = 0.042). The other variables associated with a higher overall mortality at the multivariate analysis were clinical stage III-IV (HR = 2.357, p = 0.008), size > 2 cm (HR = 2.248, p = 0.031) and Merkel cell polyomavirus (HR = 0.397, p = 0.015). Further, mPDCD1high was strongly associated with older age (81 vs 76 years, p = 0.042), absence of immune cells (92.6%, p < 0.001), no expression of PD-L1 by immune cells (70.4%, p = 0.041) and by both immune and tumor cells (70.4%, p = 0.001). mPDCD1 is a valid prognostic parameter in patients affected by Merkel cell carcinoma. In addition, it could provide an estimate of the global PD-1/PD-L1 expression with potentially relevant implications from a therapeutic point of view.


Liver failure and pancreatitis. Fluid and electrolyte concerns.
Fluid and electrolyte concerns in patients with advanced cirrhosis and acute pancreatitis are presented in this article. Pathophysiology and usual medical treatments are reviewed for both disorders. Nursing considerations related to these fluid and electrolyte concerns are identified. Major nursing diagnoses, expected patient outcomes, and nursing actions are offered.


[Bacteriological studies of travellar's diarrhoea. 5) Analysis of enteropathogenic bacteria at Osaka Airport Quarantine Station from January 1992 through September 3rd, 1994].
During the last 2 years and 8 months before the closure of Osaka Airport Quarantine Station (from Jan. 1992 to Sep. 3, 1994), a total of 7,421,909 overseas travellers were quarantined. 15,919 reported themselves of suffering from diarrhoea. Bacteriological examination of a total of 6,031 individuals' stools were performed. 1) Various enteropathogenic bacteria were isolated from 31.2% of the stools examined. Isolated species were as follows: Plesiomonas shigelloides, 1,127 cases (59.9%); Vibrio parahaemolyticus, 293 cases (15.6%); Salmonella spp., 262 cases (13.9%); Shigella spp., 235 cases (12.5%); Aeromonas sobria, 93 cases (4.9%); V. cholerae non-O1, 69 cases (3.7%). 2) The enteropathogenic bacteria were isolated through out the year without any seasonal variation. 3) The major regions where the travellers were infected with the pathogens are as follows: V. cholerae non-O1 (NAG Vibrio) and enteropathogenic Escherichia coli, South-East and South-West Asia; Vibrio other than NAG, South-East and East Asia; Shigella, widely distributed but especially in India; P. shigelloides and Salmonella, widely distributed. 4) 2 strains of toxigenic (cholera toxin-producing) V. cholerae O139 were isolated from patients who had visited Indonesia and Thailand, respectively. 5) In 320 cases (17%), plural enteropathogenic bacteria were isolated from single patients, suggesting a high frequency of the mixed infections. 6) Among Shigella strains, S. sonnei were isolated the most, followed by S. flexneri (24.7%), S. boydii (8.8%) and S. dysenteriae (2.9%). 7) Among Salmonella serovers, Salmonella Enteritidis was isolated the most frequently (39 cases, 14.1%). 8) 218 (91.6%) of 238 Shigella strains and 103 (37.6%) of 276 Salmonella strains were resistant to one or more drugs tested (SM.CP.TC.KM.ABPC.NA.OFLX). 9) All of the 22 V. cholerae O1 strains were Ogawa, E1 Tor. Among them, 19 were toxigenic strains and 3 were non-toxigenic. 10) O4:K8 was the most frequently isolated serover of V. paraemolyticus. 87.4% of all V. parahaemolyticus strains were positive with thermostable direct hemolysin (TDH) gene, and 12.6% of them were positive with TDH-related hemolysin (TRH) gene by DNA-probe methods.


Genetic engineering of Lactobacillus diolivorans.
In this study, we developed a toolbox for genetic manipulation of Lactobacillus diolivorans, a promising production organism for 1,3-propanediol from glycerol. Two major findings play a key role for successful transformation of this organism: (1) the absence of a native plasmid, because a native plasmid is a major obstacle for transformation of L. diolivorans, and (2) the absence of DNA methylation. A suitable expression plasmid, pSHM, for homologous and heterologous protein expression in L. diolivorans was constructed. This plasmid is based on the replication origin repA of L. diolivorans. The native glyceraldehyde-3-phosphate dehydrogenase promoter is used for constitutive expression of the genes of interest. Functional expression of genes in L. diolivorans was shown with two examples: production of green fluorescent protein resulted in a 40- to 60-fold higher fluorescence of the obtained clones compared with the wild-type strain. Finally, the homologous overexpression of a putatively NADPH-dependent 1,3-propanediol oxidoreductase improved 1,3-propanediol production by 20% in batch cultures.


JMJD3 as an epigenetic regulator in development and disease.
Gene expression is epigenetically regulated through DNA methylation and covalent chromatin modifications, such as acetylation, phosphorylation, ubiquitination, sumoylation, and methylation of histones. Histone methylation state is dynamically regulated by different groups of histone methyltransferases and demethylases. The trimethylation of histone 3 (H3K4) at lysine 4 is usually associated with the activation of gene expression, whereas trimethylation of histone 3 at lysine 27 (H3K27) is associated with the repression of gene expression. The polycomb repressive complex contains the H3K27 methyltransferase Ezh2 and controls dimethylation and trimethylation of H3K27 (H3K27me2/3). The Jumonji domain containing-3 (Jmjd3, KDM6B) and ubiquitously transcribed X-chromosome tetratricopeptide repeat protein (UTX, KDM6A) have been identified as H3K27 demethylases that catalyze the demethylation of H3K27me2/3. The role and mechanisms of both JMJD3 and UTX have been extensively studied for their involvement in development, cell plasticity, immune system, neurodegenerative disease, and cancer. In this review, we will focus on recent progresses made on understanding JMJD3 in the regulation of gene expression in development and diseases. This article is part of a Directed Issue entitled: Epigenetics dynamics in development and disease.


Venovenous bypass for major hepatic and caval trauma.
Severe trauma to the liver and juxtahepatic cava require vascular isolation of the lesion. In addition to the techniques of vascular clamping and atriocaval shunting, venovenous bypass is a viable alternative to repair such injuries. We herein report its use in five consecutive patients. The technique obviates the hemodynamic sequelae of uncompensated caval occlusion and the technical dangers of atriocaval shunting.


[Drug-resistant epilepsy in adults].
Various estimation of the proportion of difficult-to-treat epileptic patients is given in the literature. It varies from 5 percent to 25 percent, because of imprecise meaning of pharmacoresistancy and similar terms. There is no such thing as a unique pharmacoresistant epilepsy. Persisting seizures despite antiepileptic drug prescription does not necessarily mean refractory seizures. Seizures may be drug-resistant for a limited period only, or be intermittent, or be a long-lasting condition. Seizure frequency may remain unchanged, or decrease, more or less. Toxicity of AEDs must be considered. Unbearable side effects are a limiting factor for maintaining some active drugs. In practice, the term pharmacoresistancy may be used when seizures occur in spite of a convenient therapy, whatever their frequency, and whatever the resulting handicap. Predictive factors for intractibility may be considered under four headings, i.e. seizure types, patient, epileptic syndrome, and antiepileptic drugs. Most of the elements of the first three groups are available immediately after the first seizure and response to treatment may be estimated one or two years later. Outcome of an epilepsy may be evaluated, or guessed, rather early. This is crucial for management of epileptic patients.


Quasi-distributed vibration sensing using OFDR and weak reflectors.
We proposed a quasi-distributed vibration sensing technique using in-line weak reflectors and optical frequency domain reflectometry (OFDR). As a result, we achieved an 8 kHz measurable vibration frequency with a 15-20 cm spatial resolution employing a low repetition rate (∼8 Hz). Moreover, a measurable frequency of 30 kHz was achieved for a 1.5 m spatial resolution. The ability of the system to determine the frequency and amplitude of several sections vibrating simultaneously is evaluated for different configurations. Because of the simple arrangement, high detectable frequency, and high sensitivity, this approach is expected to be especially well suited for mechanical vibration sensing applications, particularly in medium-sized structures.


Genomics and pharmacogenomics of dementia.
Dementia is a major problem of health in developed countries, and a prototypical paradigm of chronic disability, high cost, and social-family burden. Approximately, 10-20% of direct costs in this kind of neuropathology are related to pharmacological treatment, with a moderate responder rate below 30% and questionable cost-effectiveness. Over 200 different genes have been associated with the pathogenesis of dementia. Studies on structural and functional genomics, transcriptomics, proteomics and metabolomics have revealed the paramount importance of these novel technologies for the understanding of pathogenic cascades and the prediction of therapeutic outcomes in dementia. About 10-30% of Western populations are defective in genes of the CYP superfamily. The most frequent CYP2D6 variants in the Iberian peninsula are the *1/*1 (57.84%), *1/*4 (22.78%), *1×N/*1 (6.10%), *4/*4 (2.56%), and *1/*3 (2.01%) genotypes, accounting for more than 80% of the population. The frequency of extensive (EMs), intermediate (IMs), poor (PMs), and ultra-rapid metabolizers (UMs) is about 59.51%, 29,78%, 4.46%, and 6.23%, respectively, in the general population, and 57.76, 31.05%, 5.27%, and 5.90%, respectively, in AD cases. The construction of a genetic map integrating the most prevalent CYP2D6+CYP2C19+CYP2C9 polymorphic variants in a trigenic cluster yields 82 different haplotype-like profiles, with *1*1-*1*1-*1*1 (25.70%), *1*1-*1*2-*1*2 (10.66%), *1*1-*1*1-*1*1 (10.45%), *1*4-*1*1-*1*1 (8.09%), *1*4-*1*2-*1*1 (4.91%), *1*4-*1*1-*1*2 (4.65%), and *1*1-*1*3-*1*3 (4.33%), as the most frequent genotypes. Only 26.51% of AD patients show a pure 3EM phenotype, 15.29% are 2EM1IM, 2.04% are pure 3IM, 0% are pure 3PM, and 0% are 1UM2PM. EMs and IMs are the best responders, and PMs and UMs are the worst responders to a combination therapy with cholinesterase inhibitors, neuroprotectants, and vasoactive substances. The pharmacogenetic response in AD appears to be dependent upon the networking activity of genes involved in drug metabolism and genes involved in AD pathogenesis (e.g., APOE). AD patients harboring the APOE-4/4 genotypes are the worst responders to conventional antidementia drugs. To achieve a mature discipline of pharmacogenomics in CNS disorders and dementia it would be convenient to accelerate the following processes: (i) to educate physicians and the public on the use of genetic/genomic screening in daily clinical practice; (ii) to standardize genetic testing for major categories of drugs; (iii) to validate pharmacogenomic information according to drug category and pathology; (iv) to regulate ethical, social, and economic issues; and (v) to incorporate pharmacogenomic procedures both to drugs in development and drugs on the market in order to optimize therapeutics.


Different hemodynamic stress of the ascending aorta wall in patients with bicuspid and tricuspid aortic valve.
It is unclear whether ascending aorta dilation in patients with bicuspid aortic valve is caused by abnormal hemodynamics or by a common developmental defect of the aortic valve and aortic wall. We performed an echocardiographic study to examine the differences in hemodynamic stress at the ascending aorta in patients with bicuspid and tricuspid aortic valve. We studied prospectively 58 consecutive patients referred for preoperative echocardiographic examination with aortic valve stenosis and either bicuspid or tricuspid valve and an ascending aortic diameter of </=4.5 cm. Echocardiographic examination was performed from the parasternal long-axis view using ALOKA SDD 5.500 (Aloka, Tokyo) with 3.5 MHz probe. With aortic wall tissue Doppler imaging we obtained wall motion velocity patterns from the anterolateral and posteromedial region of the ascending aorta. The tissue Doppler examination showed a significantly higher peak systolic wall velocity of the anterolateral region of the ascending aorta in patients with bicuspid aortic valve (12.2 +/- 4.3 cm/sec vs. 8.8 +/- 2.6 cm/sec, p = 0.047). We conclude that in patients with bicuspid aortic valve and aortic valve stenosis the anterolateral region of the ascending aorta is subject to greater hemodynamic stress than in patients with tricuspid aortic valve.


Combination of microneutralization and avidity assays: improved diagnosis of recent primary human cytomegalovirus infection in single serum sample of second trimester pregnancy.
Estimation of IgG avidity index is a classical serological method. Antibodies with low avidity are detectable at a very early stage of infection whereas high avidity antibodies indicate past infection. Recently, it was shown that the neutralization assay can be routinely used as a reliable method for differentiating between acute primary and non-primary infection in a single serum sample because the first neutralizing titers (NT) appeared after an average of 13 weeks (range, 10-17 weeks). A low positive NT titer in the presence of specific IgM antibodies, however, still represents a diagnostic problem especially if blood sampling occurred after the 12th week of gestation. To overcome this problem the combination of NT and IgG avidity tests was evaluated. Human cytomegalovirus (HCMV) IgG avidity indices of 350 serum samples from 227 pregnant women were investigated using 6M urea in the washing buffer. HCMV specific IgG antibodies reached full maturation approximately 20-22 weeks after seroconversion and low IgG avidity is therefore a marker of primary infection. The combined application of the microneutralization and avidity assays was shown to serve as a helpful tool in diagnosis of a recent primary HCMV infection of second trimester pregnancy particularly when previous serological data were not available.


Topic selection for the Australian census of population and housing.
"We describe how topics were selected for the Australian Census of Population and Housing. Australia has adopted an open assessment of topics submitted by users and the general public and then performed field tests of difficult or sensitive questions. For the 1986 Census, special attention was given to the development of a census question on ethnic origin."


Long-term follow-up of 246 adults with juvenile idiopathic arthritis: education and employment.
To examine the levels of education and employment in adults with juvenile idiopathic arthritis (JIA) compared with their siblings and national figures. Two hundred and forty-six adults identified with long-standing JIA had an average disease duration of 28.3 yr. Educational achievements and employment status were recorded and comparative data obtained from siblings and the National Office for Statistics, UK. The effects, incidence and nature of discrimination in the workplace were also explored. Across all levels of education the study group achieved significantly better results than both the national average and their siblings. In contrast, the rate of unemployment in the patient group was more than twice that in the national population. The percentage of patients who had encountered discrimination in the workplace was 25.1.


High-Spatial-Resolution Three-dimensional Imaging of Human Spinal Cord and Column Anatomy with Postmortem X-ray Phase-Contrast Micro-CT.
Background Modern high-spatial-resolution radiologic methods enable increasingly detailed volumetric postmortem investigations of human neuroanatomy for diagnostic, research, and educational purposes. Purpose To evaluate the viability of postmortem x-ray phase-contrast micro-CT to provide tissue-conserving, high-spatial-resolution, three-dimensional neuroimaging of the human spinal cord and column by comparing quality of x-ray phase-contrast micro-CT images of nondissected Thiel-embalmed human spines with images of extracted formalin-fixed human spinal cords. Specific focus was placed on assessing the detection of micrometric spinal cord soft-tissue structure and vasculature. Materials and Methods In this study from August 2015 to August 2019, three Thiel-embalmed human spinal column samples, unilaterally perfused with an iodinated vascular contrast agent, and three extracted formalin-fixed spinal cord samples were imaged postmortem at a synchrotron radiation facility. Propagation-based x-ray phase-contrast micro-CT was used with monochromatic 60-keV x-rays and a detector with either 46-µm or 8-µm pixel sizes. A single-distance phase-retrieval algorithm was applied to the acquired CT projection images in advance of filtered back projection CT reconstruction. The influence on image quality of Thiel versus formalin embalming was examined, and images were qualitatively evaluated in terms of the value of their anatomic representations. Results The x-ray phase-contrast micro-CT of Thiel-embalmed samples resulted in soft-tissue contrast within the vertebral canal, despite evident nervous tissue deterioration after Thiel embalming. Gross spinal cord anatomy, spinal meninges, contrast agent-enhanced spinal vasculature, and spinal nerves were all well rendered alongside surrounding vertebral bone structure. The x-ray phase-contrast micro-CT of formalin-fixed boneless cords led to much higher gray versus white matter contrast and to microscale visualization of deep medullary vasculature and neuronal perikarya. Conclusion This work demonstrated the use of x-ray phase-contrast micro-CT for detailed volumetric anatomic visualization of embalmed human spines. The method provided three-dimensional display of bone, nervous tissue, and vasculature at microscale resolutions without exogenous contrast agents. © RSNA, 2020 Online supplemental material is available for this article.


[Analysis of chimeric mice bearing the fused mutation].
Interaction of cells with different genotypes and expression of Fused (Fu) gene in chimaeric mice were studied. Genetic analysis of 20 chimaeras showed that gonads of chimaeras in our experiments consisted of white component cells. The analysis of Fu gene expression in chimaeric mice supported the conclusions of the previous papers that mutations of Fu gene appeared not in the result of the hypofunction of normal allele. Two hypotheses were proposed: 1) the product of Fu gene migrates out of the mutant cells and changes the phenotype of the cells with normal allele; 2) suppressors from C57BL/6 mice influence on the penetrance of Fu gene only on the intracellular level.


Arbidol increases the survival rate by mitigating inflammation in suckling mice infected with human coronavirus OC43 virus.
Human coronavirus OC43 (HCoV-OC43) often causes common cold and is able to neuroinvasive, but it can also induce lower respiratory tract infections (LRTI) especially in children and the elderly adults with underlying diseases. HCoV-OC43 infections currently have no approved antiviral treatment. Arbidol (ARB) is a broad-spectrum antiviral and is an antiviral medication for the treatment of influenza used in Russia and China. Due to its multiple mechanisms of action, such as inhibition of viral fusion and entry, immunomodulation, and modulation of host cell signaling pathways, ARB has the potential to be an effective treatment option for viral infections. Therefore, the study aims to investigate the activities of ARB against HCoV-OC43 infections. Suckling mice were infected with HCoV-OC43 and treated with ARB (50, 25 and 12.5 mg/kg/d) by gavage once daily for 4 days. the survival rates and body weight were recorded, the viral titer was measured by real-time quantitative polymerase chain reaction, cytokine levels were measured by Bio-Plex assays. Histopathological changes of the lungs and brain were analyzed. Our results show ARB increased the survival rate, reduced viral copy numbers in the lung, mitigated pro-inflammatory cytokine production, and improved brain and lung histopathology significantly without any significant toxicity or side effects in vivo. Our results suggest ARB could be a promising approach for the prevention and treatment of HCoV-OC43 while further studies are needed to address these possibilities and the underlying mechanism.


Extraction and partial characterization of the glycine decarboxylase multienzyme complex from pea leaf mitochondria.
Glycine decarboxylase has been successfully solubilized from pea (Pisum sativum) leaf mitochondria as an acetone powder. The enzyme was dependent on added dithiothreitol and pyridoxal phosphate for maximal activity. The enzyme preparation could catalyze the exchange of CO(2) into the carboxyl carbon of glycine, the reverse of the glycine decarboxylase reaction by converting serine, NH(4) (+), and CO(2) into glycine, and (14)CO(2) release from [1-(14)C]glycine. The half-maximal concentrations for the glycine-bicarbonate exchange reaction were 1.7 millimolar glycine, 16 millimolar NaH(14)CO(2), and 0.006 millimolar pyridoxal phosphate. The enzyme (glycine-bicarbonate exchange reaction) was active in the assay conditions for 1 hour and could be stored for over 1 month. The enzymic mechanism appeared similar to that reported for the enzyme from animals and bacteria but some quantitative differences were noted. These included the tenacity of binding to the mitochondrial membrane, the concentration of pyridoxal phosphate needed for maximum activity, the requirement for dithiothreitol for maximum activity, and the total amount of activity present. Now that this enzyme has been solubilized, a more detailed understanding of this important step in photorespiration should be possible.


Orthosteric- and allosteric-induced ligand-directed trafficking at GPCRs.
Many orthosteric agonists differentially activate downstream effectors of GPCRs. Such defined induction of signaling has strongly supported the hypothesis termed 'ligand-directed trafficking of receptor signaling' (LDTRS). More recently, subtype-selective GPCR activators, such as allosteric agonists and positive allosteric modulators, have also exhibited the capacity to activate specific signaling pathways. Based on this finding, it may be possible to achieve ligand-specific receptor active states that optimize the biological responses specific to GPCRs. This review discusses recent studies in which both orthosteric and allosteric compounds have been demonstrated to induce LDTRS.


Plasma levels of the leucocyte L1 protein in febrile conditions: relation to aetiology, number of leucocytes in blood, blood sedimentation reaction and C-reactive protein.
Plasma levels of a novel leucocyte protein (L1) were determined in a series of 176 febrile patients and compared with CRP, BLC, and BSR. Among 82 patients with bacterial infection, 81 had L1 levels above the 0.95 interval. Levels of 40 to 130 times the normal mean were seen frequently during life-threatening infections like septicaemia, meningitis, or pneumonia. In contrast, 23 of 27 patients with viral infections had normal L1 levels. A poor correlation was found between L1 levels, CRP, BLC, and BSR, suggesting that these parameters reflect different aspects of the response to tissue damage and inflammation. L1 and CRP seem equal in distinguishing between bacterial and viral infections. Low or normal L1 levels argue strongly against a bacterial infection, while elevated L1 levels discriminate poorly between bacterial and non-infectious inflammatory or malignant diseases.


Malignant histiocytosis of the skin: a case report and review of the literature.
Malignant histiocytosis is a rare neoplasm composed of abnormal histiocytes typically affecting the liver, spleen, lymph nodes, and bone marrow. This entity has been rarely documented involving the skin and has never been reported confined to the skin. A 74-year-old white man presented to the dermatology clinic with complaints of a non-healing ulcerated lesion on his cheek of several months duration. Histopathological examination revealed a poorly circumscribed neoplasm consisting of pleomorphic epithelioid cells with abundant foamy cytoplasm. Immunohistochemistry was positive for CD-43, CD-68, and lysozyme, but negative for CD-3, CD-20, CD-30, CD-34, SMA, CD-1a or S-100. The prominent CD-68 and lysozyme staining along with the histological features, the clinical presentation of erythematous nodules with diffuse erythematous plaques, and absence of bone marrow findings, led to the diagnosis of malignant histiocytosis confined to the skin. Malignant histiocytosis involving the skin is rare. The presence of large pleomorphic epithelioid cells with foamy cytoplasm, with or without engulfed erythrocytes should alert the dermatopathologist to the possibility of malignant histiocytosis. Appropriate immunohistochemical evaluation, including CD-43, CD-68, CD-1a, S-100, and lysozyme, should be completed to confirm the diagnosis.


Myxoid leiomyosarcoma of the uterus.
A case of myxoid leiomyosarcoma of the uterus is presented. In contrast to 10 of the 11 previously published cases, our patient has a tumor with a high mitotic rate. The patient presented with a 2-month history of vaginal bleeding and a 20-week-size uterine mass. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. At the time of surgery, the tumor appeared well circumscribed. Microscopically, an infiltrative growth pattern, bizarre nuclei, and 30 abnormal mitotic figures per 10 high power fields were noted. The patient was treated with ifosfamide and mesna. After the fifth course of chemotherapy, a pelvic mass was palpated. Exploratory laparotomy demonstrated a large sidewall recurrence and upper abdominal metastases which were completely resected. The patient is currently being treated with combination chemotherapy consisting of vincristine, Adriamycin, and cyclophosphamide. Ten of the 11 previously reported cases of myxoid leiomyosarcoma had a low mitotic count. However, our patient has a high mitotic count in combination with an infiltrative growth pattern. Ifosfamide was ineffective as adjuvant chemotherapy and there was aggressive tumor growth while the patient was on this regimen.


Bimodal Evans-Polanyi Relationships in Dioxirane Oxidations of sp3 C-H: Non-perfect Synchronization in Generation of Delocalized Radical Intermediates.
The selectivities in C-H oxidations of a variety of compounds by DMDO have been explored with density functional theory. There is a linear Evans-Polanyi-type correlation for saturated substrates. Activation energies correlate with reaction energies or, equivalently, BDEs (ΔH‡sat = 0.91*BDE - 67.8). Unsaturated compounds, such as alkenes, aromatics, and carbonyls, exhibit a different correlation for allylic and benzylic C-H bonds (ΔH‡unsat = 0.35*BDE - 13.1). Bernasconi's Principle of Non-Perfect Synchronization (NPS) is found to operate here. The origins of this phenomenon were analyzed by a Distortion/Interaction model. Computations indicate early transition states for H-abstractions from allylic and benzylic C-H bonds, but later transition states for the saturated. The reactivities are mainly modulated by the distortion energy and the degree of dissociation of the C-H bond. While the increase in barrier with higher BDE is not unexpected from the Evans-Polanyi relationship, two separate correlations, one for saturated compounds, and one for unsaturated leading to delocalized radicals, were unexpected.


Outpatient pediatric cardiology consultations in a tertiary academic hospital.
Cardiac diseases in the pediatric population can be congenital or acquired. If the diagnosis and treatment are early, the chance for survival increases. Thus, this study aimed to determine the indications for pediatric cardiology consultations in a single tertiary hospital in Jeddah, Saudi Arabia. This study was conducted in 2020-2021 at a tertiary center in Jeddah, Saudi Arabia. Patients younger than 14 years of age who were referred by outpatient clinics or those who presented to the emergency department and needed outpatient cardiac evaluation were included in this study. Inpatient referrals were excluded. The Statistical Package for the Social Sciences version 21 was used for statistical analyses. A total of 416 referred patients were included in this study. New patients accounted for 74% of the referrals, while known patients accounted for 26%. The median age was 2.728 years, with 56.3% being male participants. The three most common reasons for referral were: evaluation of cardiac function (21.6%), follow-up evaluation of fetal/neonatal diagnosis (19.5%), and heart murmurs (16.8%). Most of the referrals were new patients. Of those who underwent echocardiography, 48.2% had abnormal results. We recommend further studies to help guide the direction of the residents' education and to provide better patient healthcare services.


Faithful solid state optical memory with dynamically decoupled spin wave storage.
We report a high fidelity optical memory in which dynamical decoupling is used to extend the storage time. This is demonstrated in a rare-earth doped crystal in which optical coherences were transferred to nuclear spin coherences and then protected against environmental noise by dynamical decoupling, leading to storage times of up to 4.2 ms. An interference experiment shows that relative phases of input pulses are preserved through the whole storage and retrieval process with a visibility ≈1, demonstrating the usefulness of dynamical decoupling for extending the storage time of quantum memories. We also show that dynamical decoupling sequences insensitive to initial spin coherence increase retrieval efficiency.


Clinical data supporting the importance of vascular LH/hCG receptors of uterine blood vessels.
Recent studies revealed functional extragonadal gonadotropin receptors at several sites of the human body. The human chorionic gonadotropin/luteinizing hormone (hCG/LH) receptor messenger RNA and protein were found in the endothelial and vascular smooth muscle layers of the human uterine arteries. In vivo administration of hCG decreased the blood flow resistance in the human uterus and in vitro increased vasodilating eicosanoids in the vascular wall. These findings initiated a further study investigating whether the administration of hCG to patients with signs of threatened abortion has any beneficial effect. The patients were treated with either magnesium or progesterone and/or hCG. The results showed that the rate of patients reaching second trimester was higher when hCG was included in the treatment protocol, and a parallel significant decrease in uterine blood flow resistance was also found. Analyzing the long-term results, the rate of preterm and growth-retarded deliveries was lower when hCG was administered in the first trimester. As a conclusion, the uterine vascular LH/hCG receptors play a significant role in the peri-implantation period. The hCG might also participate in angiogenesis, enhancing long-term clinical results.


[Research-based assessment of antibiotic resistance of beta hemolytic group B streptococci].
Since the 1950s, beta hemolytic streptococcus group B have constituted the major etiological factor of perinatal infections. GBS colonization of the genital tract among pregnant women is diagnosed between 35 and 37 weeks of gestation, and is associated with approximately 25% risk of neonatal early-onset infections (EOD). The infection is severe among 1-3% of the newborns, and usually results in sepsis or pneumonia. beta-lactam antibiotics are drugs of choice to prevent vertical infection of group B streptococcus. In case of hypersensitivity to penicillin among pregnant women, second line drugs are macrolides and lincosamides. In light of numerous reports on the decreasing susceptibility of GBS, the aim of this study was to characterize the isolated strains of Streptococcus agalactiae in terms of their resistance to antibiotics. The study included 395 pregnant women in the third trimester of pregnancy hospitalized in the Department of Perinatology and Department of Gynecology and Obstetrics, Medical University of Lodz, between 02.2010 -02.2012. Vagino-rectal swabs were collected from all pregnant women. We recovered 121 GBS positive isolates. Identification was based on the streptococcal agglutination test. Antimicrobial susceptibility was determined by disk diffusion method. A positive result for GBS colonization was found among 89 patients, representing 22.5% of the studied population. Inducible MLSB resistance to erythromycin and clindamycin was 23.1% and 10.7% of the isolated strains, respectively Constitutive MLSB resistance was detected in 14.9% of the cases. The obtained results confirm that all GBS isolates are sensitive to beta-lactam antibiotics and prove that phenotypes resistant to macrolides and clindamycin are becoming more widespread. This leads to the conclusion that regular supervision of drug sensitivity of Streptococcus agalactiae is necessary


Prenatal diagnosis of trisomy 8 mosaicism, initially identified by cffDNA screening.
So called cell-free fetal DNA (cffDNA) in the maternal plasma, which is derived from placenta, is widely used to screen fetal aneuploidies, including trisomy 21, 18, 13 and sex chromosomes. Here we reported a case of trisomy 8 mosaicism (T8M), which was initially identified via cffDNA screening in noninvasive prenatal testing (NIPT). A 35-year-old woman received cffDNA screening at 17th week of gestation. Amniocentesis was performed subsequently, and karyotyping, single-nucleotide polymorphism array (SNP-array) and BACs-on-Beads™ (BoBs™) were used to determine fetal chromosome content. Interphase fluorescence in situ hybridization (FISH) was applied to determine the copy number of chromosome 8. An enhanced risk for fetal trisomy 8 was identified by cffDNA screening in the studied pregnant woman. After amniocentesis trisomy 8 was found in 1 of 73 metaphases. SNP-array on DNA derived from cultured amniocytes and neonatal cord blood cells suggested the presence of T8M. Interphase FISH on native neonatal cord blood cells confirmed T8M with a percentage of 10%. The Bobs™ fluorescence data also suggested that 8q23-8q24 was amplified. The current study shows that NIPT is suited to provide hints on rare autosomal trisomies, which have to be further validated and confirmed by other approaches.


Could male circumcision reduce HIV incidence in the UK?
We consider the public health relevance of three recent African clinical trials showing male circumcision (MC) to reduce female-to-male transmission of HIV for the UK. Although heterosexually acquired HIV infections now account for the majority of new diagnoses in the UK each year, it is important to note that when considering the public health relevance of MC for the UK a large majority of these infections are acquired abroad. Men who have sex with men (MSM) remain those most at risk of acquiring their HIV infection in the UK. The efficacy and effectiveness of MC among MSM and in particular its protective role in unprotected anal intercourse between men remains unknown. Any future consideration of the role of MC in reducing HIV incidence in the UK should not be at the expense of weakening existing effective interventions.


Molecular Simulation of the Separation of Some Amino Acid Enantiomers by β-Cyclodextrin in Gas-Phase.
The complexes formed by β-cyclodextrin and some amino acids (alanine, valine, leucine, and isoleucine) in vacuo are studied by molecular mechanics and dynamics simulations. These methods have been improved with respect to our previous studies with amino acids, regarding the determination of molecular structures or initial enantiomer dispositions in the molecular dynamics trajectories. The greatest contribution to the interaction energy is from the van der Waals term, although the discrimination between enantiomers is due mainly to the electrostatic contribution. The lowest energy structures of the complexes obtained from molecular mechanics are inclusion complexes in which the carboxylic end of amino acids is pointing toward the narrow (D-) or wide rim (L-) of β-cyclodextrin. The position probability density provided by molecular dynamics also confirms inclusion complex formation, because the guests spend most time inside the cavity of β-cyclodextrin along its axis, with the carboxylic end pointing toward the narrow rim. The L-amino acids are the first eluted enantiomers in all cases and chiral discrimination increases with the size of guests, except leucine, which has the lowest capacity to discriminate. During the simulation, Ala and Val remain in weakly enantioselective regions, while Leu and Ile stay in zones with great chiral selectivity.


Decreased level of soluble receptor activator of nuclear factor-κβ ligand (sRANKL) in overweight and obese children.
Childhood obesity contributes to the development of cardiovascular diseases. The molecular pathway - receptor activator of nuclear factor-κβ ligand (RANKL), its receptor RANK and osteoprotegerin (OPG) - takes part not only in bone metabolism but is also involved in the atherosclerosis process. RANKL stimulates osteogenic differentiation and calcification of vascular smooth cells. The associations between the OPG-sRANKL system and various cardiovascular risk factors were displayed. We aimed to evaluate the relationships between serum sRANKL (soluble RANKL) levels and the OPG/sRANKL ratio with cardiometabolic risk factors in overweight and obese children. The study included 70 children with overweight and obesity (mean age 13.0 ± 2.8) and 35 age-matched normal weight, healthy peers as a control group. In all patients, anthropometric measurements and laboratory tests were performed. Additionally, an oral glucose tolerance test (OGTT) was made only in overweight and obese children. Atherogenic and insulin resistance indices were calculated. Overweight and obese children had lower sRANKL levels compared to the control group (median 276.95 vs 325.90, p=0.011), and consequently a higher OPG/sRANKL ratio (0.02 vs 0.01, p = 0.013). The studied children in the lowest quartile of sRANKL levels had higher body weight, Body Mass Index, waist circumference and increased glucose and insulin levels 60 minutes after OGTT and higher uric acid values compared to children in the highest quartile. In multivariable linear regression analysis sRANKL negatively correlated only with uric acid (β = - 0.508, p = 0.041). No association was found for the OPG/sRANKL ratio. Excess fat mass seems to alter the OPG/RANKL ratio mainly by reducing serum sRANKL levels. The correlation between sRANKL and uric acid may suggest a contribution of the OPG-sRANKL system in the cardiometabolic process, but that observation should be confirmed in future studies.


Human ryudocan from endothelium-like cells binds basic fibroblast growth factor, midkine, and tissue factor pathway inhibitor.
Ryudocan, a heparan sulfate proteoglycan, was isolated from human endothelium-like EAhy926 cells by a combination of ion-exchange and immunoaffinity chromatography. Purified human ryudocan has biochemical properties similar to those of rat ryudocan isolated from microvascular endothelial cells. Human ryudocan contains only heparan sulfate (HS) glycosaminoglycan chains along with a core protein with an apparent molecular mass of 30 kDa. We evaluated the interactions between purified human ryudocan and several extracellular ligands by using a solid-phase binding assay. We found that basic fibroblast growth factor (bFGF), midkine (MK), and tissue factor pathway inhibitor (TFPI) exhibit significant ryudocan binding. Heparitinase (but not chondroitin ABC lyase) treatment destroyed the ability of ryudocan binding to bFGF, MK, and TFPI. Heparin and HS, but not chondroitin sulfate, inhibited such ryudocan binding. Thus, the HS chains of ryudocan appear to be responsible for its binding to bFGF, MK, and TFPI. The apparent dissociation constants for purified ryudocan were as follows: bFGF, 0.50 nM; MK, 0.30 nM; and TFPI, 0.74 nM. Immunohistochemical analysis revealed that ryudocan was expressed in fibrous connective tissues, peripheral nerve tissues, and placental trophoblasts. These findings suggest that ryudocan may possess multiple biological functions, such as bFGF modulation, neurite growth promotion, and anticoagulation, via HS-binding effectors in the cellular microenvironment.


Webs of reciprocity: Colonial taxation and the need for reparations.
My BJS lecture considered how dominant understandings of distributive justice and welfare have been conceptualised through the "nation" and argued that a more adequate framing requires them to be addressed also in the context of colonial and imperial relations. It argues that a just politics in the present has to account for this history and that one way of doing this effectively would be through a reparative frame. In this short response, I engage with the commentaries on my lecture.


Multimodal imaging of early stage 1 type 3 neovascularization with simultaneous eye-tracked spectral-domain optical coherence tomography and high-speed real-time angiography.
To analyze the multimodal imaging features of eyes with early Type 3 neovascularization showing primarily intraretinal proliferation without evidence of choroidal involvement. The multimodal imaging data for a consecutive series of patients with new onset stage 1 Type 3 neovascularization were reviewed and the changes at the site of early lesion development were analyzed. Nineteen eyes of 19 patients (12 women, mean age 79.9 ± 6.3 years) were included for analysis. Both fluorescein angiography and indocyanine green angiography showed a focal hyperfluorescence corresponding to the intraretinal vascular complex (early Type 3 neovascularization) and disclosed a single retinal arteriole feeding this lesion. There was no angiographic evidence of a retinal-choroidal anastomosis or underlying Type 1 or Type 2 neovascularization. In all study eyes, eye-tracked spectral-domain optical coherence tomography showed the intraretinal neovascular complex as a hyperreflective lesion located in the outer retina, which appeared adherent to the underlying retinal pigment epithelium. In all eyes, there seemed to be a focal discontinuity of the retinal pigment epithelium band through which the hyperreflective intraretinal lesions communicated with the underlying material of medium reflectivity within drusen or drusenoid pigment epithelium detachment. With spectral-domain optical coherence tomography, clear evidence of a communication with the choroid was not detected. Multimodal imaging seems to support available clinicopathologic findings showing primarily intraretinal proliferation and anastomoses between retinal vessels and evolving Type 1 (subretinal pigment epithelium) neovascular tissue within underlying drusen or drusenoid pigment epithelium detachments without evidence of anastomoses with the choroidal circulation.


Promoting screening and early detection of cancer in men.
Gender is a factor in the risk assessment for many diseases. It may also impact on the way in which men assess their personal health or illness status and take action to prevent illness or promote well-being. This paper is focused on three objectives: (i) to foster an understanding of gender differences in health promoting behaviors; (ii) to review three health issues affecting males for which dissemination of health education, increased personal awareness and early detection may be beneficial in the reduction of morbidity and mortality; and (iii) to offer suggestions for nurses and other health care professionals to promote positive patient-provider interactions within a health-care framework for action.


Evidence-based treatments for eosinophilic esophagitis: insights for the clinician.
Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder characterized by symptoms of esophageal dysfunction and eosinophil-predominant inflammation. Left untreated, EoE progresses to fibrous remodeling and stricture formation that impairs quality of life. Therefore, EoE requires either repeated treatments or maintenance therapy. Current guidelines recommend swallowed topical corticosteroids (STCs), proton-pump inhibitors (PPIs), or dietary intervention as initial options to induce and maintain long-term disease remission. Impractical exclusive elemental diets and suboptimal allergy testing-directed food avoidance paved the way for empirical elimination diets. These are moderately effective and highly reproducible in inducing EoE remission and allow for identification of specific food triggers. Step-up strategies, including two- and four-food rather than six-food elimination diets, should be considered as initial approaches for dietary treatment in patients of all ages, as they reduce the need for endoscopic procedures, shorten diagnostic processing time, and avoid unnecessary restrictions. Formulations of STC originally designed for asthma therapy are suboptimal for EoE treatment, with new effervescent orodispersible tablets and viscose formulations designed to coat the esophageal mucosa providing increased effectiveness at reduced doses. The anti-inflammatory effects of PPI in EoE are independent from gastric acid secretion inhibition; despite evidence from observational research, PPIs are the most commonly prescribed first-line therapy for EoE due to their accessibility, low cost, and safety profile. Double doses of PPI only induce remission in half of EoE patients, irrespective of the drug used or patients' age. Inflammatory rather than stricturing EoE phenotype and treatment duration up to 12 weeks increase chances of achieving EoE remission. Most responders effectively maintain long-term remission with standard PPI doses. Finally, endoscopic dilation should be considered in patients with reduced esophageal caliber or persistent dysphagia despite histological remission. This article provides a state-of-the-art review and updated discussion of current therapies and newly developed options for EoE.


Behavior Rating Inventory of Executive Function - adult version (BRIEF-A) in Iranian University students: Factor structure and relationship to depressive symptom severity.
Major depressive disorder is the most common psychiatric illness in Iran, and depression is common among university students in the country. The presence of depression is frequently associated with problems in executive functioning. The Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) is a questionnaire measure designed to assess executive functioning in everyday life in clinical and non-clinical populations. Currently, there is limited empirical validation of the measure for use in Iran. This study evaluated the psychometric properties of a Persian-language BRIEF-A in a sample of Iranian university students (n = 300). The factor structure of the BRIEF-A was examined via a confirmatory factor analysis. We also evaluated whether BRIEF-A scores differed among university students varying in severity of depressive symptoms (Minimal, Mild, Moderate, Severe) as measured by the Beck Depression Inventory - II. Results indicated that a two-factor model structure best fit the data for the BRIEF-A. Acceptable internal consistency was also observed. Furthermore, poorer subjective executive functioning was endorsed by the three depressive subgroups relative to the Minimal symptoms group. Together, these findings support a two-factor model for the Persian translation of the BRIEF-A, and indicate that more severe depressive symptoms in Iranian university students is associated with worse subjective executive functioning.


Pulmonary embolism following operative treatment of ankle fractures: a report of three cases and review of the literature.
The risks of thromboembolism following operative treatment of ankle fractures are deep vein thrombosis (DVT) and pulmonary embolism (PE). These are potentially life-threatening complications. Many orthopedic surgeons fail to appreciate the potential complications of thromboembolic events because of their rare and delayed occurrence in foot and ankle operations. The purpose of this report is to describe the potential for DVT and PE following ankle operations. We present three cases in which patients who underwent operative treatment of ankle fractures subsequently developed PE. We also review the literature on the prevalence of thrombosis, risk factors, methods of prophylaxis, and use of prophylaxis in surgical procedures of the lower extremity.


Characterization of heparin binding of human extracellular superoxide dismutase.
The C-terminal domain of human extracellular superoxide dismutase (hEC-SOD) plays a crucial role in the protein's interaction with heparin. Here we investigated this interaction in more detail by comparing the heparin-binding characteristics of two variants of hEC-SOD: the two fusion proteins containing the hEC-SOD C-terminal domain and a synthetic peptide homologous to the C-terminal. The interaction studies were performed using a surface plasmon resonance based technique on a BIAcore system. It should be emphasized that this is a model system. However, the kinetic constants, as measured, are valid in a comparative sense. Comparison of affinities for size-fractionated heparins revealed that octa- or decasaccharides are the smallest heparin fragments that can efficiently interact with the C-terminal domain of hEC-SOD. At physiological salt concentration, and pH 7.4, the hEC-SOD/heparin interaction was found to be of a high-affinity type, with an equilibrium dissociation constant, K(d), of 0.12 microM, which is 700 and 10-20 times lower than the K(d) values for the synthetic peptide and the fusion proteins, respectively. However, when an alpha-helical structure was induced in the synthetic peptide, by addition of 10% trifluoroethanol, the K(d) decreased to 0.64 microM. The differences in the K(d) values were mainly governed by differences in the association rate constants (k(ass)). The hEC-SOD/heparin interaction itself was found to have a fairly high dissociation rate constant (0.1 s(-)(1)), and a very high association rate constant (8 x 10(5) M(-)(1) s(-)(1)), suggesting that the interaction is mainly controlled by the association. These results together with circular dichroism spectra of the synthetic peptide suggest that an alpha-helical structure in the C-terminal is essential for optimal binding to heparin and that other parts of hEC-SOD moderate the affinity. Our data also demonstrate that the tetramerization itself does not substantially increase the affinity.


Pituitary function in thalassemic patients and the effect of chelation therapy.
This study examined anterior pituitary function and the effect of chelation therapy in 31 patients with beta-thalassemia/HbE disease. Patients were divided into those receiving chelation therapy by deferoxamine and those receiving no such therapy (control group). Pituitary function studies were repeated in both groups 18 months later. The results showed decreased pituitary responses following stimulation in 22 patients. Among these, gonadotropin and PRL responses were most affected. After 18 months, serum ferritin levels had significantly decreased in the deferoxamine group. PRL and GH responses were improved in 3 patients receiving chelation therapy without changes in other hormone responses. In contrast, no changes in pituitary responses were shown in the control group at the end of follow-up. There were 6 drop-outs (4 in the control and 2 in the deferoxamine group) and 3 deaths (2 in the control and 1 in the deferoxamine group) during 18 months. In conclusion, gonadotropin and PRL deficiencies occur most frequently in thalassemic patients. Chelation therapy for 18 months markedly reduced serum ferritin level and might preserve or improve PRL and GH secretions, but seems to have no beneficial effects on other pituitary hormone reserves.


Complete tubular colonic duplication in an adult: a rare incidental finding and the risk of colonoscopic perforation.
Gastrointestinal duplications are unusual congenital malformations, nearly always diagnosed in childhood. Roughly 80% are cysts-like lesions and only a small percentage (4-18%) involves the colonic wall. Almost all are asymptomatic and therefore diagnosed as an incidental finding on imaging tests or when become complicated and present with perforation or bleeding. The need for an elective surgical treatment is controversial and should be indicated on an individual basis. This report is a case of an adult with a complete tubular colonic duplication found incidentally by colonoscopy that required surgical treatment due to perforation.


Assessment of auditory impression of the coolness and warmness of automotive HVAC noise.
Noise induced by a heating, ventilation and air conditioning (HVAC) system in a vehicle is an important factor that affects the comfort of the interior of a car cabin. Much effort has been devoted to reduce noise levels, however, there is a need for a new sound design that addresses the noise problem from a different point of view. In this study, focusing on the auditory impression of automotive HVAC noise concerning coolness and warmness, psychoacoustical listening tests were performed using a paired comparison technique under various conditions of room temperature. Five stimuli were synthesized by stretching the spectral envelopes of recorded automotive HVAC noise to assess the effect of the spectral centroid, and were presented to normal-hearing subjects. Results show that the spectral centroid significantly affects the auditory impression concerning coolness and warmness; a higher spectral centroid induces a cooler auditory impression regardless of the room temperature.


Cerebral microarteriovenous malformations: diagnostic and therpeutic features in a series of patients.
Few collected series of cerebral microarteriovenous malformations (micro-AVMs) have been reported. Our propose was to assess the unique diagnostic and therapeutic challenges posed by these lesions and their influence on outcomes. The clinical presentation, diagnostic features, principles of endovascular or surgical treatment, and outcomes for a consecutive series of 10 patients (five male, five female; mean age, 48.8 years; age range, 31-65 years) with angiographically demonstrated cerebral micro-AVMs were retrospectively analyzed. All patients presented with a cerebral hematoma (supratentorial in eight, infratentorial in two, intraventricular in one, subarachnoid in one; mean volume, 11.6 cm(3)), which was superficially situated in nine patients. Neurologic deficits were observed in nine patients, and three patients had seizures. The mean delay between the onset of symptoms and diagnosis was 129.8 days (range, 6 days to 1 year). Superselective angiography was performed in seven patients and followed by successful acrylic embolization of the lesion in five. Five patients underwent surgical intervention, which led to definitive resection. Although long-term neurologic problems were present in eight patients, they were able to return to their previous activities and employment. The diagnosis of cerebral micro-AVMs requires a high index of suspicion, especially in young adults with atypical hemorrhaging. Single-shot embolization of micro-AVMs may be a safe alternative to the established surgical therapy in select cases. Outcomes depend mostly on the clinical conditions at admission.


Transcranial magnetic stimulation (TMS) of the brain in patients with mesiotemporal epileptic foci.
Transcranial magnetic stimulation (TMS) of the human brain is mainly used for the diagnosis of diseases with disturbed central motor conduction. Recent studies revealed controversial results concerning the possibility of a TMS-induced specific activation of epileptogenic foci in patients with localization-related epilepsies, which would make TMS an additional diagnostic tool for the presurgical localization of the primary epileptogenic zone. We applied TMS to 19 patients with complex-partial seizures and investigated its effects and safety. In 12 patients we performed TMS during scalp electroencephalogram (EEG) recordings. The remaining 7 patients with localization-related epilepsies of mesiobasal limbic seizure origin underwent EEG with additionally implanted foramen-ovale-electrodes (FOE). We did not notice any significant spike activation and even observed bilateral reduction of epileptic activity in some patients. On the contrary, hyperventilation induced a marked activation of the epileptic focus. Our findings support that TMS is safe since adverse effects did not occur. However, due to possible safety hazards, TMS in epileptic patients still requires cautious application until more data will be available.


Self-selection in responding to a health risk appraisal: are we preaching to the choir?
Abstract The objectives of the present study were a) to examine behavioral and sociodemographic factors associated with voluntary response to a health risk appraisal (HRA), and b) to assess the effect of HRA feedback on subsequent preventive health behaviors and risk-taking behaviors. After collection of health behavior data from a larger sample participating in a Navy-wide health promotion evaluation, an HRA was mailed to a random subsample of 625 individuals. A total of 270 (43 %) people responded to the HRA and received printed feedback. Follow-up health behavior data were collected one year later from 93 of the 270 HRA respondents. These 93 individuals were then matched with a control group who did not receive an HRA but had provided health behavior data both times. Analyses revealed that HRA respondents were older, better educated, had higher health status, smoked less, consumed less alcohol, and used seat belts more often than nonrespondents. Separate analyses of HRA respondents and matched controls indicated that HRA participation had no significant effect on subsequent preventive health behaviors or risk-taking behaviors. Results suggest limitations of the HRA as an effective due to behavior change.


Beyond multimorbidity: primary care and the older person with complex needs.
The aim of this study was to present the health and social characteristics of community-dwelling older people within the Cairns region who were identified by their GP as having complex care needs. This paper reports the subanalysis of baseline data from the Older Persons Enablement and Rehabilitation (OPEN ARCH) stepped wedge randomised controlled trial of an integrated model of care for community-dwelling older people. Data were analysed at the level of the participant and the level of the participant cluster (group of participants from the one GP). Median quality of life, as assessed by the EQ-5D, was higher for females than males (80 vs 70 respectively; P=0.05) and for people living alone than living with family (80 vs 60 respectively; P=0.0940). There was greater functional independence among non-Indigenous than Indigenous participants (median Functional Independence Measure scores of 122 vs 115 respectively; P=0.0937) and the incidence rate (95% confidence intervals) of presentation to the emergency department was sevenfold higher for Indigenous than non-Indigenous participants (11.47 (5.93-20.03) vs 1.65 (0.79-3.04) per 1000 person days respectively). Finally, 61.3% of participants required support to remain living in the community and 44% accessed allied health, with podiatry the most common intervention. The findings indicate that previous hospital utilisation is not a consistent indicator of complexity. Multimorbidity, cultural context and the living and caring situation are considered as matters of complexity, yet variation exists at the participant level.


The importance of metallothionein for the accumulation of copper, zinc and cadmium in environmentally exposed perch, Perca fluviatilis.
A field study of the role of metallothionein (MT) in the binding of heavy metals in perch (Perca fluviatilis), exposed to moderate levels of copper, zinc and cadmium, was performed. Perch were sampled at four sites in Sweden in September during two consecutive years. Two sites were located in the vicinity of a brassworks and two outside the emission range. The first year, fish from the two brassworks sites and from one of the uncontaminated sites were collected. The second year, fish from the most contaminated site and from the two uncontaminated sites were caught. The levels of hepatic copper, zinc and cadmium reflected the concentrations of these metals in water and were increased in fish from the two contaminated sites. The level of cadmium in liver was relatively low. MT was induced in liver of perch caught at the most contaminated site. The hepatic MT content in individual livers correlated well to the accumulation of copper (r = 0.85, P less than 0.001) and zinc (r = 0.75, P less than 0.001). There was a low but significant correlation between the levels of MT and cadmium in the liver (r = 0.48, P less than 0.001). The relationship between MT and metals was very similar both years. Subcellular fractionation of the metals in the liver revealed that an induction of MT was followed by an increased amount of copper, zinc and cadmium bound to the protein. The relative fraction of the total hepatic copper and cadmium bound to MT was increased at the most contaminated site, whereas there was no difference in subcellular distribution of zinc between the sites. In perch from the most contaminated site, the portions of hepatic copper, zinc and cadmium found in the cytosolic fraction were 70, 57 and 81%, respectively. Seventy-one % of the copper, 29% of the zinc and 84% of the cadmium found in hepatic cytosol of fish from the same site, eluted together with MT after gel filtration chromatography. The analysis of the subcellular distribution of copper, zinc and cadmium demonstrates that MT is responsible for the binding of a large amount of the total hepatic cellular content of copper and cadmium in perch.


L-Glutamate secretion by the N-terminal domain of the Corynebacterium glutamicum NCgl1221 mechanosensitive channel.
The Corynebacterium glutamicum NCgl1221 mechanosensitive channel mediates L-glutamate secretion by sensing changes in membrane tension caused by treatments such as biotin limitation and penicillin. The NCgl1221 protein has an N-terminal domain (1-286 a.a.) homologous to the Escherichia coli MscS and a long C-terminal domain (287-533 a.a.) of unknown function. In order to investigate the role of the C-terminal domain in L-glutamate secretion, we constructed a series of C-terminally truncated mutants of NCgl1221. We found that the N-terminal domain, homologous to E. coli MscS, retained the ability to cause L-glutamate secretion in response to the treatment. Electrophysiological analysis confirmed that the N-terminal domain mediated L-glutamate secretion. 3D homology modeling has suggested that the N-terminal domain of NCgl1221 has an extra loop structure (221-232 a.a.) that is not found in most other MscS proteins. The mutant NCgl1221, deleted for this loop structure, lost the ability to secrete L-glutamate. In addition, we found that mutant NCgl1221 lacking the C-terminal extracytoplasmic domain (420-533 a.a.) produced L-glutamate without any inducing treatment. These results suggest that the N-terminal domain is necessary and sufficient for the excretion of L-glutamate in response to inducing treatment, and that the C-terminal extracytoplasmic domain has a negative regulatory role in L-glutamate production.


A study of the pathogenicity of variants in familial heart disease. The value of cosegregation.
With the development of deep sequencing, a significant proportion of mutations already listed in studies have inconclusive pathogenicity. We aim to establish the proportion of cases in which familial studies are possible and cosegregation analysis is informative. We also compare cosegregation analysis with in silico software and a proposed pathogenicity score. 204 consecutive positive tests were reviewed. 4 different in silico software programs were used. Spaendonck-Zwarts' pathogenicity score was also calculated. A total of 73 of the missense variants could be classified by the score as being likely or definitively pathogenic. A high percentage of nonsense variants were found in desmosomal genes and missense variants in sarcomeric genes. 36.3% of the missense variants in our cohort classified as very likely or definitively pathogenic were novel. Cosegregation analysis was positive in 19.5% and could be discarded in 15.6%. There was a significant discrepancy between the in silico tools used in the setting of inherited heart disease. Multiparametric scoring systems which include cosegregation and functional studies seem to perform better than individual prediction software.


Titanium alloys: in vitro biological analyzes on biofilm formation, biocompatibility, cell differentiation to induce bone formation, and immunological response.
Biological effects of titanium (Ti) alloys were analyzed on biofilms of Candida albicans, Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus mutans, and Streptococcus sanguinis, as well as on osteoblast-like cells (MG63) and murine macrophages (RAW 264.7). Standard samples composed of aluminum and vanadium (Ti-6Al-4V), and sample containing niobium (Ti-35Nb) and zirconium (Ti-13Nb-13Zr) were analyzed. Monomicrobial biofilms were formed on the Ti alloys. MG63 cells were grown with the alloys and the biocompatibility (MTT), total protein (TP) level, alkaline phosphatase (ALP) activity, and mineralization nodules (MN) formation were verified. Levels of interleukins (IL-1β and IL-17), tumor necrosis factor alpha (TNF-α), and oxide nitric (NO) were checked, from RAW 264.7 cells supernatants. Data were statically analyzed by one-way analysis of variance (ANOVA) and Tukey's test, or T-test (P ≤ 0.05). Concerning the biofilm formation, Ti-13Nb-13Zr alloy showed the best inhibitory effect on E. faecalis, P. aeruginosa, and S. aureus. And, it also acted similarly to the Ti-6Al-4V alloy on C. albicans and Streptococcus spp. Both alloys were biocompatible and similar to the Ti-6Al-4V alloy. Additionally, Ti-13Nb-13Zr alloy was more effective for cell differentiation, as observed in the assays of ALP and MN. Regarding the stimulation for release of IL-1β and TNF-α, Ti-35Nb and Ti-13Nb-13Zr alloys inhibited similarly the synthesis of these molecules. However, both alloys stimulated the production of IL-17. Additionally, all Ti alloys showed the same effect for NO generation. Thus, Ti-13Nb-13Zr alloy was the most effective for inhibition of biofilm formation, cell differentiation, and stimulation for release of immune mediators.


Nutrition in pathophysiology and treatment of nonalcoholic fatty liver disease.
Overnutrition resulting in obesity plays a key role in nonalcoholic fatty liver disease, the major reason for abnormal liver function in many parts of the world. Currently, it is not clear which type of diet preferentially results in this common disease. Excess nutrition leads to accumulation of various lipids in the liver, where fatty acids are considered the main driving force in the disease process. A liver loaded with fat is commonly associated with insulin resistance, the key pathophysiological phenomenon observed in nonalcoholic fatty liver disease. Not surprisingly, attempts to reduce body weight and thereby total liver fat are considered the key therapeutical steps in this disorder. Although voluntary weight loss is often not successful to reverse the disease process, various surgical procedures have proven effective in reducing overweight situations and liver steatosis. Weight loss not only reduces the amount of liver fat but also might improve inflammation and fibrosis in nonalcoholic steatohepatitis. Although pharmacological approaches are eagerly awaited to achieve similar benefits; current available therapies have so far not fulfilled this expectation. Despite this frustration, such approaches are expected to be available in the near future.


On the micro-space theory of osmosis osmofiltration, "active" water-flow in membrane-gaps.
The author revised the conclusion drawn from his former experiments and recognized a complex phenomenon that he named osmofiltration. This phenomenon occurs by way of the inhibition of the diffusion within a micro-gap bordering the experimental membrane in the model. It may have a significance as a basic biological phenomenon in similar biological membranous structures, and even, it may have a medical importance. The author discusses his working hypothesis about the micro-space theory of osmosis.


The life experience of nutrition impact symptoms during treatment for head and neck cancer patients: a systematic review and meta-synthesis.
In the literature, there is limited research about the changed meaning of food, the eating and the eating experience during treatment in patients with head and neck cancer. This systematic review includes findings from a qualitative research synthesis to gain a deeper understanding of the influence and experiences of dysphagia, dysgeusia, oral mucositis and xerostomia in head and neck cancer patients (HNC) and suggests recommendations for care practice. A systematic review and meta-synthesis techniques were adopted to identify, appraise and synthesize the relevant literature regarding the experience of nutritional symptoms of HNC patients conducted according to the PRISMA guidelines. Several electronic databases such as PubMed, CINAHL, Scopus, PsycINFO and the Cochrane Library databases were searched. A systematic search yielded 121 papers, of which 12 met the inclusion criteria. A thematic account of shared nutritional symptom experiences reported across studies is highlighted and presented. Eight major themes covering three key supportive care domains were identified: impact of symptoms (symptoms during treatment, symptoms working together, affecting daily living activities and physical changes, symptoms and food changes), changing social networks and support (social life restrictions, support of peers), nutritional concerns and strategies (coping strategies, professional support). Dysphagia, dysgeusia, oral mucositis and xerostomia negatively affected the patients' quality of life throughout the period of treatment. The patients' nutritional symptom experiences do not occur in isolation. Therefore, acknowledging the patients' eating difficulties and challenges can guarantee appropriate management and support to best manage symptoms in a timely manner.


Nanopores in Graphene and Other 2D Materials: A Decade's Journey toward Sequencing.
Nanopore techniques offer a low-cost, label-free, and high-throughput platform that could be used in single-molecule biosensing and in particular DNA sequencing. Since 2010, graphene and other two-dimensional (2D) materials have attracted considerable attention as membranes for producing nanopore devices, owing to their subnanometer thickness that can in theory provide the highest possible spatial resolution of detection. Moreover, 2D materials can be electrically conductive, which potentially enables alternative measurement schemes relying on the transverse current across the membrane material itself and thereby extends the technical capability of traditional ionic current-based nanopore devices. In this review, we discuss key advances in experimental and computational research into DNA sensing with nanopores built from 2D materials, focusing on both the ionic current and transverse current measurement schemes. Challenges associated with the development of 2D material nanopores toward DNA sequencing are further analyzed, concentrating on lowering the noise levels, slowing down DNA translocation, and inhibiting DNA fluctuations inside the pores. Finally, we overview future directions of research that may expedite the emergence of proof-of-concept DNA sequencing with 2D material nanopores.


Identification of liver CYP51 as a gene responsive to circulating cholesterol in a hamster model.
Hypercholesterolaemia is a risk factor for CVD, which is a leading cause of death in industrialised societies. The biosynthetic pathways for cholesterol metabolism are well understood; however, the regulation of circulating cholesterol by diet is still not fully elucidated. The present study aimed to gain more comprehensive understanding of the relationship between circulating cholesterol levels and molecular effects in target tissues using the hamster model. Male golden Syrian hamsters were fed with chow or diets containing 36 % energy from fat with or without 1 % cholesteyramine (CA) as a modulator of circulating cholesterol levels for 35 d. It was revealed that the expression of lanosterol 14α-demethylase (CYP51) instead of 3-hydroxy-3-methyl-glutaryl (HMG)-CoA reductase mRNA expression was responsive to circulating cholesterol in hamsters fed hypercholesterolaemic diets. The high-fat diet increased circulating cholesterol and down-regulated CYP51, but not HMG-CoA reductase. The CA diet decreased cholesterol and increased CYP51 expression, but HMG-CoA reductase expression was not affected. The high-fat diet and CA diet altered the expression level of cholesterol, bile acids and lipid metabolism-associated genes (LDL receptor, cholesterol 7α-hydroxylase (CYP7A1), liver X receptor (LXR) α, and ATP-binding cassette subfamily G member 5/8 (ABCG5/8)) in the liver, which were significantly correlated with circulating cholesterol levels. Correlation analysis also showed that circulating cholesterol levels were regulated by LXR/retinoid X receptor and PPAR pathways in the liver. Using the hamster model, the present study provided additional molecular insights into the influence of circulating cholesterol on hepatic cholesterol metabolism pathways during hypercholesterolaemia.


A V3C2MXene/graphene heterostructure as a sustainable electrode material for metal ion batteries.
Individually, MXene and graphene based frameworks have been recognized as promising 2D electrode materials for metal ion batteries. Herein, we have engineered a heterostructure of V3C2MXene and graphene using computational design. A comprehensive investigation of designed heterostructure has been reported in this work. Simulated heterostructure has been evaluated for various functionalities such as high performance of thermal stability, metal ion intercalation, diffusion energy using density functional theory method. Interestingly, simulation examinations and obtained calculations demonstrate the high storage capacity of Li and Ca (598.63 mAh g-1), and Na (555.87 mAh g-1) with the designed V3C2/graphene model. Promising diffusion energy barriers for Li (0.11 eV), Na (0.17 eV) and Ca (0.15 eV) ions are also investigated and have explained systematically in the present work. Moreover, we have achieved high capacity and fast charge/discharge rates of V3C2/graphene heterostructure indicating its promising electrode potential efficiency for ion batteries especially for Na ion battery. Thus, our investigation demonstrate the advantages of newly designed V3C2MXene and graphene heterostructure for advance metal ion batteries.


A comparison of five health status instruments in patients with systemic lupus erythematosus (SLE).
The aim of the present investigation was to assess and compare health status instruments in SLE. One hundred and twenty-five patients completed five health status instruments: the Health Assessment Questionnaire (HAQ), Functional Ability Index, the Fatigue Severity Scale (FSS), the Disability Days Measure (DDM), the Centre for Epidemiological Studies-Depression Scale (CES-D), and the Medical Outcomes Study (MOS) Short Form Health Survey during their Clinic visit. Disease activity was measured using the SLE Disease Activity Index (SLEDAI). All instruments described a spectrum of quality of life outcomes in these patients. An inter-instrument correlation analysis revealed that components of the MOS correlated significantly with each of the other instruments used. There was no correlation between any of the instruments used and the SLEDAI. We conclude that health status assessment as measured by the MOS short form is a valid independent outcome measure in patients with SLE.


Simple enrichment and independent cultures to expand bacterial community analysis from Gedongsongo hot spring.
Denaturing gradient gel electrophoresis was used to identify bacterial communities from Gedongsongo hot spring, Indonesia, by culture-independent and -dependent procedures. Predominant species were found to be closely related to beta-proteobacteria, particularly from genus Ralstonia and Delftia. Other species present include alpha- and gamma-proteobacteria and Thermus groups. Some of the strains showed unique 16S rDNA sequences.


The Need for Adult Pneumococcal Vaccination in Nigeria.
Despite universal immunization coverage on a global scale among children, the vast majority of immunocompromised adults, and particularly the elderly, remain unvaccinated. Considering that a significant proportion of mortality from pneumococcal disease occurs among the elderly, preventive measures through pneumococcal vaccination in adults, especially the elderly with co-morbidities, needs to be urgently explored and implemented in Africa, and particularly in Nigeria, to stem the tide of deaths resulting from pneumococcal disease among this population. This article looks at the pneumococcal epidemiology and burden of disease in Nigeria, as well as the vaccines available and the rationale for adult pneumococcal vaccination. It also highlights the potential barriers to use and makes recommendations to overcome these barriers and improve acceptance in Nigeria.


Albumin Difference as a New Predictor of Postoperative Complications following Pancreatectomy.
Postoperative complications after pancreatectomy are a challenging problem due to their high incidence and serious consequences. The majority of studies have focused on a specific complication, but data on predictors of overall postoperative complications (OPCs) are limited. The data of patients who underwent pancreatectomy at a single institute between 2017 and 2019 were analyzed retrospectively. Univariate and multivariate logistic regression were used to investigate predictors of the outcomes of interest. The Clavien-Dindo classification and comprehensive complication index (CCI) were used to assess postoperative complications and the severity of postoperative complications. The relationship between predictors and the CCI was evaluated by linear regression. A total of 490 patients were divided into a training group (n = 339) and a validation group (n = 151). The rate of OPCs was 44.25%. Fluid transfusion and albumin difference (AD) were predictors of OPCs. AD showed a good discrimination (AUC = 0.70) and good calibration in the validation cohort. AD was associated with complications, including pancreatic fistula, intra-abdominal hemorrhage, intra-abdominal infection, delayed gastric emptying, and re-intervention, and was positively correlated with complication severity. Intraoperative blood loss and preoperative albumin were independent predictors of AD. AD, a variable that reflects dynamic physiological changes is a new and accessible predictor of OPCs following pancreatectomy.


Child feeding practices, food habits, anthropometric indicators and cognitive performance among preschoolers in Peninsular Malaysia.
This study aimed to determine the relationship between child feeding practices, food habits, and anthropometric indicators with cognitive performance of preschoolers aged 4-6 years in Peninsular Malaysia (n=1933). Parents were interviewed on socio-demographic background, nutrition knowledge, child feeding practices and food habits. Height and weight of the preschoolers were measured; BMI-for-age, weight-for-age and height-for-age were determined. Cognitive performance was assessed using Raven's Colored Progressive Matrices. The mean monthly household income was RM3610 and 59.6% of parents attained secondary education. Thirty-three percent of parents had good knowledge on nutrition, 39% satisfactory and 28% poor. For child feeding practices, perceived responsibility had the highest mean score (M=3.99, SD=0.72), while perceived child weight had the lowest (M=2.94, SD=0.38). The prevalence of possible risk of overweight, being overweight, and obesity were 3.9%, 7.9% and 8.1%, respectively, whereas the prevalence of underweight and stunting were 8.0% and 8.4%, respectively. Breakfast was the second most frequently skipped meal (16.8%) after dinner (18.1%). The mean cognitive score was 103.5 (SD=14.4). Height-for-age and consumption of dinner were found to contribute significantly towards cognitive performance after controlling for socio-demographic background and parent's nutrition knowledge.


A scoping review of school-based anthropometric measurement.
Though anthropometric measurement (AM) frequently occurs in school settings, it is not without risks to child wellbeing. The aim of this scoping review was to examine how AM in school settings takes place and is reported on to make recommendations on best practices. We identified and extracted data from 440 studies published since 2005 that conducted AM in school (pre-school through secondary/high school) settings. Privacy and sensitivity of AM were unclear in over 90% of studies. Thirty-one studies (7.0%) reported protecting student privacy, while nine (2.0%) reported public measurement. Only five studies reported sensitivity regarding AM (1.1%). Exactly who conducted AM was not specified in 201 studies (45.7%). Sixty-nine studies did not provide a weight status criteria citation (19.2%), and 10 used an incorrect citation (2.7%). In summary, serious shortcomings in the reporting of how AM is conducted and by whom, along with details concerning weight status classification, are evident. There is considerable room for improvement regarding the reporting of key methodological details. We propose best practices for AM in school settings, which also double as conditions that should be met before AM takes place in school settings.


Diagnostic accuracy of cardiac testing for coronary artery disease in potential liver transplant recipients: A systematic review and meta-analysis.
The incidence of coronary artery disease (CAD) in Liver transplant (LT) patients is much higher than prior estimates and the morbidity and mortality are significant in this group of patients. Coronary angiography is the gold standard for detection of CAD, a non-invasive test that allows appropriate risk stratification would be preferred. In this systematic review and meta-analysis, we sought to assess the pooled diagnostic accuracy of various noninvasive cardiac imaging tests in detecting CAD in patients listed for LT. We performed a systematic review and meta-analysis of studies comparing sensitivity and specificity of non-invasive tests to that of coronary angiography in diagnosing coronary artery disease in patients undergoing liver transplantation. Five studies (616 participants) evaluated myocardial perfusion imaging (MPI); five studies (1243 participants) dobutamine stress echocardiography (DSE); and three (87 participants), other tests. MPI had a pooled sensitivity of 0.62 (95% CI 0.37, 0.83), specificity of 0.60 (95% CI 0.39, 0.79), diagnostic odds ratio (DOR) of 2.5 (95% CI 1.7, 5.64) and Area under the curve (AUC) 0.649. DSE had a pooled sensitivity of 0.25 (95%CI 0.09, 0.51), specificity of 0.68 (95% CI 0.44, 0.84) and DOR of 0.7 (95% CI 0.12, 3.84). Our results show that both MPI and DSE are not effective screening tools for detecting CAD in patients with end-stage liver disease (ESLD). Future studies are needed to evaluate the role of real-time myocardial contrast echocardiography (RTMCE) and coronary artery calcium score (CAC) with coronary CT angiography in patients with ESLD.


Treatment of delirium in supportive and palliative care.
The past few years have witnessed increased research into delirium treatment and related issues, leading to better management (e.g. improved detection) and better understanding of phenomenology and pathophysiology. Many treatment and prevention trials have been conducted. Delirium phenomenology studies revealed that even subsyndromal presentations may bear a poor prognosis. Varied pathophysiology may lead to different delirium subtypes with implications for treatment, especially the hypoactive subtype, for which systematic neuroleptic treatment remains controversial. The high prevalence of delirium has led to improved use of validated instruments and better trials. Nonpharmacological interventions remain an essential step in delirium management and have yielded positive results, especially in prevention. Two trials of haloperidol prophylaxis identified reduced severity and duration of delirium in one and reduced incidence in the other. Trials comparing haloperidol with atypical antipsychotics, mainly risperidone and olanzapine, found equal efficacy but more side effects with haloperidol. Use of validated detection instruments is now standard procedure in both specialized clinical practice and research. Although haloperidol remains the mainstay of treatment, recent trials have begun to discriminate between the use of different agents and pharmacological approaches.


Genetic Algorithm-Driven Surface-Enhanced Raman Spectroscopy Substrate Optimization.
Surface-enhanced Raman spectroscopy (SERS) is a highly sensitive and molecule-specific detection technique that uses surface plasmon resonances to enhance Raman scattering from analytes. In SERS system design, the substrates must have minimal or no background at the incident laser wavelength and large Raman signal enhancement via plasmonic confinement and grating modes over large areas (i.e., squared millimeters). These requirements impose many competing design constraints that make exhaustive parametric computational optimization of SERS substrates prohibitively time consuming. Here, we demonstrate a genetic-algorithm (GA)-based optimization method for SERS substrates to achieve strong electric field localization over wide areas for reconfigurable and programmable photonic SERS sensors. We analyzed the GA parameters and tuned them for SERS substrate optimization in detail. We experimentally validated the model results by fabricating the predicted nanostructures using electron beam lithography. The experimental Raman spectrum signal enhancements of the optimized SERS substrates validated the model predictions and enabled the generation of a detailed Raman profile of methylene blue fluorescence dye. The GA and its optimization shown here could pave the way for photonic chips and components with arbitrary design constraints, wavelength bands, and performance targets.