[The clinical practice guidelines of the Sociedad Española de Cardiología on cardiomyopathies and myocarditis].
Myocardial diseases are a extraordinarily heterogeneous group of processes that only have in common the fact that they involve heart muscle and that they cause a wide spectrum of myocardial dysfunction. The approach of the management and treatment of the cardiomyopathies is a continuous matter of discussion because the vast majority of alternatives in this field have not been based on the best scientific possible evidence and, since except for the case of heart failure associated with dilated cardiomyopathy. The majority of different options have not been studied by means of large (or even small) randomized trials. Nevertheless, this chapter has tried to provide the reader with different approaches on how to deal with important clinical problems in dilated, hypertrophic and restrictive cardiomyopathies, and in myocarditis as well. For this, we have utilized the most relevant information found coupled with our best clinical judgment, although we admit that many of the clinical recommendations can be controversial.


Laparoscopic Uterosacral Suture Sacrohysteropexy: LUSSH Procedure.
To demonstrate a mesh-free laparoscopic uterosacral suture sacrohysteropexy (LUSSH). Technical video demonstrating LUSSH for uterine prolapse (Canadian Task Force classification III). University hospital. A 37-year-old woman with grade 3 uterine descent requested uterine-sparing surgery for symptomatic prolapse. The patient declined all mesh procedures. Mesh-free laparoscopic uterosacral suture sacrohysteropexy (LUSSH). Laparoscopic sacrohysteropexy is a uterine-preserving technique for uterine prolapse with high cure rates (92%) but with a mesh erosion risk of up to 2.5% [1,2]. Complications have resulted in reclassification of transvaginal meshes as restricted-use high-risk medical devices [3,4]. Sacrospinous hysteropexy and uterosacral ligament suspension are mesh-free alternatives, but they have increased rates of anterior-compartment failures and a 20% recurrence rate in the latter [5,6]. Laparoscopic suture sacrohysteropexy has been described with reported success rates of 95% [7]. This video demonstrates a modified-technique offering a simple, robust, and reproducible mesh-free approach to uterine-preserving prolapse surgery. We used 2 horizontal loop mattress sutures acting as a pulley to distribute the force evenly throughout the suture strand, leading to a significantly stronger and more secure hold and reducing risk of avulsion [8]. The technique starts with a careful dissection of the peritoneum from the sacral promontory to the cervix. Two permanent sutures are used, taking bites at the anterior longitudinal ligament, the uterosacral, a loop mattress in the midline at the cervix, the uterosacral on the way back, and finally at the sacral promontory. Damage to the uterine vessels is minimized by maintaining a central uterine position. The stitch is tied with caudal pressure on the uterus, applied via the uterine manipulator, approximating the cervix to the sacral promontory. The peritoneum is closed with dissolvable sutures, burying the Ethibond to prevent exposure and bowel obstruction. Post-procedure, the uterus was well supported with a vaginal length of 15 cm.


Examination of Glycosaminoglycan Binding Sites on the XCL1 Dimer.
Known for its distinct metamorphic behavior, XCL1 interconverts between a canonical chemokine folded monomer (XCL1mon) that interacts with the receptor, XCR1, and a unique dimer (XCL1dim) that interacts with glycosaminoglycans and inhibits HIV-1 activity. This study presents the first detailed analysis of the GAG binding properties of XCL1dim. Basic residues within a conformationally selective dimeric variant of XCL1 (W55D) were mutated and analyzed for their effects on heparin binding. Mutation of Arg23 and Arg43 greatly diminished the level of heparin binding in both heparin Sepharose chromatography and surface plasmon resonance assays. To assess the contributions of different GAG structures to XCL1 binding, we developed a solution fluorescence polarization assay and correlated affinity with the length and level of sulfation of heparan sulfate oligosaccharides. It was recently demonstrated that the XCL1 GAG binding form, XCL1dim, is responsible for preventing HIV-1 infection through interactions with gp120. This study defines a GAG binding surface on XCL1dim that includes residues that are important for HIV-1 inhibition.


Facile Site-Specific Multiconjugation Strategies in Recombinant Proteins Produced in Bacteria.
For biomedical applications, proteins may require conjugation to small and large molecules. Typical examples are dyes for imaging, cytotoxic effector molecules for cell killing, or half-life extension modules for optimized pharmacokinetics. Although many conjugation strategies are straightforward to apply, most of them do not enable site-specific and orthogonal conjugation, and do not yield a defined stoichiometry. Moreover, techniques offering these desirable features often rely on complex expression procedures and suffer from low production yields. A more promising manufacturing strategy for flexible, site-specific and stoichiometrically defined payloading of proteins is the combination of click chemistry and thiol-maleimide conjugation, which even enables dual labeling when used consecutively. Here, we describe as an example the production of Designed Ankyrin Repeat Proteins (DARPins), a non-IgG binding scaffold, in a specific E. coli strain to obtain high yields of protein carrying both a thiol and an azide group. We provide straightforward protocols for strain-promoted azide-alkyne cycloaddition (SPAAC) and thiol-maleimide conjugation, and furthermore compare these conjugation chemistries with existing alternatives like copper-catalyzed azide-alkyne cycloaddition (CuAAC). Finally, detailed instructions for reactivity analysis and yield estimations of the reactions are provided.


Association of circulating omentin level and metabolic-associated fatty liver disease: a systematic review and meta-analysis.
Metabolic-associated fatty liver disease (MAFLD) is closely associated with omentin, a novel adipokine that plays a vital role in metabolic balance. The literature about the relationship between circulating omentin and MAFLD is conflicting. Therefore, this meta-analysis evaluated circulating omentin levels in patients with MAFLD compared with healthy controls to explore the role of omentin in MAFLD. The literature search was performed up to April 8, 2022, using PubMed, Cochrane Library, EMBASE, CNKI, Wanfang, CBM, Clinical Trials Database and Grey Literature Database. This meta-analysis pooled the statistics in Stata and presented the overall results using the standardized mean difference (SMD) and 95% confidence interval (CI). Twelve studies with 1624 individuals (927 cases and 697 controls) were included, and all of them were case-control studies. In addition, ten of twelve included studies were conducted on Asian participants. Patients with MAFLD had significantly lower circulating omentin levels than healthy controls (SMD=-0.950 [-1.724, -0.177], P=0.016). Subgroup analysis and meta-regression demonstrated that fasting blood glucose (FBG) might be the source of heterogeneity and was inversely associated with omentin levels (coefficient=-0.538, P=0.009). No significant publication bias existed (P>0.05), and outcomes were robust in the sensitivity analysis. Lower circulating omentin levels were associated with MAFLD, and FBG might be the source of heterogeneity. Since Asian studies accounted for a significant portion of the meta-analysis, the conclusion might be more applicable to the Asian population. By investigating the relationship between omentin and MAFLD, this meta-analysis laid the foundation for the development of diagnostic biomarkers and treatment targets. https://www.crd.york.ac.uk/prospero/, identifier CRD42022316369.


An Evaluation of the Effectiveness of Ibuprofen and Manual Therapy in Young Women with Dysmenorrhea-A Pilot Study.
The aim of the study was to evaluate the effect of manual therapy and the use of ibuprofen on the severity of dysmenorrhea and changes in the level of sex hormones in young women with dysmenorrhea. Material and methods: The study included six women, aged 22 ± 2 years, with primary dysmenorrhea (PD). A physiotherapist examined the tenderness and flexibility of the muscles. The patients were subjected to a gynecological and physiotherapeutic examination; the concentrations of progesterone and 17-beta-estradiol were also determined. In subgroup A (n = 3), manual therapy was performed 3 × 45 min; in subgroup B (n = 3), the patients received ibuprofen 3 × 400 mg/day. Results: In subgroup A, all patients showed a decrease in the level of progesterone and an increase in the concentration of estradiol. In subgroup B, the concentration of progesterone and 17-beta estradiol decreased in two subjects. In subgroup A, manual therapy reduced the severity of headache, back pain, diarrhea, fatigue, and PMS. In subgroup B, the use of ibuprofen only alleviated back pain and fatigue. Moreover, in subgroup A, after the application of manual therapy, improvement in flexibility and pain relief of the examined muscles was demonstrated. On the other hand, in subgroup B, no improvement in flexibility or reduction in muscle soreness was found in patients who took ibuprofen. Conclusions: Manual therapy may reduce menstrual pain in women with dysmenorrhea. However, the results need to be confirmed in studies conducted on a larger group of patients with dysmenorrhea.


Fragmentation of the Golgi apparatus. A role for beta III spectrin and synthesis of phosphatidylinositol 4,5-bisphosphate.
Phosphatidylinositol 4,5-bisphosphate (PtdIns(4,5)P(2)) synthesis has been implicated in maintaining the function of the Golgi apparatus. Here we demonstrate that the inhibition of PtdIns(4,5)P(2) synthesis in vitro in response to primary alcohol treatment and the kinetics of Golgi fragmentation in vivo were very rapid and tightly coupled. Preloading Golgi membranes with short chain phosphatidic acid abrogated the alcohol-mediated inhibition of PtdIns(4,5)P(2) synthesis in vitro. We also show that fragmentation of the Golgi apparatus in response to diminished PtdIns(4,5)P(2) synthesis correlated with both the phosphorylation of a Golgi form of beta III spectrin, a PtdIns(4,5)P(2)-interacting protein, and changes in its intracellular redistribution. The data are consistent with a model suggesting that the decreased PtdIns(4,5)P(2) synthesis and the phosphorylation state of beta III spectrin modulate the structural integrity of the Golgi apparatus.


Perinatal mental health and recommendations for integral care in gyneco-obstetric hospitals.
Mental health is defined as the ability by which individuals recognize their own abilities and cope with the normal stress of life, work productively and fruitfully, contribute to their communities and enjoy the greatest possible well-being. Therefore, it is essential as a part of the health of the individual and its constant evaluation. Recently, special attention has been drawn to the study of the mental health of women, given the greater probability to suffer depression and anxiety disorders during and after pregnancy. The most vulnerable state occurs in adolescence, pregnancy, puerperium and perimenopause; Adequate mental health during pregnancy has shown beneficial effects in the resolution of pregnancy and in the health of the newborn. Regarding this paper, the fundamental aspects in the definition of perinatal mental health were reviewed, its determinants, the main mental disorders in this vital period, its role in perinatal outcomes and the importance of its evaluation. Some basic recommendations for adequate mental health care in gyneco-obstetric hospitals are also proposed.


[Minimally invasive direct coronary artery bypass in a patient with idiopathic thrombocytopenic purpura; report of a reoperative case].
A 77-year-old man who had undergone coronary artery bypass grafting (CABG) to segment 3, 7 and 12-14 with saphenous vein grafts (SVG) 15 years before, and ligation of coronary arteriovenous (AV) fistula 8 years before was admitted to our hospital, and diagnosed as acute heart failure and idiopathic thrombocytopenic purpura. Coronary angiography showed multiple stenosis of three vessels, and the grafts to segment 3 and 7 were occluded. The area of left anterior descending (LAD) had no viability, but the inferior wall had viability on dobutamine load echocardiography. The platelet count was about 5.0 x 10(4)/mm3. Minimally invasive direct coronary artery bypass (MIDCAB) for right coronary artery (RCA) using right internal thoracic artery (RITA) was performed through right parasternotomy. Operative and postoperative bleeding was slight, and postoperative course was uneventful. Reoperative MIDCAB can be safely performed in a patient with idiopathic thrombocytopenic purpura, and should be considered a viable alternative for highrisk patients.


Ontogeny of melanophore photosensitivity in rainbow trout (Oncorhynchus mykiss).
Migratory species experience morphological and physiological changes during transitions between different life stages. In particular, modification of sensory systems is critical for animals to adapt to new environments. For example, to prepare for entry into seawater, salmonids undergo smoltification with dramatic changes in ultraviolet photoreceptors and polarized vision, which are important for orientation and foraging behaviours. Extraretinal organs are also involved in photoreception; however, the ontogenetic development of extraretinal photoreceptors is not well known, especially in migratory species. Here, we investigated whether rainbow trout dermal photoreceptors, melanophores, undergo change in spectral sensitivity during smoltification and which candidate molecules may account for this ontogenetic alteration. Our results showed that, contrary to parr melanophores which are insensitive to light, smolt melanophores displayed chromatic photoresponses with the emergence of cryptochrome and melanopsin expression. We suggest that these modifications may benefit the active foraging behaviour of smolts and enable adaptation to variable environments.


[Improvement of blood filtrability with a purified extract of black currant anthocyanosides in cynomologus monkeys on a fat diet].
A fat diet has been administered for 3 months to Cynomologus monkeys treated with blackcurrant anthocyanosides as compared with others receiving no treatment. Blood filtrability of animals given a fat diet alone was significantly lowered (20.8%; p less than 0.01) as compared with that of animals receiving a standard diet. Blood filtrability of animals receiving a fat diet plus blackcurrant anthocyanosides was not significantly different from that of animals given a standard diet. Emphasis is laid on a new approach to the action of this type of product on blood vessel contents as compared with the known action on the container.


Survival of Dicor glass-ceramic dental restorations over 16 years. Part III: effect of luting agent and tooth or tooth-substitute core structure.
The influence of different types of restorative design features on the long-term survival of Dicor glass-ceramic restorations is only partially understood. This study examined the effect of different types of luting agents and preparation core structures on the survival of Dicor glass-ceramic restorations functioning in vivo. A total of 1444 Dicor glass-ceramic restorations were placed on the teeth of 417 adults. Failure was defined as a restoration that required remake because of material fracture. The survival of restorations of different types, with different luting agents and preparation core structures, was described with Kaplan-Meier survival functions. The significance of differences in survival between different tooth or tooth-substitute preparation core structures and different luting agents was determined with the log-rank test. The probability of survival of a typical acid-etched Dicor restoration luted to gold preparation core structures was 91% at 16 years compared with 75% for dentin preparation core structures (P<.01). The survival of acid-etched Dicor restorations luted to dentin preparations was significantly better than nonacid-etched restorations luted to dentin. Acid-etched Dicor restorations luted with resin composite exhibited a more favorable survival function than those luted with glass ionomer (P<.01) and zinc phosphate (P<.05). Differences between restorations luted with glass ionomer or zinc phosphate agents were not significant. Acid-etched Dicor restorations luted to gold preparation core structures exhibited significantly better intraoral survival than restorations luted to dentin. Acid-etched Dicor restorations survived better than nonacid-etched restorations when luted to dentin preparations. Acid-etched Dicor restorations luted with resin composite exhibited more favorable survivor functions than restorations luted with glass ionomer or zinc phosphate agents.


Creatine: endogenous metabolite, dietary, and therapeutic supplement.
Creatine and phosphocreatine serve not only as an intracellular buffer for adenosine triphosphate, but also as an energy shuttle for the movement of high-energy phosphates from mitochondrial sites of production to cytoplasmic sites of utilization. The spontaneous loss of creatine and of phosphocreatine to creatinine requires that creatine be continuously replaced; this occurs by a combination of diet and endogenous synthesis. Vegetarians obtain almost no dietary creatine. Creatine synthesis makes major demands on the metabolism of glycine, arginine, and methionine. Large doses of creatine monohydrate are widely taken, particularly by athletes, as an ergogenic supplement; creatine supplements are also taken by patients suffering from gyrate atrophy, muscular dystrophy, and neurodegenerative diseases. Children with inborn errors of creatine synthesis or transport present with severe neurological symptoms and a profound depletion of brain creatine. It is evident that creatine plays a critical, though underappreciated, role in brain function.


The molecular control of corpus luteum formation, function, and regression.
The corpus luteum (CL) is one of the few endocrine glands that forms from the remains of another organ and whose function and survival are limited in scope and time. The CL is the site of rapid remodeling, growth, differentiation, and death of cells originating from granulosa, theca, capillaries, and fibroblasts. The apparent raison d'etre of the CL is the production of progesterone, and all the structural and functional features of this gland are geared toward this end. Because of its unique importance for successful pregnancies, the mammals have evolved a complex series of checks and balances that maintains progesterone at appropriate levels throughout gestation. The formation, maintenance, regression, and steroidogenesis of the CL are among the most significant and closely regulated events in mammalian reproduction. During pregnancy, the fate of the CL depends on the interplay of ovarian, pituitary, and placental regulators. At the end of its life span, the CL undergoes a process of regression leading to its disappearance from the ovary and allowing the initiation of a new cycle. The generation of transgenic, knockout and knockin mice and the development of innovative technologies have revealed a novel role of several molecules in the reprogramming of granulosa cells into luteal cells and in the hormonal and molecular control of the function and demise of the CL. The current review highlights our knowledge on these key molecular events in rodents.


Effects of postweaning calorie restriction on accelerated growth and adiponectin in nutritionally programmed microswine offspring.
Poor prenatal development, followed by rapid childhood growth, conveys greater cardiometabolic risk in later life. Microswine offspring exposed to perinatal maternal protein restriction [MPR; "low protein offspring" (LPO)] grow poorly in late-fetal/neonatal stages. After weaning to an ad libitum (AL) diet, LPO-AL exhibit accelerated growth and fat deposition rates with low adiponectin mRNA, despite low-normal body fat and small intra-abdominal adipocytes. We examined effects of caloric restriction (CR) on growth and metabolic status in LPO and normal protein offspring (NPO) randomized to AL or CR diets from weaning. CR transiently reduced growth in both LPO and NPO, delaying recovery in female LPO-CR. Over 7.5-12.5 weeks, linear growth rates in LPO-CR were slower than LPO-AL ( P < 0.001) but exceeded NPO-AL; body weight growth rates fell but were lower in LPO-CR versus NPO-CR. Linear acceleration ceased after 12 weeks. At 16 weeks, percent catch-up in LPO-CR was reduced versus LPO-AL ( P < 0.001). Plasma growth hormone was low in LPO ( P < 0.02). CR normalized fat deposition rate, yet adiponectin mRNA remained low in LPO-CR ( P < 0.001); plasma adiponectin was low in all LPO-AL and in female LPO-CR. Insulin sensitivity improved during CR. We conclude that in LPO: 1) CR delays onset of, but does not abolish, accelerated linear growth, despite low growth hormone; 2) CR yields stunting via delayed onset, plus a finite window for linear growth acceleration; 3) MPR lowers adiponectin mRNA independently of growth, adiposity, or adipocyte size; and 4) MPR reduces circulating adiponectin in LPO-AL and female LPO-CR, potentially enhancing cardiometabolic risk.


Monitoring trends in dextromethorphan abuse using the National Poison Data System: 2000-2010.
Dextromethorphan (DXM) abuse persists among US youth and should be closely monitored because of the risks of severe medical complications, addiction, and psychiatric sequelae. Prior investigations have demonstrated DXM to be an emerging drug of abuse with increasing national prevalence through 2004. To extend existing substance abuse survey results by describing demographic, geographic, product, and outcome trends in medically significant DXM abuse cases (those reported to US poison centers). National Poison Data System (NPDS) data are collected and compiled in real time by all 57 US poison centers. Demographic, geographic, product, and outcome data for all intentional DXM abuse cases reported to the NPDS between 2000 and 2010 were analyzed. A total of 44,206 DXM abuse cases met inclusion criteria, 34,755 of which were single-substance exposures. The mean annual prevalence of DXM cases reported to poison control centers was 13.4 cases per million population for all ages and 113.0 cases per million for 15-19 year olds. The prevalence of DXM cases for all ages increased steadily (p = 0.002, Cochran-Armitage trend test) until 2006 to a peak of 17.6 calls/million and has subsequently plateaued at 15.7 cases per million in 2010. This trend is also seen in the most commonly abused brand of DXM products, Coricidin(®). A preponderance of male adolescents was noted throughout the study period. The odds of a severe outcome are increased for a multi-substance exposure (OR: 2.53; 95% CI: 2.14-2.99, logistic regression); odds were not significantly increased for any of the most commonly abused product brands. The increasing trend of DXM abuse cases noted in the first half of the decade by previous studies seems to have peaked at 17.6 calls per million population in 2006. It is likely that a combination of legislative, educational, and economic initiatives are responsible for the observed plateau.


Lysosomal alpha-mannosidase and alpha-mannosidosis.
Lysosomal alpha-mannosidase with acidic pH optimum is ubiquitous in human tissues where is expressed in two major forms, A and B that are the product of a single gene located on chromosome 19. Mutations in the gene encoding for alpha-mannosidase cause alpha- mannosidosis, an autosomal recessive disease, resulting in the accumulation of unprocessed mannose containing oligosaccharide material. This rare disease has an estimated incidence of 1/500.0.00 live births and clinically is divided into three subgroups. Today the most promising therapy for this disease is the enzyme replacement therapy. To develop this strategy a mouse model for alpha-mannosidosis has been generated and a recombinant human alpha-mannosidase has been produced from Chinese-hamster ovary cells. Interestingly it has been shown that the recombinant enzyme, used in high dose, can cross the blood brain barrier. This recombinant enzyme has been tested in the first randomized study investigating the efficacy of enzyme replacement therapy in patients with alpha-mannosidosis. This review contains the scientific progresses on lysosomal alpha-mannosidase from the cloning to the beginning of the therapy.


Relative axial myopia induced by prolonged light exposure in C57BL/6 mice.
Ambient lighting is essential for ocular development in many species, however, disruption in diurnal lighting cycle can affect the development in refraction and axial growth of the eye. This study investigated the effects of prolonged daily lighting on refraction and various optical components of the eye by raising C57BL/6 mice under three different light/dark cycles (18/6, 12/12 and 6/18). Egr-1 mRNA expression, apoptosis and histology of the retina and size of the scleral fibrils were evaluated in these three lighting cycles. Results showed that there was a trend of myopic development, increasing vitreous chamber depth and thinning of the retina in eyes from 6/18 to 18/6 groups. Retinal Egr-1 mRNA expression and diameter of scleral fibrils were reduced with the prolongation of daily lighting from 6/18 to 18/6. However, retinal apoptosis was not detected in all the groups. These results suggest that prolonged lighting can induce axial myopia in inbred mice. This model, which uses mice with similar genetic backgrounds, provides an alternative to the currently available models and therefore is useful for evaluation of refractive errors caused by changes in environmental illumination.


Use of a report card to implement a network-based palliative care program.
To report on implementation of a Veterans Affairs (VA) network-wide, standardized, high-quality palliative care (PC) program using a Web-based PC Report Card for performance monitoring and improvement. The PC director and coordinator and facility directors established interdisciplinary teams at five acute care and three nursing home sites. Teams were trained together and subsequently met quarterly for ongoing training. Additionally, the PC director and coordinator developed and implemented a Web-based PC Report Card on the network Intranet for PC coordinator to report performance data monthly to the PC teams. The number of patients in the network who received PC consults more than doubled in the first 4 years of the PC program. The percentage of deaths with PC consultation prior to death increased from 23% in fiscal year (FY) 2002 to 57% in FY06. Over the same period, the average days between the initial PC consultation and patients' death across all sites increased from 23 days to 106 days. All the sites established PC teams and the number of consultations showed a sustained increase over baseline in 2002. All sites improved on the key process measures captured by the Report Card.


Compensatory Effects of Sequential 4-Channel Neuromuscular Electrical Stimulation for the Treatment of Acute, Subacute, and Chronic Dysphagia in a Prospective, Double-Blinded Randomized Clinical Trial.
Background. The precise mechanism of 2-channel neuromuscular electrical stimulation (NMES) treatment is unknown, and controversy remains over its efficacy. The sequential 4-channel NMES was newly developed based on normal contractile sequences of swallowing-related muscles. Objective. To assess the clinical efficacy of sequential 4-channel NMES during swallowing. Methods. In this prospective RCT, 52 inpatients with dysphagia (acute, subacute, and chronic state) after stroke, brain tumor, or encephalitis were enrolled. Participants who underwent a videofluoroscopic swallowing study (VFSS) and clinical evaluation were enrolled and were randomly assigned to the 4-channel NMES or sham group. The 4-channel NMES and sham groups swallowed thin and honey-like fluids under NMES (sequential stimulation on suprahyoid and infrahyoid) and sham stimulation, respectively. The procedures were evaluated with the VFSS. Pre- and post-treatment evaluations were performed with the videofluoroscopic dysphagia scale (VDS), penetration-aspiration scale (PAS), Likert scale, and kinematic analysis. Results. The 4-channel NMES group showed significantly greater improvements than the sham group with respect to oral VDS, pharyngeal VDS, total VDS, and PAS (P < .05). Furthermore, the Likert scale for satisfaction, easiness, and discomfort for swallowing showed favorable results for the 4-channel NMES group (P < .05). In the kinematic analysis, the peak speed point, distance, and velocity of hyoid movement were significantly greater in the 4-channel NMES group (P < .05). Conclusions. Sequential 4-channel NMES activating the suprahyoid, thyrohyoid, and other infrahyoid muscles during swallowing showed significant clinical improvement with respect to VDS, PAS, and kinematic analysis. Therefore, sequential 4-channel NMES is a potential new functional electrical stimulation system for the treatment of dysphagia.


Antiviral Meroterpenoid Rhodatin and Sesquiterpenoids Rhodocoranes A-E from the Wrinkled Peach Mushroom, Rhodotus palmatus.
Rhodatin (1), a meroterpenoid featuring a unique pentacyclic scaffold with both spiro and spiroketal centers, and five unusual acorane-type sesquiterpenoids, named rhodocoranes A-E (2-6, respectively), are the first natural products isolated from the basidiomycete Rhodotus palmatus. Their structures were elucidated by two-dimensional NMR experiments and HRESIMS, while the absolute configuration of the substance family was determined by Mosher's method utilizing 2. Rhodatin strongly inhibited hepatitis C virus, whereas 4 displayed cytotoxicity and selective antifungal activity.


Integration of adeno-associated virus (AAV) and recombinant AAV vectors.
The driving interest in adeno-associated virus (AAV) has been its potential as a gene delivery vector. The early observation that AAV can establish a latent infection by integrating into the host chromosome has been central to this interest. However, chromosomal integration is a two-edged sword, imparting on one hand the ability to maintain the therapeutic gene in progeny cells, and on the other hand, the risk of mutations that are deleterious to the host. A clearer understanding of the mechanism and efficiency of AAV integration, in terms of contributing viral and host-cell factors and circumstances, will provide a context in which to evaluate these potential benefits and risks. Research to date suggests that AAV integration in any context is inefficient, and that the persistence of AAV gene delivery vectors in tissues is largely attributable to episomal genomes.


Experimental bacterial infection of the biliary tract.
The bacterial species commonly found in the human obstructed biliary tract were studied in an animal model of acute hepato-cholangitis. A rank order of their virulence and persistence in the bile and liver was shown which corresponded well to the clinical effects in the animals and also to the prevalence of bile bacteria in the benign bile duct stricture of man. Anaerobic organisms were found to be of low pathogenicity.


Epigenetic regulation of transcription in intermediate heterochromatin.
Constitutive heterochromatin is a compact, transcriptionally inert structure formed in gene-poor and repeat- and transposon-rich regions. In Arabidopsis, constitutive heterochromatin is characterized by hypermethylated DNA and histone H3 dimethylated at lysine (K) 9 (H3K9me2) together with depletion of histone H3 dimethylated at lysine 4 (H3K4me2). Here, we describe loci with intermediate properties of heterochromatin in which transcription downregulation is inherited in a manner similar to constitutive heterochromatin, although the loci are associated with opposing histone marks--H3K4me2 and H3K9me2. In the ddm1 (decrease in DNA methylation 1) mutants, their transcriptional activation is accompanied by the expected shift in the H3 modifications--depletion of H3K9me2 and enrichment in H3K4me2. In mom1 (Morpheus' molecule 1) mutants, however, a marked increase in transcription is not accompanied by detectable changes in the levels of H3K4me2 and H3K9me2. Therefore, transcriptional regulation in the intermediate heterochromatin involves two distinct epigenetic mechanisms. Interestingly, silent transgenic inserts seem to acquire properties characteristic of the intermediate heterochromatin.


Suppression of electron relaxation and dephasing rates in quantum dots caused by external magnetic fields.
An external magnetic field has been applied in laterally coupled quantum dots (QDs) and we have studied the QD properties related to charge decoherence. The significance of the applied magnetic field to the suppression of electron-phonon relaxation and dephasing rates has been explored. The coupled QDs have been studied by varying the magnetic field and the interdot distance as well as other system parameters. Our numerical results show that the electron scattering rates are strongly dependent on the applied external magnetic field and the details of the double QD configuration.


Comparison of a LightCycler-based real-time PCR for quantitation of Epstein-Barr viral load in different clinical specimens with semiquantitative PCR.
Measurement of viral load is important in predicting and monitoring of Epstein-Barr virus (EBV)-associated diseases especially in immunocompromised patients. The objectives of this study were the development of a LightCycler-based real-time PCR assay using primers and probes which recognize the virus capsid antigen p23-encoding region and its comparison to the semiquantitative PCR. The LightCycler protocol shows a high degree of specificity and inter- and intra-assay reproducibility. Concerning sensitivity, a good correlation between both methods was demonstrated for standard plasmid DNA, reference DNA isolated from the EBV-genome containing Namalwa cell line, and DNA extracted from plasma/cerebrospinal fluid (CSF). The detection limit was determined with 1 copy/microl eluate for the standard plasmid DNA and with 500 copies/ml plasma or CSF. For DNA derived from peripheral blood mononuclear cells (PBMCs), a decrease of sensitivity by factor 10-100 was found when larger amounts of background DNA (500 and 100 ng) were used presuming an inhibitory effect of cellular DNA. This was supported by running dilutions of the plasmid standard carried out with EBV-negative Ramos cell DNA. Thus, the cut-off level was estimated with 100-500 copies/10(5) PBMCs, when 50 or 10 ng total DNA were tested. The results indicate that the real-time PCR described here is a first line tool for the determination of viral load in plasma and CSF. Semiquantitative nested PCR is used for screening of PBMCs viral load. Positive specimens containing more than 500 copies/10(5) cells are measured for exact values by real-time PCR. To circumvent inhibitory effects of cellular DNA, measurements should be carried out generally with 50-10 ng DNA.


Pulmonary immune responses during primary mycobacterium bovis- Calmette-Guerin bacillus infection in C57Bl/6 mice.
Mechanisms of protective immunity to mycobacterial infection in the lung remain poorly defined. In this study, T-cell subset expansion and cytokine expression in bronchoalveolar spaces, lung parenchyma, and mediastinal lymph nodes of mice infected intratracheally with Mycobacterium bovis-Calmette-Guerin bacillus (BCG) were analyzed in parallel with histopathology and bacterial burden. M. bovis-BCG was cleared rapidly from bronchoalveolar spaces without evidence for persistence. In lung parenchyma bacteria grew during the first 4 wk followed by gradual clearance with less than 0.1% of the original inoculum persisting for more than 8 mo. Clearance of M. bovis-BCG from bronchoalveolar lavage was associated with recruitment of both neutrophils and lymphocytes. Lung CD4(+), CD8(+), and gammadelta T-cell receptor-positive T cells expanded maximally by Week 4, and declined by Week 8 to control values despite bacterial persistence. Both CD4(+) and CD8(+) lung T cells produced interferon (IFN)-gamma in response to M. bovis-BCG. Four distinct pathologic states of lung parenchymal infection were noted. Early focal sub-bronchial inflammation with transmigration of cells into airways was followed by diffuse peribronchitis, perivasculitis, and alveolitis with activated macrophages, lymphoblasts, and occasional giant cells. The latter stage corresponded to maximal M. bovis-BCG growth. Resolving infection consisted of small lymphocytes and foamy macrophages, which coincided with decreasing M. bovis-BCG colony-forming units, T-cell infiltration, and IFN-gamma expression. A final quiescent phase consisted of residual lymphoid aggregates and perivasculitis associated with persistent spontaneous IFN-gamma production. Bacterial dissemination to lymph node and spleen occurred by Week 4 and declined in parallel to lung. In contrast to lung, IFN-gamma secretion was detected only late despite early expansion of CD4(+) and CD8(+) T cells. By reverse transcriptase/polymerase chain reaction, IFN-gamma and interleukin (IL)-12 p40 messenger RNA (mRNA) in lung paralleled IFN-gamma protein production. Tumor necrosis factor-alpha, IL-4 and IL-10 mRNA expression was not increased during M. bovis-BCG lung infection. Thus, protective immunity to M. bovis-BCG in the lung evolved differently in air space, lung, and lymph node.


Large area, patterned growth of 2D MoS2 and lateral MoS2-WS2 heterostructures for nano- and opto-electronic applications.
The patterned growth of transition metal dichalcogenides (TMDs) and their lateral heterostructures is paramount for the fabrication of application-oriented electronics and optoelectronics devices. However, the large scale patterned growth of TMDs remains challenging. Here, we demonstrate the synthesis of patterned polycrystalline 2D MoS2 thin films on device ready SiO2/Si substrates, eliminating any etching and transfer steps using a combination of plasma enhanced atomic layer deposition (PEALD) and thermal sulfurization. As an inherent advantage of ALD, precise thickness control ranging from a monolayer to few-layered MoS2 has been achieved. Furthermore, uniform films with exceptional conformality over 3D structures are obtained. Finally, the approach has been leveraged to obtain in-plane lateral heterostructures of 2D MoS2 and WS2 thin films over a large area which opens up an avenue for their direct integration in future nano- and opto-electronic device applications.


Endonasal treatment of postsaccal stenoses of lacrimal ducts: intranasal retrograde probing in congenital stenosis.
Congenital stenosis of nasolacrimal duct is a common medical problem affecting up to 20% of newborn infants. When symptoms persists for more than 5 to 6 months the lacrimal ducts should be subjected to probing and irrigation. Anterograde probing through inferior lacrimal punctum using a rigid Bowman probe is the standard approach to such cases. We could not find reports of a retrograde endonasal probing of the lacrimal ducts in the available literature published in the last five years. Between 1992 and 2002, we treated 328 children (136 boys and 192 girls) with congenital stenoses of the lacrimal passageways. The mean age of the children was 7.4 (Sx +/- 13) months. Endonasal probing and retrograde irrigation of lacrimal ducts were performed in all children, taking into consideration the individual peculiarities of the obstruction and the anatomical accessibility of the opening of ductus nasolacrimalis in the inferior nasal passageway. Outflow of irrigation fluid from lacrimal puncta was observed at the first probing in 90% out of a total number of 401 primary probings. Because of persistent membranes in the inferior lacrimal punctum in 3 cases (0.8%) we had to repeat the initial dilatation. The repeated probing failed to ensure reliable establishment of lacrimal duct patency only in 1% of the cases. In such children we recommended and performed endonasal dacryocystorhinostomy with balloon intubations placing a catheter and this restored lacrimal drainage to the nasal cavity. Endonasal probing and irrigation of lacrimal ducts used in the treatment of congenital stenoses is a highly effective (99%), physiologically consistent and little traumatic method of reestablishing the patency of the tear draining system. If it fails, endonasal dacryocystorhinostomy with stents is the definitive treatment of children's dacryocystitis.


Impact of the COVID-19 Pandemic on Individuals With Low Vision: Life Goes On.
This qualitative case study explored the impact of lockdown and social distancing measures used during COVID-19 on the lives of individuals with low vision. A purposive sample of 6 participants with low vision was recruited. Data were collected using in-depth semistructured interviews consisting of 10 open-ended questions. A thematic analysis was conducted to understand the unified subjective experiences of the participants. The analysis revealed 4 themes: (1) Changes, a lot of them; (2) Emotional roller coaster; (3) Life goes on; and (4) Technology as the catalyst. Participants demonstrated ongoing adaptation to meet the changing demands imposed by the pandemic.


Isolation, sequence and expression of a novel mouse brain cDNA, mIA-2, and its relatedness to members of the protein tyrosine phosphatase family.
This study describes the isolation of a putative transmembrane protein tyrosine phosphatase (PTP), mIA-2, from a mouse brain cDNA library. The cDNA encodes 979 amino acids containing a unique extracellular domain and a single intracellular catalytic domain. Expression of mIA-2 was found primarily in the central nervous system and in neuroendocrine cells. The sequence shares a high degree of homology with its human counterpart (92% identity), especially in the intracellular domain, which shows 99.3% identity between the two species. In both human and mouse IA-2, several substitutions were found in the highly conserved regions including an Ala to Asp substitution in the core sequence. Bacterial expression of a glutathione S-transferase fusion protein showed that mIA-2 had no enzyme activity with conventional substrates such as Raytide, myelin basic protein, angiotensin, RR-src and pNpp. When tested with the total tyrosine-phosphorylated cellular proteins isolated on an anti-phosphotyrosine antibody column, it also showed little, if any, enzyme activity. These findings suggest that mIA-2 is a new member of the transmembrane PTP family that either has very narrow substrate specificity perhaps requiring post-translational modification for enzyme activity or has a still unknown biological function.


Results of the 2008-2009 International Pressure Ulcer Prevalence Survey and a 3-year, acute care, unit-specific analysis.
The National Quality Forum has identified a pressure ulcer as a hospital-acquired condition (HAC) that is high-cost and high-volume and may be preventable with implementation of evidence-based guidelines. The Center for Medicare and Medicaid Services no longer reimburses acute care facilities for the ancillary cost of facility-acquired (FA) ulcers. Benchmarking patient safety indicators, such as FA, may help facilities reduce pressure ulcer rates. The purpose of this observational, cross-sectional cohort study was to report the International Pressure Ulcer Prevalence Survey (IPUP) in the United States in 2008 and 2009. In addition, previously collected data (2006/2007) were used to evaluate and report general and unit-specific prevalence rates in acute care facilities. The overall prevalence and FA pressure ulcer rates were 13.5% and 6% (2008, N = 90,398) and 12.3 and 5% (2009, N = 92,408), respectively. In 2008 and 2009, overall prevalence rates were highest in long-term acute care (22%). FA rates were highest in adult intensive care units (ICUs) and ranged from 9.2% (general cardiac care unit [CCU]) to 12.1% (medical ICU) in 2008 and from 8.8% (general CCU) to 10.3% (surgical ICU) in 2009. In 2009, 3.3% of ICU patients developed severe FA ulcers (Stage III, Stage IV, eschar/unable to stage, or deep tissue injury). In 2009, approximately 10% (n = 1,631) of all ulcers were described as device-related. The most common anatomic locations for device-related ulcers were the ear (20%) and sacral/coccyx region (17%). Both the overall and FA pressure ulcer prevalence rates were lower in 2008 and 2009 than in 2006 and 2007. Results indicate that, although overall prevalence trends are encouraging, there is a stark contrast from the desired state, especially in adult ICUs.


Crystal habit modifications of ibuprofen and their physicomechanical characteristics.
Ibuprofen was crystallized from methanol, ethanol, isopropanol, and hexane at similar conditions. Marked differences in crystal habit of the samples obtained from these solvents were observed. The samples crystallized from methanol and ethanol had a polyhedral crystal habit, while those from hexane were needlelike. Those from isopropanol were elongated crystals. X-ray powder diffraction (XPD) and diferential scanning calorimetry (DSC) studies confirmed that these samples were structurally similar, therefore, polymorphic modifications were ruled out. The results showed that crystal habit modification had a great influence on the mechanical properties (compressibility, flow rate, and bulk density) of ibuprofen crystals. Samples obtained from methanol and ethanol exhibited the highest bulk density and the best flow rate, while those from hexane showed the lowest bulk density and the worst flow rate. The samples obtained from ethanol exhibited the best compression force/hardness profiles, and those obtained from hexane produced the softest tablets.


Molecular Detection of Rickettsia africae in Amblyomma variegatum Collected from Sudan.
Despite the increasing awareness of the importance of emerging vector-borne diseases, human tick-borne diseases, particularly rickettsial infections, are overlooked, especially in the countries such as Sudan with limited resources to perform molecular-based surveys. This study aimed at detection and genetic characterization of Rickettsia spp. in ticks collected from Sudan. The samples were first screened for the presence of rickettsial agents by gltA real-time PCR and subsequently characterized by gltA and ompA PCR and size-based multispacer typing. The results demonstrated the wide distribution of Rickettsia africae and/or closely related species across Sudan. The results of this report highlight the need for careful consideration of rickettsial infections in patients with nonmalarial febrile illness in this country. Nationwide surveillance on ticks associated with human rickettsial infections in Sudan is warranted.


Bilateral chylothorax, chylopericardium and chylous ascitis.
Non-Hodgkin's lymphoma (NHL) can commonly present as chylothorax and rarely as chylopericardium. Here we are presenting a case of a 21-years-old female with bilateral chylothorax, chylopericardium and chylous ascites all together finally diagnosed to have NHL as the etiology. To the best of our knowledge, it has been reported very infrequently.


SnO2@C@VO2 Composite Hollow Nanospheres as an Anode Material for Lithium-Ion Batteries.
Porous SnO2@C@VO2 composite hollow nanospheres were ingeniously constructed through the combination of layer-by-layer deposition and redox reaction. Moreover, to optimize the electrochemical properties, SnO2@C@VO2 composite hollow nanospheres with different contents of the external VO2 were also studied. On the one hand, the elastic and conductive carbon as interlayer in the SnO2@C@VO2 composite can not only buffer the huge volume variation during repetitive cycling but also effectively improve electronic conductivity and enhance the utilizing rate of SnO2 and VO2 with high theoretical capacity. On the other hand, hollow nanostructures of the composite can be consolidated by the multilayered nanocomponents, resulting in outstanding cyclic stability. In virtue of the above synergetic contribution from individual components, SnO2@C@VO2 composite hollow nanospheres exhibit a large initial discharge capacity (1305.6 mAhg-1) and outstanding cyclic stability (765.1 mAhg-1 after 100 cycles). This design of composite hollow nanospheres may be extended to the synthesis of other nanomaterials for electrochemical energy storage.


CSE1L, a novel microvesicle membrane protein, mediates Ras-triggered microvesicle generation and metastasis of tumor cells.
Tumor-derived microvesicles are rich in metastasis-related proteases and play a role in the interactions between tumor cells and tumor microenvironment in tumor metastasis. Because shed microvesicles may remain in the extracellular environment around tumor cells, the microvesicle membrane protein may be the potential target for cancer therapy. Here we report that chromosome segregation 1-like (CSE1L) protein is a microvesicle membrane protein and is a potential target for cancer therapy. v-H-Ras expression induced extracellular signal-regulated kinase (ERK)-dependent CSE1L phosphorylation and microvesicle biogenesis in various cancer cells. CSE1L overexpression also triggered microvesicle generation, and CSE1L knockdown diminished v-H-Ras-induced microvesicle generation, matrix metalloproteinase (MMP)-2 and MMP-9 secretion and metastasis of B16F10 melanoma cells. CSE1L was preferentially accumulated in microvesicles and was located in the microvesicle membrane. Furthermore, anti-CSE1L antibody-conjugated quantum dots could target tumors in animal models. Our findings highlight a novel role of Ras-ERK signaling in tumor progression and suggest that CSE1L may be involved in the "early" and "late" metastasis of tumor cells in tumorigenesis. Furthermore, the novel microvesicle membrane protein, CSE1L, may have clinical utility in cancer diagnosis and targeted cancer therapy.


Xp11.2 Translocation Renal Cell Carcinoma: A Rare Renal Cell Carcinoma.
Translocation-associated renal cell carcinoma (TRCC) is a group of under-recognized malignant renal neoplasms owing to the unavailability of ancillary diagnostic tools and considering the fact that these tumors may histomorphologically mimic a heterogeneous group of neoplasms ranging from benign to malignant ones. Xp11.2 translocation-associated renal cell carcinoma is a disease of the young with a relatively less known prognosis owing to the rarity of such reported neoplasms. The histological appearance of bulbous tumor cells with abundant, vacuolated cytoplasm and the presence of psammomatoid bodies are clues to the diagnosis but are not entirely specific. The immunohistochemistry (IHC) finding of transcription factor E3 (TFE3) positivity is an important pointer, but the demonstration of Xp11.2 translocation by fluorescence in situ hybridization (FISH) serves as the confirmatory test. In our case report, we highlight the fact that a combined approach involving light microscopy, immunohistochemistry, and fluorescence in situ hybridization is the key to its diagnosis.


Detection and identification of Bartonella species pathogenic for humans by PCR amplification targeting the riboflavin synthase gene (ribC).
Several Bartonella species have now been implicated as human pathogens. The recovery of these fastidious organisms in the clinical microbiology laboratory remains difficult, and current methods are still relatively insensitive. Thus, the bartonellae are good candidates for detection by PCR. We have developed a PCR assay which uses a single primer pair targeting the riboflavin synthase gene (ribC) and detected six Bartonella species that have been implicated in human disease, B. henselae, B. quintana, B. bacilliformis, B. clarridgeiae, B. elizabethae, and B. vinsonii subsp. berkhoffii. Species identification is achieved simply by restriction enzyme digestion of the amplicon. This PCR assay appears to be specific for the Bartonella genus because it failed to amplify DNA from several other bacterial species.


Polyoxometalate-modified carbon nanotubes: new catalyst support for methanol electro-oxidation.
A new catalyst support, polyoxometalate-modified carbon nanotubes, is presented in this paper through the chemisorption between polyoxometalate and carbon. Pt and Pt-Ru nanoparticles were electrochemically deposited on polyoxometalate-modified carbon nanotubes electrodes, and their electrocatalytic properties for methanol electro-oxidation are investigated in detail. Due to the unique electrical properties of carbon nanotubes and the excellent redox properties and the high protonic conductivity of polyoxometalate, for the similar deposition charge of Pt and Pt-Ru catalysts, 1.4 times larger exchange current density, 1.5 times higher specific activity, and better cycle stabilities can be obtained at polyoxometalate-modified carbon nanotube electrodes as compared to the electrodes without polyoxometalate modification. These results show that polyoxometalate-modified carbon nanotubes as a new catalyst support have good potential application in direct methanol fuel cells.


Determination of acrylamide levels in selected foods in Brazil.
Selected carbohydrate-rich foods available on the Brazilian market (111 samples representing 19 product categories) were analysed for acrylamide content using a liquid chromatography-tandem mass spectrometry method. A limit of detection of 10 microg kg(-1), a limit of quantitation of 20 microg kg(-1) and mean recoveries ranging 100 to 115% were obtained during a laboratory validation procedure. The concentration of acrylamide in the samples ranged from <20 to 2528 microg kg(-1), with a considerable variation between individual foodstuffs within the same food product class. The highest levels were found in potato products processed at high temperature and in instant coffee, while the lowest concentrations were detected in cassava- and maize-based products, bread and beer. These results are comparable with those reported in other countries.


Membrane phospholipid abnormalities in postmortem brains from schizophrenic patients.
Previous studies in schizophrenia have shown alterations in membrane phospholipids and polyunsaturated fatty acids. However, these studies have primarily examined peripheral (non-neuronal) cell types. The purpose of the present study was to examine whether the membrane deficits seen in peripheral tissues are also observed in the brain. The caudate was the primary region of interest for this study. Using high-pressure liquid chromatography in conjunction with an evaporative light-scattering detector, we first measured the level of various membrane phospholipids (PL) in schizophrenic (n=11) and control groups with (n=7) and without (n=14) other mental disorders. Polyunsaturated fatty acids (PUFAs) were then determined by capillary gas chromatography. Within groups, there are no significant correlations between membrane PL levels and other collection and demographic parameters including age, postmortem interval, storage time and brain weight. Significantly lower amounts of phosphatidylcholine and phosphatidylethanolamine were found in postmortem brain tissue from schizophrenic patients than in those from control groups, even after accounting for potential confounds. In addition, strong reductions of total PUFAs and saturated fatty acids were found in schizophrenic brains, relative to control brains. Specifically, the reduced PUFAs were largely attributable to decreases in arachidonic acid (AA) and, to a lesser extent, its precursors, linoleic and eicosadienoic acids. There are no significant differences between the control groups with and without other mental disorders. The present findings suggest that deficits identified in peripheral membranes may also be present in the brain from schizophrenic patients. Such a deficit in membrane AA may contribute to the many biological, physiological, and clinical phenomena observed in schizophrenia.


Fetal platelet consumption: a feature of placental insufficiency.
The involvement of fetal platelets in placental insufficiency was investigated. Platelet life span and the rate of platelet turnover were measured by a novel technique in fetuses with moderate and severe placental insufficiency and in controls. This procedure involves the measurement of platelet count and concentration of free glycocalicin in plasma. Placental insufficiency was defined by antenatal Doppler ultrasound analysis of the umbilical artery waveform, which was used to categorize the subjects according to whether their systolic-diastolic ratios were normal, moderately raised, or severely raised. Mean platelet life span in fetuses affected by placental insufficiency was only 60% of the normal fetal platelet life span (P less than .001). In addition, affected fetuses had a higher rate of platelet turnover, reflected in an elevated plasma glycocalicin concentration (4.06 +/- 0.19 versus 3.28 +/- 0.15 microgram/mL for severe placental insufficiency and control fetuses, respectively; P less than .01). Platelet life span did not differ between the moderate and severe placental insufficiency groups. We hypothesize that the observed changes in platelet life span and turnover result from increased platelet activation, which plays a role in the development of placental insufficiency.


Mums Alone: Exploring the Role of Isolation and Loneliness in the Narratives of Women Diagnosed with Perinatal Depression.
In this study, we explore the role that isolation and loneliness play in the narratives of women diagnosed with perinatal depression. Isolation and loneliness are increasingly seen as risk factors for depression, including in the perinatal period, but little is known about whether, and in what ways, women themselves associate isolation or loneliness with perinatal distress. Based on the thematic analysis of semi-structured interviews with fourteen mothers in England, we found that women often connected feelings of depression during and after pregnancy to feeling dislocated from their previous identities and relationships. Women felt lost, confined to their homes, and often unsupported by their partners and families. However, fears of being judged to be inadequate mothers made it difficult for women to make authentic connections with others or to express negative feelings, increasing isolation and depression. We drew on the intersectionality theory to illustrate how the intersect between motherhood and other aspects of women's identities (being young, single, deprived and/or from an ethnic minority) could leave some women particularly isolated and marginalised. Our conclusions emphasise the need to challenge social constructions of the good/bad mother, advocate for social change to lessen pressures on mothers, and develop support that addresses women's interpersonal contexts and social networks.


Clinical features of chronic hepatitis B patients with YMDD mutation after lamivudine therapy.
To study the clinical features of chronic hepatitis B (CHB) patients with tyrosine-methionine-aspartate-aspartate (YMDD) mutation after lamivudine therapy. This investigation was a retrospective study of 63 CHB patients with YMDD mutation during lamivudine therapy. Clinical data, including period and types of YMDD mutation; hepatitis B virus (HBV) DNA levels and alanine aminotransferase (ALT) levels before and after YMDD mutation were measured. YMDD mutation in the HBV DNA polymerase gene was determined using polymerase chain reaction (PCR) and direct sequencing. HBV DNA quantification was determined using real-time PCR. Relevant serum markers of HBV were measured. The follow-up period was 12 months after YMDD mutation. YMDD mutation occurred 7-44 months (median, 21.5 months) after the start of lamivudine therapy. The majority of the cases (42/63, 66.6%) had YMDD mutants detected between 12 and 24 months. Four types of YMDD mutation were observed in this study, rtL180M/M204V mutation was the predominant type (26/63, 41.3%). A proportion of patients (16/63, 25.4%; 12/63, 19.1%) had higher HBV DNA levels and ALT levels (after mutation vs before mutation), respectively. The majority of patients with YMDD mutants had similar or lower HBV DNA levels and ALT levels compared with baseline values. This subset of patients might have benefited from the continued lamivudine therapy. The patients with increased ALT and HBV DNA levels (breakthrough hepatitis) should benefit from the addition of a newer nucleotide analogue (e.g. adefovir).


Benzoxazinoid metabolites regulate innate immunity against aphids and fungi in maize.
Benzoxazinoids (BXs), such as 2,4-dihydroxy-7-methoxy-2H-1,4-benzoxazin-3(4H)-one (DIMBOA), are secondary metabolites in grasses. The first step in BX biosynthesis converts indole-3-glycerol phosphate into indole. In maize (Zea mays), this reaction is catalyzed by either BENZOXAZINELESS1 (BX1) or INDOLE GLYCEROL PHOSPHATE LYASE (IGL). The Bx1 gene is under developmental control and is mainly responsible for BX production, whereas the Igl gene is inducible by stress signals, such as wounding, herbivory, or jasmonates. To determine the role of BXs in defense against aphids and fungi, we compared basal resistance between Bx1 wild-type and bx1 mutant lines in the igl mutant background, thereby preventing BX production from IGL. Compared to Bx1 wild-type plants, BX-deficient bx1 mutant plants allowed better development of the cereal aphid Rhopalosiphum padi, and were affected in penetration resistance against the fungus Setosphaeria turtica. At stages preceding major tissue disruption, R. padi and S. turtica elicited increased accumulation of DIMBOA-glucoside, DIMBOA, and 2-hydroxy-4,7-dimethoxy-1,4-benzoxazin-3-one-glucoside (HDMBOA-glc), which was most pronounced in apoplastic leaf extracts. Treatment with the defense elicitor chitosan similarly enhanced apoplastic accumulation of DIMBOA and HDMBOA-glc, but repressed transcription of genes controlling BX biosynthesis downstream of BX1. This repression was also obtained after treatment with the BX precursor indole and DIMBOA, but not with HDMBOA-glc. Furthermore, BX-deficient bx1 mutant lines deposited less chitosan-induced callose than Bx1 wild-type lines, whereas apoplast infiltration with DIMBOA, but not HDMBOA-glc, mimicked chitosan-induced callose. Hence, DIMBOA functions as a defense regulatory signal in maize innate immunity, which acts in addition to its well-characterized activity as a biocidal defense metabolite.


TGF-β signaling in fibrosis.
Transforming growth factor β (TGF-β) is a central mediator of fibrogenesis. TGF-β is upregulated and activated in fibrotic diseases and modulates fibroblast phenotype and function, inducing myofibroblast transdifferentiation while promoting matrix preservation. Studies in a wide range of experimental models have demonstrated the involvement of the canonical activin receptor-like kinase 5/Smad3 pathway in fibrosis. Smad-independent pathways may regulate Smad activation and, under certain conditions, may directly transduce fibrogenic signals. The profibrotic actions of TGF-β are mediated, at least in part, through induction of its downstream effector, connective tissue growth factor. In light of its essential role in the pathogenesis of fibrosis, TGF-β has emerged as an attractive therapeutic target. However, the pleiotropic and multifunctional effects of TGF-β and its role in tissue homeostasis, immunity and cell proliferation raise concerns regarding potential side effects that may be caused by TGF-β blockade. This minireview summarizes the role of TGF-β signaling pathways in the fibrotic response.


Induction of urokinase receptor expression in nephrotoxic nephritis.
The urokinase receptor (uPAR) is a multifunctional molecule involved in pericellular, fibrinolytic, and proteolytic activities, as well as in cell adhesion and chemotaxis and may play a role in the pathogenesis of tissue remodeling occurring during glomerulonephritis. We analyzed sequentially the expression of uPAR by immunohistochemistry and in situ hybridization in an accelerated model of nephrotoxic nephritis in rats. A strong induction of uPAR mRNA expression was observed in glomeruli as soon as 1 h after nephrotoxic serum injection. The intensity of glomerular uPAR mRNA and antigen expression increased and peaked at 24 h. At that time, numerous glomerular fibrin deposits, monocyte/marcrophage infiltration, and heavy proteinuria were observed. Fibrin deposition was detected at 6 h, peaked at 24 h, and progressively declined over the next 3 weeks, while uPAR antigen expression remained elevated until the end of the study (3 weeks). By double labeling, we showed that the expression of uPAR was mediated by both intrinsic glomerular cells and infiltrating macrophages. Severe podocytic lesions developed within 3 days after antiserum injection, and glomerulosclerosis rapidly progressed within 2-3 weeks. These results show that glomerular uPAR expression is induced in nephrotoxic nephritis and suggest that uPAR may promote local proteolysis and also tissue remodeling, leading to the late development of glomerulosclerosis.


Searching for self and relationships online.
The purpose of this project was to study how Internet use relates to psychological well-being, relationships, the self and identity. University students (N = 203) completed a battery of questionnaires including measures of time spent online, "pathological" Internet use, Internet motivation, loneliness, relationship quality, self-concept clarity, and ego identity. Results showed positive relationships between measures of Internet use and loneliness. As well, face-to-face relationships were rated higher on both positive and negative quality dimensions relative to online relationships. Finally, Internet use was negatively correlated with self-concept clarity, and associated with moratorium identity status. These results suggest that the Internet may be an important aid for young adults as they searched for an adult identity.


Construction of Partially Protected Nonsymmetrical Biaryldiols via Semipinacol Rearrangement of o-NQM Derived from Enynones.
The construction of partially protected nonsymmetrical biaryldiols catalyzed by AgBF4 has been achieved. The approach facilitates the formation of two new aryl rings and the introduction of two hydroxyl groups (one free and one TBS-protected) via the o-NQM generation/semipinacol rearrangement cascade, featuring high atom- and step-economy to afford a diverse array of partially protected nonsymmetrical biaryldiols under mild conditions.


Identification and validation of a 17-gene signature to improve the survival prediction of gliomas.
Gliomas are one of the most frequent types of nervous system tumours and have significant morbidity and mortality rates. As a result, it is critical to fully comprehend the molecular mechanism of glioma to predict prognosis and target gene therapy. The goal of this research was to discover the hub genes of glioma and investigate their prognostic and diagnostic usefulness. In this study, we collected mRNA expression profiles and clinical information from glioma patients in the TCGA, GTEx, GSE68848, and GSE4920 databases. WGCNA and differential expression analysis identified 170 DEGs in the collected datasets. GO and KEGG pathway analyses revealed that DEGs were mainly enriched in gliogenesis and extracellular matrix. LASSO was performed to construct prognostic signatures in the TCGA cohort, and 17 genes were used to build risk models and were validated in the CGGA database. The ROC curve confirmed the accuracy of the prognostic signature. Univariate and multivariate Cox regression analyses showed that all independent risk factors for glioma except gender. Next, we performed ssGSEA to demonstrate a high correlation between risk score and immunity. Subsequently, 7 hub genes were identified by the PPI network and found to have great drug targeting potential. Finally, RPL39, as one of the hub genes, was found to be closely related to the prognosis of glioma patients. Knockdown of RPL39 in vitro significantly inhibited the proliferation and migration of glioma cells, whereas overexpression of RPL39 had the opposite effect. And we found that knockdown of RPL39 inhibited the polarization and infiltration of M2 phenotype macrophages. In conclusion, our new prognosis-related model provides more potential therapeutic strategies for glioma patients.


Management of adhesion using a pretarsal fibromuscular flap or graft in secondary blepharoplasty.
In double eyelid operations, if the eyes have too little fat and soft tissue, or if too much of the orbital fat was removed during the operation, the double eyelid crease is placed too high and the supratarsal recess becomes hollow and adhesion of the eyelid crease occurs even in the orbital septum and levator muscle. A secondary double eyelid operation in response to these problems needs to correct the height of the eyelid crease by releasing the inadequately high eyelid fold and preventing readhesion. Moreover, in case the muscle and scar tissue are bulged below the incision line, the height of the double eyelid should be appropriately lowered and the bulky lower flap should be flattened. In cases where the adjacent tissue (e.g., preaponeurotic fat) was excessively removed during the primary double eyelid operation, a free fat or dermis fat graft was performed to correct supratarsal depression and readhesion. These graft materials are extracted from a distant donor site. Even if the adjacent tissue was not sufficient, the authors made the superiorly based local flap or graft of pretarsal scar-muscle tissue obtained after thinning the bulky lower flap. In these cases, the fibrous muscle flap or graft compensated tissue depletion with a proper mass around the double eyelid crease, thus helping to prevent readhesion. Of the 1225 patients with high placement of the supratarsal fold with a bulky lower skin flap, we used pretarsal fibromuscular flaps in 914 patients and pretarsal fibromuscular grafts in treating 311 patients between November of 1997 and October of 2004. In the authors' series, 425 of 1225 patients underwent follow-up ranging from 2 to 23 months. Most of these patients were satisfied; however, 33 patients (7.8 percent) expressed dissatisfaction with the postoperative results based on their subjective judgment; 29 patients (6.8 percent) had mild asymmetry, and surgical revision was required in only 17 patients (4 percent). The authors eventually found that the pretarsal fibromuscular flap or graft was successful in making a natural eye shape and preventing readhesion, with no requirement of a distant donor site. They also found that the operation was effective in reducing the operative time and lowering the risk of postoperative infection.


All-day uninterrupted thermoelectric generator by simultaneous harvesting of solar heating and radiative cooling.
Passive power generation has recently stimulated interest in thermoelectric generators (TEGs) using the radiative cooling mechanism. However, the limited and unstable temperature difference across the TEGs significantly degrades the output performance. In this study, an ultra-broadband solar absorber with a planar film structure is introduced as the hot side of the TEG to increase the temperature difference by utilizing solar heating. This device not only enhances the generation of electrical power but also realizes all-day uninterrupted electrical output due to the stable temperature difference between the cold and hot sides of the TEG. Outdoor experiments show the self-powered TEG obtains maximum temperature differences of 12.67 °C, 1.06 °C, and 5.08 °C during sunny daytime, clear nighttime, and cloudy daytime, respectively, and generates output voltages of 166.2 mV, 14.7 mV, and 95 mV, respectively. Simultaneously, the corresponding output powers of 879.25 mW/m2, 3.85 mW/m2, and 287.27 mW/m2 are produced, achieving 24-hour uninterrupted passive power generation. These findings propose a novel strategy to combine solar heating and outer space cooling by a selective absorber/emitter to generate all-day continuous electricity for unsupervised small devices.


Rapid microbiological assay for chlorhydroxyquinoline that uses a cryogenically stored inoculum.
A rapid microbiological assay for chlorhydroxyquinoline is described. It is a turbidimetric procedure that uses Streptococcus faecalis as the test organism. Results are available within 5 h. Data are presented to show the advantages of using a cryogenically stored inoculum over an inoculum prepared on a daily basis.


Pharmacokinetics and blood-brain barrier penetration of (+)-catechin and (-)-epicatechin in rats by microdialysis sampling coupled to high-performance liquid chromatography with chemiluminescence detection.
(+)-Catechin (C) and (-)-epicatechin (EC), as the basic monomer units of flavanols, can be widely found in natural products or medicinal herbs. Recent pharmacological studies have revealed that C and EC exhibit good neuroprotective effects. However, there is little information about pharmacokinetic profiles in the brain and in vivo BBB penetration of C and EC. In this paper, an ultrasensitive method using high-performance liquid chromatography (HPLC) with chemiluminescence (CL) detection was developed for the analysis of microdialysis samples. The detection limits for C and EC in Ringer's solution were 1.0 and 1.2 ng/mL, respectively. The intraday and interday accuracies for C and EC in Ringer's solution ranged from -3.0 to 4.4%, and the intraday and interday precisions were below 5.2%. The mean in vivo recoveries of C and EC in microdialysis probes were 33.7% and 26.5% in blood while 38.3% and 29.1% in brain. Pharmacokinetic parameters were estimated using the statistical moment method after iv administration (C and EC, 20 mg/kg of body weight) in rats. Brain-to-blood (AUC(brain)/AUC(blood)) distribution ratios were 0.0726 ± 0.0376 for C and 0.1065 ± 0.0531 for EC, indicating that C and EC could pass through the BBB, which is further evidence of their neuroprotective effects.


Establishment of six new human biliary tract carcinoma cell lines and identification of MAGEH1 as a candidate biomarker for predicting the efficacy of gemcitabine treatment.
The aim of this study was to establish new biliary tract carcinoma (BTC) cell lines and identify predictive biomarkers for the potential effectiveness of gemcitabine therapy. Surgical specimens of BTC were transplanted directly into immunodeficient mice to establish xenografts, then subjected to in vitro cell culture. The gemcitabine sensitivity of each cell line was determined and compared with the genome-wide gene expression profile. A new predictive biomarker candidate was validated using an additional cohort of gemcitabine-treated BTC cases. From 55 BTC cases, we established 19 xenografts and six new cell lines. Based on their gemcitabine sensitivity, 10 BTC cell lines (including six new and four publicly available ones) were clearly categorized into two groups, and MAGEH1 mRNA expression in the tumor cells showed a significant negative correlation with their sensitivity to gemcitabine. Immunohistochemically, MAGEH1 protein was detected in three (50%) out of six sensitive cell lines, and four (100%) out of four resistant cell lines. In the validation cohort of gemcitabine-treated recurrence cases, patients were categorized into "effective" and "non-effective" groups according to the RECIST guidelines for assessment of chemotherapeutic effects. MAGEH1 protein expression was detected in two (40%) out of five "effective" cases and all four (100%) "non-effective" cases. We have established a new BTC bioresource that covers a wide range of biological features, including drug sensitivity, and is linked with clinical information. Negative expression of MAGEH1 protein serves as a potential predictive marker for the effectiveness of gemcitabine therapy in BTC.


Cryptococcal chorioretinitis with immune reconstitution inflammatory syndrome.
Immune Reconstitution Inflammatory Syndrome (IRIS) is an inflammatory syndrome in the context of immune restoration directed at a specific infectious antigen despite resolution of infection, often associated with opportunistic infections. IRIS has been reported in 30% to 35% of HIV patients who have cryptococcosis in whom antiretroviral therapy was initiated. We would like to report a case of IRIS localized to the eye secondary to cryptococcal infection.


Differential expression pattern of genes encoding for anti-microbial peptides in the fetal membranes of patients with spontaneous preterm labor and intact membranes and those with preterm prelabor rupture of the membranes.
Increased amniotic fluid concentrations of anti-microbial peptides, components of the innate immune system, have been reported in patients with preterm labor (PTL) with intact membranes and intra-amniotic infection and/or inflammation (IAI), as well as in patients with preterm prelabor rupture of the membranes (PPROM). This study was designed to confirm these results using a targeted approach, detecting DEFA1, DEFB1, GNLY, and S100A9 gene expression in the choriamniotic membranes in pregnancies complicated with PTL and intact membranes or PPROM, with and without histologic chorioamnionitis. Human fetal membranes were obtained from patients in the following groups: (1) PTL with intact membranes (n = 15); (2) PTL with intact membranes with histologic chorioamnionitis (n = 12); (3) PPROM (n = 17); and (4) PPROM with histologic chorioamnionitis (n = 21). The mRNA expression of alpha-defensin-1, beta-defensin-1, calgranulin B and granulysin in the fetal membranes was determined by qRT-PCR. (1) The expression of alpha-defensin-1 mRNA in the fetal membranes was higher in patients with PTL and intact membranes with histologic chorioamnionitis, than those without chorioamnionitis (19.4-fold, p < 0.001); (2) Among patients with histologic chorioamnionitis, patients with PTL and intact membranes had a higher alpha-defensin-1 mRNA expression than those with PPROM (5.5-fold, p = 0.003); (3) Histologic chorioamnionitis was associated with a higher calgranulin B mRNA expression in the chorioamniotic membranes of patients with both PTL and intact membranes (7.9-fold, p = 0.03) and PPROM (7.6-fold, p < 0.0001); (4) The expression of calgranulin B mRNA in the fetal membranes was higher in patients with PTL and intact membranes without histologic chorioamnionitis than in those with PPROM without histologic chorioamnionitis (2.7-fold, p = 0.03); (5) There were no differences in the expression of beta-defensin-1 and granulysin in the chorioamniotic membranes between the study groups even in the presence of histologic chorioamnioniotis. (1) Among patients with histologic chorioamnionitis, the mRNA expression of alpha-defensin-1 and calgranulin B in the fetal membranes of patients with PTL and intact membranes as well as that of calgranulin B in the fetal membranes of patients with PPROM is higher than in the membranes of those without histologic chorioamnionitis; (2) histologic chorioamnionitis is associated with differences in the pattern of alpha-defensin-1 mRNA expression in the fetal membranes in patients with PTL and intact membranes and those with PPROM.


[Relationship between microelements content of drinkable water and nephrolithiasis formation in Moscow region residents].
The article covers theoretical and practical matters on prevalence, incidence of nephrolithiasis in Moscow region and influencing ecological hazards. Predictive role of those matters is evaluated. The author presented features of drinkable water in Moscow region and revealed changes in nephrolithiasis prevalence in accordance with antropogenous load. Correlation between the nephrolithiasis prevalence and the microelements ratio in drinkable water is established.


Improvements in insulin resistance with weight loss, in contrast to rosiglitazone, are not associated with changes in plasma adiponectin or adiponectin multimeric complexes.
It has been suggested that changes in adiponectin levels may contribute to improved insulin sensitivity in insulin-resistant individuals both after weight loss and after treatment with thiazolidinedione compounds. If this is correct, then changes in total circulating adiponectin and/or distribution of its multimeric complexes should coincide with improvements in insulin sensitivity after both interventions. To address this issue, fasting adiponectin concentrations and distribution of adiponectin complexes were measured in plasma samples in 24 insulin-resistant, nondiabetic subjects before and after 3-4 mo of treatment with either rosiglitazone or caloric restriction. The degree of insulin resistance in each group of 12 subjects was equal at baseline and improved to a similar extent ( approximately 30%) after each therapy. Whereas total adiponectin levels increased by nearly threefold and the relative amount of several higher molecular weight adiponectin complexes increased significantly in the rosiglitazone treatment group, there were no discernible changes in adiponectin levels or in the distribution between high or low molecular weight complexes in the weight loss group. These data indicate that, although changes in total adiponectin and several specific adiponectin complexes paralleled improvements in insulin resistance in thiazolidinedione-treated subjects, neither circulating adiponectin concentrations nor multimeric complexes changed in association with enhanced insulin sensitivity after moderate weight loss in 12 insulin-resistant, obese individuals.


Electronic properties of several two dimensional halides from ab initio calculations.
Using density functional theory, we study the electronic properties of several halide monolayers. We show that their electronic bandgaps, as obtained with the HSE hybrid functional, range between 3.0 and 7.5 eV and that their phonon spectra are dynamically stable. Additionally, we show that under an external electric field some of these systems exhibit a semiconductor-to-metal transition.


Biobased foams for thermal insulation: material selection, processing, modelling, and performance.
With the urgent need for the development of sustainable materials and a circular economy, a surge of research regarding biobased materials and associated processing methods has resulted in many experimental biobased foams. Although several biobased foams are already shown to have thermal and mechanical properties competitive with expanded polystyrene, there remains a fundamental knowledge gap leading to limited understanding of the principles that determine performance. This review outlines the progress in this burgeoning field, introducing materials selection and processing, comparing performance, examining efforts in modelling physical properties, and discusses challenges in applying models to real biobased systems. The focus is on low thermal conductivity, which is a critical property for temperature-controlled applications such as packaging for refrigerated/frozen foods, medications, and vaccines as well as building materials. Currently, the trend in the field is moving towards fully biobased and compostable foams, though partially biobased polyurethane foams remain the most consistent performers. To illustrate the foam structure-property relationship, thermal conductivity, cell size, and density data were compiled. Given the complexity of biobased foams, heat transfer models aid in identifying crucial variables. However, data relevant to the insulation capability of biobased foams is not fully reported in many references. To address this issue, we employed a dimensional analysis to fill the gaps, revealing a power law correlation between thermal conductivity and relative density. Our approach is not intended as a robust prediction technique, but rather a simple demonstration of how biobased foams data could be utilized to predict the most promising materials and methods.


A cost benefit analysis of continued stay certification.
A large portion of the resources of the Professional Standards Review Organization Program have been directed toward the review of inpatients to determine their need for continued hospitalization. The primary goal of this review process is the containment of hospital costs through the elimination of unnecessary patient hospitalization. A cost benefit analysis of this review process shows that the potential financial savings accrued are unlikely to offset the costs associated with the review procedure.


Relevance of fluoroquinolone use in hospitals in the Lorraine region of France before and after corrective measures: an investigation by the Antibiolor Network.
This study of fluoroquinolone use was carried out before and after an educational intervention run by Antibiolor, a regional network to all hospitals in the Lorraine region of France. The relevance of fluoroquinolone prescription according to regional guidelines was assessed using a standard card filled out by physicians and pharmacists at the voluntarily participating hospitals. A therapeutic index of adequacy was established for each card. The initial survey took place in January 2008, with feedback and proposals for corrective measures in January 2009. The second survey was organized in June 2009. The results of the 2 surveys were compared. Twenty-four hospitals completed a total of 1336 cards in the first survey (S1) and 944 cards in the second (S2). The appropriateness of indications for fluoroquinolone use improved by 57% between the 2 surveys. All the criteria analyzed (choice of drug, dosage, treatment duration) were significantly improved in S2 compared to S1, as was the adequacy index (70% improvement). In view of the consequences of fluoroquinolone use, many hospitals in Lorraine were keen to participate in this study, confirming its feasibility over a large area. In view of the study results, the book of guidelines was re-examined and republished at the conclusion of S2. Greater adherence to guidelines was noted in S2, demonstrating the benefit of assessing the situation thoroughly before proposing corrective measures and evaluating their impact.


Examining factors that increase and decrease stress in adolescent community college students.
In contrast to adolescents attending traditional universities, adolescents attending community colleges represent a large but relatively unstudied population with respect to stress and mental health issues. The purpose of this study was to determine what factors increase and decrease stress in a sample of adolescent community college students (N = 166). Findings from a self-administered questionnaire indicated that students had moderate levels of stress and resilience. Contrary to predictions, males demonstrated statistically significant higher levels of stress than females, but as expected, resilience had a significant negative effect on stress (p < .05). Practice and research implications are discussed for nurses in pediatric settings.


Perinatal Complications as a Mediator of the Association Between Chronic Disease and Postpartum Mental Illness.
Background: Chronic disease is associated with increased risk of postpartum mental illness, but the mechanisms underlying this association are unclear. Our aim was to explore the mediating role of perinatal complications in the association between chronic disease and postpartum mental illness. Materials and Methods: This was a population-based retrospective cohort study of all women in Ontario, Canada, from 2005 to 2015 with a singleton live birth and no recent history of mental illness during or 2 years before pregnancy. The outcome was mental illness diagnosis between delivery and 365 days postpartum, with perinatal complications, including pregnancy, delivery, and neonatal complications. Modified Poisson regression models were used to examine the association between chronic disease and perinatal mental illness, with generalized estimating equations for the calculation of total, direct, and indirect effects. All models were adjusted for sociodemographic characteristics and remote history of mental health care. Results: Of the 792,972 women, 21.1% had a chronic disease. Chronic disease was associated with an increased risk of postpartum mental illness (adjusted relative risk [aRR] 1.15 [95% confidence interval, CI 1.14-1.16]). There was no evidence of an indirect effect of chronic disease on postpartum mental illness via perinatal complications (aRR 1.003, 95% CI 1.002-1.003). Perinatal complications explained only 1.5% of the association between chronic disease and postpartum mental illness. Results were consistent by type of perinatal complication and chronic disease diagnosis. Conclusion: We observed no clinically meaningful mediating effect of perinatal complications in the association between chronic disease and postpartum mental illness. Future research should investigate alternative mechanisms explaining this association.


[The effect of social support on the symptoms of depression experienced by Portuguese patients with multiple sclerosis].
The prevalence of depressive symptoms is high among patients with multiple sclerosis (MS). Despite being associated with low levels of social support, few studies showing the importance of the buffer effect on depressive symptoms. The aim is to analyze the effect of social support on depressive symptoms. The sample is composed by 150 MS consecutive patients attending the MS Outpatient Clinic of Hospital S. Joao, Porto, that gave written consent; illiterate subjects were excluded. The disease parameters, as duration, clinical course and disability (Expanded Disability Status Scale) were collected in the clinical protocols. In the comparison of socio-demographic variables and parameters with the depressive symptoms we used the Mann-Whitney U and Kruskal-Wallis H. In interferential analysis we used the MLR with stepwise selection of variables. Age, education emotional social support, disability, duration of illness and the primary and secondary forms determine together 42.4% of depressive symptoms. Gender, marital status, be unskilled worker, have material social support and relapsing- remitting form does not determine any change in depressive symptoms. The emotional social support is a predictor of depressive symptoms. This study reinforces the need for professionals to be sources of social support in promoting programs that reduce the risk of depressive symptoms.


Efficacy of new low-cost filtration device for recovering Schistosoma haematobium eggs from urine.
A new, inexpensive filtration device for the diagnosis of urinary schistosomiasis was tested against the commonly used Millipore device. The experimental protocol was performed with 25 urine samples known to be positive for Schistosoma haematobium. The results suggest that the new device is as effective as the Millipore device for the diagnosis of urinary schistosomiasis. Its low cost will be attractive to schistosomiasis control programs.


Investigation on the Injury Severity of Drivers in Rear-End Collisions Between Cars Using a Random Parameters Bivariate Ordered Probit Model.
The existing studies on drivers' injury severity include numerous statistical models that assess potential factors affecting the level of injury. These models should address specific concerns tailored to different crash characteristics. For rear-end crashes, potential correlation in injury severity may present between the two drivers involved in the same crash. Moreover, there may exist unobserved heterogeneity considering parameter effects, which may vary across both crashes and individuals. To address these concerns, a random parameters bivariate ordered probit model has been developed to examine factors affecting injury sustained by two drivers involved in the same rear-end crash between passenger cars. Taking both the within-crash correlation and unobserved heterogeneity into consideration, the proposed model outperforms the two separate ordered probit models with fixed parameters. The value of the correlation parameter demonstrates that there indeed exists significant correlation between two drivers' injuries. Driver age, gender, vehicle, airbag or seat belt use, traffic flow, etc., are found to affect injury severity for both the two drivers. Some differences can also be found between the two drivers, such as the effect of light condition, crash season, crash position, etc. The approach utilized provides a possible use for dealing with similar injury severity analysis in future work.


Multi-Connectivity Representation Learning Network for Major Depressive Disorder Diagnosis.
The pathophysiology of major depressive disorder (MDD) has been demonstrated to be highly associated with the dysfunctional integration of brain activity. Existing studies only fuse multi-connectivity information in a one-shot approach and ignore the temporal property of functional connectivity. A desired model should utilize the rich information in multiple connectivities to help improve the performance. In this study, we develop a multi-connectivity representation learning framework to integrate multi-connectivity topological representation from structural connectivity, functional connectivity and dynamic functional connectivities for automatic diagnosis of MDD. Briefly, structural graph, static functional graph and dynamic functional graphs are first computed from the diffusion magnetic resonance imaging (dMRI) and resting state functional magnetic resonance imaging (rsfMRI). Secondly, a novel Multi-Connectivity Representation Learning Network (MCRLN) approach is developed to integrate the multiple graphs with modules of structural-functional fusion and static-dynamic fusion. We innovatively design a Structural-Functional Fusion (SFF) module, which decouples graph convolution to capture modality-specific features and modality-shared features separately for an accurate brain region representation. To further integrate the static graphs and dynamic functional graphs, a novel Static-Dynamic Fusion (SDF) module is developed to pass the important connections from static graphs to dynamic graphs via attention values. Finally, the performance of the proposed approach is comprehensively examined with large cohorts of clinical data, which demonstrates its effectiveness in classifying MDD patients. The sound performance suggests the potential of the MCRLN approach for the clinical use in diagnosis. The code is available at https://github.com/LIST-KONG/MultiConnectivity-master.


[Hepatic Hernia through a Diaphragmatic Defect Mimicking Pleural Tumor:Report of a Case].
Hepatic heria in adult without history of trauma or surgery is rare, and is sometimes operated under the diagnosis of lung or diaphragmatic tumor. Here, we report a case of hepatic hernia which had been preoperatively suspected of pleural tumor and surgically treated. At surgery, multiple lesions mimicking ectopic endometriosis were found on the diaphragma and hepatic profrusion was found from one of lesions.


Biological methods for speciation of heavy metals: different approaches.
Heavy metals are found in their different forms in the environment. The distribution, mobility, and toxicity of metals are strongly related to these different forms. This necessitates the exploration of different methods for the remediation and speciation of heavy metals. Some direct and indirect physico-chemical methods such as filtration, chemical precipitation, ion-exchange, electro deposition, and membrane systems have been used for the last four decades. However, it is only in last few years that reliable biological methods have also been used. The biological methods include the use of microorganisms (fungi, algae, bacteria), plants (live or dead) and biopolymers. The use of these methods for the speciation of heavy metals is reviewed here.


Unrecognized chronic dehydration in older adults: examining prevalence rate and risk factors.
Dehydration has serious consequences for older adults, including increased risk of illness or death. This retrospective review of medical records describes the prevalence, assessment, and risk factors for chronic dehydration in 185 older adults who visited an emergency department in June 2000. Results showed chronic dehydration was present in 89 (48%) patients. Physicians documented assessment for signs of dehydration in 23 (26%) of the dehydrated older adults, but no independent assessments for dehydration were recorded by nurses. These findings indicate many older adults may suffer from unrecognized dehydration, and nurses should be alert to the possibility that dehydration may be present in community-dwelling older adults as well as those who live in residential facilities.


Serological and Pathogenic Analyses of Fowl Adenovirus Serotype 4 (FAdV-4) Strain in Muscovy Ducks.
Hydropericardium hepatitis syndrome (HHS) is a lethal disease caused by Fowl adenovirus serotype 4(FAdV-4) that mainly infects 3- to 6-week-old broiler chicks. In 2015, an infectious disease characterized similar symptom to HHS in broilers outbroke in commercial duck flocks in Shandong province. FAdV-4 was isolated from naturally infected ducks and determined by polymerase chain reaction (PCR) amplification and DNA sequence analysis. In order to investigate the effect of FAdV-4 infection on muscovy ducks, we determined and characterized the FAdV-4 Isolate, and assessed its pathogenicity. In this study, HHS was respectively reproduced in 5-week-old muscovy duck by intramuscular injection and intranasal inoculation of allantoic fluid containing FAdV-4, ducks in the negative control group were inoculated with allantoic fluids of healthy duck embryos in the same manner. Clinical symptoms, gross and microscopic lesions, cytokines and antibodies, blood biochemical indices were detected and recorded for 12 days after infection. Typical hydropericardium and hepatitis was observed in experimental muscovy duck in the 3rd day post-inoculation (dpi). FAdV-4 can be replicated in tissues and cause pathological damage, especially in the liver and immune organs. Most of the immune-related cytokines and antibodies levels are up-regulated and then decreased, which may be caused by the initial infection and the normal immune response, later the virus caused the immunosuppression and led to the decrease of levels. To the best of our knowledge, this is the first systematic trial of the pathogenicity of FAdV-4 in muscovy ducks mainly based on the serological test, which will provide new insights into the study of the disease.