Recent advancement of therapeutic endoscopy in the esophageal benign diseases.
Over the past 30 years, the field of endoscopy has witnessed several advances. With the advent of endoscopic mucosal resection, removal of large mucosal lesions have become possible. Thereafter, endoscopic submucosal resection was refined, permitting en bloc removal of large superficial neoplasms. Such techniques have facilitated the development of antireflux mucosectomy, a promising novel treatment for gastroesophageal reflux. The introduction and use of over the scope clips has allowed for endoscopic closure of defects in the gastrointestinal tract, which were traditionally treated with surgical intervention. With the development of per-oral endoscopic myotomy (POEM), the treatment of achalasia and spastic disorders of the esophagus have been revolutionized. From the submucosal tunnelling technique developed for POEM, Per oral endoscopic tumor resection of subepithelial tumors was made possible. Simultaneously, advances in biotechnology have expanded esophageal stenting capabilities with the introduction of fully covered metal and plastic stents, as well as biodegradable stents. Once deemed a primarily diagnostic tool, endoscopy has quickly transcended to a minimally invasive intervention and therapeutic tool. These techniques are reviewed with regards to their application to benign disease of the esophagus.


Attenuated aversiveness of electric shock during nitrous oxide exposure.
The analgesic properties of nitrous oxide (N2O) were evaluated with a fractional escape procedure ("shock titration" schedule). Shock intensity rose by a small step every few seconds. Each designated response by a rat or squirrel monkey subject reduced the amplitude of the shock by one step. Both species maintained stable tolerated levels of shock when exposed to pure oxygen or to air. Exposure to N2O yielded an elevation in maintained shock level whose magnitude depended on concentration. Statistically significant rises generally were apparent at N2O concentrations of 30 to 70%, which also tended to reduce shock level fluctuations. Since the raised shock levels were not accompanied by changes in overall response rate, they can be attributed to the analgesic properties of N2O.


Implementation of a novel primary care pathway for patients with severe and enduring mental illness.
Aims and method New collaborative care models with an emphasis on primary care are required for long-term management of patients with severe and enduring mental illness (SMI). We conducted a descriptive evaluation of clinical outcomes of the first 3 years of a novel enhanced primary care (EPC) service. Data from 2818 patients and staff survey results were analysed. Results 2310 patients were discharged to EPC (508 not assessed as clinically suitable or patients/general practitioners declined the transfer); mean length of stay with secondary care service of the cohort was 9.8 years (range 0-24). 717 patients (31%) have been discharged to primary care only out of the EPC services and 233 patients (10%) have been transferred back to secondary care. Patient and staff satisfaction with the new EPC model was high. No severe untoward incidents were recorded. Clinical implications The data suggest that EPC can be safely provided for a significant proportion of patients with SMI, who traditionally received long-term secondary care support. The novel EPC model can be utilised as a template for the provision of cost-effective, recovery-oriented and non-stigmatising care in the community.


Prognostic Relevance of ZNF844 and Chr 19p13.2 KRAB-Zinc Finger Proteins in Clear Cell Renal Carcinoma.
Clear-cell renal cell carcinoma (ccRCC) is the most common and aggressive form of all urological cancers, with poor prognosis and high mortality. Despite growing evidence of involvement in carcinogenesis, the role of KRAB-ZFP in ccRCC has not been fully explored. KRAB Zinc finger proteins (KRAB-ZFPs) are the largest family of mammalian transcription regulators. They are differentially expressed in various tissues during cellular development and phenotypic differentiation. In this study, the levels of transcripts of ccRCC from The Cancer Genome Atlas (TCGA) dataset were used to identify prognostic biomarkers in this disease. Using bioinformatics techniques, we demonstrate that approximately 60% of KRAB zinc finger proteins located on chromosome 19p13.2 are differentially expressed, with all but two being down-regulated in ccRCC. Moreover, ZNF844, a paralog of ZNF433, was the most down-regulated across all histological grades and pathological stages (p<0.001). In addition, the decrease in ZNF844 expression was associated with poor patient survival (HR=0.41; 95% CI=0.3-0.56; p<0.0001). Gene Set Enrichment Analysis of genes inversely co-expressed with ZNF844 revealed that enriched pathways were consistently related to immune and translation processes (p<0.05, FDR <0.05). Lastly, ZNF844 expression showed moderate, inverse correlation to Helper T-cell (CD4 or Th1) subtype 1 (R=-0.558, p=5.15×10-39) infiltration and with the exhausted T-cell phenotype (R=-0.37; p=4.1×10-21). Down-regulation of KRAB-ZFPs at 19p13.2 may represent a signature for ccRCC. Moreover, ZNF844 is a prognostic marker for ccRCC and may serve as a putative immune-related tumor suppressor gene.


The prognostic role of surgery and a nomogram to predict the survival of stage IV breast cancer patients.
Since numerous retrospective studies and prospective trials have shown divergent results, whether the surgical excision of the primary tumor results in survival benefits for de novo stage IV breast cancer patients is inconclusive. Consequently, we need a prediction model of prognosis, judge the efficiency of breast surgery, and identify the advanced breast cancer patients who would benefit from surgery. We analyzed the data of 2,747 metastatic breast cancer patients (the surgery group) and 4,508 patients (the non-surgery group) from the Surveillance, Epidemiology, and End Results (SEER) database during 2010-2015. Propensity score matching (PSM) was used to attain a balance between the covariates of both groups. We then assessed the potential risk factors for the breast cancer-specific survival (BCSS) of patients in the non-surgery group by Cox regression and constructed a nomogram to predict BCSS. All the patients were classified into different risk groups based on the median risk score obtained from the nomogram. The hazard ratios of BCSS and overall survival (OS) of patients in the two groups were calculated. After PSM, 2,288 patients severally in the two groups (the surgery group and the non-surgery group) were enrolled in the study. A nomogram incorporating 13 potential risk factors (i.e., age, race, cohabitation status, income, tumor grade, histotype, tumor size, lymph node status, molecular subtype, metastasis to brain, liver, lung, and chemotherapy) was constructed using the data of patients in the non-surgery group. The C statistics for the internal (patients in the non-surgery group) and external (patients in the surgery group) validation of the nomogram were 0.70 [95% confidence interval (CI), 0.69-0.71] and 0.73 (95% CI, 0.72-0.74), respectively. In the low-risk group, patients in the surgery group had lower risks of breast cancer-specific mortality (BCSM) (hazard ratio =0.53; 95% CI, 0.47-0.59; P for interaction =0.014) and overall mortality (OM) (hazard ratio =0.52; 95% CI, 0.46-0.58; P for interaction =0.002) than those in the non-surgery group. Breast surgery might improve the survival of metastatic breast cancer patients in the low-risk group. The established nomogram could provide a reference for clinicians in enabling personalized treatment among advanced breast cancer patients.


Competition between heterogeneous and homogeneous nucleation near a flat wall.
We studied the competition between heterogeneous and homogeneous nucleation of an aqueous suspension of charged colloidal spheres close to the container walls. Samples of equilibrium crystalline structure were shear-melted and the metastable melt left to solidify after the cessation of shear. The crystallization kinetics was monitored using time-resolved scattering techniques: at low particle number densities n we applied an improved static light scattering method while at large particle concentrations ultra-small-angle x-ray scattering was applied for the first time. Our results show some unexpected behavior: the heterogeneous nucleation at the container walls is delayed in comparison to the homogeneous bulk nucleation and its rate density appears surprisingly slightly smaller, demonstrating the complexity of the observed crystallization process.


Impact of the COVID-19 pandemic on the HIV care continuum: a mixed methods systematic review protocol.
The objective of this systematic review is to synthesize evidence on the impact of the COVID-19 pandemic on the HIV care continuum for persons living with or at risk of living with HIV. The COVID-19 pandemic affected the self-management and care of people living with HIV. Self-regulation to acquire recurring treatment for HIV is essential for managing symptoms as well as viral suppression. Therefore, this review will systematically appraise and synthesize primary literature on the impact of the COVID-19 pandemic on all phases of the HCC for people living with, or at risk of acquiring, HIV. This systematic review will include quantitative, qualitative, and mixed methods studies. The search will be limited to studies reporting findings from March 2020. Selected studies must focus on one or more steps of the HIV care continuum, which are diagnosis of HIV infection, linkage to care, retention in care, adherence to antiretroviral therapy, and viral suppression. There are no age, gender, or geographic location restrictions for this review. Studies that examined the impact on other diseases as well as HIV will be included only if the data for HIV can be extracted separately. The JBI methodology for convergent integrated mixed methods systematic reviews will guide this review. The following databases will be searched: MEDLINE (Ovid), CINAHL (EBSCOhost), CAB Direct, and Embase. Articles will be screened by 2 independent reviewers. In the case of a disagreement between reviewers, a third independent reviewer will resolve the conflict. Articles will be appraised for methodological quality and their data extracted using an original extraction tool created for the study's purpose. PROSPERO CRD42021285677.


Differences in Absorbance (OD620) of Various Strains of Staphylococcus aureus as Determined by Direct Microscopic Counts.
A modification of the Breed direct microscopic method for counting Staphylococcus aureus and its use in preparing standard curves with the spectrophotometer is described. Eight strains of S. aureus were grown on various media. The organisms were formalin killed, diluted in phosphate buffered saline (PBS), and mildly sonicated to disperse clumped organisms. Each suspension was further diluted in PBS to yield absorbance (OD620) readings of 0.60 to 1.60 at OD620. After measuring absorbance, each dilution of S. aureus was further diluted in a solution containing crystal violet, bovine sera, 70% ethanol, and 0.01M PBS pH 6.8, to a concentration of approximately 105 cells/ml. Ten microliters of the S. aureus -dye suspension was uniformly spread on a somatic cell slide circle and allowed to dry. The film dried evenly due to the lower surface tension caused by the ethanol. S. aureus appeared dark purple against a light purple background. A fixed diameter of each circle was counted using a lens reticle at a magnification of 1000X. Care was taken to grow and handle the organisms in a repeatable fashion to avoid loss of exopolysaccharide and shrinkage or swelling of cells, which was shown to cause changes in absorbance. The effect of trypsin treatment on the standard curves was examined in four of the strains.


Rhizobiales as functional and endosymbiontic members in the lichen symbiosis of Lobaria pulmonaria L.
Rhizobiales (Alphaproteobacteria) are well-known beneficial partners in plant-microbe interactions. Less is known about the occurrence and function of Rhizobiales in the lichen symbiosis, although it has previously been shown that Alphaproteobacteria are the dominating group in growing lichen thalli. We have analyzed the taxonomic structure and assigned functions to Rhizobiales within a metagenomic dataset of the lung lichen Lobaria pulmonaria L. One third (32.2%) of the overall bacteria belong to the Rhizobiales, in particular to the families Methylobacteriaceae, Bradyrhizobiaceae, and Rhizobiaceae. About 20% of our metagenomic assignments could not be placed in any of the Rhizobiales lineages, which indicates a yet undescribed bacterial diversity. SEED-based functional analysis focused on Rhizobiales and revealed functions supporting the symbiosis, including auxin and vitamin production, nitrogen fixation and stress protection. We also have used a specifically developed probe to localize Rhizobiales by confocal laser scanning microscopy after fluorescence in situ hybridization (FISH-CLSM). Bacteria preferentially colonized fungal surfaces, but there is clear evidence that members of the Rhizobiales are able to intrude at varying depths into the interhyphal gelatinous matrix of the upper lichen cortical layer and that at least occasionally some bacteria also are capable to colonize the interior of the fungal hyphae. Interestingly, the gradual development of an endosymbiotic bacterial life was found for lichen- as well as for fungal- and plant-associated bacteria. The new tools to study Rhizobiales, FISH microscopy and comparative metagenomics, suggest a similar beneficial role for lichens than for plants and will help to better understand the Rhizobiales-host interaction and their biotechnological potential.


Blood profiling of proteins and steroids during weight maintenance with manipulation of dietary protein level and glycaemic index.
Weight regain after weight loss is common. In the Diogenes dietary intervention study, a high-protein and low-glycaemic index (GI) diet improved weight maintenance. The objective of the present study was to identify (1) blood profiles associated with continued weight loss and weight regain (2) blood biomarkers of dietary protein and GI levels during the weight-maintenance phase. Blood samples were collected at baseline, after 8 weeks of low-energy diet-induced weight loss and after a 6-month dietary intervention period from female continued weight losers (n 48) and weight regainers (n 48), evenly selected from four dietary groups that varied in protein and GI levels. The blood concentrations of twenty-nine proteins and three steroid hormones were measured. The changes in analytes during weight maintenance largely correlated negatively with the changes during weight loss, with some differences between continued weight losers and weight regainers. Increases in leptin (LEP) and C-reactive protein (CRP) were significantly associated with weight regain (P < 0·001 and P = 0·005, respectively), and these relationships were influenced by the diet. Consuming a high-protein and high-GI diet dissociated the positive relationship between the change in LEP concentration and weight regain. CRP increased during the weight-maintenance period only in weight regainers with a high-protein diet (P < 0·001). In addition, testosterone, luteinising hormone, angiotensinogen, plasminogen activator inhibitor-1, resistin, retinol-binding protein 4, insulin, glucagon, haptoglobin and growth hormone were also affected by the dietary intervention. The blood profile reflects not only the weight change during the maintenance period, but also the macronutrient composition of the dietary intervention, especially the protein level.


Homosexual Fellatio: Erect Penis Licking between Male Bonin Flying Foxes Pteropus pselaphon.
A recent focus of interest has been on the functional significance of genital licking (fellatio and cunnilingus) in relation to sexual selection in Pteropodid bats. In the present paper, a form of fellatio in wild Bonin flying foxes, Pteropus pselaphon, performed between adult males has been reported. During the mating season, adult flying foxes roost in same-sex groups, forming ball-shaped clusters which provide warmth. The female clusters may also contain a few males. Unassociated with allogrooming, same-sex genital licking occurred among males in the all male clusters. As such, male-male fellatio can be considered as homosexual behavior, two functional explanations could account for this behavior; the social bonding and the social tension regulation hypotheses suggested in a previous review. Given that neither the simpler alternative that in all male groups such fellatio may represent misdirected sexual behavior, nor the two previously proposed functional hypotheses were supported by the data, I propose another functional hypothesis. Homosexual fellatio in this species could help males solve inconsistent situations in the roost when there are conflicts between cooperative behavior for social thermoregulation and competition for mating.


Biodegradable κ-carrageenan/nanoclay nanocomposite films containing Rosmarinus officinalis L. extract for improved strength and antibacterial performance.
In this study, biodegradable κ-carrageenan films containing 3% nanoclay and different amounts of rosemary extract (1, 2 and 3% v/v) were fabricated and their physical, thermal, and mechanical properties, as well as antimicrobial activity were examined. The film thickness did not change significantly by the addition of rosemary extract. UV light transmission value in the control film was 20.46%, while the value for the film with 3% v/v rosmary extract reduced to 0.13%. Elongation at break (EB%) and tensile strength (TS) of the carrageenan film without the extract were 19.07% and 15.96MPa, respectively, while after adding 3% v/v of rosemary extract, the EB and TS were increased to 27.17% and 30.77MPa, respectively. Incorporation of rosemary extract greatly reduced water vapor permeability (WVP) (5.27×10-10g/m·s·Pa in control film vs 2.14×10-10g/m·s·Pa in the film containing 3% v/v rosemary extract). More importantly, the carrageenan film with 3% extract displayed >99% inhibition against B. cereus, E. coli, P. aeruginosa, and S. aureus compared with the control film. The present study showed that rosemary extract is an excellent additive to enhance the mechanical strength and antibacterial activity of carrageenan films and can be used for active packing in food packing industry.


Quality of care for cardiometabolic disease: associations with mental disorder and rurality.
This study examines quality of cardiometabolic care among veterans receiving care in the Veterans Affairs (VA) health system. We assess whether quality of care disparities by mental disorder status are magnified for individuals living in rural areas. We identified all patients in a 2005 national Veterans Administration cardiometabolic quality of care chart review. The intersection of this cohort and VA registries, that include patients with and without mental disorder, permitted identification of chart review patients with and without mental disorder. Using residential ZIP code, patients were assigned to rural-urban commuting area codes. We used logistic regression adjusting for age, demographics, comorbidities, and income. We assessed association between rural residence and 9 cardiometabolic care quality indicators including care processes and intermediate outcomes. Compared with those without mental disorder, patients with mental disorder were less likely to receive diabetes sensory foot exams (OR: 0.82; 95% CI: 0.72-0.94), retinal exams (OR: 0.82; 95% CI: 0.73-0.93), and renal tests (OR: 0.79; CI: 0.74-0.90). Rural residence was associated with no differences in quality measures. Primary care visit volume was associated with significantly greater likelihood of obtaining diabetic retinal examination and renal testing, but did not explain disparities among patients with mental disorder. Mental disorder is associated with lesser attainment of quality cardiometabolic care. In this integrated VA care system, rurality and visit volume did not explain this disparity. Other explanations for disparities must be explored to improve the health and health care of this population.


PU.1 antisense lncRNA against its mRNA translation promotes adipogenesis in porcine preadipocytes.
Antisense long non-coding RNAs (AS lncRNAs) play important roles in refined regulation of animal gene expression. However, their functions and molecular mechanisms for domestic animal adipogenesis are largely unknown. Here, we found a novel AS lncRNA transcribed from the porcine PU.1 gene (also known as SPI1) by strand-specific RT-PCR. Results showed that PU.1 AS lncRNA was expressed and generally lower than the level of PU.1 mRNA in porcine subcutaneous adipose, heart, liver, spleen, lympha, skeletal muscle and kidney tissues. We further found that the levels of PU.1 mRNA and PU.1 protein were significantly lower in subcutaneous and intermuscular adipose than in mesenteric and greater omentum adipose, whereas the levels of PU.1 AS lncRNA showed no difference in porcine adipose tissues from four different parts of the body. During porcine adipogenesis, levels of PU.1 mRNA increased at day 2 and then gradually decreased. Meanwhile, PU.1 AS lncRNA exhibited an expression trend similar to PU.1 mRNA but sharply decreased after day 2. Interestingly, PU.1 protein level rose during differentiation. In addition, at day 6 after differentiation, knockdown of endogenous PU.1 promoted adipogenesis, whereas knockdown of endogenous PU.1 AS lncRNA had the opposite effect. Moreover, peroxisome proliferator-activated receptor gamma (PPARG) and fatty acid synthase (FASN) were significantly upregulated in the PU.1 shRNA treatment group (P < 0.05), whereas they were downregulated in the PU.1 AS shRNA treatment group (P < 0.05). Adipose triglyceride lipase [ATGL; also known as patatin-like phospholipase domain containing 2 (PNPLA2)] and hormone-sensitive lipase [HSL; also known as lipase, hormone-sensitive (LIPE)] contrasted with PPARG and FASN. Finally, the PU.1 mRNA/PU.1 AS lncRNA duplex was detected by an endogenous ribonuclease protection assay combined with RT-PCR. Based on the above results, we suggest that PU.1 AS lncRNA (vs. its mRNA translation) promotes adipogenesis through the formation of a sense-antisense RNA duplex with PU.1 mRNA.


Tilavonemab in early Alzheimer's disease: results from a phase 2, randomized, double-blind study.
Tau accumulation in patients with Alzheimer's disease tracks closely with cognitive decline and plays a role in the later stages of disease progression. This phase 2 study evaluated the safety and efficacy of tilavonemab, an anti-tau monoclonal antibody, in patients with early Alzheimer's disease. In this 96-week, randomized, double-blind, placebo-controlled study (NCT02880956), patients aged 55-85 years meeting clinical criteria for early Alzheimer's disease with a Clinical Dementia Rating-Global Score of 0.5, a Mini-Mental State Examination score of 22 to 30, a Repeatable Battery for the Assessment of Neuropsychological Status-Delayed Memory Index score of ≤85, and a positive amyloid PET scan were randomized 1:1:1:1 to receive one of three doses of tilavonemab (300 mg, 1000 mg, or 2000 mg) or placebo via intravenous infusion every 4 weeks. The primary end point was the change from baseline up to Week 96 in the Clinical Dementia Rating-Sum of Boxes (CDR-SB) score. Safety evaluations included adverse event monitoring and MRI assessments. A total of 453 patients were randomized, of whom 337 were treated with tilavonemab (300 mg, n = 108; 1000 mg, n = 116; 2000 mg, n = 113) and 116 received placebo. Baseline demographics and disease characteristics were comparable across groups. The mean age was 71.3 (SD 7.0) years, 51.7% were female, and 96.5% were White. At baseline, the mean CDR-SB score was 3.0 (1.2), which worsened through Week 96 for all treatment groups. The least squares mean change from baseline at Week 96 in the CDR-SB score with tilavonemab was not significantly different compared with placebo [300 mg (n = 85): -0.07 (95% confidence interval, CI: -0.83 to 0.69); 1000 mg (n = 91): -0.06 (95% CI: -0.81 to 0.68); 2000 mg (n = 81): 0.16 (95% CI: -0.60 to 0.93); all P ≥ 0.05]. The incidence of any adverse event and MRI findings were generally comparable across groups. Tilavonemab was generally well tolerated but did not demonstrate efficacy in treating patients with early Alzheimer's disease. Further investigations of tilavonemab in early Alzheimer's disease are not warranted.


Increased expression of alpha-synuclein reduces neurotransmitter release by inhibiting synaptic vesicle reclustering after endocytosis.
The protein alpha-synuclein accumulates in the brain of patients with sporadic Parkinson's disease (PD), and increased gene dosage causes a severe, dominantly inherited form of PD, but we know little about the effects of synuclein that precede degeneration. alpha-Synuclein localizes to the nerve terminal, but the knockout has little if any effect on synaptic transmission. In contrast, we now find that the modest overexpression of alpha-synuclein, in the range predicted for gene multiplication and in the absence of overt toxicity, markedly inhibits neurotransmitter release. The mechanism, elucidated by direct imaging of the synaptic vesicle cycle, involves a specific reduction in size of the synaptic vesicle recycling pool. Ultrastructural analysis demonstrates reduced synaptic vesicle density at the active zone, and imaging further reveals a defect in the reclustering of synaptic vesicles after endocytosis. Increased levels of alpha-synuclein thus produce a specific, physiological defect in synaptic vesicle recycling that precedes detectable neuropathology.


A nationwide survey of behavioral pediatric residency training.
This survey assessed the prevalence of behavioral pediatric residency training in the U.S., the professional background of faculty, training methods utilized, curriculum content, and barriers to expansion of behavioral training. Questionnaires were returned by 60% of 246 accredited pediatric residency programs; of these, 49% had a "formal" behavioral training program, 38% offered some training, and 13% offered none. Formal programs identified 419 faculty members involved in teaching behavioral pediatrics to residents: physicians (48%), psychologists (21%), social workers (19%), nurses (8%), other (4%). Mandatory training was more frequent than elective training; continuous training was more likely than block rotations to be mandatory. "Inadequate funding" and "lack of appropriately trained faculty" were most frequently cited as barriers to expansion of the teaching of behavioral pediatrics.


Interexaminer variability of fetal Doppler velocity waveforms.
A study was made of the interexaminer variability of Doppler velocity waveform determinations of the fetal circulation. Three investigators recorded Doppler ultrasound tracings of the blood velocity in the fetal thoracic and abdominal aorta and umbilical artery in 23 uncomplicated pregnancies. Of these recordings, a hard copy was made, and the pulsatility indices were computed. An analysis of variance was performed and the reliability calculated. The interexaminer variability was nonsignificant in measurements of the three blood vessels under examination. Both thoracic and abdominal aorta measurements showed poor reliability (intraclass correlation coefficient of reliability 0.30 and 0.19, respectively) due to high random errors. Umbilical artery measurements showed a better reliability (intraclass correlation coefficient of reliability 0.61), and, therefore, these hold the greatest clinical applicability.


[Nucleolus organizer region--centromere translocation].
A karyotype 45,XX,-13,-15,+psudic (13;15)(p12.9;11.200) was observed in a young woman after two spontaneous miscarriages. After R-, C-, and NOR - banding - the rearranged element was shown to include: the long arm, the active centromere, and the NOR of chromosome 13, followed by the inactivated centromere, and the long arm of chromosome 15.


Association of Urine Metanephrine Levels with CardiometaBolic Risk: An Observational Retrospective Study.
No research has explored the role of catecholamine metabolites in the stratification of cardiovascular risk. We aimed to evaluate the relationship between urine metanephrines and cardiometabolic risk/complications. In this retrospective cross-sectional study, we collected the data of 1374 patients submitted to the evaluation of urine metanephrines at the City of Health and Science University Hospital of Turin between 2007 and 2015, mainly for investigating the suspicion of secondary hypertension or the secretion of an adrenal lesion. The univariate analysis showed associations between metanephrines and cardiometabolic variables/parameters, particularly considering noradrenaline metabolite. At univariate regression, normetanephrine was associated with hypertensive cardiomyopathy (OR = 1.18, 95% CI 1.11-1.25; p < 0.001) and metabolic syndrome (OR = 1.11, 95% CI 1.03-1.20; p = 0.004), while metanephrine was associated with hypertensive cardiomyopathy (OR = 1.23, 95% CI 1.06-1.43; p = 0.006) and microalbuminuria (OR = 1.30, 95% CI 1.03-1.60; p = 0.018). At multivariate regression, considering all major cardiovascular risk factors as possible confounders, normetanephrine retained a significant association with hypertensive cardiomyopathy (OR = 1.14, 95% CI 1.07-1.22; p < 0.001) and metabolic syndrome (OR = 1.10, 95% CI 1.02-1.19; p = 0.017). Moreover, metanephrine retained a significant association with the presence of hypertensive cardiomyopathy (OR = 1.18, 95% CI 1.01-1.41; p = 0.049) and microalbuminuria (OR = 1.34, 95% CI 1.03-1.69; p = 0.019). The study showed a strong relationship between metanephrines and cardiovascular complications/metabolic alterations. Individuals with high levels of these indirect markers of sympathetic activity should be carefully monitored, and they may benefit from an aggressive treatment to reduce the cardiometabolic risk.


Caries prevention and adhesiveness of restorative materials submitted to cariogenic mixed biofilm.
This in vitro study evaluated the mechanical properties of different restorative materials submitted to cariogenic conditions with induced mixed biofilm. Extracted bovine incisors (n = 108) were divided into 3 groups (n = 36) [Group 1, resin; Group 2, glass ionomer cement (GIC); and Group 3, resin-modified GIC] and were bonded on a previously prepared enamel surface with a 25 mm² area delimited with nail varnish. Each group was then further subdivided into 3 groups and tested for shear bond strength and effectiveness in caries protection. Groups 1A-3A were tested immediately after bonding, Groups 1B-3B were tested after 5 days in brain heart infusion media, and Groups 1C-3C were tested after 5 days under cariogenic conditions with mixed biofilm. The mixed biofilm system was composed of Streptococcus mutans and Candida albicans in order to artificially create white spot lesions (WSLs). Group 1 presented the most samples with WSLs, whereas Groups 2 and Group 3 presented the highest preventive effect (P < 0.05) across all subgroups. The mean bond strengths were highest in Group 1 across all subgroups (P < 0.05). The majority of the specimens in the Group 1 subgroups presented mixed and cohesive fractures, whereas Groups 2 and 3 subgroups presented the largest amount of adhesive fractures.


Palliative Care Issues in Amyotrophic Lateral Sclerosis: An Evidenced-Based Review.
As palliative care physicians become increasingly involved in the care of patients with amyotrophic lateral sclerosis (ALS), they will be asked to provide guidance regarding the use of supplements, diet, exercise, and other common preventive medicine interventions. Moreover, palliative care physicians have a crucial role assisting patients with ALS in addressing health care decisions to maximize quality of life and cope with a rapidly disabling disease. It is therefore important for palliative care physicians to be familiar with commonly encountered palliative care issues in ALS. This article provides an evidenced-based review of palliative care options not usually addressed in national and international ALS guidelines.


Current and Emerging Approaches to Engineer Antibacterial and Antifouling Electrospun Nanofibers.
From ship hulls to bandages, biological fouling is a ubiquitous problem that impacts a wide range of industries and requires complex engineered solutions. Eliciting materials to have antibacterial or antifouling properties describes two main approaches to delay biofouling by killing or repelling bacteria, respectively. In this review article, we discuss how electrospun nanofiber mats are blank canvases that can be tailored to have controlled interactions with biologics, which would improve the design of intelligent conformal coatings or freestanding meshes that deliver targeted antimicrobials or cause bacteria to slip off surfaces. Firstly, we will briefly discuss the established and emerging technologies for addressing biofouling through antibacterial and antifouling surface engineering, and then highlight the recent advances in incorporating these strategies into electrospun nanofibers. These strategies highlight the potential for engineering electrospun nanofibers to solicit specific microbial responses for human health and environmental applications.


Highly active antiretroviral therapy-induced lipodystrophy has minor effects on human immunodeficiency virus-induced changes in lipolysis, but normalizes resting energy expenditure.
Combination antiretroviral therapy for the treatment of human immunodeficiency virus type 1-infected patients is associated with development of the lipodystrophy syndrome (LD). We previously showed that plasma levels of free fatty acids are higher in patients with lipodystrophy. The purpose of this study was to evaluate the postabsorptive rate of lipolysis, using [(2)H(5)]glycerol infusion, the resting energy expenditure (REE) measured by indirect calorimetry, and the responses of both to epinephrine infusion ( approximately 15 ng/kg.min) in patients with LD. Results were compared with those obtained in five matched human immunodeficiency virus type 1-infected patients. The postabsorptive rate of appearance of glycerol did not differ between the two groups. There was no difference in the lipolytic response to epinephrine, although the response in the LD group was delayed (P < 0.001). The postabsorptive REE adjusted for lean body mass was lower and remained lower during epinephrine infusion in the LD group. Postabsorptive norepinephrine concentrations were higher and remained elevated during epinephrine infusion in the LD group. We conclude that the lipolytic response to epinephrine in the LD group was normal, albeit delayed. Norepinephrine concentrations were increased in patients with lipodystrophy, indicating increased sympathetic activity. Postabsorptive REE was lower in the patients with lipodystrophy. Our data suggest that highly active antiretroviral therapy-associated lipodystrophy normalizes the REE, but has only minor effects on lipolysis as a result of concomitant sympathetic stimulation of adipose tissue.


[Evaluation of an inpatient parent-child-rehabilitation program: symptoms of psychological distress and quality of life].
To evaluate the short- and medium-term effectiveness of an inpatient parent-child rehabilitation program in reducing symptoms of psychological distress and in increasing the quality of life of parents and children. Psychological problems and quality of life of parents and children were assessed 4 weeks before admission, at admission and discharge from the program, and 3 months post discharge using standardized questionnaires. The sample consisted of 256 parents, parent ratings of 397 children and self reports of 124 school-aged children. Compared to the waiting period prior to admission significant decreases in psychological problems as well as improvements in quality of life were found for both, parents and children. These effects proved to be stable over the follow-up period. Inpatient parent-child rehabilitation programs are effective in improving the psychological well-being and quality of life of parents and children.


Screw loosening with interchangeable abutments in internally connected implants after cyclic loading.
The purpose of this study was to observe and compare any loosening of screws attaching several interchangeable abutments to internally connected implants after cyclic loading. Four different abutment groups mated with Straumann single-stage transmucosal implants (n = 7 each group) were assessed: Straumann solid abutment, Restore COC abutment, Neoplant solid abutment, and AVANA solid abutment. Each implant was fixed rigidly in a special holding jig. Abutments were tightened to 35 Ncm with a torque controller. A cyclic load of 150 N at a 30-degree angle to the long axis was applied to the implants for 1 million cycles. Prior to loading, Periotest values (PTVs) were measured. After cyclic loading, PTVs were measured and removal torque values (RTVs) of abutments were measured with a digital torque gauge. No mechanical failures were noted for the Straumann solid abutment or the Restore COC abutment. Six Neoplant abutment screws fractured (86%), and four implants fractured (57%) in the group restored with AVANA solid abutments. The RTVs of the Straumann solid abutment were significantly higher than those of the other abutments. The final mean PTV of the Straumann solid abutment was significantly lower than the final mean PTVs of the other abutments. The final mean PTV (4.76 ± 5.58) was significantly higher than the initial mean PTV (-4.29 ± 0.47). Although different abutments are interchangeable with each other, they possess different chemical compositions and physical characteristics. The use of an abutment and implant manufactured by the same company is recommended to prevent the loosening of the abutment screw.


Microbial biofilm as a smart material.
Microbial biofilm colonies will in many cases form a smart material capable of responding to external threats dependent on their size and internal state. The microbial community accordingly switches between passive, protective, or attack modes of action. In order to decide which strategy to employ, it is essential for the biofilm community to be able to sense its own size. The sensor designed to perform this task is termed a quorum sensor, since it only permits collective behaviour once a sufficiently large assembly of microbes have been established. The generic quorum sensor construct involves two genes, one coding for the production of a diffusible signal molecule and one coding for a regulator protein dedicated to sensing the signal molecules. A positive feedback in the signal molecule production sets a well-defined condition for switching into the collective mode. The activation of the regulator involves a slow dimerization, which allows low-pass filtering of the activation of the collective mode. Here, we review and combine the model components that form the basic quorum sensor in a number of Gram-negative bacteria, e.g., Pseudomonas aeruginosa.


The adolescent dissociative experiences scale: psychometric properties and difference in scores across age groups.
Adolescence is thought to be a key developmental period for dissociative processes. However, there has been little empirical investigation of dissociation in adolescence. This paper reports the results of a study (N = 768) that investigated the psychometric properties of the Adolescent Dissociative Experiences Scale (A-DES) and compares dissociation scores across the adolescent age range (11 to 16 years). The A-DES had good internal reliability and a one-factor solution. No significant age or gender differences in A-DES scores were found. The implications of these findings for future research and theory are outlined.


Pretreatment endoscopy--pro & contra: endoscopy is needed before treatment in all patients with gastroesophageal reflux disease.
Most current endoscopic guidelines do not recommend the use of routine esophagoscopy in the evaluation of patients with typical symptoms of gastroesophageal reflux disease (GERD), unless alarm features are present. In patients with known reflux esophagitis, esophagoscopy is considered to have no role either in the further management or follow-up. Screening of reflux patients for Barrett's esophagus is not considered to be cost-effective. On the basis of a critical review of the available literature, and of some recent papers in particular, we disagree with these suggestions. We would argue, on the contrary, that a negative esophagoscopy can provide the GERD patient with reassurance, and that esophagoscopy allows targeted therapy to be offered if it is positive for esophagitis. When Barrett's esophagus is diagnosed, it usually leads to a surveillance program being initiated. The potential benefits of endoscopy for the patient's quality of life are probably underestimated when financial issues alone are taken into account. Even if it is true that a large percentage of GERD patients do not have endoscopic abnormalities (those with nonerosive reflux disease), surrogate tests such as the proton-pump inhibitor test or symptom questionnaires do not provide a more accurate diagnosis. We would therefore suggest that, at least in the specialist setting, all patients with suspected GERD should undergo accurate symptom analysis as well as endoscopic evaluation before treatment is started.


Comprehensive preventive care assessments for adults with intellectual and developmental disabilities: Part 1: How do we know if it is happening?
To determine how best to measure the provision of comprehensive preventive care assessment of adults with intellectual and developmental disabilities (IDD). Cross-sectional study. Ontario. Adults with IDD between 40 and 64 years of age in 2013 and 2014. Health examination was defined using the Ontario Health Insurance Plan billing data fee code A003 (with diagnostic code 917 or 319) or fee code K131, and the Primary Care Quality Composite Score (PCQS), a measure combining 7 different screening maneuvers (lipid, glucose, breast cancer, cervical cancer, colorectal cancer, eye, and hemoglobin A1c screening), was identified using administrative health data. A total of 28 825 adults with IDD were identified in 2013 and 2014. Overall, 12.1% of adults with IDD received a health examination; 51.2% received a high (≥ 0.6) PCQS. Male patients were more likely to have received all of their eligible screening maneuvers if they had had a health examination compared with female patients (odds ratio of 5.73 vs 3.99, respectively). Less than 60% of adults with IDD appear to be receiving comprehensive preventive care. Future studies assessing the quality of preventive care received by adults with IDD should combine health examination billing codes and the PCQS.


Controlled release of thymosin beta 4 using a collagen-chitosan sponge scaffold augments cutaneous wound healing and increases angiogenesis in diabetic rats with hindlimb ischemia.
It is important to establish an efficient vascularization for the long-term acceptance of bioengineered skin equivalents treating the cutaneous wounds of diabetic rats with hindlimb ischemia. This study investigates the possible use of a collagen-chitosan sponge scaffold encapsulated with thymosin beta 4 (CCSS-eTβ4), an angiogenic factor, to accelerate cutaneous wound healing in streptozotocin (STZ)-induced diabetic rats with hindlimb ischemia. CCSSs-eTβ4 was fabricated using a freeze-drying method. The scaffolds were analyzed by scanning electron microscopy, swelling and degradation assays, mechanical properties, and scaffolds of 50:50 collagen-chitosan were selected and applied. The controlled release of Tβ4 from the scaffolds elicited localized and prolonged effects over 12 days, as shown by an enzyme-linked immunosorbent assay (ELISA). In vivo, CCSSs-eTβ4 improved diabetic cutaneous wound healing, with faster wound reepithelialization, better dermal reorganization, and higher wound vascularization. Furthermore, CCSSs-eTβ4 downregulated inflammatory genes and upregulated angiogenic genes in the wound tissue. Significant increases in CD31-positive endothelial cells and new vessel density were also observed. In vitro, Tβ4 increased the migratory and proliferative activity of high glucose (HG)-treated human umbilical vein endothelial cells (HUVECs). Meanwhile, we found that Tβ4 could promote HG-treated HUVECs migration and improve angiogenesis by activation of the VEGF/AKT pathway. Overall, these findings demonstrated the promising potential of CCSSs-eTβ4 to promote more effective wound healing and suggest its possible application for diabetic cutaneous wound treatment.


The Origin and Identification of Mesenchymal Stem Cells in Teeth: from Odontogenic to Non-odontogenic.
Mesenchymal stem cells (MSCs) in teeth have been exploited as vital seed cells for stem cell-based dental medicine. To date, several mesenchymal stem cell populations originated from odontogenic tissue have been isolated and characterized by their expression of MSC surface markers and capacity of multi-lineage differentiation, including dental pulp stem cells (DPSCs), stem cells from human exfoliated deciduous teeth (SHED), stem cells from apical papilla (SCAP) and so on. However, their identity in vivo remains elusive, which hinders further understanding of their application in stem cell-based tooth regeneration. Label retaining and lineage tracing analyses, which serve as gold standards for identification of stem cells in vivo, provide feasibility for identifying MSCs in teeth. In this review, we will discuss the issues of MSCs, including the origin and identification of both odontogenic and non-odontogenic MSCs, and address the role of nerve-derived Sonic hedgehog (Shh) in the regulation of MSCs in the neurovascular bundle (NVB). Based on label retaining and lineage tracing analyses, latest studies have found new populations of non-odontogenic MSCs in teeth, periarterial-derived and glial-derived, regulated by the Shh derived from nerves in the NVB, which provides a new hope for tooth regeneration.


Trends and Patterns of Opioid Analgesic Prescribing: Regional and Rural-Urban Variations in Kentucky From 2012 to 2015.
Increased opioid analgesic prescribing (OAP) has been associated with increased risk of prescription opioid diversion, misuse, and abuse. We studied regional and rural-urban variations in OAP trends in Kentucky, from 2012 to 2015, and examined potential county-level risk and protective factors. This study used prescription drug monitoring data. Marginal models employing generalized estimating equations were used to model repeated counts of residents with opioid analgesic prescriptions within county-quarter, 2012-2015, with offset for resident population, by rural-urban classification exposure, and adjusting for time-varying socioeconomic and relevant health status measures. There were significant downward trends in rates of residents receiving dispensed opioid analgesic prescriptions, with no regional or rural/urban differences in the degree of decline over time. The adjusted models showed the Kentucky Appalachian region retained a significantly higher rate of residents with opioid analgesic prescriptions per 1,000 residents (30% higher than Central Kentucky and 19% higher than Kentucky Delta regions). Residents of nonmetropolitan not adjacent-to-metropolitan counties had significantly higher adjusted rates of OAP (33% higher than metropolitan counties and 17% higher compared to nonmetropolitan adjacent-to-metropolitan counties). The rate of OAP was significantly positively associated with emergency department visit injury rates and negatively associated with buprenorphine/naloxone prescribing rates. Information on OAP trends and patterns will be used by Kentucky stakeholders to inform targeted interventions. Further research is needed to evaluate the availability and accessibility of nonopioid pain treatment in rural counties and the role of geography and time/distance traveled as risk factors for increased OAP.


Antibiotic treatment is not effective in patients infected with Helicobacter pylori suffering from extragastric MALT lymphoma.
Apart from anecdotal reports implicating Helicobacter pylori (HP) in the development of extragastric mucosa associated lymphoid tissue (MALT) lymphoma, no large scale prospective studies have been performed on this topic. A total of 77 patients with extragastric MALT lymphoma were prospectively studied. The presence or absence of HP was tested by histology, urease breath test, and serology. Patients were also tested for hepatitis A, B, and C and autoimmune conditions along with assessment of MALT lymphoma-specific genetic changes. Evidence for infection with HP was present in 35 of 77 patients (45%), and three of 75 patients tested (4%) were positive for hepatitis C and one for hepatitis B. All patients with HP-infection underwent eradication, 16 before initiation of further therapy. Apart from one patient with lymphoma involving parotid and colon, who achieved regression of the colonic lesions, none of these 16 patients showed regression of the lymphoma after a median follow-up of 14 months (range, 8 to 48+ months) before initiation of definitive treatment. No correlation between HP-status, localization, stage, autoimmune diseases, and genetic findings was seen. In our series, HP-eradication was ineffective for treatment of extragastric MALT lymphomas. This finding, along with an infection rate of 45%-as could also be expected in the general Austrian population-suggests that HP does not play a role in the development of these lymphomas. Antibiotic treatment targeting HP should, therefore, be discouraged in patients with extragastric MALT lymphomas.


Structure of the major carrot allergen Dau c 1.
Dau c 1 is a major allergen of carrot (Daucus carota) which displays IgE cross-reactivity with the homologous major birch-pollen allergen Bet v 1. The crystal structure of Dau c 1 has been determined to a resolution of 2.7 A, revealing tight dimers. The structure of Dau c 1 is similar to those of the major allergens from celery, Api g 1, and birch pollen, Bet v 1. Electron density has been observed in the hydrophobic cavity of each monomer and has been modelled with polyethylene glycol oligomers of varying length. Comparison of the surface topology and physicochemical properties of Dau c 1 and Bet v 1 revealed that they may have some, but not all, epitopes in common. This is in agreement with the observation that the majority of carrot-allergic patients have Bet v 1 cross-reactive IgE antibodies, whereas others have Dau c 1-specific IgE antibodies which do not recognize Bet v 1.


Water-assisted stability of carbene: cyclic voltammetric investigation of 1-ethyl-3-methylimidazolium ethylsulfate ionic liquid.
In this work, we report electrochemical studies on imidazolium-based ionic liquids with an objective to explore the possibility of carbene formation in their dilute aqueous solutions. Conventionally, water plays a detrimental role during investigations involving ionic liquids, and this role has been investigated via electrochemical studies in aqueous ionic liquid solutions. There are varying opinions regarding the influence of water on the physicochemical behaviour of ionic liquids that require an in-depth understanding. To eludicate the role of water, we attempted to evaluate the electrochemical performance of ionic liquids in water as a solvent, and the influence of water on ionic liquids was explored through feasibility and stability studies on carbene formed in an aqueous imidazolium-based ionic liquid solution. The electrochemical investigation of an aqueous solution of 1-ethyl-3-methylimidazolium ethylsulfate ([EMIM][EtSO4]) revealed a redox couple. Detailed investigations suggest that reduction of the imidazolium cation occurs at the C2 position, with subsequent formation of carbene. Furthermore, an anodic peak was found to be associated with the oxidation of carbene. The coulometric process associated with the anodic peaks indicated that the two-electron oxidation of carbene occurred. The stability of carbene in water was evaluated through the use of different protic and aprotic solvents. The hydrogen bond-forming ability of carbene with water seems to be responsible for its improved stability in water.


Complete chloroplast genome of Ligularia biceps Kitam, 1941 (Asteraceae).
Ligularia biceps is a plant belonging to Ligularia Cass., most of which have certain medicinal value. In this study, the chloroplast (cp) genome of L. biceps was sequenced for the first time. The L. biceps cp genome sequence length was 151,153 bp, with an large single-copy (LSC) region length of 83,259 bp, an small single-copy (SSC) region length of 18,234 bp, a pair of inverted repeat regions (IRs) length of 24,830 bp and GC content of 37.5%. In total, 131 genes were annotated, including 86 protein-coding genes, eight rRNA genes, and 37 tRNA genes. The phylogenetic tree was built based on 23 species, using the maximum-likelihood method. The results showed that the species clustered with other Ligularia Cass. species. This study provides a theoretical basis for establishing a classification system.


[The effect of bone marrow ablation on regional biomechanical properties of rat tibia].
Regional (metaphyseal-diaphyseal) biomechanical properties of normal rat tibia, and changes on these biomechanical properties after bone marrow ablation, a model of fracture healing, were examined. The study included 24 Sprague-Dawley rats that underwent tibial marrow ablation, and eight control rats with no surgical procedure. Proximal metaphyseal, proximal diaphyseal, distal diaphyseal, and distal metaphyseal samples were prepared from the tibias of all rats. In the control group, stiffness (elastic modulus, E), strength (maximum strength, Smax), and toughness (total energy absorption, U) parameters of the regional tibial segments were evaluated under compression loads. In the experimental group, compression was applied following bone marrow ablation on days 1, 3, 7, 9, and 15, and ablation-induced changes in the regional biomechanical properties were studied. The lowest E, Smax, and U values were obtained from the proximal metaphysis. The highest E and Smax values were from the distal diaphyseal, and the highest U values were from the proximal diaphyseal regions. In ablation-induced rats, decreases were observed in all the mechanical test values during days 1 to 7, followed by slight increases on days 7 to 9, and eventual decreases on days 9 to 15. There were significant differences between the two groups with respect to biomechanical parameters (p<0.05), but no significant differences were found between the tibial regions (p>0.05). Biomechanically, the most resistant and the weakest anatomic regions of normal rat tibia are the diaphyseal region and proximal metaphysis, respectively. The metabolic changes occurring after bone marrow ablation lead to changes in the mechanical properties of the tibia. The most affected tibial segments from ablation-induced intramedullary injury are the metaphyseal segments.


Review of State-of-the-Art FPGA Applications in IoT Networks.
Modern networks used for integrating custom Internet of Things (IoT) systems and devices have restrictions and requirements unique to their individual applications. These application specific demands require custom designed hardware to maximize throughput, security and data integrity whilst minimizing latency, power consumption, and form factor. Within this paper, we describe current, state-of-the-art works that utilize FPGAs for IoT network developments. We analyze two categories of works: those that prioritize reducing power consumption, and those that prioritize networking features. Further, we describe how future works can improve upon these designs and therefore improve the efficiency of resource-constrained IoT networks.


Improved separation with the intermittently pressed tubing of multilayer coil in type-I counter-current chromatography.
The intermittently pressed tubing was introduced in type-I counter-current chromatographic system as the separation column to improve the separation performance in the present study. The separations were performed with two different solvent systems composed of 1-butanol-acetic acid-water (4:1:5, v/v) (BAW) and hexane-ethyl acetate-methanol-0.1 M HCl (1:1:1:1, v/v) (HEMW) using dipeptides and DNP-amino acids as test samples, respectively. The chromatographic performance was evaluated in terms of retention of the stationary phase (Sf), theoretical plate (N) and peak resolution (Rs). In general, the type-I planetary motion with the multilayer coil of non-modified standard tubing can yield the best separation at a low revolution speed of 200 rpm with lower flow rate. The present results with intermittently pressed tubing indicated that the performance was also optimal at the revolution speed of 200 rpm where the lower flow rate was more beneficial to retention of stationary phase and resolution. In the moderately hydrophobic two-phase solvent system composed of hexane-ethyl acetate-metanol-0.1 M hydrochloric acid (1:1:1:1, v/v), DNP-amino acids were separated with Rs at 1.67 and 1.47, respectively, with 12.66% of stationary phase retention at a flow rate of 0.25 ml/min. In the polar solvent system composed of 1-butanol-acetic acid-water (4:1:5, v/v), dipeptide samples were resolved with Rs at 2.18 and 18.75% of stationary phase retention at a flow rate of 0.25 ml/min. These results indicate that the present system substantially improves the separation efficiency of type-I counter-current chromatographic system.


Effective treatment of a BRAF V600E-mutant epithelioid glioblastoma patient by vemurafenib: a case report.
Epithelioid glioblastoma (E-GBM) is a recently described variant of glioblastoma (GBM) which is associated with short survival and now added as a provisional entity to WHO 2016 classification of central nervous system tumors. About half of these tumors show the BRAF mutant. Therefore, this is a target of special interest for this group of patients. Meanwhile, unlike conventional glioblastoma, E-GBM lacks specific prognostic markers. We described a case of a long-term surviving 37-years-old men patient diagnosed with a BRAF V600E and TERT mutated E-GBM with wild-type in the isocitrate dehydrogenase gene (IDH wild-type). The tumor displayed atypical exophytic growth, an obvious proliferation of vascular endothelial cells, especially tumor tissue can be seen under subarachnoid space. Notably, tumor tissue was found under subarachnoid space. After postoperative conventional treatment options were exhausted, vemurafenib treatment was initiated. The patient remained clinically stable, and follow-up magnetic resonance images were consistent with stable disease for the following fifteen months up to now. Whole-exome sequencing analysis and RNA-seq results of formalin-fixed and paraffin-embedded tissue revealed nine mutant genes (AHNAK2, BFSP1, BRAF, CNTNAP3, DNHD1, MTOR, NFATC3, NOM1). For E-GBM patients, the use of BRAF inhibitors combined with inhibitors of these seven genes may be a useful remedial treatment option.


Achieving an exceptionally high loading of isolated cobalt single atoms on a porous carbon matrix for efficient visible-light-driven photocatalytic hydrogen production.
Single-atom catalysts (SACs) have shown great potential in a wide variety of chemical reactions and become the most active new frontier in catalysis due to the maximum efficiency of metal atom use. The key obstacle in preparing SAs lies in the development of appropriate supports that can avoid aggregation or sintering during synthetic procedures. As such, achieving high loadings of isolated SAs is nontrivial and challenging. Conventional methods usually afford the formation of SAs with extremely low loadings (less than 1.5 wt%). In this work, a new in situ preparation strategy that enables the synthesis of isolated cobalt (Co) SAs with an exceptionally high metal loading, up to 5.9 wt%, is developed. The approach is based on a simple one-step pyrolysis of a nitrogen-enriched molecular carbon precursor (1,4,5,8,9,12-hexaazatriphenylene hexacarbonitrile) and CoCl2. Furthermore, due to the successful electron transfer from carbon nitride to the isolated Co SAs, we demonstrate a high-performance photocatalytic H2 production using Co SAs as a co-catalyst, and the evolution rate is measured to be 1180 μmol g-1 h-1. We anticipate that this new study will inspire the discovery of more isolated SACs with high metal loadings, evidently advancing the development of this emerging type of advanced catalysts.


Intracellular organelles in the saga of Ca2+ homeostasis: different molecules for different purposes?
An increase in the concentration of cytosolic free Ca(2+) is a key component regulating different cellular processes ranging from egg fertilization, active secretion and movement, to cell differentiation and death. The multitude of phenomena modulated by Ca(2+), however, do not simply rely on increases/decreases in its concentration, but also on specific timing, shape and sub-cellular localization of its signals that, combined together, provide a huge versatility in Ca(2+) signaling. Intracellular organelles and their Ca(2+) handling machineries exert key roles in this complex and precise mechanism, and this review will try to depict a map of Ca(2+) routes inside cells, highlighting the uniqueness of the different Ca(2+) toolkit components and the complexity of the interactions between them.


Effects of kappa-selenocarrageenan on membrane fluidity and ghost reseal ability of rat erythrocyte.
Effects of kappa-selenocarrageenan (kappa-SeC) on membrane fluidity and ghost reseal ability of rat erythrocyte were studied by measuring the fluorescence polarization and the NADH-cytochrome C oxido-reductase, respectively. After rats were given ig kappa-SeC 140 mg.kg-1.d-1 x 30 d, the fluorescence polarization was decreased in comparison with saline control group (P < 0.05). It suggested that kappa-SeC increased the membrane fluidity. The reseal ability of erythrocyte membrane (ghost) was also elevated after ig kappa-SeC 140 and 70 mg.kg-1.d-1 x 30 d (P < 0.05).


Mask use during the COVID-19 pandemic: A descriptive survey in South Korea.
Extensive research on the coronavirus disease 2019 (COVID-19) is underway. However, there are not many studies on the use of masks, which are essential for infection prevention. This descriptive study aimed to understand the factors influencing the use of masks by Korean adults during COVID-19. We conducted an online survey with 280 adults in South Korea between August and September 2020, analyzing the data using SPSS version 24.0. Multiple regression analyses were performed to understand the factors that influence individuals' use of masks. The participants' perceived susceptibility, perceived barriers, other people's dignity, compliance with public order, reasonable decision making, and subjective norms explained 21.6% of mask use. Mask use is expected to increase further if people perceive a personal need to wear masks, if their peers perceive the importance of mask use, and if they possess civic consciousness that considers society as a whole. This paper makes a significant contribution to the field of public health, with evidence-based recommendations for increasing mask use, going beyond simply attributing mask use to individual preferences.


Association of body size with health status in patients beginning dialysis.
Greater weight-for-height has been associated with prolonged survival in patients with end-stage renal disease (ESRD) but not in the general population. The association between body size and health status has not been carefully evaluated. We compared the self-reported health status of 2467 participants in the Dialysis Morbidity and Mortality Study Wave 2 by using body mass index (BMI; in kg/m2) to approximate body size and composition. BMI was categorized into 4 groups (<19, 19 to <25, 25 to <30, and > or = 30) corresponding to World Health Organization criteria for underweight, normal-weight, overweight, and obese status. We adjusted for demographic, clinical, and laboratory factors that may have confounded the association between body size and health status. Scores on the physical component summary and the physical functioning scale were significantly lower for obese subjects than for those with normal weight or moderately high BMI after adjustment for demographic factors, comorbidity, and laboratory markers of nutritional status. Mental component summary and symptom scores were unrelated to BMI. The underweight group scored lower on many Medical Outcomes Study 36-Item Short Form scales than did the normal-weight group. Whereas higher BMI has consistently been associated with enhanced dialysis-related survival, health status-particularly physical function-may be impaired by obesity. Additional longitudinal studies of body weight and composition are needed for a better understanding of the complex effects of obesity and undernutrition in persons with ESRD and advanced chronic kidney disease.


Responses of Eucalyptus globulus and Ficus nitida to different potential of heavy metal air pollution.
The present study aimed to explore the tolerance potential of Cd, Pb and Cu and physiological alterations in two common tree species growing in Minia governorate (Egypt) namely: Eucalyptus globulus and Ficus nitida and to investigate the leaf features [leaf area (LA) and specific leaf area (SLA)] associated with the phytoremediation process. The findings may be useful for future surveillance as preliminary reference values for levels of heavy metals in urban and industrial settings. The levels of cadmium, lead and Cupper in plant leaf were determined. The results showed that heavy metals could inhibit the growth of plants including LA and SLA. The water content (WC) and photosynthetic pigments of Eucalyptus and Ficus decreased with the increased concentration of metals. Contrary to chlorophylls (a) and (b), carotenoids and chlorophyll ratio (a/b) showed a significant increase with increasing metals concentration especially that of Cd and Cu. Proline content was relatively increased and soluble carbohydrate content decreased in plants with high metal accumulation. Eucalyptus showed better tolerance capacity for Cd, Pb and Cu when compared to Ficus. The ability of Eucalyptus to accumulate and tolerate metal stress makes this species a good candidate to recuperate heavy metals-contaminated conditions.


[Implant-ceramometal prosthesis relation: esthetic and technical improvements].
Two major concerns characterize the difficulties encountered with prostheses on implants. 1--The difference in orientation between the implant, imposed by anatomical requirements, and the restoration anatomy. It should be kept in mind that a sufficient occlusal space is required to house the restoration. The regularization of the occlusal curve of the opposite arch, in the example given, was obtained by bonding ceramic overlays. 2--The visibility of the abutment at the gingival level. In this clinical case, after removing the old prosthesis, it is observed that the position of the screws is unsuitable, as one of them emerges into the embrasure. A solution to these problems may be found in building an intermediate screwed core. The technical protocol requires the use of long screwed transfers, a specific impression method and plastic preforms. The intermediate core is formed by the combination of two hollow dowel cores into which a conventional metal ceramic bridge is incorporated. Aesthetically speaking, the prosthetic construction is characterized by the absence of metal visibility. The use of the pterygoid bone radically transforms prosthetic indications. It is advisable that the extremity of the implant remains accessible. Linking to the restoration can be carried out with a screwed telescopic substructure. It is not necessary, at the level of the pterygoid bone situated outside the limits of the arch, to carry out any dental morphology. A smooth, polished construction situated below the plane of occlusion is sufficient.


Controllable Synthesis of Mo3C2 Encapsulated by N-Doped Carbon Microspheres to Achieve Highly Efficient Microwave Absorption at Full Wavebands: From Lemon-like to Fig-like Morphologies.
Mo3C2@N-doped carbon microspheres (Mo3C2@NC) have been discovered to be a family of superior microwave absorbing materials. Herein, Mo3C2@NC was synthesized through a simple high-temperature carbonization process by evaporating a graphite anode and Mo wire in Ar and N2 atmospheres with an N-doping content of 6.4 at. %. Attributing to the self-assembly mechanism, the number of Mo wires inserted into the graphite anode determined the morphologies of Mo3C2@NC, which were the unique lemon-like (1- and 2-Mo3C2@NC) and fig-like (3-, 4-, and 5-Mo3C2@NC) microstructures. 1- and 2-Mo3C2@NC exhibited powerful reflection losses (RLs) of -45.60, -45.59, and -47.11 dB at the S, C and X bands, respectively, which corresponded to thinner thicknesses. 3-, 4-, and 5-Mo3C2@NC showed outstanding absorption performance at the C, X, and Ku bands, respectively, with each value of a minimum RL less than -43.00 dB. In particular, the strongest RL (-43.56 dB) for 5-Mo3C2@NC corresponded to an ultrathin thickness of 1.3 mm. In addition, the maximum effective absorption bandwidth was 6.3 GHz for 4-Mo3C2@NC. After analysis, all Mo3C2@NC samples showed well-matched impedance due to the enhanced dielectric loss caused by the unique carbon structure and moderate magnetic loss derived from the weak magnetic property of Mo3C2. More importantly, the unique lemon-like and fig-like microstructures created sufficient interfaces and differentiated multiple reflection paths, which greatly contributed to the strong microwave absorptions at full wavebands. In full consideration of the simple preparation method and tunable absorption properties, Mo3C2@NC composites can be regarded as excellent electromagnetic wave absorption materials.


Expression of membrane and nuclear progesterone receptors in two human placental choriocarcinoma cell lines (JEG-3 and BeWo): Effects of syncytialization.
A vital function of the human placenta is to produce steroid hormones such as progesterone, which are essential for the maintenance of pregnancy and the onset of parturition. Although choriocarcinoma cell lines are valuable placental models for investigations of steroid hormone actions, little is known about the expression of progesterone receptors (PRs) in these cell lines. Therefore, in this study, the expression of membrane and nuclear PRs was investigated in cultures of fusigenic (BeWo) and non-fusigenic (JEG-3) human choriocarcinoma cell lines. In addition, the effects of an inducer of syncytialization (forskolin) on the PR expression in BeWo cells were assessed. Quantitative RT-PCR revealed that in fully syncytialized BeWo cells (treated with 50 µM forskolin for 72 h) there was a significant down-regulation of mPRα and up-regulation of mPRβ and of the progesterone membrane component-1 (PGRMC1) when compared with non-syncytialized BeWo cells. Expression of all the mPR and PGRMC1 mRNAs was significantly lower in JEG-3 cells compared to non-syncytialized BeWo cells. Interestingly, expression of PR-B was unaltered between the two BeWo states but was significantly higher in JEG-3 cells. Immunofluorescence analysis revealed that mPR proteins are differentially expressed in these choriocarcinoma cell lines as well as in the human placenta. The data demonstrate that human choriocarcinoma cell lines have a complex system of progesterone signalling involving multiple classes of PRs. The finding that syncytialization is accompanied by changes in the expression of these receptors may suggest that this process influences progesterone signalling.


Mechanisms Linking High Residential Mobility to Decreased Contraceptive Use: The Importance of Method Availability.
While research has demonstrated that high residential mobility has negative consequences for an array of outcomes, particularly among women and young adults, the mechanisms underlying these associations are unclear. The consequences of high residential mobility may be comprised solely of a series of short-term disruptions surrounding individual moves, or there may also be long-term, cumulative effects from repeated moves. High residential mobility may diminish access to resources as individuals move to different neighborhoods, impose a cognitive burden that impairs their ability to plan ahead, or decrease the relative power they have in their relationships to limit exposure to risk behaviors. We adjudicate between these possibilities by predicting the effects of high residential mobility on sexual intercourse and contraceptive use, the proximate determinants of pregnancy, during women's transition to adulthood. Using 2.5 years of monthly address data for 882 respondents in the Relationship Dynamics and Social Life study-a random sample of young women in Genesee County, Michigan-we find that high residential mobility is associated with long-term decreases in contraceptive use. These long-term consequences are independent of the short-term effects of individual moves and attributable to diminished contraceptive access. We disentangle the effects of home-leaving, which is distinct from subsequent moves.


Eating attitudes and barriers to healthy eating and physical activity among a sample of university students in Egypt.
More students are concerned about their body shape and have a desire to have a lower BMI. As a consequence, many of them have disordered eating attitudes (DEAs) and engage in unhealthy weight control behaviors. To measure the frequency of DEAs among Ain Shams University students and to identify the barriers to healthy eating and physical activity among them. A cross-sectional study was done on a sample of 445 students in Ain Shams University from different faculties using a self-reported questionnaire. The weight and height were measured and the BMI was calculated. The eating attitudes were measured using the Eating Attitudes Test-26 questionnaire. The students' age ranged between 17 and 26 years with a mean of 20.3±1.5 years, 40.7% of them were men and 59.3% women. The majority of students (50.8%) had normal BMI, and about 39% were overweight and obese. The frequency of DEAs was 73.3%. There was no significant relation between the presence of DEAs and personal data of students such as age, sex, faculty, and BMI. Lack of time was the most highlighted barrier to both physical activity and healthy eating. There was a high prevalence of obesity and DEA that necessitates a lot of efforts to help youth control their body weights and correct unhealthy behaviors by overcoming barriers against healthy behaviors.


Improved Shinnar-Le Roux algorithm.
Selective excitation pulses are widely used in magnetic resonance imaging in order to excite predetermined slices of the body under examination. Such pulses are optimally designed by means of the Shinnar-Le Roux algorithm. In this paper, we show that under minimal assumptions, the complexity and computing cost of the original Shinnar-Le Roux algorithm can be drastically reduced. We further propose an improved version of the algorithm, involving only real quantities, which is both easier to implement and faster to execute, so it is suitable for implementation at the hardware level, in the context of a real-time fully digital magnetic resonance transceiver.


Clinical application of CyberKnife for high-risk central nervous system tumors: A clinical trial report of 60 cases.
The objective of the present study was to evaluate the application potential of CyberKnife for high-risk tumors of the central nervous system and to analyze the effectiveness of CyberKnife in relation to dose recovery and gain division (times). A total of Eighty-one targeted areas from 139 central nervous tumor lesions in 60 patients were treated with I-VI ranged CyberKnife for 1 week. Following CyberKnife treatment, imaging tests revealed a decrease in tumor volume, reduction of central nervous system symptoms and an increase in the life quality of patients. The advantages of CyberKnife include non-invasiveness, individualized treatment, flexibility, high accuracy and rapid treatment. CyberKnife produces slight damage and a favorable therapeutic effect and expands our concepts concerning precise radiotherapy for tumors. It is an indispensable method for personalized tumor treatment.


A Cyclic Peptide Mimic of the β-Amyloid Binding Domain on Transthyretin.
Self-association of β-amyloid (Aβ) into oligomers and fibrils is associated with Alzheimer's disease (AD), motivating the search for compounds that bind to and inhibit Aβ oligomerization and/or neurotoxicity. Peptides are an attractive class of such compounds, with potential advantages over small molecules in affinity and specificity. Self-complementation and peptide library screening are two strategies that have been employed in the search for peptides that bind to Aβ. Alternatively, one could design Aβ-binding peptides based on knowledge of complementary binding proteins. One candidate protein, transthyretin (TTR), binds Aβ, inhibits aggregation, and reduces its toxicity. Previously, strand G of TTR was identified as part of a specific Aβ binding domain, and G16, a 16-mer peptide with a sequence that spans strands G and H of TTR, was synthesized and tested. Although both TTR and G16 bound to Aβ, they differed significantly in their effect on Aβ aggregation, and G16 was less effective than TTR at protecting neurons from Aβ toxicity. G16 lacks the β-strand/loop/β-strand structure of TTR's Aβ binding domain. To enforce proper residue alignment, we transplanted the G16 sequence onto a β-hairpin template. Two peptides with 18 and 22 amino acids were synthesized using an orthogonally protected glutamic acid derivative, and an N-to-C cyclization reaction was carried out to further restrict conformational flexibility. The cyclized 22-mer (but not the noncyclized 22-mer nor the 18-mer) strongly suppressed Aβ aggregation into fibrils, and protected neurons against Aβ toxicity. The imposition of structural constraints generated a much-improved peptidomimetic of the Aβ binding epitope on TTR.


Trends in the incidence and treatment of parathyroid cancer in the United States.
Parathyroid cancer is a rare cause of hyperparathyroidism. The objectives of this study were to determine the patterns of disease, treatment trends, and outcomes among patients with parathyroid cancer by using a population-based data source. Surveillance, Epidemiology, and End Results (SEER) cancer registry data were used to identify patients who were diagnosed with parathyroid cancer from 1988 through 2003. To assess whether the incidence rate, treatment, tumor size, and cancer stage changed over time, the Cochrane-Armitage trend test was used, and Cox proportional-hazards modeling was used to identify the factors associated with an improved overall survival rate. From 1988 through 2003, 224 patients with parathyroid cancer were reported in the SEER data. Over that 16-year study period, the incidence of parathyroid cancer increased by 60% (1988-1991, 3.58 per 10,000,000 population; 2000-2003, 5.73 per 10,000,000 population). Most patients (96%) underwent surgery (parathyroidectomy, 78.6% of patients; en bloc resection, 12.5% of patients; other, 4.9% of patients). The rate of surgical treatment increased significantly during the study period. The 10-year all-cause mortality rate was 33.2%, and the 10-year cancer-related mortality rate was 12.4%. Patient age (P<.0001), sex (P=.0106), the presence of distant metastases at diagnosis (P=.0004), and the year of diagnosis (P=.0287) were associated significantly with the overall survival rate. Tumor size, lymph node status, and type of surgery were not associated significantly with the overall survival rate. Although parathyroid cancer is rare, the incidence increased significantly in the United States from 1988 through 2003. Young age, female gender, recent year of diagnosis, and absence of distant metastases were associated significantly with an improved survival rate.


Legionella pneumophila secretes an endoglucanase that belongs to the family-5 of glycosyl hydrolases and is dependent upon type II secretion.
Examination of cell-free culture supernatants revealed that Legionella pneumophila strains secrete an endoglucanase activity. Legionella pneumophila lspF mutants were deficient for this activity, indicating that the endoglucanase is secreted by the bacterium's type II protein secretion (T2S) system. Inactivation of celA, encoding a member of the family-5 of glycosyl hydrolases, abolished the endoglucanase activity in L. pneumophila culture supernatants. The cloned celA gene conferred activity upon recombinant Escherichia coli. Thus, CelA is the major secreted endoglucanase of L. pneumophila. Mutants inactivated for celA grew normally in protozoa and macrophage, indicating that CelA is not required for the intracellular phase of L. pneumophila. The CelA endoglucanase is one of at least 25 proteins secreted by the type II system of L. pneumophila and the 17th type of enzyme effector associated with this pathway. Only a subset of the other Legionella species tested expressed secreted endoglucanase activity, suggesting that the T2S output differs among the different legionellae. Overall, this study represents the first documentation of an endoglucanase (EC 188.8.131.52) being produced by a strain of Legionella.


Risk Communication Distributed among Migrant Workers during the COVID-19 Crisis in Thailand: Analysis on Structural and Networking Gaps.
Language and cultural barriers among migrant workers hamper access to health risk information. This study aims to explore health risk communication structure and processes and identify the communication network of migrant workers during the COVID-19 pandemic in Thailand. This study used a parallel mixed-methods design combined with in-depth interviews and questionnaires for social network analysis from November 2020 to June 2021 in the headquarter district of Samut Sakhon, Ranong, and Phuket provinces. We conducted purposive sampling of representatives from public and non-public organisations and local communities. Thirty-six key informants participated in in-depth interviews, and fifty-six respondents completed the questionnaire for social network analysis. Although health risk communication included various activities, there was no formal governing body responsible for health risk communication among migrants, and monitoring and evaluation of communication process were not well-implemented. The health risk communication network was centralised, especially in the rural area; however, migrant health volunteers (MHVs) and local media were key sources of information for most migrants in communities. Overall, a governing body led by the government with intersectional collaboration and a health risk communication process should be promoted while considering migrants' characteristics and concerns. The health risk communication network should identify key communicators such as MHVs and local media. This can be an effective strategy to fill the gap of information dependency.


A facilitated cyclic ether formation and its potential application in solid-phase peptide and organic synthesis.
A "trimethyl lock" system has been known to facilitate lactonization reactions through what has been termed a stereopopulation control mechanism. We have found that a similar trimethyl lock system can also facilitate cyclic ether formation with the concomitant release of a carboxylic acid in the presence of anhydrous tetrabutylammonium fluoride. To study this base-mediated trimethyl lock-facilitated cyclic ether formation, we synthesized fifteen model compounds. All model compounds underwent base-mediated cyclic ether formation in high yields at 0 degree C to room temperature (r.t.) with the concomitant release of the attached carboxylate. Such a system potentially could be used for the development of a two-dimensional linker for solid phase peptide and organic synthesis.


Beneficial Performance Effects of Training Load Intensification Can Be Abolished by Functional Overreaching: Lessons From a Water Polo Study in Female Athletes.
Brisola, GMP, Dutra, YM, Murias, JM, and Zagatto, AM. Beneficial performance effects of training load intensification can be abolished by functional overreaching: Lessons from a water polo study in female athletes. J Strength Cond Res 37(6): e391-e402, 2023-The purpose of this study was to compare the outcomes from 2 weeks of training load intensification strategy in female water polo players diagnosed with functional overreaching (F-OR) with no F-OR players (acute fatigue) on the performance outcomes and hormonal, immunological, and cardiac autonomic nervous system responses. Twenty-two female water polo players were allocated into control and intensification group during 7 weeks. The swimming performance, biochemical parameters, heart rate variability, profile of mood states, and upper respiratory tract infection symptoms were assessed twice before and twice after 2 weeks of intensification period. F-OR showed a worsening in total time of the repeated sprint ability (RSA) test compared with the control group and the acute fatigue group after intensification ( p ≤ 0.035). Furthermore, after the tapering period, the F-OR group maintained worse total time of the RSA test than the acute fatigue group ( p = 0.029). In addition, the acute fatigue group showed improvement in total time of the RSA test after intensification compared with the control group ( p < 0.001). No significant interactions were found for the other parameters. Therefore, periods of intensification without the F-OR development can promote higher gains in the total time of the RSA test after intensification and tapering period.


Leptin in bovine colostrum and milk.
We studied leptin content in bovine colostrum, milk and plasma during the first month of lactation, and investigated relationships between selected milk components and milk leptin in five multiparous dairy cows. Colostrum/milk yield and composition were measured on days 0, 10, 20, and 30 of lactation. Leptin was assayed using a multi-species leptin RIA kit. Leptin concentration was 56 % lower in mature milk (day 10) than colostrum (13.90 vs. 6.14 microg/l; p < 0.001), but remained steady over the twenty days afterwards. Daily secretion of leptin into mature milk was 28 % lower than into colostrum (173.2 microg/d vs. 220.0 microg/d; p = 0.09) notwithstanding an 80 % increase in production. Colostrum and milk leptin levels correlated with fat (0.90; p < 0.001) and choline phospholipid (0.76; p < 0.05). Plasma and milk leptin decreased during the first month, but remained higher in milk, and highest in colostrum. Thus, leptin is present in large quantities in colostrum, less so and more variably in untreated milk, and is likely to be decreased in skimmed milk. These findings have implications for the use of untreated milk and colostrum-based (functional) food products.


The Impact of the COVID-19 Public Health Crisis on Communication and Quality of Life: Insights From a Community of Stroke and Brain Trauma Survivors.
Purpose The COVID-19 pandemic has led to stay-at-home orders and social distancing guidelines that have the potential to greatly impact individuals' behavior and social engagement. Adults recovering from stroke or other brain trauma, who often have communication difficulties and other long-term challenges, are a population already at risk of isolation and lower quality of life. We investigated the impact of public health guidelines and related behavioral changes on self-perceptions of communication abilities and psychosocial factors in this population. Method The Stroke Comeback Center, a community-based center for stroke and other brain trauma survivors with communication impairments, disseminated an online survey to current members to investigate changes in communication, social engagement, and quality of life. Results Participants (N = 50) reported a number of changes in their day-to-day activities that reflect the current social distancing guidelines, such as reduced outings into the community and fewer in-person conversations with those living outside one's home. Overall, feelings of connectedness to others and overall quality of life were reported to be decreased when compared to before the COVID-19 pandemic, whereas receptive language abilities and technology skills were reported to have improved. Perhaps most interestingly, certain behavioral changes (including healthy movement activities and participation in virtual programs) had specific relationships with perceived communication abilities and social engagement. Conclusions Changes in daily life resulting from the COVID-19 pandemic have had a tangible impact on self-perceived psychosocial elements (e.g., quality of life) and communication abilities among stroke and other brain trauma survivors. Clinicians and researchers may consider these perceived changes when engaging with this population as the effects of the pandemic continue and in the period of community re-entry that may follow. Supplemental Material https://doi.org/10.23641/asha.14830881.


[Effect of Hepatic P450 2e1 Activity Modulation on the Toxicity and Carcinogenicity of Diethylnitrosamine in Mice].
In this paper, the biological effects of diethylnitrosamine have been studied under controlled conditions of its metabolism in mice of different ages. The data presented indicate that diethylnitrosamine in a non-metabolized form exerts general toxic and hepatocarcinogenic effects while alkylating agents of this compound produce toxic liver injury. To our knowledge, the data presented impel to revise the general notion of an exceptional role of mutagenic activation in the carcinogenic effect of chemicals.


Energy system contribution to Olympic distances in flat water kayaking (500 and 1,000 m) in highly trained subjects.
Olympic flat water kayaking races take place over a distance of 500 and 1,000 m. This study was designed to determine the aerobic and anaerobic contributions to 500- and 1,000-m races during flat water paddling in open water, using the accumulated oxygen deficit (AOD) method. Seven internationally ranked athletes, specialized in 500-m races and familiar with 1,000-m races, participated in this study (age: 21.86 ± 1.68 years, body mass: 78.54 ± 3.41 kg, height: 1.84 ± 0.03 m, body fat%: 10.14 ± 0.69%). All the participants performed 3 track-kayaking sessions. During the first session, the maximal oxygen uptake and maximal aerobic speed were determined using a portable gas analyzer and a global positioning system. During the successive testing sessions, paddlers performed in a randomized counterbalanced order a 500- and a 1,000-m race under field conditions (open water track kayaking). The 500-m AOD was significantly higher than the 1,000-m AOD (18.16 ± 4.88 vs. 9.34 ± 1.38 ml·kg(-1), p < 0.05). The aerobic contribution resulted in being higher during the 1,000 m compared with that in the 500-m condition (86.61 ± 1.86% vs. 78.30 ± 1.85%, respectively, p < 0.05). The results of this study showed that the 500- and 1,000-m races are 2 physiologically different kayaking events with a higher aerobic contribution in the 1,000 m. The training prescription for elite athletes should emphasize aerobic high-intensity training for the 1,000 m and anaerobic short-term training for the 500-m race.


[The role of thrombin in the pathogenesis of atherosclerosis and its complications].
Thrombin is a key regulator of the homeostasis system. Also, it actively participates in progression of various systemic diseases, including atherosclerosis. There is a large amount of experimental and clinical data on the involvement of thrombin in the pathogenesis of ischemic heart disease (IHD). Thus, studying thrombin activity regulation is promising. Also, the question whether it is possible to use biomarkers of thrombin activity as predictors of cardiovascular complications in IHD patients is relevant. The present review focuses on major mechanisms of thrombin functioning, its role in development and progression of atherosclerosis, and available tests for evaluation of thrombin functional activity. Major clinical studies are discussed that evaluated the efficacy of thrombin inhibitors and protease-activated receptor antagonists.


Risk Factors for Lung Function Decline in Pediatric Asthma under Treatment: A Retrospective, Multicenter, Observational Study.
Background: Childhood asthma is a major risk for low lung function in later adulthood, but what factors in asthma are associated with the poor lung function during childhood is not known. Objective: To identify clinical factors in children with asthma associated with low or declining lung function during the treatment. Methods: We enrolled children with asthma who had been treated throughout three age periods, i.e., 6−9, 10−12, and 13−15 years old, at seven specialized hospitals in Japan. Clinical information and lung function measurements were retrieved from the electronic chart systems. To characterize the lung function trajectories during each age period, we evaluated the forced expiratory volume 1 (FEV1) with % predicted values and individual changes by the slope (S) from linear regression. We defined four trajectory patterns: normal (Group N) and low (Group L), showing %FEV1 ≥80% or <80% throughout all three periods; upward (Group U) and downward (Group D), showing S ≥ 0 or S < 0%. Logistic regression analysis was performed to compare factors associated with the unfavorable (D/L) versus favorable (N/U) groups. Results: Among 273 eligible patients, 197 (72%) were classified into Group N (n = 150)/U (n = 47), while 76 (28%) were in Group D (n = 66)/L (n = 10). A history of poor asthma control, long-acting beta2 agonist use, and a lower height Z-score during 13−15 years were associated with an unfavorable outcome (Group D/L). Conversely, inhaled corticosteroid (ICS) use during 10−12 years and high-dose ICS use during 13−15 years were associated with a favorable outcome (Group N/U). Conclusion: We identified several factors that are associated with unfavorable lung function changes in pediatric asthma. Attention should be paid to the possible relationship between yearly changes in lung function and poor asthma control, use of ICS (and its dose) and use of LABA.


Successful treatment of thrombotic microangiopathy after haematopoietic stem cell transplantation with rituximab.
Thrombotic microangiopathy (TMA) is a grave complication after haematopoietic stem cell transplantation (HSCT) and effective treatment is undefined. Five patients with postHSCT TMA, which was refractory to at least 1 week of plasma exchange and prednisolone, were treated with rituximab (375 mg/m(2)/week x 4). Remission was achieved in four patients, of whom three remained in remission and one had died of sepsis at a median follow-up of 10 months. ADAMTS13 levels were low in all evaluable patients, and only one patient showed significant anti-ADAMTS13 antibody. The levels of ADAMTS13 and anti-ADAMTS13 antibody did not change significantly with rituximab-induced remission.


Cytoarchitectonic development of the prefrontal cortex in the rat.
This paper gives an account of the cytoarchitectonic characteristics that make it possible to delineate, from as early as day 6, different subareas of the prefrontal cortex of the rat. Three phases can be distinguished during postnatal development. The first phase (from day 1 until day 18) is dominated by differentiation of the neurons within the cortical plate and by the formation of the cortical layers. At day 1, regional differences are observed in the cytoarchitecture of the cortical plate which correspond to the future subareas of the prefrontal cortex. The formation of layer IV occurs in the dorsolateral cortex around day 6, and from this age the agranular prefrontal cortex is well demarcated from the other parts of the frontal cortex. Between day 6 and day 10, the cortical plate has disappeared and all cortical layers can be recognized in the prefrontal cortex. Differentiation of the cells within the cortical layers changes the cytoarchitectonic character of the layers through day 18. During the second phase (from day 18 until day 30) little change occurs in the cytoarchitectonic characteristics of the prefrontal subareas. During the third phase (from day 30 until day 90) the delineation of the cortical layers becomes less clear in Nissl-stained sections, and the individual cytoarchitectonic variance increases. On the basis of cytoarchitectonic criteria it can be concluded that the orbital prefrontal cortex develops earlier than does the medial prefrontal cortex.


Quantitative small animal PET.
Small animal PET is increasingly utilized to assess efficacy of therapeutic interventions; and in parallel, to validate the use of current and novel imaging agents and targets for translation to the clinic. One of the many advantages of PET imaging is that it offers quantifiable measures of the underlying biology. With that in mind, we review kinetic modeling in quantifying small animal PET images. The review provides a primer on PET image quantification followed by a brief discussion on factors that may affect PET image quantification. We will conclude with application of quantitative imaging in metabolic imaging and delve into advanced topics on voxel-by-voxel kinetic modeling.


Prevalence of diarrheogenic Escherichia coli and rotavirus among children from Botucatu, São Paulo State, Brazil.
In a one-year prospective study carried out to define the role of rotavirus and Escherichia coli in local childhood diarrhea, we determined the prevalence of both agents in 54 diarrheic children attending a health center in Botucatu. Diarrheogenic E. coli (DEC) strains were characterized by O:H serotyping, a search for virulence genetic markers, and assays of adherence to HEp-2 cells. Except for enteroaggregative E. coli (EAEC), no other DEC category was detected in the children's stools. Both EAEC and rotavirus were isolated from 22 of the 54 (41.0%) diarrheic children as single agents or in combination with other enteropathogens. However, when considering the presence of a single agent, EAEC was dominant and isolated from 20.4% of the patients, whereas rotavirus was detected in 14.8%. These results indicate that rotavirus and EAEC play a significant role as agents of childhood diarrhea in the local population.