Age-related changes in neuronal receptive fields of primary auditory cortex in frequency, amplitude, and temporal domains.
Aging populations often experience difficulties hearing. This phenomenon, known as age-related hearing loss, is associated with decreases in hearing sensitivity and pathophysiological changes in the central auditory system, including the primary auditory cortex (AI). To better understand changes in the central auditory system, this study is designed to compare the receptive fields of AI neurons of young and old C57 mice in frequency, amplitude, and temporal domains by using random-delivery (various interval) of multi-frequency gamma-shaped tone pips and a novel data processing approach known as the intensity-stacked spectrotemporal receptive field (iSTRF). We show that the fundamental changes in the response properties of AI neurons in old mice were in line with the literature. Compared to young mice, AI neurons in old mice tuned to lower frequency and higher amplitude of tones with broader frequency tuning, shorter dB (dynamic) range, longer response duration, as well as a higher firing rate. We further compared the entire iSTRF and core iSTRF (above 50% maximal firing rate) between young and old mice; the core iSTRF represented the AI neuronal responses to sound that fall into the central frequency and amplitude ranges from the auditory periphery. It is remarkable that the difference was significant in the entire iSTRF while little difference was observed in the core iSTRFs between young and old mice. However, the lower best frequency and higher best amplitude were obvious in both iSTRFs that were mostly determined by the deficits in the inner ears of old mice. In the frequency domain, the tuning quality factor of entire iSTRFs was significantly greater in old mice, while that of core iSTRFs was not compared to young mice. In the amplitude domain, significantly shorter dB range in old mice were observed in the entire iSTRF, but not in the core iSTRF. In the temporal domain, the response duration of old AI neurons was significantly longer in entire iSTRFs, but not in core iSTRFs, when compared to young AI neurons. Furthermore, the average firing rate of old AI neurons was significantly higher in entire iSTRF, but not in core iSTRF. It is also interesting that the ratio of the firing rate to background firing rate (signal-noise ratio) were similar between young and old AI neurons. Our data suggests that age-related hearing loss has relatively less impact on auditory information processing when sounds fall into the optimal frequency and amplitude ranges of given AI neurons.


The ophthalmological complications of targeted agents in cancer therapy: what do we need to know as ophthalmologists?
Recently, there has been an increase in the use of targeted therapies for cancer treatments. Nevertheless, the ocular side-effects of the commonly used targeted agents are generally under-reported and not well studied in the literature. We conducted multiple searches in databases, including Medline, EMBASE, Cochrane Library and conference proceedings, using the following strings: 'name of targeted therapeutic agent (both generic and commercial names)' AND 'eye OR ocular OR vision OR ophthalmological'. Various targeted agents have been found to be associated with ocular side-effects due to their specific targeting of activities in the eye. Imatinib commonly causes periorbital oedema, epiphora and occasionally conjunctival haemorrhage. Cetuximab causes corneal lesions, meibomian gland dysfunction, periorbital and lid dermatitis, blepharitis and conjunctivitis. Erlotinib is related to various ocular toxicities, mainly on the ocular surface, and perifosine has been reported to be associated with severe keratitis. Bevacizumab could potentially disrupt intrinsic ocular circulation and lead to the development of thromboembolic events; there are rare reported cases of optic neuritis or optic neuropathy. Other targeted agents, such as trastuzumab, sunitinib and crizotinib, also have specific ocular toxicities. In conclusion, ocular effects of targeted agents are not uncommon in cancer patients receiving targeted therapy. Ophthalmologists should have high indexes of suspicion to diagnose and treat these complications promptly.


Is surgical decontamination definitive treatment of "body-packers"?
The current recommendations for body-packers are based on packet content, the presence of drug toxicity, or of bowel obstruction. Asymptomatic patients are usually treated with activated charcoal and whole bowel irrigation (WBI). Surgical removal of packets is advocated in symptomatic cocaine body-packers and in those with bowel obstruction. Currently, surgery is regarded as definitive. However, we report 2 body-packers who show the limitations of this technique. These cases show the importance of confirming the absence of drug packets in the gastrointestinal (GI) tract as the definitive end-point in the treatment of body-packers.


Is there a classical role for the clinical laboratory in digital health?
The classical role of the clinical laboratory, seen as the central place where the samples converge and from where the results are distributed, will be challenged by the development of digital health, the application of information technology (big data) and genomics to health care. When the development of disruptive new technologies will allow the production of accurate results outside the laboratory, its role will dramatically change. However, several factors are slowing down these evolutions. The quality of the existing data is relatively poor: lack of standardization of results, different units, different reference intervals, etc. The lab-on-a-chip technology is still relatively far from broad range application and the costs are higher than the traditional methods. There is the need for regulations of direct to consumer approaches that are posing big ethical problems. In the future, the clinical laboratory will maintain part of the "classical" role in the areas of research education and services. The large production will continue, favored by consolidation and reduction of the number of laboratories. The specialists of laboratory medicine have the task of collaborating with the national scientific societies and with the industry for improving harmonization of all the production phases, thus allowing the production of meaningful big data. Clinical laboratories have the role of implementing translational medicine. The new point-of-care (POC) technologies still need validation, the clinical laboratory is the place to do it. The advisory role toward clinicians and patients has to be improved, and a role in validating laboratory data interpretation apps and in controlling and supervising the functionality and the quality of the POC devices has to be developed.


The stability and anti-apoptotic function of A1 are controlled by its C terminus.
Most Bcl-2 family members can localize to intracellular membranes via hydrophobic sequences within their C-terminal portion. We found that the C terminus of the anti-apoptotic family member A1 did not function as a membrane anchor. Instead, this stretch of the protein rendered A1 highly unstable by mediating its polyubiquitination and rapid proteasomal degradation. Moreover, the domain did not only function independently of its position within the A1 protein but when transferred could even destabilize unrelated proteins like enhanced green fluorescent protein and caspase-3. A1 was, however, much more stable in the presence of the Bcl-2 homology-only protein BimEL, suggesting that direct interaction of A1 with pro-apoptotic members of the Bcl-2 family strongly reduces its rate of turnover. We further show that the C-terminal end of A1 also contributes to the anti-apoptotic capacity of the protein. In conclusion, our data demonstrate that the C terminus serves a dual function by controlling the stability of A1 and by amplifying the capacity of the protein to protect cells against apoptosis.


Linking Chromosomal Silencing With Xist Expression From Autosomal Integrated Transgenes.
Xist is the master regulator of X-Chromosome Inactivation (XCI), the mammalian dosage compensation mechanism that silences one of the two X chromosomes in a female cell. XCI is established during early embryonic development. Xist transgene (Tg) integrated into an autosome can induce transcriptional silencing of flanking genes; however, the effect and mechanism of Xist RNA on autosomal sequence silencing remain elusive. In this study, we investigate an autosomal integration of Xist Tg that is compatible with mouse viability but causes male sterility in homozygous transgenic mice. We observed ectopic Xist expression in the transgenic male cells along with a transcriptional reduction of genes clustered in four segments on the mouse chromosome 1 (Chr 1). RNA/DNA Fluorescent in situ Hybridization (FISH) and chromosome painting confirmed that Xist Tg is associated with chromosome 1. To determine the spreading mechanism of autosomal silencing induced by Xist Tg on Chr 1, we analyzed the positions of the transcriptionally repressed chromosomal sequences relative to the Xist Tg location inside the cell nucleus. Our results show that the transcriptionally repressed chromosomal segments are closely proximal to Xist Tg in the three-dimensional nucleus space. Our findings therefore support a model that Xist directs and maintains long-range transcriptional silencing facilitated by the three-dimensional chromosome organization.


MicroRNAs as Potential Mediators for Cigarette Smoking Induced Atherosclerosis.
Smoking increases the risk of atherosclerosis-related events, such as myocardial infarction and ischemic stroke. Recent studies have examined the expression levels of altered microRNAs (miRNAs) in various diseases. The profiles of tissue miRNAs can be potentially used in diagnosis or prognosis. However, there are limited studies on miRNAs following exposure to cigarette smoke (CS). The present study was designed to dissect the effects and cellular/molecular mechanisms of CS-induced atherosclerogenesis. Apolipoprotein E knockout (ApoE KO) mice were exposed to CS for five days a week for two months at low (two puffs/min for 40 min/day) or high dose (two puffs/min for 120 min/day). We measured the area of atherosclerotic plaques in the aorta, representing the expression of miRNAs after the exposure period. Two-month exposure to the high dose of CS significantly increased the plaque area in aortic arch, and significantly upregulated the expression of atherosclerotic markers (VCAM-1, ICAM-1, MCP1, p22phox, and gp91phox). Exposure to the high dose of CS also significantly upregulated the miRNA-155 level in the aortic tissues of ApoE KO mice. Moreover, the expression level of miR-126 tended to be downregulated and that of miR-21 tended to be upregulated in ApoE KO mice exposed to the high dose of CS, albeit statistically insignificant. The results suggest that CS induces atherosclerosis through increased vascular inflammation and NADPH oxidase expression and also emphasize the importance of miRNAs in the pathogenesis of CS-induced atherosclerosis. Our findings provide evidence for miRNAs as potential mediators of inflammation and atherosclerosis induced by CS.


Three year field test of a plant growth promoting rhizobacteria enhanced phytoremediation system at a land farm for treatment of hydrocarbon waste.
Phytoremediation of total petroleum hydrocarbons (TPH) has the potential to be a sustainable waste management technology if it can be proven to be effective in the field. Over the past decade, our laboratory has developed a system which utilizes plant growth promoting rhizobacteria (PGPR) enhanced phytoremediation (PEP) that, following extensive greenhouse testing, was shown to be effective at remediating TPH from soils. This system consists of physical soil manipulation and plant growth following seed inoculation with PGPR. PGPR elicit biomass increases, particularly in roots, by minimizing plant stress in highly contaminated soils. Extensive development of the root system enhances degradation of contaminants by the plants and supports an active rhizosphere that effectively promotes TPH degradation by a broad microbial consortium. Following promising greenhouse trials, field tests of PEP were performed over a period of three years at a Southern Ontario site (approximately 130 g kg(-1) TPH) used for land farming of refinery hydrocarbon waste for many years. The low molecular weight fractions (the Canadian Council of Ministers of the Environment (CCME) fractions 1 and 2) were removed through land farming and bioremediation; the high molecular weight, recalcitrant fractions (CCME fractions 3 and 4) remained at high levels in the soil. Using PEP, we substantially remediated fractions 3 and 4, and lowered TPH from 130 g kg(-1) to approximately 50 g kg(-1) over a three year period. The amount of plant growth and extent of oil remediation were consistently enhanced by PGPR.


Statistical Considerations for an Adaptive Design for a Serious Rare Disease.
Neuromyelitis optica spectrum disorder (NMOSD) is a rare, disabling autoimmune disorder of the central nervous system. Clinical trials in NMOSD present unique design and statistical challenges to adequately determine treatment effect and to minimize risk. The N-MOmentum trial (NCT02200770) is evaluating the efficacy and safety of MEDI-551, an anti-CD 19 B-cell depleting monoclonal antibody, in patients with NMOSD and employs a number of unique design features. Patients are randomized (3:1) to receive MEDI-551 or placebo for up to 197 days. NMOSD attacks are evaluated by the investigator and confirmed by an independent adjudication committee. The primary endpoint is time to first relapse as determined by adjudication committee. Sample size re-estimation and futility analyses are planned interim analyses. Novel multiplicity adjustment methods are developed to control the study-wise type I error. Methods for assessing inter- and intrarater reliability are proposed. The N-MOmentum study minimizes exposure to placebo for individual patients. The application of several statistical methods in the N-MOmentum trial is novel in NMOSD and aims to achieve a balance between minimizing risk and maintaining scientific integrity.


[60]Fullerene metal complexes with large effective two-photon absorption cross-section.
Fourteen novel complexes of fullerene C(60) with metal dialkyldithiophosphate, {[(RO)(2)PS(2)](2)M}·2C(60) (R = Me and Et; M = Mn, Fe, Co, Ni, Cu, Zn and Pd), can be obtained in high yield by the reaction of metal(II) dialkyldithiophosphate complexes with C(60) fullerene. Their structures are determined by (1)H, (13)C, and (31)P NMR spectroscopy, elemental analysis, FT-IR and UV-vis, and are supplied by single crystal X-ray data. The compound {[(EtO)(2)PS(2)](2)Pd}·2C(60) was also studied by the HRTEM image and SAED patterns. Studies of the optical properties of the complexes of fullerene C(60) with metal dialkyldithiophosphate show that these compounds all have very strong nonlinear optical absorption effects. The nonlinear absorption of fourteen complexes of fullerene C(60) with metal dialkyldithiophosphate (in o-dichlorobenzene and in the solid state) was measured by the open-aperture Z-scan technique at a wavelength of 532 nm. DFT calculations are also used to discuss the stability of these complexes and to confirm the structural assignments.


Antidepressant use in children and adolescents in Germany.
The expanded use of antidepressants in youth has been the subject of numerous studies and some concerns in recent years. This study describes prescription patterns of antidepressants (ATD) for youths in Germany for the years 2000-2003 and includes prescription use of St. John's Wort. Prescription data from a health insurance organization with 1.4 million members per year across Germany, of whom approximately 280,000 were under 20 years of age, were accessed. Total age- and gender-specific ATD yearly utilization rates were computed. Prevalence was defined as the dispensing of 1 or more prescriptions for an ATD per calendar year per 1000 continuously enrolled youth. ATD prevalence was 3.43 per 1000 (95% Confidence Interval [CI], 3.21-3.65) in 2000 and 3.74 per 1000 (3.25-3.97) in 2003. St John's Wort products, which are approved for antidepressant use by the German drug agency, and tricyclic antidepressants (TCAs), accounted for more than 80% of antidepressant use. Although selective serotonin reuptake inhibitors (SSRIs) represented only 15% of antidepressant use, there was a doubling of its use over the 4-year period. Adolescent girls (age, 15-19 years) had utilization rates ranging from 11.44 to 13.82 per 1000, and accounted for most ATD use. Overall, females were twice as likely as males to get an antidepressant. Among users, there were low rates of multiple medication use (5.6% used more than one class of ATD, and 6.7% more than one drug). Prescription patterns in Germany reveal predominate use of St. John's Wort and TCAs, which contrasts sharply with U.S. patterns, wherein SSRIs predominate. Also, in the United States, unlike Germany, 5-9- and 10-14 year olds receive sizable proportions of ATDs. Labeling status (only herbal hypericum preparations and TCAs are labeled for the treatment of depression in children and adolescents in Germany) and cost restrictions appear to influence the prescribing pattern of doctors in Germany. Recent treatment recommendations of national and international regulatory agencies need to take into account the different national situations.


Elevation of maternal serum sFlt-1 in pregnancy with mirror syndrome caused by fetal cardiac failure.
Mirror syndrome (MS) is characterized by the combination of maternal generalized edema, fetal hydrops and placental hypertrophy. A shift of the serum placenta-derived angiogenic factor like sFlt-1 in MS is similar to that in pre-eclampsia (PE). We experienced a MS case caused by cardiac myopathy in the fetus with normal cardiac structure. A 27-year-old primiparous woman at 28 weeks of gestation had systemic edema without hypertension and proteinuria. Her symptoms rapidly disappeared after delivery. Compared with previously reported MS cases with maternal hypertension or proteinuria, the serum sFlt-1 level was lower in our case. Severity of maternal symptoms in MS might be paralleled with the serum sFlt-1 level. Additionally, serum hCG level in MS is much higher than that in PE. Maternal edema rather than hypertension and proteinuria can be more remarkable in MS compared with PE. It can be potentially explained by increased serum hCG level.


Competition between CO2 Reduction and Hydrogen Evolution on a Gold Electrode under Well-Defined Mass Transport Conditions.
Gold is one of the most selective catalysts for the electrochemical reduction of CO2 (CO2RR) to CO. However, the concomitant hydrogen evolution reaction (HER) remains unavoidable under aqueous conditions. In this work, a rotating ring disk electrode (RRDE) setup has been developed to study quantitatively the role of mass transport in the competition between these two reactions on the Au surface in 0.1 M bicarbonate electrolyte. Interestingly, while the faradaic selectivity for CO formation was found to increase with enhanced mass transport (from 67% to 83%), this effect is not due to an enhancement of the CO2RR rate. Remarkably, the inhibition of the competing HER from water reduction with increasing disk rotation rate is responsible for the enhanced CO2RR selectivity. This can be explained by the observation that, on the Au electrode, water reduction improves with more alkaline pH. As a result, the decrease in the local alkalinity near the electrode surface with enhanced mass transport suppresses HER due to the water reduction. Our study shows that controlling the local pH by mass transport conditions can tune the HER rate, in turn regulating the CO2RR and HER competition in the general operating potential window for CO2RR (-0.4 to -1 V vs RHE).


Influence of Fermentation Temperature, Yeast Strain, and Grape Juice on the Aroma Chemistry and Sensory Profile of Sauvignon Blanc Wines.
Sauvignon blanc wine, balanced by herbaceous and tropical aromas, is fermented at low temperatures (10-15 °C). Anecdotal accounts from winemakers suggest that cold fermentations produce and retain more "fruity" aroma compounds; nonetheless, studies have not confirmed why low temperatures are optimal for Sauvignon blanc. Thirty-two aroma compounds were quantitated from two Marlborough Sauvignon blanc juices fermented at 12.5 and 25 °C, using Saccharomyces cerevisiae strains EC1118, L-1528, M2, and X5. Fourteen compounds were responsible for driving differences in aroma chemistry. The 12.5 °C-fermented wines had lower 3-mercaptohexan-1-ol (3MH) and higher alcohols but increased fruity acetate esters. However, a sensory panel did not find a significant difference between fruitiness in 75% of wine pairs based on fermentation temperature, in spite of chemical differences. For wine pairs with significant differences (25%), the 25 °C-fermented wines were fruitier than the 12.5 °C-fermented wines, with high fruitiness associated with 3MH. We propose that the benefits of low fermentation temperatures are not derived from increased fruitiness but a better balance between fruitiness and greenness. Even so, since 75% of wines showed no significant difference, higher fermentation temperatures could be utilized without detriment, lowering costs for the wine industry.


Lamina propria mast cells in biopsies from children with Crohn's disease.
Biopsies from actively inflamed areas of terminal ileum or colon in children with Crohn's disease were examined both for lamina propria mast cell density and histamine content. These were reduced in comparison with those of normal controls. The release of histamine from biopsies of inflamed tissue did not differ greatly from that of normal tissue, either spontaneously or after receiving an antihuman IgE challenge.


Interindustry linkages of prices-Analysis of Japan's deflation.
The interactions among macroprices with leads and lags play a significant role in explaining the behavior of an aggregate price index. Thus, to understand inflation and deflation, it is essential to explore the mechanism according to which these macroprices interact with each other. On the basis of a new method, we show that, irrespective of the sources of shocks, a robust flow of changes occurs in domestic prices from upstream to downstream. Moreover, we demonstrate that macroprices change in clusters, and we identify these clusters. Firms are not symmetric. Overall, our analysis suggests that the inertia arising from input/output linkages in production explains the behavior of aggregate prices.


t(8;21) acute myeloid leukaemia cells are dependent on vascular endothelial growth factor (VEGF)/VEGF receptor type2 pathway and phosphorylation of Akt.
Several anti-angiogenic drugs have recently been clinically tested for haematological malignancies. To improve the efficacy of molecular target therapy against angiogenic molecules in acute myeloid leukaemia (AML), we examined the dependency of AML cells on the vascular endothelial growth factor (VEGF)/VEGF receptor type2 (VEGFR2) system by using VEGFR2 kinase inhibitor. Nineteen patient AML samples were cultured with or without VEGFR2 kinase inhibitor. All four t(8;21) viable AML cells showed significant reductions when treated with VEGFR2 kinase inhibitor, although VEGFR2 kinase inhibitor did not affect the cell proliferation of five t(15;17) AML samples. Other AML cases showed variable responses. VEGFR2 kinase inhibitor greatly suppressed the growth of Kasumi-1, a t(8;21) cell line in a dose-dependent manner through induction of apoptosis, but did not show any significant influence on NB4, a t(15;17) cell line. In addition, VEGFR2 kinase inhibitor potentiated the growth inhibitory effect of cytarabine in Kasumi-1. Finally, it was shown that the Akt phosphorylation was augmented by VEGF(165) in Kasumi-1, which was abrogated by VEGFR2 kinase inhibitor. NB4 showed undetectable Akt phosphorylation even with VEGF(165). These data demonstrated that t(8;21) AML cells are dependent on VEGF through VEGFR2, resulting in the phosphorylation of Akt.


[What can a chair on alternatives to animal experimentation effectuate?].
The DZ foundation has, together with the Thurgau Foundation for Arts and Science (CH) and the state Baden-Wuerttemberg (D), made it possible for the University of Konstanz to establish an endowed chair for In vitro Alternative Methods. Such a step has never been taken before at a German university, and many may ask what the purpose is, and what this should lead to. The foundation document states... "the endowed chair will introduce the 3R principles of moderate and rational animal protection (reduce, replace, refine) into the academic curriculum and the profile of the University in practical and theoretical form". Furthermore, the goal is defined to develop and judge alternative methods to animal experiments in the domain of consumer- and health protection with the help of interdisciplinary research. Is therefore the purpose to establish 3R research in Germany--or make it socially acceptable? Of course, a No is the answer to the first part of the question, as 3R research is already successfully established and practiced at many universities and institutes. The second part of the question touches an interesting point. If one of the most highly-reputed faculties of the state creates a chair to this topic, then there is a clear signaling effect associated with it: in Konstanz 3R research is not seen as a haphazard spin-off, a compulsory exercise during the animal experimentation course, or a recycled use of an old cell culture system, but it is rather seen as an independent subject with high self-esteem and a function in creating a broad awareness.


Influence of histo blood group antigen expression on susceptibility to enteric viruses and vaccines.
Gastroenteritis results in substantial morbidity and mortality worldwide, especially in young children in low-and-middle-income settings. Rotavirus and norovirus are the leading causes of viral gastroenteritis. Although introduction of rotavirus vaccines into childhood immunization programmes has reduced disease burden, vaccine effectiveness remains low in developing countries. Norovirus is replacing rotavirus as the most common cause of diarrhea hospitalization in settings where rotavirus vaccines are highly effective. Genetically determined host factors, such as expression of histo blood group antigens (HBGAs) are hypothesized to play key roles in susceptibility to infections and gastroenteritis caused by these virus, as well as influence vaccine take. Epidemiology studies provide strong support for virus genotype-dependent effects of host HBGA expression, specifically secretor status on susceptibility to rotavirus and norovirus. Secretor-positive persons are significantly more susceptible to gastroenteritis caused by rotavirus P[8] genotype, and to infection with the GII.4 genotype of human norovirus. There is increasing data on the role of secretor status on rotavirus vaccine take but results are currently conflicting. For analyses involving young infants, maternal HBGA status is an important factor to be considered in future studies. Genetically determined HBGA expression influences susceptibility to enteric viruses of public health importance.


Vitrectomy for macular pucker.
Vitreous surgery was used to treat 130 consecutive cases with epiretinal membranes causing macular pucker. The membrane: (1) occurred after otherwise successful retinal reattachment surgery in 78 eyes (60%), (2) was idiopathic in 28 eyes (22%), (3) was associated with other ocular disorders in 20 eyes (15%), and (4) in four eyes may have been developmental. The abnormal tissue was successfully removed in 128 of 130 eyes, and vision improved at least two lines on the Snellen chart in 108 eyes (83%). Postoperative visual acuity was 20/20 in five eyes (4%), 20/25 to 20/40 in 41 eyes (31.5%), 20/50 to 20/100 in 64 eyes (49%), 20/200 in 15 eyes (11.5%), and 20/400 in five eyes (4%). Complications included one case of sterile endophthalmitis and one case of infective endophthalmitis (Staphylococcus epidermidis). Peripheral retinal tears occurred in six eyes (5%). No posterior retinal breaks occurred in this series. Later retinal detachment occurred in eight eyes (6%) requiring further retinal surgery. Progressive postoperative nuclear sclerotic lens changes occurred in 31 (34%) of 90 phakic eyes. Sizable amounts of epiretinal tissue recurred postoperatively in four eyes (3%).


Effect of Mindfulness-Based Stress Reduction Therapy on Work Stress and Mental Health of Psychiatric Nurses.
Psychiatric nurses are a special group of nursing staff, they experience greater work stress and lower mental health levels than regular nurses. In order to address this problem, the effect of mindfulness-based stress reduction (MBSR) therapy on work stress and mental health of psychiatric nurses is investigated in this study. From August 2017 to November 2017, 100 psychiatric nurses, including 68 females and 32 males, were selected as participants from three hospitals in Hunan Province of China. They were randomly divided into the intervention and control groups, with 50 respondents in each group. MBSR therapy was used as psychological intervention in the intervention group. Before and after the intervention, the two groups were assessed with the Symptom Checklist-90 (SCL-90) scale, Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Nursing Stress Scale. (1) After the intervention, the SCL-90 score of the intervention group decrease significantly, and a statistically significant difference is observed with the figure before the intervention (P<0.001). No statistically significant difference is found in the control group (P>0.05). (2) After the intervention, the SDS and SAS scores of the intervention group decrease significantly, and a statistically significant difference is observed with the figures before the intervention (P<0.001). No statistically significant difference is found in the control group (P>0.05). (3) After the intervention, the Nursing Stress Scale score of the intervention group Nursing Stress Scale decrease significantly, and a statistically significant difference is observed with the figure before the intervention (P<0.001). No statistically significant difference is found in the control group (P>0.05). MBSR therapy can reduce work stress, anxiety, depression, and other negative emotions among psychiatric nurses and improve their mental health.


Oral health inequalities and disability: Closing the gap.
The social determinants of health impact disproportionately on disabled people creating a cumulative risk of unequal oral health outcomes, compounded by impairment. Problems in early life, education and employment, poor social status and support, social exclusion, poverty and stress characterize the life course of many disabled people. Ableism and exclusion combine to ensure that disabled voices are rarely heard, ignorance and indifference lead to prejudice in policy-making and enforcement and negative media attitudes fuelled by political austerity lead to stigmatization. Yet, the health disparities experienced by disabled people are still perceived as being uniquely caused by a medical condition or impaired body function, excluding disabled people from the inequalities discourse. In parallel, the influence of medical conditions within other marginalized groups are minimized (e.g. mental health), leading to the underestimation of the impact of disability on oral health generally. The common ground between all groups subject to oral health inequalities can be conceptualized using the WHO International Classification of Functioning. Outcomes for all might be improved by emphasizing this common ground; by considering disability as a primary variable, such as gender or age; by identifying disabled people within existing inequalities research; and by explicitly including disabled people in future research.


Anatomical variation in the position of the brachiocephalic trunk (innominate artery) with respect to the trachea: a computed tomography-based study and literature review of Innominate Artery Compression Syndrome.
Respiratory compromise due to tracheal compression by the brachiocephalic trunk (BT), a condition first labeled as Innominate Artery Compression Syndrome (IACS), has been controversially attributed to an anomalous origin of this vessel to the left of, and hence crossing, the trachea. The aim of this study was to establish the normal relationship between the BT and trachea in infants, children, and young adults without obstructive respiratory symptoms. One hundred and eighty-one computed tomography (CT) examinations of the thorax, in three age groups, were reviewed. In axial cross section, the origin of the BT from the aortic arch was identified. The BT origin, with respect to the trachea, was recorded as for a clock face, approximated to the nearest half hour. There were 62 CTs in Group 1 (1 day to 3 years of age), 48 CTs in Group 2 (10-15 years), and 71 examinations in Group 3 (20-40 years). In 96.8% of Group 1, 91.7% of Group 2, and 74.6% of Group 3 the BT origin was to the left of the trachea, between the half past twelve and 3 o'clock positions. The BT origin occurred more the left in Group 1 when compared with the other two groups (P < 0.001). An origin of the BT to the left of the trachea is a normal finding in children and young adults without obstructive respiratory symptoms. There is a tendency for the origin to become progressively more rightward with age.


[Course studies in patients with cytologically inconspicuous, decreasingly accumulating struma nodes].
In 100 patients with inconspicuous findings of a thin-needle puncture of the thyroid gland after 2 years a clinical and cytological after-examination was performed. All test persons were primarily recommended a treatment with thyroid hormone. During the control in no case references to malignant process of the thyroid gland were the result, so that the puncture cytology also retrospectively showed a high exactness. Meanwhile 16 test persons had been strumectomized, in which cases the present histological findings always showed only regressive changes. The clinical after-examination confirmed former results so that also in decreasingly and not accumulating struma nodes a conservative approach is not promising a success. In 12 patients by application of hormones of the thyroid gland the struma had completely receded.


Recombinant baculoviruses for insect control.
Baculoviruses are double-stranded DNA viruses which are highly selective for several insect groups. They are valuable natural control agents, but their utility in many agricultural applications has been limited by their slow speed of kill and narrow host specificity. Baculoviruses have been genetically modified to express foreign genes under powerful promoters in order to accelerate their speed of kill. In our and other laboratories, the expression of genes coding for insect juvenile hormone esterases and various peptide neurotoxins has resulted in recombinant baculoviruses with promise as biological insecticides. These viruses are efficacious in the laboratory, greenhouse and field and dramatically reduce damage caused by insect feeding. The recombinant viruses synergize and are synergized by classical pesticides such as pyrethroids. Since they are highly selective for pest insects, they can be used without disrupting biological control. Because the recombinant virus produces fewer progeny in infected larvae than the wild-type virus, they are rapidly out-competed in the ecosystem. The viruses can be used effectively with crops expressing endotoxins of Bacillus thuringiensis. They can be produced industrially but also by village industries, indicating that they have the potential to deliver sustainable pest control in developing countries. It remains to be seen, however, whether the current generation of recombinant baculoviruses will be competitive with the new generation of synthetic chemical pesticides. Current research clearly indicates, though, that the use of biological vectors of genes for insect control will find a place in agriculture. Baculoviruses will also prove valuable in testing the potential utility of proteins and peptides for insect control.


Endothelial cell membrane vesicles in the study of organ preference of metastasis.
Many malignancies exhibit distinct patterns of metastasis that appear to be mediated by receptor/ligand-like interactions between tumor cells and organ-specific vascular endothelium. In order to study endothelial cell surface molecules involved in the binding of metastatic cells, we developed a perfusion method to isolate outside-out membrane vesicles from the lumenal surface of rat lung microvascular endothelium. Lungs were perfused in situ for 4 h at 37 degrees C with a solution of 100 mM formaldehyde, 2 mM dithiothreitol in phosphate-buffered saline to induce endothelial cell vesiculation. Radioiodinated rat lung endothelial cell membrane vesicles bound lung-metastatic tumor cells (B16F10, R323OAC-MET) in significantly higher numbers than their low or nonmetastatic counterparts (B16F0, R323OAC-LR). In contrast, leg endothelial membrane vesicle showed no binding preference for either cell line. Neuraminidase treatment of vesicles abolished specificity of adhesion of lung-derived vesicles to lung metastatic tumor cells. These results demonstrate that in situ perfusion is an appropriate technique to obtain pure endothelial cell membrane vesicles containing functionally active adhesion molecules. The preferential binding of lung-derived endothelial cell membrane vesicles by lung metastatic tumor cells is evidence of the importance of endothelial cell adhesion molecules in the formation of metastases.


Different doses of consensus interferon plus ribavirin in patients with hepatitis C virus genotype 1 relapsed after interferon monotherapy: a randomized controlled trial.
To assess the efficacy of different schedules of consensus interferon (CIFN) plus ribavirin in retreating chronic hepatitis C patients who relapsed after recombinant interferon (rIFN) monotherapy. Forty-five patients (34 males and 11 females) with chronic hepatitis due to hepatitis C virus (HCV) genotype 1 who relapsed after a previous course of rIFN monotherapy were randomized to receive 9 mug CIFN three times per week for 52 wk (group A, n = 22) or 18 mug CIFN three times per week for 52 wk (group B, n = 23) in combination with ribavirin 800 to 1200 mg daily for 52 wk (according to body weight). Virological response was evaluated at week 24 (EVR), at the end of treatment (ETR) and at 76 wk (SVR). By intention-to-treat analysis, subjects in group A had an EVR in 35% of cases, an ETR in 35% and a SVR in 27.3% of cases. Subjects in group B had an EVR in 32% of cases, an ETR in 35% and a SVR in 26.1% of cases. Treatment was stopped because of adverse effects (mostly intolerance) in 15 patients (6 in group A and 9 in group B). IFN dose reduction was needed in 2 patients (1 in group A and 1 in group B). Ribavirin dose was reduced in 2 patients in group A and 1 in group B respectively. Among the 15 subjects who received at least 80% of the intended schedule, the rate of SVR was 80% (6 in group A and 6 in group B). CIFN in combination with ribavirin when given to HCV genotype 1 relapsers after rIFN monotherapy obtains an unsatisfactory rate of sustained viral clearance independently of dosage of the drug. This may be due to its scarce tolerability.


Hemorrhagic cystitis: a review of the literature and treatment options.
Hemorrhagic cystitis (HC) is a morbid condition for patients and can be challenging for urologists to manage. There are many potential contributing etiologies and the severity of bleeding can be variable. It is important to consider each clinical scenario when formulating management strategies in order to provide the highest quality of care to patients. We provide a review of the literature including diagnosis and treatment options. We performed a literature search on PubMed using the following keywords: hemorrhagic cystitis, cystitis, gross hematuria, intractable hematuria. We considered all available published articles with no specific inclusion or exclusion criteria for the purposes of this review. We reviewed a total of 41 articles and identified a broad differential diagnosis for intractable hemorrhagic cystitis including infection, chemical exposure, malignancy, nephropathy, trauma, radiation therapy, and idiopathic etiology. Depending on the severity of bleeding, many treatments have been described. These range from conservative strategies (bladder fulguration and continuous irrigation) to more extreme and morbid therapies (intravesical instillations, embolization, and urinary diversion). Hemorrhagic cystitis is a relatively common and can be a difficult condition to manage for urologists. It is important to understand the etiology and available treatments options in order to best treat our patients. We provide a comprehensive and thorough review of the literature and propose a stepwise treatment approach.


Involvement of the purinergic P2X7 receptor in the formation of multinucleated giant cells.
Multinucleated giant cells (MGC), a hallmark of chronic inflammatory reactions, remain an enigma of cell biology. There is evidence implicating the purinergic P2X7 receptor in the fusion process leading to MGC. To investigate this, we used HEK 293 cells stably transfected with either 1) the full-length rat P2X7 receptor (P2X7 cells), 2) a rat P2X7 receptor lacking the C-terminal domain (P2X7TC), or 3) a mock vector, and rat alveolar macrophages (MA) expressing the native receptor. P2X7 cells cultured in serum-free medium formed increased numbers of MGC and displayed a higher fusion index compared with mock transfectants. Stimulation of P2X7 pore-forming activity in P2X7 cells by polymyxin B (PMB) further increased significantly the formation of MGC. Conversely, blockers of P2X-receptors including oxidized ATP, brilliant blue G, and pyridoxal phosphate-6-azophenyl-2'-4'-disulfonic acid inhibited significantly MGC formation in both unstimulated and PMB-stimulated P2X7-transfected cells. In contrast, cells transfected with the truncated P2X7TC were devoid of pore-forming activity, did not respond to PMB stimulation, and failed to form enhanced numbers of MGC, thus behaving as mock transfectants. As found for P2X7-transfected cells, PMB also potentiated dose-dependently the formation of multinucleated MA by rat alveolar MA. Pretreatment with oxidized ATP abrogated the PMB stimulatory effects. Together, these data demonstrate unequivocally the participation of P2X7 receptor in the process of MGC formation. Our study also provides evidence suggesting that stimulation of the P2X7 receptor pathway in MA may mediate increased formation of MGC during chronic inflammatory reactions.


[Cationic equilibrium in femur capitulum at smoking and nonsmoking people].
In this paper was presented factor cationic equilibrium for lemur capitulum smoking women and men. The factor equilibrium was solved according Czarnowski model. At comparing element was calcium. The factor equilibrium for smoking and nonsmoking were likely and small different between its.


Clinicopathological significance of CEACAM1 gene expression in breast cancer.
Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) is a cell adhesion molecule expressed in a variety of cell types. The role of CEACAM1 in breast cancer development and progression is largely unknown. Immunohistochemical analysis was used to examine CEACAM1 expression in breast cancer with long-term follow-up. CEACAM1 expression level in primary breast cancer was low or undetectable. In 65% of the cases, CEACAM1 expression within tumor tissue was lower than that in adjacent tissues. In 20% of the cases, CEACAM1 was negative. In 28.3% of cases, equivalent CEACAM1 expression level was detected in tumor and adjacent tissues. The expression level of CEACAM1 in tumor tissue was negatively correlated with patient mortality, while positively correlated with the expression level of ER+/PR+. CEACAM1 expression was not related with patients' age, pathological classification, lymphatic involvement and the size of tumor. The down-regulation of CEACAM1 was correlated with negative ER-/PR- and might be attributed to the malignant process of breast cancer. The prognosis of the patients with low CEACAM1 expression and high tumor pathological grade were poorer than those patients with high expression and low pathological grade, P < 0.05. Clinically, it is possible to predict the prognosis among the patients of breast cancer by measuring CEACAM1 gene expression in the tumor tissues.


Extracellular acidic polysaccharide production by a two-membered bacterial coculture.
A two-membered coculture of strains KYM-7 and KYM-8, identified as Cellulomonas cellulans and Agrobacterium tumefaciens, respectively, produced a large amount of an extracellular polysaccharide, designated APK-78, from starch. Each strain in pure culture produced only very little amount of polysaccharide from starch; the coexistence of the two strains from the early stage of cultivation was indispensable for a large amount of polysaccharide to be produced. The polysaccharide APK-78 was acidic and composed of glucose, galactose, succinic acid, and pyruvic acid with a molar ratio of 8.1:1.0:1.7:1.0, indicating that it is a succinoglycan type of polysaccharide.


Synthesis and study of cross-linked chitosan-N-poly(ethylene glycol) nanoparticles.
The present investigation describes the synthesis and characterization of novel biodegradable nanoparticles based on chitosan. Poly(ethylene glycol) dicarboxylic acid was used for intramolecular cross-linking of the chitosan linear chains. The condensation reaction of carboxylic groups and pendant amino groups of chitosan was performed by using water-soluble carbodiimide. The prepared nanosystems were stable in aqueous media. The structure of the products was determined by nuclear magnetic resonance (NMR) spectroscopy, and the particle size was identified by dynamic light scattering (DLS) and transmission electron microscopy (TEM) measurements. It was found that biodegradable cross-linked chitosan nanoparticles experienced considerable swelling because of the length and flexibility of the cross-linking agent. The aqueous solutions or dispersions of nanoparticles were stable and clear or mildly opalescent systems depending on the ratio of cross-linking and molecular weight of chitosan, findings consistent with values of transmittance above 75%. Particle size measured by TEM varied in the range of 4-24 nm. In the swollen state, the average size of the individual particles measured by DLS was in the range of 50-120 nm depending on the molecular weight of chitosan and the ratio of cross-linking.


Astraodoric acids A-D: new lanostane triterpenes from edible mushroom Astraeus odoratus and their anti-Mycobacterium tuberculosis H37Ra and cytotoxic activity.
Tuberculosis (TB) is one of the chronic infectious diseases caused by Mycobacterium tuberculosis that causes about 2-3 million deaths per year. Isoniazid and rifampicin are examples of first line drugs used for TB treatment; however, they are potentially hepatotoxic. More effective and safer drugs are urgently needed, especially from natural products. Basidiomycete mushrooms are known as important sources of pharmaceutically active metabolites including an anti-TB agent. In this work, the chemical constituents of the edible mushroom Astraeus odoratus were isolated and investigated for antibacterial activity against M. tuberculosis H(37)Ra. The cytotoxic activity against cancerous cell lines was also evaluated. Four new lanostane triterpenes, astraodoric acids A-D, and new 5-hydroxyhypaphorine have been isolated together with four known compounds. The structures were elucidated by NMR spectroscopic methods, HR-ESI-MS results, and X-ray crystallographic analysis. Astraodoric acids A and B exhibited moderate antibacterial (MICs of 50 and 25 μg/mL) and cytotoxic activities (IC(50) values of 34.69 and 18.57 μg/mL against KB and 19.99 and 48.35 μg/mL against NCI-H187), respectively. The results of this study show that A. odoratus could be a significant natural source for safer antitubercular and anticancer agents.


Purification and characterization of a cellulase from Dolabella auricularia.
A highly purified cellulase [EC 126.96.36.199] preparation (B beta) was obtained from a crude extract of gastric teeth of Dolabella auricularia by successive chromatographies on Sephadex G-100, DEAE-Toyopearl and CM-Toyopearl. The purified cellulase showed a single protein band on disc electrophoresis, and its isoelectric point was at pH 8.6. It contained relatively large amounts of basic amino acids and its molecular weight was estimated to be approximately 44,000 by sodium dodecyl sulfate (SDS) electrophoresis. The highest activity of this enzyme was attained at pH 6.3, but the enzyme was rather labile to heat. The activity of this enzyme was strongly inhibited by Hg2+, Mn2+, Zn2+, and Cu2+, whereas Ca2+ and Mg2+ showed no significant effect on the activity. The purified cellulase hydrolyzed sodium carboxymethyl cellulose (CMC) and phosphoric acid-swollen cellulose (swollen cellulose), as well as cellooligosaccharides and their reduction products, in an endowise fashion. It produced higher cellooligosaccharides effectively from swollen cellulose. Cellooligosaccharides with degrees of polymerization of 4-6 (G4-G6) were also hydrolyzed by the purified cellulase, but the modes of hydrolysis of these oligosaccharides were different from each other. The enzyme did not effectively attack cellooligosaccharides lower than G4. It produced G4 and G2 from G6, and G4 and glucose from G5. When these oligosaccharides were modified by reduction with sodium borotritide, the second linkage from the reducing end became, in each case, significantly susceptible to the enzyme and was preferentially cleaved.


[Clinical statistics of the operations during a 10-year period at the Department of Urology, Kouga Public Hospital: 1993-2002].
A clinical statistical survey of the operations was performed at our urology department during a 10-year period from 1993 to 2002. The total number of operations was 2,909 including 806 sessions of extracorporeal shock-wave lithotripsy (ESWL) that started in 1999. Since a combination unit of ESWL, fluoroscopic apparatus and digital video-urodynamics system was built next to the outpatient department in 1999, the number of operations and examinations has dramatically increased. Operations for bladders made up the greatest portion of all the surgeries and especially transurethral resection of bladder tumor and hydrodistention have been increasing.


Large meningoencephalocele after orbital decompression.
A 71-year-old woman with a history of thyroid eye disease was seen for evaluation of a skull-base mass noted on neuroimaging. She had previously under-gone bilateral orbital decompressions and strabismus surgery and had no neurologic symptoms. Bony defects along the skull base and cerebrospinal fluid leaks are known risks of orbital surgery. This is the first report of a large, asymptomatic meningoencephalocele after orbital decompression surgery.


[Accessible price lists at the anaesthesiologist's workplace enhance cost consciousness as a part of process and cost optimization].
The imminent introduction of the DRG (diagnosis-related-group) system is putting hospitals in Germany under considerable pressure. This requires that personnel are efficiently allocated by optimizing organizational procedures and that the limited resources be distributed in a cost-effective manner. One prerequisite for this is a marked cost-consciousness on the part of those who "incur costs" in providing a service. To increase the awareness of costs in clinical physicians, the cost structures must be transparent. In order to achieve this goal, a project was initiated at the Department of Anaesthesiology at the University Hospital of Heidelberg, which aimed to enhance the cost-consciousness of the staff by making price lists available to anaesthesiologists at the workplace. In addition to the price lists, the 25 most expensive medications and medical products were added as an ABC analysis. The departmental staff was interviewed by questionnaire as to whether this project was reasonable. After 1 year the interview was repeated. The results of the questionnaire showed that in the opinion of the staff, price lists are an effective tool, as cost-consciousness on the part of clinical physicians can be enhanced by making price structures transparent. This is a major prerequisite for individual motivation in the cost-effective management. Although the ABC analyses demonstrate no long-term effect of the price-transparency on the cost structures, the staff showed increased cost-consciousness and individual motivation for economic tasks.


Role of FliC and FliD flagellar proteins of Clostridium difficile in adherence and gut colonization.
In vitro and in vivo adhesive properties of flagella and recombinant flagellin FliC and flagellar cap FliD proteins of Clostridium difficile were analyzed. FliC, FliD, and crude flagella adhered in vitro to axenic mouse cecal mucus. Radiolabeled cultured cells bound to a high degree to FliD and weakly to flagella deposited on a membrane. The tissue association in the mouse cecum of a nonflagellated strain was 10-fold lower than that of a flagellated strain belonging to the same serogroup, confirming the role of flagella in adherence.


Performance evaluation of digital breast tomosynthesis systems: comparison of current virtual clinical trial methods.
Virtual clinical trials (VCT) have been developed by a number of groups to study breast imaging applications, with the focus on digital breast tomosynthesis imaging. In this review, the main components of these simulation platforms are compared, along with the validation steps, a number of practical applications and some of the limitations associated with this method. VCT platforms simulate, up to a certain level of detail, the main components of the imaging chain: the x-ray beam, system geometry including the antiscatter grid and the x-ray detector. In building VCT platforms, groups use a number of techniques, including x-ray spectrum modelling, Monte Carlo simulation for x-ray imaging and scatter estimation, ray tracing, breast phantom models and modelling of the detector. The incorporation of different anthropomorphic breast models is described, together with the lesions needed to simulate clinical studies and to study detection performance. A step by step comparison highlights the need for transparency when describing the simulation frameworks. Current simulation bottlenecks include resolution and memory constraints when generating high resolution breast phantoms, difficulties in accessing/applying relevant, vendor specific image processing and reconstruction methods, while the imaging tasks considered are generally detection tasks without search, evaluated by computational observers. A number of applications are described along with some future avenues for research.


Re-Starting the Cruise Sector during the COVID-19 Pandemic in Greece: Assessing Effectiveness of Port Contingency Planning.
Coronavirus disease (COVID-19) outbreaks on board cruise ships early in the pandemic highlighted gaps worldwide in public health emergency contingency plans (PHECPs) for responding to unknown threats. To restart cruise operations in 2021 and respond to potential COVID-19 outbreaks, a major tourist-based Greek island port (Port A) developed a COVID-19 PHECP. We assessed plan effectiveness by reviewing epidemiological data and monitoring outcomes, followed by an intra-action review (IAR) analyzing three event responses. From May to December 2021, 118 calls from 23 cruise ships with 119,930 passengers were recorded, with 29 COVID-19 cases in 11 cruises on board 7 ships. No outbreak was recorded during the study period. Strengths of the introduced PHECP included commitment of senior management; a core multi-disciplinary team of local authorities/ship agents involved in design and execution; interoperability agreements for port and ships' PHECPs; cruise industry commitment to compliance; and pre-existing scenarios considering capacity needs. Central government coordination for preparedness planning at local ports is essential for successful responses. Monitoring local and country level response capacities is critical to inform planning, risk assessment, and decision-making. Immediately recording ports' response actions provides the basis to capture lessons and improve contingency plans. To facilitate communication and common response protocols between European and non-European ports, IARs should be conducted between countries.


Arthroscopic rotator cuff repair with and without acromioplasty in the treatment of full-thickness rotator cuff tears: a multicenter, randomized controlled trial.
The primary objective of this prospective randomized controlled trial was to compare functional and quality-of-life indices and rates of revision surgery in arthroscopic rotator cuff repair with and without acromioplasty. Eighty-six patients consented and were randomly assigned intraoperatively to one of two study groups, and sixty-eight of them completed the study. The primary outcome was the Western Ontario Rotator Cuff (WORC) index. Secondary outcome measures included the American Shoulder and Elbow Surgeons (ASES) shoulder assessment form and a count of revisions required in each group. Outcome measures were completed preoperatively and at three, six, twelve, eighteen, and twenty-four months after surgery. WORC and ASES scores improved significantly in each group over time (p < 0.001). There were no differences in WORC or ASES scores between the groups that had arthroscopic cuff repair with or without acromioplasty at any time point. There were no differences in scores on the basis of acromion type, nor were any interaction effects identified between group and acromion type. Four participants (9%) in the group that had arthroscopic cuff repair alone, one with a Type-2 and three with a Type-3 acromion, required additional surgery by the twenty-four-month time point. The number of patients who required additional surgery was greater (p = 0.05) in the group that had arthroscopic cuff repair alone than in the group that had arthroscopic cuff repair and acromioplasty. Our findings are consistent with previous research reports in which there was no difference in functional and quality-of-life indices for patients who had rotator cuff repair with or without acromioplasty. The higher reoperation rate was found in the group without acromioplasty. Further study that includes follow-up imaging and patient-reported outcomes over a greater follow-up period is needed.


Comparison of Premium Technology Utilization in Total Hip Arthroplasty Between Safety-net Hospitals and Non-safety-net Hospitals.
The objective of our study was to investigate the association of safety-net hospital (SNH) status with the use of premium technologies in total hip arthroplasty (THA) using the American Academy of Orthopaedic Surgeons American Joint Replacement Registry. Premium technology was defined as having one or more of the following three characteristics: ceramic femoral head, dual mobility (DM) bearing, or surgery conducted with robotic assistance (RA). Patients of all ages were included and subdivided into ceramic femoral head, DM, and RA cohorts. SNH status (based on disproportionate share data), patient demographics, geographical region, hospital size, and teaching affiliation were assessed. Multivariate regression analysis was conducted to analyze any notable associations. A total of 624,933 THAs between SNHs and non-SNHs were available for analysis. Based on the three different premium technology categories, there were 551,838 THAs for ceramic femoral head utilization analysis, 601,223 THAs for DM utilization analysis, and 199,250 THAs for RA utilization analysis. SNHs were associated with less use of DM and RA (odds ratio [OR] 0.53 P < 0.0001, 0.39 P < 0.0001, respectively). No difference was observed in ceramic femoral head utilization between SNHs and non-SNHs. Patient age was significantly associated with less utilization of all three premium THA technologies (ceramic: OR 0.43 P < 0.0001; DM: OR 0.93 P < 0.0001, RA: OR 0.89 P < 0.001). Teaching hospitals were significantly associated with increased utilization of premium THA technologies (ceramic: OR 1.23 P < 0.0001, DM: OR 1.62 P < 0.0001, RA: OR 5.33 P < 0.001). Premium THA technologies are becoming increasingly used across the US healthcare system; however, that growth is not equal in hospitals with marginalized patient populations. The utilization of ceramic femoral heads is becoming increasingly common across healthcare systems suggesting that ceramic femoral heads may no longer be considered premium technology but rather standard THA care. Level III.


LETM1, deleted in Wolf-Hirschhorn syndrome is required for normal mitochondrial morphology and cellular viability.
Wolf-Hirschhorn syndrome (WHS) is a complex congenital syndrome caused by a monoallelic deletion of the short arm of chromosome 4. Seizures in WHS have been associated with deletion of LETM1 gene. LETM1 encodes for the human homologue of yeast Mdm38p, a mitochondria-shaping protein of unclear function. Here we show that human LETM1 is located in the inner membrane, exposed to the matrix and oligomerized in higher molecular weight complexes of unknown composition. Down-regulation of LETM1 did not disrupt these complexes, but led to DRP1-independent fragmentation of the mitochondrial network. Fragmentation was not associated with changes in the levels of respiratory chain complexes, or with obvious or latent mitochondrial dysfunction, but was recovered by nigericin, which catalyzes the electroneutral exchange of K+ against H+. Down-regulation of LETM1 caused 'necrosis-like' death, without activation of caspases and not inhibited by overexpression of Bcl-2. Primary fibroblasts from a WHS patient displayed reduced LETM1 mRNA and protein, but mitochondrial morphology was surprisingly unaffected, raising the question of whether and how WHS patients counteract the consequences of monoallelic deletion of LETM1. LETM1 highlights the relationship between mitochondrial ion homeostasis, integrity of the mitochondrial network and cell viability.


Serological and Molecular Evidence of Patients Infected with Anaplasma phagocytophilum in Mexico.
Human granulocytic Anaplasmosis (HGA), is a tick-borne infectious disease transmitted by ticks, resulting in acute feverish episodes. The etiological agent is the bacteria Anaplasma phagocytophilum; which is spread by ticks of the genus Ixodes spp. to complete its life cycle. In Mexico, there is only one case report. The primary challenge is understanding how other bacteria affect or overlap with the clinical manifestation of the disease. Sample collection occurred over the period September 2017 through October 2019. Blood samples from human subjects were obtained immediately after they signed consent forms. We analyzed for the presence for A. phagocytophilum by serological (IFA IgG two times) and PCR targeting 16SrRNA and groEL genes, followed by DNA sequencing. All patients with a history of travel abroad were dismissed for this project. In total, 1924 patients participated and of these, 1014 samples across the country were analyzed. Of these, 85 (8.38%) had IFA results that ranged from 1:384 to 1:896. Of the positive samples, 7.10% were used for PCR. Significant clinical manifestations included: dizziness, nausea, petechial, epistaxis, enlarged liver and/or spleen and thrombocytopenia. Hospitalization of at least 1.5 days was necessary for 3.2% of patients. None of the cases analyzed were lethal. This is the first clinical manifestations along with serological test results and molecular analysis confirmed the presence of A. phagocytophilum resulting in HGA in patients from Mexico. Health institutions and medical practitioners in general should include diagnostic testing for HGA among high risk populations and should recognize it as a vector-borne emerging infectious disease in Mexico.


Molecular dynamics simulations of the transport of reactive oxygen species by mammalian and plant aquaporins.
Aquaporins are responsible for water transport across lipid membranes. They are also able to transport reactive oxygen species, playing an important role in redox signaling. Certain plant aquaporins have even the ability to be regulated by oxidative stress. However, the underlying mechanisms are still not fully understood. Here, molecular dynamics simulations were employed to determine the activation free energies related to the transport of reactive oxygen species through both mammalian and plant aquaporin models. Both aquaporins may transport hydrogen peroxide (H2O2) and the protonated form of superoxide radicals (HO2). The solution-to-pore transfer free energies were low for small oxy-radicals, suggesting that even highly reactive hydroxyl radicals (HO) might have access to the pore interior and oxidize amino acids responsible for channel selectivity. In the plant aquaporin, no significant change in water permeability was observed upon oxidation of the solvent-exposed disulfide bonds at the extracellular region. During the simulated time scale, the existence of a direct oxidative gating mechanism involving these disulfide bonds could not be demonstrated. Simulation results may improve the understanding of redox signaling mechanisms and help in the interpretation of protein oxidative labeling experiments.


Pain experience in hospitalized adults with sickle cell disease.
Adult patients with sickle cell disease often report high pain intensity ratings during hospitalization. However, no evidence of upward titration in analgesics was found particularly during prolonged episodes. Development of algorithms to facilitate decisions regarding titration of medications is recommended.


Water-Quality Trends in the Nation's Rivers.
Water-quality records from two nationwide sampling networks now permit nationally consistent analysis of long-term water-quality trends at more than 300 locations on major U.S. rivers. Observed trends in 24 measures of water quality for the period from 1974 to 1981 provide new insight into changes in stream quality that occurred during a time of major changes in both terrestrial and atmospheric influences on surface waters. Particularly noteworthy are widespread decreases in fecal bacteria and lead concentrations and widespread increases in nitrate, chloride, arsenic, and cadmium concentrations. Recorded increases in municipal waste treatment, use of salt on highways, and nitrogen fertilizer application, along with decreases in leaded gasoline consumption and regionally variable trends in coal production and combustion during the period appear to be reflected in water-quality changes.


Observational case-control study of small-fiber neuropathies, with regards on smoking and vitamin D deficiency and other possible causes.
Small fiber neuropathies (SFNs) are disorders of skin nerve endings inducing pruritus, burning pain, numbness, and paresthesia. The aims of this study were to search for putative etiologies of SFN and their occurrence in a cohort of patients and to compare patients with SFN to a group of patients without SFN to highlight potential factors associated with SFN. This study was observational, retrospective, and monocentric. All patients with symptoms of SFN who underwent skin biopsies with intraepidermal nerve density counts were included. Patients with a count lower than 5 percentiles were considered to be in the SFN group. Other patients were considered to be the control group. A total of 162 patients with SFN and 161 controls were included. No cause was identified for 108 patients (61.7%). The established causes were autoimmune diseases (9.1%), diabetes or glucose intolerance (8%), medication (4%), liver disease (3.4%), and monoclonal gammopathy of undetermined significance (2.9%). Current or former smokers were more numerous in the SFN group (26.5%) than in the control group (16.1%), while vitamin D amounts were significantly lower in the SFN group than in the control group. Hence, tobacco smoking and vitamin D deficiency might be new putative causes of SFN.


A New Mathematical Model of Functionally Graded Porous Euler-Bernoulli Nanoscaled Beams Taking into Account Some Types of Nonlinearities.
A new mathematical model of flexible physically (FN), geometrically (GN), and simultaneously physically and geometrically (PGN) nonlinear porous functionally graded (PFG) Euler-Bernoulli beams was developed using a modified couple stress theory. The ceramic phase of the functionally material was considered as an elastic material. The metal phase was considered as a physically non-linear material dependent on coordinates, time, and stress-strain state, which gave the opportunity to apply the deformation theory of plasticity. The governing equations of the beam as well as boundary and initial conditions were derived using Hamilton's principle and the finite difference method (FDM) with a second-order approximation. The Cauchy problem was solved by several methods such as Runge-Kutta from 4-th to 8-th order accuracy and the Newmark method. Static problems, with the help of the establishment method, were solved. At each time step, nested iterative procedures of Birger method of variable elasticity parameters and Newton's method were built. The Mises criterion was adopted as a criterion for plasticity. Three types of porosity-dependent material properties are incorporated into the mathematical modeling. For metal beams, taking into account the geometric and physical nonlinearity, the phenomenon of changing the boundary conditions, i.e., constructive nonlinearity (CN) was found.


Assessment of the Antioxidant and Reactive Oxygen Species Scavenging Activity of Methanolic Extract of Caesalpinia crista Leaf.
"Oxidative stress" is initiated by reactive oxygen species (ROS), which are responsible for majority of the diseases. However, antioxidants with ROS scavenging ability may have great relevance in the prevention of oxidative stress. The present study was undertaken, using a 70% methanolic extract of Caesalpinia crista leaves, to examine different in vitro tests in diversified fields including total antioxidant activity, scavenging activities for various ROS, iron chelating activity and phenolic and flavonoid contents. Total antioxidant activity was evaluated as trolox equivalent antioxidant capacity value of 0.546 ± 0.014. The extract was investigated for different ROS scavenging activities and IC(50) values were found to be 0.44 ± 0.1 mg/ml, 24.9 ± 0.98 μg/ml, 33.72 ± 0.85 μg/ml, 61.13 ± 3.24 μg/mL and 170.51 ± 4.68 μg/mL for hydroxyl, superoxide, nitric oxide, singlet oxygen and hypochlorous acid, respectively; however, no significant results were obtained in scavenging of hydrogen peroxide and peroxynitrite anion. The extract was found to be a potent iron chelator with IC(50) = 279.85 ± 4.72 μg/mL. The plant extract (100 mg) yielded 50.23 ± 0.003 mg/mL gallic acid equivalent phenolic content and 106.83 ± 0.0003 mg/mL quercetin equivalent flavonoid content. In the in vivo experiments, the extract treatment showed significant increase in the level of superoxide dismutase, catalase, glutathione-S-transferase and reduced glutathione. In a word, it may be concluded that 70% methanol extract of C. crista leaves acts as an antioxidant and ROS scavenger; which may be due to the presence of phenolic and flavonoid compounds.


Verification of chemical composition of commercially available propolis extracts by gas chromatography-mass spectrometry analysis.
Propolis is a resin that is collected by honeybees from various plant sources. Due to its pharmacological properties, it is used in commercial production of nutritional supplements in pharmaceutical industry. In this study, gas chromatography-mass spectrometry was applied for quality control analysis of the three commercial specimens containing aqueous-alcoholic extracts of bee propolis. More than 230 constituents were detected in analyzed products, including flavonoids, chalcones, cinnamic acids and their esters, phenylpropenoid glycerides, and phenylpropenoid sesquiterpenoids. An allergenic benzyl cinnamate ester was also identified in all tested samples. This analytical method allows to evaluate biological activity and potential allergenic components of bee glue simultaneously. Studies on chemical composition of propolis samples may provide new approach to quality and safety control analysis in production of propolis supplementary specimens.


[Cementless hip prosthesis design: a basic study and analysis of the proximal femur in normal Japanese people].
Using CT images the proximal part of 50 femora was morphologically analysed in 28 normal Japanese adults. The purpose was to determine the normal stem size and shape in order to manufacture an artificial hip joint. The results were as follows: 1) The periosteal shape and the size of the normal femur were proportional. 2) The endosteal shape and the size of the normal femur were less proportional than the periosteal shape and size. 3) The endosteal width 20 mm distal from the lesser trochanter of the normal femur was 18.2 +/- 2.7 mm. 4) The femoral head offset of the normal femur was 41.8 +/- 4.8 mm. 5) The taper angle was 4.9 degrees on average, but the tapering of the proximal medullary canal was different from the tapering of the distal medullary canal.


[Preparation methods for morphological analysis of vessel alterations in the neck ].
A technique is described for the preparation of combined morphological analyses of the arteries in the neck region: In situ fixation after opening of thorax and head and perfusion with electrolyte solution. Expansion of the vessel wall during the fixation by means of an especially elaborated experimental procedure. Presentation of a basic preparation for optimization and standardization of endothelial lesions, discussions to integrate the procedure into a medicolegal autopsy.


Prevalence and risk factors associated with Tritrichomonas foetus infection in cattle in the state of Paraíba, Brazil.
The objective of this study was to determine the prevalence of Tritrichomonas foetus infection and to evaluate risk factors associated with this infection among cattle in the state of Paraíba in northeastern Brazil. Samples of cervicovaginal mucus from 290 females and smegma from 59 males [beef, 31; mixed aptitude (beef and dairy), 10; and dairy, 18] from 31 farms were collected. Modified Diamond's medium and polymerase chain reaction (PCR) were used for the laboratory diagnosis of T. foetus infection. Univariate analysis and logistic regression were performed to test for potential risk factors in addition to prevalence mapping. No sample was positive for T. foetus in culture, and the prevalence of T. foetus infection using PCR was 3.7% (13/349) [confidence interval (CI) 95%, 2.1%-6.4%]. In total, 19.3% (6/31) of the farms had at least one animal positive for T. foetus. The contact of females with males from other farms [Odds ratio, 5.9; 95% CI, 1.5-22.4; p = 0.009] was identified as a risk factor for T. foetus infection. This study demonstrates that T. foetus infection is prevalent among dairy cows in the state of Paraíba, Brazil. Sexual resting, removal of positive females, and avoiding contact of females with males from other farms are recommended to reduce the risk of infection.


Early Influence of the COVID-19 Pandemic on Volunteer Water Monitoring Programs in the United States and Canada.
Volunteer water monitoring programs generate new scientific knowledge, contribute data to decision-making processes, and increase social networks, technical knowledge, and skills of participants. Declaration of the COVID-19 pandemic threatened the ability of these programs to continue to engage volunteers to achieve such outcomes. A national water monitoring network hosted a brainstorming webinar to facilitate communication across programs to identify potential solutions to pandemic-influenced challenges. Following that webinar, a survey of United States and Canadian volunteer monitoring programs that was conducted about 3 months into the pandemic revealed that 72% of 80 responding programs planned to carry on through the 2020 field season despite most having experienced delayed starts. Other common program modifications implemented in the first months of the pandemic included adding COVID-19 safety information to program guidance, changing field team composition, monitoring timing and logistics, and adopting new communications strategies. Most programs reported loss or anticipated loss in number of data observations (74%) and volunteers (66%), while 44% reported known or anticipated losses in funding. Seventeen percent of responding programs were able to swiftly develop distance learning tools to train participants, which led to increased program capacity to reach broader audiences.


Practice Competition and Treatment of Newly Diagnosed Prostate Cancer.
To examine the effect of urology practice market competition on use of treatment in men with newly diagnosed prostate cancer. We performed a retrospective national cohort study of 48,067 Medicare beneficiaries with newly diagnosed prostate cancer between 2014 and 2018. The primary exposure was urology practice-level market competition. Markets were established by the flow of patients to a practice using a variable radius approach. Practice level competition was measured annually using the Herfindahl-Hirschman Index. The primary outcome was use of treatment for prostate cancer (ie, surgery, radiation, or cryotherapy) stratified by 10-year risk of noncancer mortality. Between 2014 and 2018, there was a decrease in the total percent of urologists practicing in small single-specialty groups (49%-41%) with an increase in multispecialty practices (38%-47%). After adjusting for demographic and clinical characteristics, a lower percentage of men underwent treatment in practices with low competition relative to those managed in practices with high competition (70% vs 67.0%, P < .001). Among men with the highest risk of noncancer mortality, those managed in practices in the least competitive markets were less likely to receive treatment relative to men managed by practices in the most competitive markets (48% vs 60%, P-value<.001). Reduction in competition between urology practices is not associated with greater use of treatment in men with newly diagnosed prostate cancer, particularly in those with a high risk of noncancer mortality.


REPRODUCIBILITY OF SCHATZKER CLASSIFICATION THROUGH SMARTPHONE APPLICATIONS.
To evaluate the intra-observer reproducibility of Schatzker classification for tibial plateau fractures through smartphone applications. Radiographs were evaluated in two incidences (anteroposterior and profile) and CT slices (axial, sagittal and coronal) of 37 patients with tibial plateau fracture. Two evaluators, knee surgery experts, classified the cases by viewing the images of the isolated radiographs and then X-rays associated with CT slices in four different stages via smartphones and then presential assessment. Data were statistically analyzed with the Kappa coefficient (k). There was intra-observer agreement by comparing the two methods of evaluation: display or via smartphone, and the analysis made showed statistical significance. The use of smartphones did not affect the reliability of Schatzker classification. Level of Evidence III, Diagnostic Study - Investigating a Diagnostic Test.


[Clinical studies of cefoxitin with special reference to pulmonary suppuration and pyothorax with respiratory tract infection].
Cefoxitin (CFX) was administered to 12 patients with respiratory tract infections, including mainly patients with pulmonary suppuration or pyothorax. The results were as follows: CFX was effective in 75% of the total patients, and in 83% of the 6 patients with pulmonary suppuration or pyothorax. Microorganisms which were considered to be causative were isolated in 8 of 12 patients. Bacteriological responses were "eradicated" in 4 patients, "replaced" in 3 patients, "unchanged" in 1 patient. A slight elevation of S-GPT was observed in one patient and elevation of A1-P in another following CFX administration; however, these values returned to normal shortly after completion of drug administration. No adverse effects, allergic symptoms or laboratory abnormalities were observed.


Reduction of carboxylic acids by Nocardia aldehyde oxidoreductase requires a phosphopantetheinylated enzyme.
Aldehyde oxidoreductase (carboxylic acid reductase (Car)) catalyzes the magnesium-, ATP-, and NADPH-dependent reduction of carboxylic acids to their corresponding aldehydes. Heterologous expression of the car gene in Escherichia coli afforded purified recombinant enzyme with a specific activity nearly 50-fold lower than that of purified native Nocardia sp. enzyme. The 5-fold increase in specific activity obtained by incubating purified recombinant Car with CoA and Nocardia cell-free extracts indicated that post-translational phosphopantetheinylation of Car is required for maximum enzyme activity. Nocardia phosphopantetheine transferase (PPTase) expressed in E. coli was isolated and characterized. When incubated with [(3)H]acetyl-CoA and Nocardia PPTase, the labeled acetylphosphopantetheine moiety was incorporated into recombinant Car. Coexpression of Nocardia Car and PPTase in E. coli gave a reductase with nearly 20-fold higher specific activity. Site-directed mutagenesis in which Ser(689) was replaced with Ala resulted in an inactive Car mutant. The results show that Car expressed in Escherichia coli is an apoenzyme that is converted to a holoenzyme by post-translational modification via phosphopantetheinylation. Doubly recombinant resting E. coli cells efficiently reduce vanillic acid to vanillin.


Cell block is a valuable adjunct to conventional smear for thyroid fine needle aspiration: 2395 cases with histological correlation.
Conventional smears (CS) of samples obtained by fine needle aspiration (FNA) have proven useful in thyroid nodules evaluation, but the additional contribution of cell block (CB) has only been investigated in a limited fashion. In this study, we aimed to evaluate whether the auxiliary application of CB adds to the diagnostic accuracy of the CS by a College of American Pathologists-accredited hospital laboratory. All thyroid FNA samples processed with CS only or combined CB and CS in West China Hospital from January 2011 to December 2015 were retrospectively collected. All specimens were classified according to Bethesda System, and the distribution of Bethesda (2009) categories was compared between CS and combined CS and CB. Further, we compared the diagnostic performance between these two groups for nodules with follow-up histopathology. A total of 11 011 thyroid nodules from 10 206 patients were included. Of these, 2395 nodules from 2211 patients underwent surgical resection. The unsatisfactory rate decreased significantly from 18.1% to 9.8% in the total group and from 1.7% to 0.8% in the group with surgery after combined use of CS and CB. The proportion of atypia/follicular lesion of undetermined significance also declined slightly. Furthermore, all of the sensitivities, specificities, accuracies and positive predictive values increased significantly after the combined use of CS and CB for different calculation methods. Combined use of CS and CB can significantly decrease the unsatisfactory rate of thyroid FNAs, improve the diagnostic efficacy, and thus should be routinely applied in thyroid nodule evaluation if available.


Regulation of steroid 21-hydroxylation by 17 beta-estradiol in rat liver: in vivo and in vitro study.
In various extraadrenal organs, progesterone (P4) is converted to deoxycorticosterone (DOC) by steroid 21-hydroxylation. To investigate the regulation of extraadrenal 21-hydroxylase activity by 17 beta-estradiol (E2), the following two experiments were performed. Exp. 1). Three-week-old male SD rats were testectomized (TX) and injected with E2 (1 mg) or sesame-oil s.c. Sham rats were treated with sesame-oil. In these groups the serum concentration of DOC and corticosterone (B), microsomal 21-Hydroxylase activity and the expression of P450c21 mRNA of the liver and the adrenals were analyzed. Exp. 2). Isolated rat hepatocytes were cultured and stimulated by E2, 10(-9) approximately 10(-5) M. 21-Hydroxylase activity of these cells was analysed by the rate of production of DOC in the medium containing P4. The results of experiment 1 showed that both serum DOC concentration and 21-hydroxylase activity in the liver microsomal fraction were increased by E2 injection, but the expression of P450c21 mRNA was not detected in the liver even after E2 injection. In experiment 2, the activity of steroid 21-hydroxylase in isolated rat hepatocytes was stimulated by E2 in a dose dependent manner. These data provided evidence that: in rats the liver was one sites of the extraadrenal steroid 21-hydroxylase activity which had been stimulated by E2. The results also suggested that this hepatic enzyme was a different enzyme from the steroid 21-hydroxylase P450c21 expressed in the adrenal gland.


Osmotic demyelination and hypertonic dehydration in a 9-year-old girl: changes in cerebrospinal fluid myelin basic protein.
A 9-year-old girl was admitted for the treatment of hyper-natremic dehydration. Her history was significant for psychogenic polydipsia, hyponatremia, and a renal concentrating defect. She presented with a 2-day history of altered mental status, ataxia, lethargy, fever, nausea, vomiting, and diarrhea. Meningitis was ruled out. Over the course of her illness, slow rehydration was maintained with a gradual decrease (10 mEq per 24 hours) of the serum sodium. Despite this care, she developed quadriparesis, and magnetic resonance imaging performed on day 6 of her illness was consistent with osmotic demyelination (central pontine myelinolysis). To rule out an excessively rapid correction of hypernatremia as the etiology of the problem, a myelin basic protein was measured in the cerebrospinal fluid that had been obtained on hospital day 1. The myelin basic protein was 649.50 ng/mL (normal, 0.07-4.10 ng/mL). The current literature is presented regarding the postulated pathogenesis of central pontine myelinolysis and suggested therapies, previous reports of central pontine myelinolysis in children are reviewed, and the potential role of myelin basic protein in its diagnosis is discussed.


Occlusion pressure-response in patients with chronic obstructive lung disease.
Occlusion pressure (P100) at rising inspiratory CO2 concentration was measured in 9 healthy adults and in two groups of patients with chronic obstructive lung disease, of which 29 had an arterial CO2 tension (PaCO2) of less than 43 mm Hg and 15 a PaCO2 of more than 43 mm Hg. Statistically the three groups could be separated significantly from each other in terms of occlusion pressure at rising alveolar CO2 tensions (PACO2). At a standard endexpiratory PACO2 of 60 mm Hg the absolute values of P100 of the obstructive patients with a normal PaCO2 are significantly higher than those of the two other groups. The differences in ventilatory response between the three groups are discussed.


Parents as partners in adolescent HIV prevention in Eastern and Southern Africa: an evaluation of the current United Nations' approach.
The United Nations's (UN) sustainable development goals (SDGs) include the target (3.3) of ending the HIV/AIDS epidemic by 2030. A major challenge in this regard is to curb the incidence of HIV among adolescents, the number two cause of their death in Africa. In Eastern and Southern Africa, they are mainly infected through heterosexual transmission. Research findings about parental influence on the sexual behavior of their adolescent children are reviewed and findings indicate that parental communication, monitoring and connectedness contribute to the avoidance of risky sexual behavior in adolescents. This article evaluates the extent to which these three dimensions of parenting have been factored in to current HIV prevention recommendations relating to adolescent boys and girls. Four pertinent UN reports are analyzed and the results used to demonstrate that the positive role of parents or primary caregivers vis-à-vis risky sexual behavior has tendentially been back-grounded or even potentially undermined. A more explicit inclusion of parents in adolescent HIV prevention policy and practice is essential - obstacles notwithstanding - enabling their indispensable partnership towards ending an epidemic mostly driven by sexual risk behavior. Evidence from successful or promising projects is included to illustrate the practical feasibility and fruitfulness of this approach.


Vascular smooth muscle relaxation by endothelium-dependent beta 1-adrenergic action.
1. Norepinephrine (NE) (10(-5) M) in rabbit aorta relaxed ring segments with endothelium precontracted with 10(-6) M NE, but not segments without endothelium. 2. The relaxation was inhibited with metoprolol and methylene blue, but not inhibited with yohimbine and indomethacin. 3. NE (10(-5) M) significantly elevated tissue c-GMP levels in segments with endothelium. 4. These studies suggest that the vascular relaxation by high doses of NE is mediated by the release of endothelium-derived relaxing factor (EDRF) induced by the stimulation of beta 1-adrenoceptor.


Color-flow doppler sonography in patients with subclinical thyroid dysfunction.
To assess the value of color-flow Doppler sonography (CFDS) in evaluating intrathyroidal blood flow and velocity in patients with subclinical thyroid dysfunction. In this prospective study, patients with subclinical hypothyroidism, patients with subclinical hyperthyroidism, and euthyroid patients without known thyroid autoimmune disease who served as controls were included. Subclinical thyroid dysfunction was defined as normal se-rum free thyroxine (FT4) and free triiodothyronine (FT3) in the presence of high (subclinical hypothyroidism), or low-suppressed (subclinical hyperthyroidism) serum thyrotropin (TSH) levels. Serum FT4, FT3, TSH, and antibodies to thyroid peroxidase and thyroglobulin were measured in all participants. In addition, TSH receptor antibody levels were determined in patients with subclinical hyperthyroid-ism. All participants underwent conventional sonography and CFDS. Mean peak systolic velocity (PSV) and resistive index were obtained from multiple extranodular thyroid parenchyma samplings and inferior thyroid artery measurements. The study population included 27 patients with subclinical hypothyroidism, 15 patients with subclinical hyperthyroidism, and 20 euthyroid patients. Patients with subclinical hypothyroidism had significantly higher mean intrathyroidal PSV values than control patients (19.9 +/- 5.6 cm/s vs 15.7 +/- 4.4 cm/s; P = .008), whereas patients with subclinical hyperthyroidism had significantly higher mean PSV values than control patients at the inferior thyroid artery level (29.7 +/- 10.7 cm/s vs 21.9 +/- 6.8 cm/s; P = .014). Compared with control patients, a greater proportion of patients with subclinical hypothyroidism and patients with subclinical hyperthyroidism had marked CFDS patterns (78% vs 15% [P<.001] and 53% vs 15%; [P<.001], respectively). A significant association was found between positivity for thyroid autoantibodies and intense CFDS patterns. No correlation was found between TSH or thyroid hormone levels and CFDS pattern or blood flow velocity. We have demonstrated that significantly increased thyroid blood flow velocity and vascularity are already present in patients with mild thyroid dysfunction.


High-Versatility Left Ventricle Pump and Aortic Mock Circulatory Loop Development for Patient-Specific Hemodynamic In Vitro Analysis.
The importance of experimental setups able to reproduce cardiac functions was well established in the field of clinical innovations. The mock circulatory loops acquired rising relevance, and the possibility to have a complete reproduction of different and specific fluid dynamic conditions within the setup is pivotal. A system with enough versatility to reproduce the physiologic range of both flows and pressures is required. This study describes the design of a versatile setup composed by a custom pulsatile left ventricular pump system and a 3D-printed mock circulatory loop for the in vitro analysis of a patient-specific case of an aortic complex. The performances of the pump were validated first with a set of test flow profiles. It was demonstrated that the system was able to cover a wide range of aortic and mitral flows. Second, the pump system was inserted within the full mock circulatory loop. A patient-specific case was reproduced, both in terms of flow and pressure profiles. A successful validation of the flow and pressure waveforms was obtained by using patient-specific in vivo data from magnetic resonance analysis.


Multiple diverticula of the ureter.
Multiple ureteral diverticula are rare and not previously reported in Scandinavian literature. Various etiologic factors have been considered. In our opinion, it is a congenital abnormality, not in itself demanding specific therapy. Diverticulosis ureteris is not seen at ordinary excretory pyelography, and only occasionally at a high volume excretory pyelography with compression. They are best visualized by retrograde pyelography, and the incidence may, therefore, be higher than hitherto anticipated.


Effect of streptozotocin-diabetes and insulin treatment on regulation of Leydig cell function in the rat.
The present study was performed to further clarify the possible role played by insulin deficiency on the steroidogenic capacity of the rat testis. Sprague-Dawley rats weighing 250-300 g were used in all experiments. Diabetes was induced by i.p. injection (40 mg/kg b.w.) of streptozotocin and was monitored at 2-day intervals by measuring body weight and serum glucose, glucosuria and ketonuria levels. The effect of insulin therapy on pituitary LH content and plasma LH concentrations, as well as on the cyclic AMP level in interstitial cell incubation medium and plasma testosterone concentrations, was measured 30 days after the induction of diabetes by radioimmunoassay. Streptozotocin-induced diabetes resulted in significantly reduced pituitary LH (16%, P less than 0.025) and plasma LH (34%, P less than 0.02); insulin treatment completely restored these levels. Similarly, the cyclic AMP content of interstitial cell incubation medium and the plasma testosterone concentrations were dramatically decreased in the diabetic state (50%, P less than 0.005 and 63%, P less than 0.025, respectively) and combined treatment with insulin plus hCG appeared slightly more effective than treatment with either of these hormones alone, suggesting a possible synergistic action. It is concluded that decreased testicular steroidogenesis in the diabetic rat may represent, at least in part, a direct consequence of insulin deficiency at the hypothalamic and/or pituitary levels. However, our findings would also be consistent with other reports suggesting that insulin may play a direct role in the rat testis.


Self-Assembly Properties and Aggregation Behavior of Amphiphilic Water-Dispersed Polyester with Different Contents of Sulfonate Groups in an Aqueous Solution.
Amphiphilic polymer water-dispersed polyester (WPET) has an important application value in the textile field. However, due to the potential interactions among water-dispersed polyester (WPET) molecules, the stability of their solution is susceptible to external factors. This paper focused on the self-assembly properties and aggregation behavior of amphiphilic water-dispersed polyester with different contents of sulfonate groups. In addition, the effects of WPET concentration, temperature, and Na+, Mg2+, or Ca2+ on WPET aggregation behavior were systematically investigated. The results show that compared with the low sulfonate group content of WPET, the high sulfonate group content of the WPET dispersion has higher stability with or without a high electrolyte concentration. In contrast, dispersions with low sulfonate group content are very sensitive to electrolytes and aggregate immediately at low ionic strength. WPET concentration, temperature, and electrolyte play important and complex roles in controlling the self-assembly properties and aggregation behavior of the WPET. The increase in WPET concentration can promote the self-assembly of WPET molecules. With the increase in temperature, the self-assembly properties for water-dispersed WPET are significantly reduced, resulting in enhanced stability. In addition, the electrolytes Na+, Mg2+, and Ca2+ in the solution can significantly accelerate the aggregation of WPET. This fundamental research on the self-assembly properties and aggregation behavior of WPETs can be used to effectively control and improve the stability of WPET solutions and provide guidance for the prediction of stability for WPET molecules not yet synthesized.