Interest in Telerehabilitation Among Patients with Mild to Severe Multiple Sclerosis: Results of the Czech Republic.
Background: Research in telerehabilitation (TR) in neurology tends to focus on patients with low to moderate disability. For neurology patients with severe mobility limitations, TR can help to enable rehabilitation for people whose mobility limitations make it difficult for them to access rehabilitation facilities. The aim of this study is to evaluate the interest of people with neurological disability caused by multiple sclerosis (MS) in TR services. Methods: This electronic survey targeted individuals with MS, specifically those with a higher level of disability. Results: A total of 355 patients with MS (155 with severe disabilities) participated in this study. There was no difference in interest in rehabilitation between people with mild-to-moderate and severe disabilities (p = 0.1258, confidence interval [CI] = 95%). However, we found a higher interest in upper limb exercises (p = 0.0006, CI = 95%) and balance training (p = 0.0000, CI = 95%) among people with higher disability. Conclusion: The results of this study may help to improve the planning and targeting of TR interventions, where a different focus of intervention is appropriate for patients with different levels of disability. This may enable TR to be maximally tailored to patient capabilities and current greatest limitations. For example, for people with severe disabilities, it is appropriate to focus on training the upper limb function to maintain self-sufficiency and implement interventions to prevent falls.


Three-dimensional videomonitor in microsurgery.
The operation microscope was equipped with two small camera heads on both sides, with a 35-mm still camera, and with or without a binocular observer tube. These camera heads were connected with a 3-dimensional (3D) converter. The operator can observe the 3D images of the operation field on a TV monitor through polarization glasses. The microscope with two camera heads is easy to handle because these camera heads are small and light. This is a promising monitoring system for microsurgery.


A Stroop effect for spatial orientation.
The author investigated the conditions under which a congruent or incongruent orientation word affects processing of the orientation of visual objects. Participants named the orientation of a rectangle that partially occluded another rectangle. Congruent or incongruent orientation words appeared in the relevant object, in the irrelevant object, or in the background. There were two main results. First, congruent orientation words produced faster orientation-naming responses than incongruent orientation words. This finding constituted a new Stroop effect for spatial orientation. Second, only words in the relevant (i.e., attended) object produced Stroop effects, whereas words outside the relevant object had no significant effects. This object-dependent modulation of Stroop effects resembled previous findings with color-naming tasks, and hence indicated that these modulations are not restricted to a particular type of task. In summary, results suggested that object-based attention plays an important role in processing of irrelevant words.


Prompts to increase physical activity at points-of-choice between stairs and escalators: what about escalator climbers?
Since 1980, many studies have evaluated whether stair-use prompts increased physical activity by quantifying changes in stair use. To more completely evaluate changes in physical activity, this study addressed the often-overlooked assessment of climbing up escalators by evaluating the degree to which stair-use sign prompts increased active ascent-defined as stair use or escalator climbing. Over 5 months, at an airport stairs/escalator point of choice, we video-recorded passersby (N = 13,544) who ascended either stairs or escalators, on 10 days with signs and 10 days without signs. Ascenders using the stairs, standing on the escalator, and climbing the escalator were compared on days with versus without signs using multivariable logistic regression. The percentage of ascenders on days with versus without signs were as follows: stair use, 6.9 versus 3.6 percent; escalator standing, 75.2 versus 76.0 percent; and escalator climbing, 18.5 versus 20.4 percent. Signs more than doubled the odds of stair use (vs. escalator use; OR = 2.25; 95% CI = 1.90-2.68; p < .001). Signs decreased the odds of escalator climbing (vs. escalator standing or stair use); OR = 0.90; 95% CI = 0.82-0.99; p = .028). Signs increased the odds of active ascent versus escalator standing by 15 percent (OR = 1.15; 95% CI = 1.05-1.25; p = .002). Although stair-use prompts increased stair use more than twofold (125%), they increased active ascent by only 15 percent, partly because escalator climbing-a behavior not targeted by the intervention-decreased. Although our results corroborated the established consensus that point-of-choice prompts increase stair use, future studies should test interventions designed to increase active ascent.


Circulating IGF1 regulates hippocampal IGF1 levels and brain gene expression during adolescence.
GH and its anabolic mediator, IGF1, are important not only in somatic growth but also in the regulation of brain function. Even though GH treatment has been used clinically to improve body composition and exercise capacity in adults, its influence on central nervous system function has only recently been recognized. This is also the case for children with childhood-onset GH deficiency (GHD) where GH has been used to stimulate bone growth and enhance final adult height. Circulating IGF1 is transported across the blood-brain barrier and IGF1 and its receptors are also synthesized in the brain by neurons and glial and endothelial cells. Nevertheless, the relationship between circulating IGF1 and brain IGF1 remains unclear. This study, using a GH-deficient dwarf rat model and peripheral GH replacement, investigated the effects of circulating IGF1 during adolescence on IGF1 levels in the brain. Our results demonstrated that hippocampal IGF1 protein concentrations during adolescence are highly regulated by circulating IGF1, which were reduced by GHD and restored by systematic GH replacement. Importantly, IGF1 levels in the cerebrospinal fluid were decreased by GHD but not restored by GH replacement. Furthermore, analysis of gene expression using microarrays and RT-PCR indicated that circulating IGF1 levels did not modify the transcription of Igf1 or its receptor in the hippocampus but did regulate genes that are involved in microvascular structure and function, brain development, and synaptic plasticity, which potentially support brain structures involved in cognitive function during this important developmental period.


Folate content of Iranian breads and the effect of their fiber content on the intestinal absorption of folic acid.
Folate deficiency is a relatively uncommon disorder in central Iran. In order to explain this finding; the acid content of various Iranian breads was determined, since bread is the staple food in Iran. Tanok, the village wholemeal bread, has an average "free" folate content (without conjugase incubation) of 0.34 mug/g. Sangask and Bazari, leavened breads made from flours of high extraction rates and widely consumed in towns and cities, have aberage "free" folate contents of 0.38 and 0.71 mug/g, respectively. The folate content of these breads are significantly higher than that of white bread from refined flour (0.13 mug/g) or oatmeal bread (0.09 mug/g). Iranian breads also have a high content of indigestible fiber (1.6 to 4.2% of dry weight). Since substances within the bread, such as fiber, may interfere with folate absorption by the small intestine, sequential folate absorption tests (tritiated pterolymonoglutamic acid) were performed in four subjects with meals of increasing fiber content and fasting. No interference with folate absorption was found. Furthermore, in vitro studies did not demonstrate the formation of insoluble complexes between bread fiber and folic acid, which might indicate decreased availability.


Natural polypeptide scaffolds: beta-sheets, beta-turns, and beta-hairpins.
This paper provides an introduction to fundamental conformational states of polypeptides in the beta-region of phi,psi space, in which the backbone is extended near to its maximal length, and to more complex architectures in which extended segments are linked by turns and loops. There are several variants on these conformations, and they comprise versatile scaffolds for presentation of side chains and backbone amides for molecular recognition and designed catalysts. In addition, the geometry of these fundamental folds can be readily mimicked in peptidomimetics.


Associative plasticity in supplementary motor area - motor cortex pathways in Tourette syndrome.
The important role of the supplementary motor area (SMA) in the generation of tics and urges in Gilles de la Tourette syndrome (GTS) is underscored by an increased SMA-motor cortex (M1) connectivity. However, whether plasticity is also altered in SMA-M1 pathways is unclear. We explored whether SMA-M1 plasticity is altered in patients with Tourette syndrome. 15 patients with GTS (mean age of 33.4 years, SD = 9.9) and 19 age and sex matched healthy controls were investigated with a paired association stimulation (PAS) protocol using three transcranial magnetic stimulation (TMS) coils stimulating both M1 and the SMA. Standard clinical measures for GTS symptoms were collected. There was a significant PAS effect showing that MEP amplitudes measured in blocks during and after PAS were significantly higher compared to those in the first block. However, the degree of PAS was not differentially modulated between patients and controls as shown by a Bayesian data analysis. PAS effects in GTS correlated positively with the YGTSS motor tic severity. Plasticity previously reported to be altered in sensorimotor pathways in GTS is normal in SMA-M1 projections suggesting that the dysfunction of the SMA in GTS is not primarily related to altered plasticity in SMA-M1 connections.


An infant with acute gastroenteritis caused by a secondary infection with a Rotarix-derived strain.
Rotavirus vaccines have been successful in controlling severe diarrhea and have decreased deaths of young children globally. Rotarix and RotaTeq are the two currently available live-attenuated rotavirus vaccines. The vaccine virus can grow in a recipient's gut and spread from the vaccinee to naïve individuals. The potential for the emergence of revertant viruses is a concern with live-attenuated vaccines. We identified a previously healthy infant with severe acute gastroenteritis that was positive for rotavirus in a non-endemic season. A whole genome sequencing revealed that all of the viral genome segments were highly similar to those of the Rotarix virus, with the exception of five amino acid mutations in viral genes that could be associated with virulence. The younger sibling of this patient was administered Rotarix before the onset of disease in this patient, although no gastrointestinal symptoms were reported. Epidemiological data, circumstantial evidence, and the genome analysis suggest that the vaccine virus was transmitted from the vaccinee to the patient. This is a severe acute gastroenteritis case most probably attributed to the secondary infection of Rotarix-related virus without underlying diseases. The importance of molecular surveillance of rotavirus infections is discussed. What is Known: • The live-attenuated rotavirus vaccines, Rotarix and RotaTeq, have been successful in controlling severe diarrhea and have decreased deaths of young children globally. • Attenuated vaccine virus can grow in a recipient's gut and spread to naïve individuals and may revert to cause secondary symptomatic infections. What is New: • This is the first report describing a Rotarix-associated secondary infection resulting in severe acute gastroenteritis in an infant without underlying diseases. • Amino acid mutations that might contribute to viral pathogenesis were identified by whole genome sequencing.


Comparative genetic variability in HIV-1 subtype C nef gene in early age groups of infants.
Targeting properties of vertically transmitted viruses in early infancy is important to understand disease progression. To investigate genotypic characteristics of transmitted viruses, blood samples were obtained from infants aged 6 weeks-18 months, categorized in two age groups, acute (<6 months) and early (>6-18 months). Nef having an important role in pathogenesis was selected to explore the viral characteristics. A total of 57 PCR positive samples, amplified by nef gene were sequenced. Analysis showed that 50 sequences belonged to subtype C. In one sequence of acute age group, a long insertion of 10 residues (AAERMRRAEP) in variable region and a 13 residues deletion (ATNNADCAWLEAQ) around proteolytic cleavage region of gene in another sequence was observed. Insertions were also observed in sequences of early age group, however, they ranged from two to eight residues only. In one sequence of early age group, 3/4 arginines at positions 19, 21, 22 of arginine cluster were mutated to glutamine, alanine, and glutamine, respectively. Entropy analysis of two age groups revealed presence of several residues with statistically significant differences in their variability. Among these, 15 (R18,R23,R24; A66,L68,Q71; E74,E77,E78; V87,M92; R119, P144, E167, and C176) belonged to functional motifs, out of which, 12 were in acute age group, suggesting that variability was greater in this group. Prediction of HLA binding peptide motif revealed that epitope LTFGWCFKL was present in >80% study sequences. This epitope was also present in maximum number of HLA types circulating in India and vaccine candidate sequences, suggesting that it may be helpful in designing an epitope-based vaccine.


Measurement of the pregnant cervix by transvaginal sonography: an interobserver study and new standards to improve the interobserver variability.
Transvaginal sonography has become an important tool for assessing the gravid cervix uteri, especially in patients at risk for cervical incompetence and preterm delivery. The purpose of our prospective study was to evaluate interobserver variability in measurements of the cervical length and, as a second step, improve the reproducibility and interobserver discrepancy by the introduction of quality control standards when producing and measuring the image of the cervix. Before the introduction of these standards we obtained 46 measurements and observed a mean cervical length (internal to external os) of 33.7 mm (range 26-52 mm) and an interobserver average discrepancy of 3.04 mm (range 0-6 mm). Later, measurements were obtained only when the following conditions were assured and visualized on the screen: (1) the internal os is either flat or is an isosceles triangle; (2) the whole length of the cervical canal can be observed; (3) a symmetric image of the external os can be obtained; and (4) the distance from the surface of the posterior lip to the cervical canal is equal to the distance from the anterior lip to the cervical canal. After the implementation of these quality control standards, 70 measurements were performed obtaining a mean length of 35.3 mm (range 27-51) and an average interobserver discrepancy of 1.24 mm (range 0-4). Thus the measurement error was significantly lower following introduction of quality control standards. Furthermore, the coefficient of variation dropped from 7.1% to 3.3% after the introduction of the guidelines. We believe that these guidelines could be helpful by making the measurements of the cervical length more accurate, reducing the interobserver variability, improving the reproducibility and promoting the role of transvaginal sonography in monitoring the incompetent cervix.


A novel solution to the gated x-ray detector gain droop problem.
Microchannel plate (MCP), microstrip transmission line based, gated x-ray detectors used at the premier ICF laser facilities have a drop in gain as a function of mircostrip length that can be greater than 50% over 40 mm. These losses are due to ohmic losses in a microstrip coating that is less than the optimum electrical skin depth. The electrical skin depth for a copper transmission line at 3 GHz is 1.2 μm while the standard microstrip coating thickness is roughly half a single skin depth. Simply increasing the copper coating thickness would begin filling the MCP pores and limit the number of secondary electrons created in the MCP. The current coating thickness represents a compromise between gain and ohmic loss. We suggest a novel solution to the loss problem by overcoating the copper transmission line with five electrical skin depths (∼6 μm) of Beryllium. Beryllium is reasonably transparent to x-rays above 800 eV and would improve the carrier current on the transmission line. The net result should be an optically flat photocathode response with almost no measurable loss in voltage along the transmission line.


Charge Carrier Transport Through the Interface Between Hybrid Electrodes and Organic Materials in Flexible Organic Light Emitting Diodes.
We investigated the electronic properties of composite-type hybrid transparent conductive electrodes (h-TCEs) based on Ag nanowire networks (AgNWs) and indium tin oxide (ITO). These h-TCEs were developed to replace ITO, and their mechanical flexibility is superior to that of ITO. However, the characteristics of charge carriers and the mechanism of charge-carrier transport through the interface between the h-TCE and an organic material are not well understood when the h-TCE is used as the anode in a flexible organic light-emitting diode (f-OLED). AgNWs were spin coated onto polymer substrates, and ITO was sputtered atop the AgNWs. The electronic energy structures of h-TCEs were investigated by ultraviolet photoelectron spectroscopy. f-OLEDs were fabricated on both h-TCEs and ITO for comparison. The chemical bond formation at the interface between the h-TCE and the organic layer in f-OLEDs was investigated by X-ray photoelectron spectroscopy. The performances of f-OLEDs were compared based on the analysis results.


Clinical predictors of recurrent venous thromboembolism: a single institute experience in Korea.
Racial disparities in incidence rate as well as risk factors for venous thromboembolism (VTE) exist between Asian and Western populations. Moreover, predictors for recurrent VTE were not identified in Asians. Thus, this study was undertaken to investigate risk factors for recurrent VTE events in Korean people. Three hundred-three patients newly diagnosed as VTE were enrolled from Seoul National University Hospital. Recurrence rate based on risk factors for VTE were investigated. Cumulative incidence of recurrent VTE was calculated by the Kaplan and Meier method. Independent predictors for VTE were determined using Cox proportional hazards model. After a median follow-up of 44 months, 24 (8%) of 303 patients relapsed for a total observation time of 1,217 patient-year. Cumulative incidences of recurrent VTE were 3% at 1 year, 10% at 5 years, and 18% at 8 years. Independent predictors for recurrent VTE were presence of residual thrombosis (hazard ratio [HR]=3.1, 95% confidence interval [CI] 1.0-9.3; p=0.044), antiphospholipid syndrome (APS) (HR=4.3, 95% CI 1.0-19.0; p=0.052), and age 50 years or younger (HR=2.5, 95% CI 1.0-6.6; p=0.053) by multivariate analysis. Residual thrombosis and APS remained predictive of recurrence by the anticoagulation-period stratified analysis. In contrast to Western populations, Korean patients with VTE had the lower recurrent rate. Extended anticoagulation is necessary for Korean patients with residual thrombosis or APS.


Amniotic membrane transplantation with topical interferon alfa-2b after excision of ocular surface squamous neoplasia.
To evaluate the outcome of amniotic membrane transplantation (AMT) after tumor excision followed by topical interferon alfa-2b (IFNα2b) drops for primary ocular surface squamous neoplasia (OSSN). Twelve eyes of 12 patients with a mean age of 66±10y were included. The average follow-up was 23±10mo. All 12 patients had limbal involvement. Smooth ocular surface and transparent cornea were achieved in all cases. No sign of inflammation, neovascularization, symblepharon or recurrence was noted at the last follow-up. We conclude that AMT with topical IFNα2b drops restores a healthy ocular surface in OSSN without recurrence.


Characterization of the biliary and urinary glutathione and N-acetylcysteine metabolites of the hepatic carcinogen 1'-hydroxysafrole and its 1'-oxo metabolite in rats and mice.
The hepatocarcinogen safrole is metabolized both to 1'-hydroxysafrole, a proximate hepatocarcinogen, and to 1'-oxosafrole, which is electrophilic but has little or no carcinogenic activity in rats and mice. As a part of a study on the metabolic interrelationships of these metabolites, their biliary and urinary conjugates were investigated. Administration of a single i.p. dose of [2',3'-3H]-1'-oxosafrole to male Sprague-Dawley rats or female CD-1 mice with cannulated bile ducts resulted in the excretion of 2 major biliary metabolites. These metabolites were isolated by high-performance liquid chromatography and characterized by 1H-nuclear magnetic resonance spectroscopy as 3'-(glutathion-S-yl)-1'-oxo-2',3'-dihydrosafrole and 3'-(N-acetylcystein-S-yl)-1'-oxo-2',3'-dihydrosafrole. The latter conjugate was also found in the urine. These conjugates were synthesized by non-enzymatic reaction of 1'-oxosafrole with glutathione and N-acetylcysteine at pH 8. After a single i.p. dose of [2',3'-3H]-1'-hydroxysafrole, the major biliary and urinary metabolite in rats was the glucuronide of this alcohol. Lower levels of the glutathione and N-acetylcysteine conjugates of 1'-oxosafrole appeared in the bile, and the latter conjugate was also found in the urine. Similar findings were made on the biliary metabolites of 1'-hydroxysafrole in mice. Although the sulfuric acid ester of 1'-hydroxysafrole is the major metabolite leading to the formation of DNA adducts in the liver, it was, at most, of minor importance in the formation of glutathione adducts. Only a very small percentage of a dose of 1'-hydroxysafrole was excreted in the bile of rats or mice as products that cochromatographed with 1'-(glutathion-S-yl)-safrole and 3'-(glutathion-S-yl)-isosafrole; no 3'-(N-acetylcystein-S-yl)-isosafrole was detected. These latter conjugates were synthesized by nonenzymatic reactions at pH 8.5 of the model electrophilic ester 1'-acetoxysafrole with glutathione or N-acetylcysteine.


Travelling wave solutions for higher-order wave equations of kdv type (iii).
By using the theory of planar dynamical systems to the travelling wave equation of a higher order nonlinear wave equations of KdV type, the existence of smooth solitary wave, kink wave and anti-kink wave solutions and uncountably infinite many smooth and non-smooth periodic wave solutions are proved. In different regions of the parametric space, the sufficient conditions to guarantee the existence of the above solutions are given. In some conditions, exact explicit parametric representations of these waves are obtain.


Trio Wins Nobel for Hypoxia Discoveries.
William G. Kaelin Jr., MD; Sir Peter J. Ratcliffe, MD; and Gregg L. Semenza, MD, PhD, won this year's Nobel Prize in Physiology or Medicine for their research elucidating how cells sense and adapt to oxygen levels-work that not only is fundamental to biology, but also has clinical applications for a range of diseases, including cancer.


The Integrated Care for Kids Model: Addressing Fragmented Care for Pediatric Medicaid Enrollees in Seven Communities.
Children with complex health and behavioral health conditions face challenges accessing coordinated health and community-based services. Adverse childhood experiences (ACEs), social determinants of health, and care delivery silos can lead to negative long-term outcomes. This paper provides an update on the Integrated Care for Kids (InCK) model from the Centers for Medicare & Medicaid Services' Innovation Center and discusses barriers and facilitators to program implementation in the seven communities. The three core InCK activities-supported by flexible alternative payment models-are early identification, risk stratification, and service integration. Challenges include obtaining the appropriate Medicaid and Children's Health Insurance Program (CHIP) authorities, sharing data across non-traditional partners, assessing impact in non-clinical domains, and evaluating the program's impact on child health. InCK enables innovation in value-based purchasing by creating a guiding framework that allows states to design and implement a service delivery and payment model that accounts for the heterogeneity of Medicaid programs.


Presence of gonadotropin-releasing hormone-like proteins in bovine and ovine ovaries.
Recently, the rat ovary was shown to contain significant levels of a GnRH-like protein, but no detectable GnRH. In the present studies, extracts of bovine ovaries and ovine corpora lutea were examined for their content of both GnRH-like protein and GnRH. The GnRH-like proteins were detected with a rat ovarian membrane radioreceptor assay, and GnRH was detected with a specific GnRH RIA. The biological activity of the GnRH-like protein was evaluated with a rat luteal cell assay. GnRH-like activity, but not GnRH, was clearly present in extracts of the entire bovine ovary, bovine corpus luteum, bovine granulosa cells, and ovine corpus luteum. The highest levels of GnRH-like activity were present in granulosa cells. Neither GnRH-like activity nor GnRH was detected in extracts of bovine follicular fluid or bovine jugular plasma. Fractionation of the bovine and ovine GnRH-like proteins by reverse phase HPLC resulted in retention times similar to that of the rat ovarian GnRH-like protein, but distinctly different from that of authentic GnRH. The bovine and ovine GnRH-like fractions, like those in the rat, were sensitive to protease and heat. The bovine GnRH-like protein, obtained by preparative reverse phase HPLC, evoked a dose-dependent inhibition of LH-stimulated cAMP accumulation in rat luteal cells similar to that caused by GnRH. Based on these results, we suggest that the bovine ovary, granulosa cells, and corpus luteum and the ovine corpus luteum contain an antigonadotropic GnRH-like protein similar to the GnRH-like protein of the rat ovary. The presence of a similar GnRH-like protein (but the absence of GnRH) in ovaries of domestic species and the rat raises the possibility that this substance may play a paracrine antigonadotropic role in the ovary of diverse species.


Redirection of transfusion waste and by-products for xeno-free research applications.
Whole blood is processed to derive a red cell concentrate, plasma, and buffy coat (BC) (from which platelets can be further extracted). Unused plasma and BCs are common in most blood establishments and considered a liability. The redirection of these products to xeno-free applications is not complicated or time-consuming and cannot only benefit the research recipients but also the blood establishment suppliers interested in research collaboration. The aim of this study is to describe a diverse yet by no means an exhaustive list of options for preparing blood products for research applications. Plasma and BCs from healthy donors were processed using basic laboratory techniques under aseptic conditions and tested for their ability to support the culture of mesenchymal stem cells in both 2D and 3D cultures using fibrin clots. The white blood cells (WBC) from the BCs were induced by phytohemagglutinin and CD marker expression was monitored using quantitative polymerase chain reaction. All the methods tested for preparing blood products were successful but the applicability to different settings varied greatly with the most successful being the supplementation of Dulbecco's Modified Eagle Medium: Nutrient Mixture F-12 with 20% cryodepleted plasma and 0.1 mg/mL platelet lysate, the formation of fibrin clots using a ratio of 3:1 (medium: plasma) and the culturing of WBCs with 5 µg/mL phytohemagglutinin. Using the wastes and by-products of blood establishments for xeno-free cell culturing of stem cells will reduce the reliance on commercially available, ready-made products, and increasing the potential for therapeutic stem cell research. Despite the benefits presented both in terms of cost and applications, further characterization and optimization of each blood product for reproducibility of results is required. The availability of low-cost xeno-free reagents will speed up therapeutic stem cell research and allow patients to receive treatments of the expected high standards at lower costs.


A shower before bedtime may improve the sleep onset latency of youth soccer players.
During the competitive season, soccer players are likely exposed to numerous factors that may disrupt the process of sleep. The current investigation looked to evaluate a practical sleep hygiene strategy (10-min showering at ∼40°C before lights out), within a group of 11 youth soccer players in comparison to normal sleeping conditions (control). Each condition consisted of three days within a randomised crossover trial design. Sleep information was collected using a commercial wireless bedside sleep monitor. Measures of skin temperature were evaluated using iButton skin thermistors to establish both distal and proximal skin temperatures and distal to proximal gradient. The shower intervention elevated distal skin temperature by 1.1°C (95% CI: 0.1-2.1°C, p = .04) on average prior to lights out. The elevation in distal temperature was also present during the first 30-min following lights out (1.0°C, 95% CI: 0.4-1.6°C, p < .01). The distal to proximal gradient also showed a significant effect between the conditions within the first 30-min after lights out (0.7°C, 95% CI: 0.3-1.2°C, p < .01). On average the sleep latency of the youth soccer players was -7-min lower (95% CI: -13 to -2 min, p < .01) and sleep efficiency +2% higher (95% CI: 1-3%; p < .01) in the shower condition. These findings demonstrate that a warm shower performed before lights out may offer a practical strategy to promote thermoregulatory changes that may advance sleep onset latency and improve sleep efficiency in athletes.


Functional and structural vascular biomarkers in women 1 year after a hypertensive disorder of pregnancy.
Women with a previous hypertensive disorder of pregnancy (HDP: gestational hypertension and preeclampsia) have increased long-term cardiovascular disease risk. Recent meta-analyses show adverse levels of non-invasive functional and structural cardiovascular risk markers such as pulse wave velocity (PWV), heart-rate adjusted augmentation index (AIx75), carotid intima-media thickness (CIMT), and reactive hyperemia index (RHI) after HDPs, and suggest using these for cardiovascular risk stratification. However, it is not known if a previous HDP predict levels of these markers beyond classical cardiovascular risk factors. Study design and main outcome measures. We assessed PWV, AIx75, CIMT, RHI, classical cardiovascular risk factors, and pregnancy characteristics in 221 women 1 year postpartum (controls: 95, previous HDP: 126). Uni- and multi- variate regression analysis were conducted to assess associations between previous HDP and PWV, AIx75, CIMT or RHI. We adjusted for classical cardiovascular risk factors and pregnancy characteristics. A p-level < 0.05 was considered statistically significant. PWV was associated with previous HDP on univariate analysis. This effect was confounded by blood pressure and not significant after adjustment. We found no significant associations between AIx75, RHI, CIMT, and a previous HDP, neither before nor after adjustments. Associations between a previous HDP and PWV, AIx75, CIMT, or RHI 1 year postpartum can largely be explained by adverse levels of classical cardiovascular risk markers in women with a previous HDP. Women with previous HDP should receive primary prevention of cardiovascular disease, but PWV, AIx75, CIMT or RHI are unlikely to aid in cardiovascular risk stratification 1 year postpartum.


Red blood cell aggregation and dissociation in shear flows simulated by lattice Boltzmann method.
In this paper we develop a lattice Boltzmann algorithm to simulate red blood cell (RBC) behavior in shear flows. The immersed boundary method is employed to incorporate the fluid-membrane interaction between the flow field and deformable cells. The cell membrane is treated as a neo-Hookean viscoelastic material and a Morse potential is adopted to model the intercellular interaction. Utilizing the available mechanical properties of RBCs, multiple cells have been studied in shear flows using a two-dimensional approximation. These cells aggregate and form a rouleau under the action of intercellular interaction. The equilibrium configuration is related to the interaction strength. The end cells exhibit concave shapes under weak interaction and convex shapes under strong interaction. In shear flows, such a rouleau-like aggregate will rotate or be separated, depending on the relative strengths of the intercellular interaction and hydrodynamic viscous forces. These behaviors are qualitatively similar to experimental observations and show the potential of this numerical scheme for future studies of blood flow in microvessels.


Effect of biologicals and JAK inhibitors during pregnancy on health-related outcomes in children of women with inflammatory bowel disease.
Current guidelines advise to maintain immunomodulators and biologicals in pregnant patients because relapse of inflammatory bowel is associated with unfavourable pregnancy outcome. With the exception of Methotrexate, IBD therapy seems not to be related to an increase of congenital malformations or infections requiring hospitalisation of the babies, although the effect the on the developing immune system of the exposed infants remains unknown. In this review we will focus on the effect of IBD drugs on health-related outcomes in children taking into account possible long-term effects of biologicals and immunomodulators, which are transferred across the placenta.


[Dementia with motor and language disorders].
Memory is not the only core diagnostic criteria in Alzheimer's disease and many dementias are characterized by other cognitive deficits. Moreover dementias are often associated with multiple and complex motor signs. The first part of this reviewcovers parkinsonism in diffuse Lewy Body Disease and other neurodegenerative diseases, corticobasal syndrome, or motor deficit in the motoneurone disease-frontotemporal dementia spectrum. In the second part, primary progressive aphasia and its three variants including basic clinical evaluation are described. These complex clinical syndromes involving motor and language systems are important for the clinical practice since they are part of diagnostic criteria of several neurodegenerative diseases and can be considered as phenotypical markers of neurodegeneration.


Effect of neonatal nociceptin or nocistatin imprinting on the brain concentration of biogenic amines and their metabolites.
Noradrenaline (NA), dopamine (DA), homovanillic acid (HA), serotonin (5HT) and 5-hydroxyindole acetic acid (5HIAA) content of five brain regions (hypothalamus, hippocampus, brainstem, striatum and frontal cortex) and the cerebrospinal fluid (CSF) was measured in adult (three months old) male and female rats treated neonatally with a single dose of 10 microg nociceptin (NC) or 10 microg nocistatin (NS) for hormonal imprinting. The biogenic amine and metabolite content of cerebrospinal fluid was also determined. In NC treated animals the serotonergic, dopaminergic as well as noradrenergic systems were influenced by the imprinting. The 5HT level increased in hypothalamus, the 5HIAA tissue levels were found increased in hypothalamus. Hippocampus and striatum and the HVA levels increased highly significantly in brainstem. Dopamine level decreased significantly in striatum, however in frontal cortex both noradrenalin and 5HIAA level decreased. Nevertheless, in NS-treated rats decreased NA tissue levels were found in hypothalamus, brainstem and frontal cortex. Decreased DA levels were found in the hypothalamus, brainstem and striatum. NS imprinting resulted in decreased HVA level, but increased one in the brainstem. The 5HT levels decreased in the hypothalamus, brainstem, striatum and frontal cortex, while 5HIAA content of CSF, and frontal cortex decreased, and that of hypothalamus, hippocampus and striatum increased. There was no significant difference between genders except in the 5HT tissue levels of NC treated rats. Data presented show that neonatal imprinting both by NC and NS have long-lasting and brain area specific effects. In earlier experiments endorphin imprinting also influenced the serotonergic system suggesting that during labour release of pain-related substances may durably affect the serotonergic (dopaminergic, adrenergic) system which can impress the animals' later behavior.


Static Magnetic Field Stimulation over Parietal Cortex Enhances Somatosensory Detection in Humans.
The role of neuronal oscillations in human somatosensory perception is currently unclear. To address this, here we use noninvasive brain stimulation to artificially modulate cortical network dynamics in the context of neurophysiological and behavioral recordings. We demonstrate that transcranial static magnetic field stimulation (tSMS) over the somatosensory parietal cortex increases oscillatory power specifically in the alpha range, without significantly affecting bottom-up thalamocortical inputs indexed by the early cortical component of somatosensory evoked potentials. Critically, we next show that parietal tSMS enhances the detection of near-threshold somatosensory stimuli. Interestingly, this behavioral improvement reflects a decrease of habituation to somatosensation. Our data therefore provide causal evidence that somatosensory perception depends on parietal alpha activity.SIGNIFICANCE STATEMENT Artificially increasing alpha power by placing a powerful magnetic field over the somatosensory cortex overcomes the natural decline in detection probability of a repeated near-threshold sensory stimulus.


[A preliminary study on the correlation between clinical makers with the length of patients' hypertension history].
To investigate the correlation between length of hypertension history with plasma level of A Phospholipids Component with the Similar Solubility of Lyso-Phosphatidic Acid (APCSSLPA or briefly AP). So that to farther understand the changes accompanied with prolongation of hypertension history. This is a small cross-sectional study. 170 patients with primary hypertension and 79 normal controls without hypertension history were enrolled. The lengths of case history were recorded and compared with their plasma levels of AP. Similar study were also conducted on other 11 clinical makers as references. AP correlated significantly with the length of hypertension history. Correlation coefficient beta is 0.186, P = 0.015. But AP did not correlated significantly with systolic or diastolic pressure of patients. The age of patients did not correlated with AP either (beta = 0.027, P = 0.71). The patient's number with middle or high level of AP was significantly larger in the group in which hypertension history was 10 years or more, than in the group in which hypertension history was less then 10 years. chi(2) = 6.51, P = 0.012. OR = 2.444, 95%CI = 1.219 - 4.903. However, lysophosphatidic acid and other 10 bio-makers which often be used in cerebrovascular and cardiovascular diseases, such as blood lipid, blood sugar, different kinds of lipoprotein and D-dimer etc. did not correlated significantly with hypertension history. Comparing with 11 clinical makers, AP was the only one correlated with the length of hypertension history. Our findings suggest: the prolongation of hypertension history may accompanied with increased oxidative damages. The patients with prolonged hypertension history should prevent this possible threaten. Furthermore, AP is a very promising marker with unique worth in cardiovascular and cerebrovascular diseases.


A long-term follow-up study of Class II malocclusion correction after treatment with Class II elastics or fixed functional appliances.
The aim of this study was to compare dentofacial morphology and long-term follow-up changes in growing males with skeletal Class II malocclusions treated without extractions and with either Begg or Herbst appliances. Lateral cephalograms were obtained at the start of treatment, after active treatment, and after long-term follow-up. Treatment effects differed between the groups, with usually more favorable effects in the Herbst group. However, during the follow-up period, many of the changes were reversed. During the total observation period, maxillary prognathism and lower anterior facial height increased more in the Begg group than in the Herbst group. Although there were initial marked differences in the treatment outcomes, most of these differences were not sustained over the longer term.


Photogrammetry-Based Head Digitization for Rapid and Accurate Localization of EEG Electrodes and MEG Fiducial Markers Using a Single Digital SLR Camera.
The performance of EEG source reconstruction has benefited from the increasing use of advanced head modeling techniques that take advantage of MRI together with the precise positions of the recording electrodes. The prevailing technique for registering EEG electrode coordinates involves electromagnetic digitization. However, the procedure adds several minutes to experiment preparation and typical digitizers may not be accurate enough for optimal source reconstruction performance (Dalal et al., 2014). Here, we present a rapid, accurate, and cost-effective alternative method to register EEG electrode positions, using a single digital SLR camera, photogrammetry software, and computer vision techniques implemented in our open-source toolbox, janus3D. Our approach uses photogrammetry to construct 3D models from multiple photographs of the participant's head wearing the EEG electrode cap. Electrodes are detected automatically or semi-automatically using a template. The rigid facial features from these photo-based models are then surface-matched to MRI-based head reconstructions to facilitate coregistration to MRI space. This method yields a final electrode coregistration error of 0.8 mm, while a standard technique using an electromagnetic digitizer yielded an error of 6.1 mm. The technique furthermore reduces preparation time, and could be extended to a multi-camera array, which would make the procedure virtually instantaneous. In addition to EEG, the technique could likewise capture the position of the fiducial markers used in magnetoencephalography systems to register head position.


Digging a hole: Scaled-particle theory and cavity solvation in organic solvents.
A recent extension of scaled-particle theory for cavity solvation in polyatomic solvents developed by Ashbaugh and Pratt [J. Phys. Chem. B 111, 9330 (2007)] is tested against molecular simulations of 13 organic liquids. This molecular scaled-particle theory incorporates the intramolecular structure of the solvent in the calculation of the cavity excluding volume, compared with traditional applications of scaled-particle theory where the solvent is treated as an individual hard sphere with no internal structure. Once the diameters of the constituent carbon interaction sites are specified, molecular scaled-particle theory is able to discriminate between geometrically distinct solvents and provides accurate predictions for cavity solvation free energies and near quantitative predictions of the cavity contact correlation function. The diameters of the solvent interaction sites are argued to be transferable between related groups on different solvents, leading to a truly predictive scaled-particle theory given only information on the solvent pressure, density, and molecular topology.


Study on Quality Standard of Processed Curcuma Longa Radix.
To control the quality of Curcuma Longa Radix by establishing quality standards, this paper increased the contents of extract and volatile oil determination. Meanwhile, the curcumin was selected as the internal marker, and the relative correlation factors (RCFs) of demethoxycurcumin and bisdemethoxycurcumin were established by high performance liquid chromatography (HPLC). The contents of multicomponents were calculated based on their RCFs. The rationality and feasibility of the methods were evaluated by comparison of the quantitative results between external standard method (ESM) and quantitative analysis of multicomponents by single-marker (QAMS). Ethanol extracts ranged from 9.749 to 15.644% and the mean value was 13.473%. The volatile oil ranged from 0.45 to 0.90 mL/100 g and the mean value was 0.66 mL/100 g. This method was accurate and feasible and could provide a reference for further comprehensive and effective control of the quality standard of Curcuma Longa Radix and its processed products.


Screening An alpha-glucosidase Inhibitor from A Phage-displayed Peptide Library.
A phage-displayed peptide library was biopanned with Aspergillus niger glucoamylase. Three specifically binding phage clones (GB-1, GB-2 and GB-3) were identified after three cycles of screening and amplification. All three peptides contained a disulfide bridge, and the impairment of disulfide bond greatly lowered the binding activity. One peptide, cyclic KCHFEECLAY, representing the N-terminal 10 amino acid residues from GB-1, competitively inhibited A. niger glucoamylase (K(I) 0.2 mmol/L) as well as rat intestinal alpha-glucosidase (KI 1.4 mmol/L).


Subarachnoid microcatheter anesthesia in small children.
Standard single dose spinal anesthesia is a recognized technique for neonates and small children. The advent of the subarachnoid microcatheter technique potentially expands the use of spinal anesthesia. The authors studied the use of repeated neuroblock via spinal catheters in 10 children under 5 years, undergoing major abdominal surgery of 2 hours or longer. The children had a mean weight of 8 +/- 1.8 kg and a mean age of 12.5 +/- 5.7 months. General anesthesia was administered as isoflurane 1%-1.5% in a 50% oxygen in air mixture via an endotracheal tube connected to an Ohmeda ventilator. A Kendall Cospan microcatheter pack was used to place a 28-gauge catheter via a 22-gauge needle at the L4-5 or L5-S1 interspace. Isobaric plain bupivacaine 0.5% was injected at 0.2 mL/kg, up to a maximum of 1 mL. This was repeated whenever the pulse or systolic blood pressure rose above 20% of baseline values. Neurologic examinations for motor or sensory deficits were done 24 hours after the block, at discharge, and 1 month later. The catheters were easily placed and removed without difficulty. Surgical conditions were excellent and, as judged by pulse and blood pressure, analgesia during surgery was optimum. The mean duration of the neuroblock was 59.7 +/- 2.1 minutes. Systolic blood pressure decreased initially by a mean of 8% (6.5 +/- 0.7 mmHg) and after follow-up doses by 2%-6% below baseline values. On recovery, analgesic levels were T1-T6. Three children had the catheters left in situ for postoperative analgesia. All three leaked 2-3 mL of clear glucose-containing fluid alongside the catheter overnight. No neurologic deficits were seen. The technique was a very effective method of providing adjunct operative anesthesia in infants and small children. Analgesia, muscle relaxation, and cardiovascular stability were present and no complications arose besides the apparent cerebrospinal fluid leak. The resultant risk of infection or possible duracutaneous fistula formation contraindicates the use of subarachnoid catheters of 28 gauge for postoperative analgesic use in young children.


Pathways to "Involved Professionalism": Making Processes of Professional Acculturation Intentional and Transparent.
Context - An increase in managerialism and a decrease in trust of the professions have challenged traditional concepts of professionalism. The market model of professionalism espoused by some critics also poses problems for professions, professionals and recipients of professional services. Professional development is now an important component of medical curricula. We believe professionalism is evolving and suggest a concept of involved professionalism as a framework for understanding the complex relationships between professional practice, community and responsibility. Purpose - The purpose of this article is to unpack and compare varying concepts of professionalism, and examine how these concepts can impact on the health care professions and on professional acculturation of new recruits on entry to their medical work environment. Summary - In a changing socio-political climate, traditional notions of professionalism have met criticism in that the autonomy of a profession can disempower the consumers of its service. In New Zealand and elsewhere, market reformers have introduced business oriented decision making structures accompanied by the rhetoric of consumer choice. This shift has constrained the professional decision making ability of medical professionals. Conclusion - We suggest that a further model of professionalism is required to address the challenges of the need for community responsiveness, collaboration, high quality health care and a hospitable professional environment. 'Involved professionalism' ties together knowledge, individual responsibility, collective responsibility and responsiveness to society. It is offered as a framework for health practitioners, policy makers and medical educators.


Nephrotoxicity of the constituents of the gentamicin complex.
Commercial gentamicin C is a mixture of gentamicin C1, C1a, and C2. The nephrotoxicity of each of these constituents was compared with that of the gentamicin complex. After seven days the mean creatinine level in serum was 0.8 mg/dl in rats given C2 and 0.5 mg/dl in rats given C1, C1a, or the gentamicin complex (P less than .001). Toxicity attributable to C1a was not detected until day 14, and only minimal toxicity was noted in C1-treated rats after 21 days. Nephrotoxicity caused by the gentamicin complex was similar to that caused by C2. By a new high-pressure liquid chromatographic method, the renal concentration of C1, C1a, and C2 was quantified in rats given the gentamicin complex. The results indicated an early, preferential renal accumulation of C2. Subsequently, the C2 content of 12 commercial lots of gentamicin C was measured. The C2 concentration ranged from 12.4 to 20.1 mg/ml. In short, experimental nephrotoxicity from gentamicin C is largely the result of the C2 constituent, and the concentration of this constituent in commercial preparations of gentamicin varies by as much as 7.7 mg/dl.


COVID-19 vaccination hesitancy and willingness among pregnant women in Italy.
Pregnant women, especially those with comorbidities, compared to those non-pregnant, have higher risk of developing a severe form of COVID-19. However, COVID-19 vaccine uptake is very low among them. An anonymous questionnaire was administered to randomly selected women 18 years of age that were currently pregnant or had just given birth between September 2021 and May 2022 in the geographic area of Naples. Vaccine hesitancy was assessed using the vaccine hesitancy scale (VHS). A total of 385 women participated. Women who had not been infected by SARS-CoV-2 and who needed information about vaccination against COVID-19 had a higher perceived risk of being infected with SARS-CoV-2. More than half (54.3%) of the women were very afraid of the potential side effects of the COVID-19 vaccination on the fetus. There was higher concern of the side effects of the vaccine on the fetus among those who did not have a graduate degree, those with high-risk pregnancy, those who had not been infected by SARS-CoV-2, those who were more concerned that they could be infected by SARS-CoV-2, those who did not know that this vaccination was recommended for them, and those trusting mass media/internet/social networks for information. Only 21.3% were vaccinated when pregnant, mostly women with a university degree, those who had been infected by SARS-CoV-2 before pregnancy, those who did not need information, and those who acquired information about the vaccination from gynecologists. Almost three-quarters (71.9%) were willing to receive the vaccination and those more likely were those with a university degree, those who have had at least one relative/cohabitant partner/friend who had been infected by SARS-CoV-2, those who were more concerned that they could be infected by SARS-CoV-2, and those who were not extremely concerned of the side effects of the vaccine on the fetus. A total of 86.4% were highly hesitant. Highly hesitant were respondents who did not get a graduate degree, those less concerned that they could be infected by SARS-CoV-2, and those trusting mass media/internet/social networks for information. Public health efforts and education campaigns for pregnant women are needed for changing their perception patterns and for supporting gynecologists in promoting the uptake of this vaccination.


Physicochemical Properties of Chicken Breast and Thigh as Affected by Sous-Vide Cooking Conditions.
Sous-vide is a cooking method used to improve the tenderness and juiciness of chicken breast. However, the comparative changes in meat quality attributes of sous-vide cooked chicken breast and thigh muscles are not fully understood. The objective of this study was to investigate the effects of sous-vide cooking conditions, based on collagen denaturation temperature of intramuscular connective tissue, on the physicochemical properties of chicken breasts and thighs. Chicken breast and thigh were cooked at four sous-vide cooking conditions (55 °C for 3/6 h and 65 °C for 3/6 h) and conventional cooking at 75 °C (core temperature of 71 °C) as control. No significant differences in pH and lightness were found between the sous-vide cooking conditions. Moisture content, cooking loss, protein solubility, shear force, myofibrillar fragmentation index, and lipid oxidation were affected by sous-vide cooking conditions (p < 0.05). The decreased shear force and total collagen content of 65 °C sous-vide cooking treatment might be associated with collagen denaturation (p < 0.05). Sous-vide cooking at 55 °C could decrease cooking loss, with higher moisture than sous-vide cooking at 65 °C (p < 0.05). These tendencies on water-holding capacity and shear force at the two different temperatures were similarly observed for both chicken breast and thigh. Therefore, this study indicates that chicken breast and thigh are similarly affected by the sous-vide cooking conditions and suggests that a novel strategy to apply together two temperature ranges based on the thermal denaturation of intramuscular connective tissue would be required.


Growth inhibitory properties of aromatic alpha-ketoaldehydes toward bacteria and yeast. Comparison of inhibition and glyoxalase I activity.
The alpha-ketoaldehydes methylglyoxal and substituted phenylglyoxals are similar in their abilities to inhibit the growth of Escherichia coli and yeast. When logarithmically growing cells are added to media containing 0.3-1 mM alpha-ketoaldehyde, growth stops for several hours, after which normal growth resumes. The period of growth inhibition does not appear to show any correlation with the ability of glyoxalase I to detoxify these alpha-ketoaldehydes. E. coli and yeast glyoxalase I show markedly different substrate specificities. For example, although both enzymes show broad specificity for both aliphatic and aromatic alpha-ketoaldehydes, 2,4,6-trimethylphenylglyoxal is a substrate for the E. coli enzyme but not for the yeast enzyme. Nevertheless, this alpha-ketoaldehyde inhibits the growth of both E. coli and yeast, similar to the other alpha-ketoaldehydes. Enzymes other than glyoxalase I must play a major role in the metabolism of these alpha-ketoaldehydes during the period of growth inhibition.


An immunoassay for histamine based on monoclonal antibodies.
Monoclonal antibodies with high specificity for histamine as well as for 1-methylhistamine were obtained after immunization of mice with a conjugate where the histamine was coupled via its ring 1-nitrogen to dog serum albumin. An immunoassay was developed for the quantitation of histamine release from basophils and 1-methylhistamine release from mast cells after provocation. The test method is based on competitive inhibition between histamine and a labelled histamine conjugate for the antigen binding sites of the antibodies. The separation step is performed by the addition of solid phase bound anti-mouse subclass specific antibodies. The sensitivity of the assay is 2 micrograms/l for histamine and 0.1 micrograms/l for 1-methylhistamine. No cross-reactivity was obtained with other metabolites of histamine or with histidine. Serotonin and dopamine were detectable, but only in doses (mg/l) well above the normal concentration found in the circulation. The immunoassay has been evaluated for its capacity to measure histamine release in vitro. A good correlation with the conventional fluorometric assay was obtained when histamine released from allergen stimulated leucocytes from allergic patients was tested. Urinary samples from patients undergoing hyposensitization showed a mean excretion of 1-methylhistamine at a level of 131 mumol MeHi/mol creatinine. The release of histamine and 1-methylhistamine in vivo was examined in plasma samples taken during a bronchial provocation test. A significant elevation above the basal analyte level occurred ten minutes after provocation.


Treatment of public lice infestation: a comparison of two agents.
Bulletins issued by both the United States Public Health Service and the Pan American Health Organization have noted a sharp increase in the incidence of public lice infestation (pediculosis pubis) in this country. At the Haight-Ashbury Free Medical Clinic we conducted a controlled, open study comparing the efficacy and safety of Kwell Shampoo (gamma benzene hexachloride; lindane) with RID, an over-the-counter, pyrethrin-based pediculicide. The results showed the two treatments to be equally effective and safe. All adult lice, nymphs, and nits were eradicated at the one week follow-up in fifteen patients treated with single applications of either product. Two patients in each group experienced very slight and transient erythema.


Crystal-to-Crystal Transition and the Structure Development of Electrospun Poly(ethylene 2,6 naphthalate) (PEN) Nanofibers from Solution.
Poly(ethylene naphthalate) (PEN) nanofiber membranes were prepared using hexafluoroisopropanol (HFIP) as a solvent. Crystallization and conformation of PEN nanofibers were characterized for the first time by scanning electron microscopy (SEM), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), and Raman spectroscopy. SEM micrographs revealed that the size and uniformity of nanofibers depended on the PEN concentration in HFIP solution. DSC results showed that cold crystallization temperature (Tcc) decreased and the crystallinity of PEN nanofibers increased with increasing the concentration of spinning PEN/HFIP solution. FTIR and Raman spectroscopies showed that PEN nanofibers formed metastable β-crystals during electrospinning due to the fast evaporation of a solvent, while the concentration of spinning solution did not affect the crystal form of as-prepared PEN nanofibers. Upon annealing of PEN nanofiber membranes above 140 °C, metastable β-crystals were transformed into the thermodynamically most stable α-crystals. Our polarized FTIR spectroscopic studies revealed that no molecular orientation was developed when fibers were collected randomly.


Quantitative Evaluation of a New Posturo-Locomotor Phenotype in a Rodent Model of Acute Unilateral Vestibulopathy.
Vestibular pathologies are difficult to diagnose. Existing devices make it possible to quantify and follow the evolution of posturo-locomotor symptoms following vestibular loss in static conditions. However, today, there are no diagnostic tools allowing the quantitative and spontaneous analysis of these symptoms in dynamic situations. With this in mind, we used an open-field video tracking test aiming at identifying specific posturo-locomotor markers in a rodent model of vestibular pathology. Using Ethovision XT 14 software (Noldus), we identified and quantified several behavioral parameters typical of unilateral vestibular lesions in a rat model of vestibular pathology. The unilateral vestibular neurectomy (UVN) rat model reproduces the symptoms of acute unilateral peripheral vestibulopathy in humans. Our data show deficits in locomotion velocity, distance traveled and animal mobility in the first day after the injury. We also highlighted alterations in several parameters, such as head and body acceleration, locomotor pattern, and position of the body, as well as "circling" behavior after vestibular loss. Here, we provide an enriched posturo-locomotor phenotype specific to full and irreversible unilateral vestibular loss. This test helps to strengthen the quantitative evaluation of vestibular disorders in unilateral vestibular lesion rat model. It may also be useful for testing pharmacological compounds promoting the restoration of balance. Transfer of these novel evaluation parameters to human pathology may improve the diagnosis of acute unilateral vestibulopathies and could better follow the evolution of the symptoms upon pharmacological and physical rehabilitation.


Phosphatidylinositol 3-kinase is a negative regulator of cellular differentiation.
Phosphatidylinositol 3-kinase (PI3K) has been shown to be an important mediator of intracellular signal transduction in mammalian cells. We show here, for the first time, that the blockade of PI3K activity in human fetal undifferentiated cells induced morphological and functional endocrine differentiation. This was associated with an increase in mRNA levels of insulin, glucagon, and somatostatin, as well as an increase in the insulin protein content and secretion in response to secretagogues. Blockade of PI3K also increased the proportion of pluripotent precursor cells coexpressing multiple hormones and the total number of terminally differentiated cells originating from these precursor cells. We examined whether any of the recently described modulators of endocrine differentiation could participate in regulating PI3K activity in fetal islet cells. The activity of PI3K was inversely correlated with the hepatocyte growth factor/scatter factor-induced downregulation or nicotinamideinduced upregulation of islet-specific gene expression, giving support to the role of PI3K, as a negative regulator of endocrine differentiation. In conclusion, our results provide a mechanism for the regulation of hormone-specific gene expression during human fetal neogenesis. They also suggest a novel function for PI3K, as a negative regulator of cellular differentiation.


Update on the current modalities used to screen high risk youth for prediabetes and/or type 2 diabetes mellitus.
The modalities currently employed to screen for type 2 diabetes mellitus (T2DM)/prediabetes are HbA1c, fasting plasma glucose (FPG), and 2-hour plasma glucose (PG) during an oral glucose tolerance test (OGTT). The purpose of this review is to highlight the positive qualities and pitfalls of these diagnostic modalities and reflect on the most reasonable and effective approach to screen high risk youth. Given its inherent preanalytical advantages, glycated hemoglobin (HbA1c) continues to be the preferred diagnostic modality used by pediatricians to screen high risk youth. However, when the three aforementioned tests are performed in youths of different races/ethnicities, discrepant results for T2DM/prediabetes are observed. The prevalence rates for T2DM vary from 0.53% in Chinese youth (including youth of all body mass indexes) to 18.3% in high-risk, overweight, obese Korean youth. Moreover, the FPG is abnormal (>100 less than <126 mg/dL) in 15% of Korean youth versus 8.7% of Chinese youth. The prevalence rates for prediabetes are 1.49% in Chinese youth versus 21% in Emirati youth (HbA1c, 5.7%-6.4%). The coefficient of agreement, k, between these screening tests for T2DM are fair, 0.45-0.5 across all youth. However, using HbA1c as a comparator, the agreement is weak with FPG (k=0.18 in German youth versus k=0.396 in Korean youth). The American Diabetes Association (ADA) Standards of Medical Care Guidelines define "high risk youth" who need to be tested for T2DM and/or prediabetes. OGTT and HbA1c do not always detect T2DM in similar individuals. HbA1c may not be an ideal test for screening Hispanic and African American youth. FPG and OGTT are suitable screening tests for youth of ethnic minorities and those with cystic fibrosis or hemoglobinopathies. Performing all three tests either together or sequentially may be the only way to encompass all youth who have aberrations in different aspects of glucose homeostasis.


The dual role of innate immunity in the antiphospholipid syndrome.
The antiphospholipid syndrome (APS), as both a primary syndrome and a syndrome in association with systemic lupus erythematosus (SLE), can be a devastating disease. It is unclear what factors (genetic and/or environmental) lead to the generation of antiphospholipid antibodies (aPL). It is equally unclear why only certain individuals with aPL develop clinical events. We hypothesize that innate immune activation plays a critical role at two distinct stages of APS, namely, the initiation phase, in which aPL first appear, and the effector phase, in which aPL precipitate a thrombotic event. According to the model we propose, aPL alone are insufficient to cause thrombosis and a concomitant trigger of innate immunity, e.g. a toll-like receptor (TLR) ligand, must be present for thrombosis to occur. Here, we discuss our findings that mice immunized with beta(2)-glycoprotein I (beta(2)GPI) and lipopolysaccharide (LPS), a TLR ligand, produce high levels of aPL and other SLE-associated autoantibodies, and develop lupus-like glomerulonephritis. We also discuss our data showing that autoantibodies to heat shock protein 60 (HSP60), an 'endogenous TLR ligand', promote thrombus generation in a murine model of arterial injury. Thus, both pathogen-derived TLR ligands (e.g. LPS) and endogenous TLR ligands (e.g. HSP60) may contribute to the pathogenesis of APS. This putative dual role of innate immunity provides new insight into the generation of aPL as well as the enigma of why some individuals with aPL develop APS, while others do not.


Social Cost of Blindness Due to AMD and Diabetic Retinopathy in the United States in 2020.
To estimate the social cost of blindness due to wet age-related macular degeneration (wAMD), diabetic macular edema (DME), and proliferative diabetic retinopathy (PDR) in the United States in 2020. Excess costs that occur because of blindness were estimated as the difference in costs in blind versus non-blind individuals. Per-patient costs were aggregated using the number of cases of blindness due to wAMD, DME, and PDR projected in 2020. Associated annual excess direct costs, indirect costs, and quality-adjusted life year loss per blind individual were $4,944, $54,614, and 0.214, respectively. Combining estimates with 246,423 projected cases of blindness due to wAMD, DME, and PDR translated to total societal costs of $20 billion in 2020, estimated to triple by 2050. Excess social costs associated with blindness in individuals with wAMD, DME, and PDR are substantial, with more than half of the burden attributed to indirect costs. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:S6-S14.].


Thrombin Receptor Agonist Peptide-Induced Platelet Aggregation Is Reduced in Patients Receiving Dabigatran.
The availability of direct oral anticoagulants has caused a paradigm shift in thrombosis management. The direct thrombin inhibitor dabigatran seems to obstruct tenase complex by inhibiting thrombin generated in the initial phase and feed back to the amplification phase of cell-based coagulation reactions. However, it is still not fully understood if and how dabigatran impact platelet function. This observational study aimed to assess in vitro platelet function in patients with atrial fibrillation receiving dabigatran. Platelet aggregability was tested with platelet-rich plasma using platelet aggregometry (PACKS-4 aggregometer). Blood samples were stimulated with thrombin receptor agonist peptide (TRAP; 32 μmol/L). A total of 28 patients with nonvalvular atrial fibrillation were enrolled. The mean age was 71.57 (9.75) years (range: 50-87 years), 16 patients were women, and the mean CHA2DS2VASc score was 3.93 (1.41). All patients began treatment with dabigatran as initial anticoagulant treatment. The minimum term use of dabigatran was 18 days. Dabigatran doses were 110 mg (57.14%) or 150 mg (42.86%) twice daily. The TRAP-induced platelet aggregation was significantly lower 2 hours after taking dabigatran compared to baseline value (79.39 [13.38] vs 90.14 [10.5]). The TRAP-induced platelet aggregation was reduced in cardiovascular patients 2 hours after receiving dabigatran. Our findings could have some important clinical implications because platelet aggregation and coagulation cascade are affected at the same time.


Multifunctional high-simulation 3D-printed hydrogel model manufacturing engineering for surgical training.
Advanced bionic organ models with vivid biological structures and wetness and softness are essential for medical-surgical training. Still, there are many challenges in the preparation process, such as matching mechanical properties, good feedback on surgical instruments, reproducibility of specific surgical scenarios, and distinguishability between structural levels. In this paper, we achieved tissuemimicking dual-network (DN) hydrogels with customizable stiffness by adjusting the composition of the hydrogel matrix and the immersion time of the ionic solution to match different biological soft tissues precisely. Combined with advanced threedimensional (3D) printing fabrication techniques, various performance-tunable bionic hydrogel organ models with structural complexity and fidelity, including kidney, liver, pancreas, and vascular tissues, were perfectly fabricated. The simulation and applicability of the model were also simulated for the forced change of the suture needle in the puncture and suture of a single tissue and between different tissues, the cutting of substantive organs by ultrasonic scalpel, the coagulation and hemostasis of blood vessels, the visualization of the internal structure under ultrasound, and the microwave ablation of liver tumors. By constructing advanced biomimetic organ models based on hydrogel with specific and tunable properties, the development of surgical training, medical device testing, and medical education reform will be significantly promoted.


Effects of Betaine on LPS-Stimulated Activation of Microglial M1/M2 Phenotypes by Suppressing TLR4/NF-κB Pathways in N9 Cells.
Microglia mediate multiple facets of neuroinflammation. They can be phenotypically divided into a classical phenotype (pro-inflammatory, M1) or an alternative phenotype (anti-inflammatory, M2) with different physiological characteristics and biological functions in the inflammatory process. Betaine has been shown to exert anti-inflammatory effects. In this study, we aimed to verify the anti-inflammatory effects of betaine and elucidate its possible molecular mechanisms of action in vitro. Lipopolysaccharide (LPS)-activated microglial cells were used as an inflammatory model to study the anti-inflammatory efficacy of betaine and explore its mechanism of regulating microglial polarisation by investigating the morphological changes and associated inflammatory changes. Cytokine and inflammatory mediator expression was also measured by ELISA, flow cytometry, immunofluorescence, and western blot analysis. Toll-like receptor (TLR)-myeloid differentiation factor 88 (Myd88)-nuclear factor-kappa B (NF-κB) p65, p-NF-κB p65, IκB, p-IκB, IκB kinase (IKK), and p-IKK expression was determined by western blot analysis. Betaine significantly mitigated the production of pro-inflammatory cytokines and increased the release of anti-inflammatory cytokines. It promoted the conversion of the microglia from M1 to M2 phenotype by decreasing the expression of inducible nitric oxide synthase and CD16/32 and by increasing that of CD206 and arginase-1. Betaine treatment inhibited the TLR4/NF-κB pathways by attenuating the expression of TLR4-Myd88 and blocking the phosphorylation of IκB and IKK. In conclusion, betaine could significantly alleviate LPS-induced inflammation by regulating the polarisation of microglial phenotype; thus, it might be an effective therapeutic agent for neurological disorders.


Toxoplasma gondii and Neospora caninum in Free-Range Chickens in Henan Province of China.
Background. Chickens serve as an intermediate host for Toxoplasma gondii and Neospora caninum; infection of free-range (FR) chickens with these organisms is a useful indicator of soil and environmental contamination with oocysts. A total of 700 FR chicken serum samples and 300 heart samples were collected from Henan province from March to July 2015. Antibodies to T. gondii were found in 18.86% (132/700) of the chickens by modified agglutination test (cut-off 1 : 25), while 23.14% (162/700) were positive for N. caninum by indirect fluorescent antibody test (cut-off 1 : 25). T. gondii DNA was detected in the myocardium digestion liquids of 4/25 (16%) FR chickens. The PCR results of N. caninum DNA from FR chicken myocardium digestion liquids (n = 25) were all negative. Attempts to isolate viable T. gondii were unsuccessful. The results showed that there were antibodies to T. gondii and N. caninum in FR chickens from Henan province. Accordingly, effective control of feces from cats and dogs and improved pets hygiene habits were needed. To the author's knowledge, this is the first report of the presence of N. caninum antibody in chickens from China.


Electrochemical synthesis of the protected cyclic (1,3;1,6)-β-glucan dodecasaccharide.
Automated electrochemical assembly is an electrochemical method to synthesise middle-sized molecules, including linear oligosaccharides, and some linear oligosaccharides can be electrochemically converted into the corresponding cyclic oligosaccharides effectively. In this study, the target cyclic oligosaccharide is a protected cyclic (1,3;1,6)-β-glucan dodecasaccharide, which consists of two types of glucose trisaccharides with β-(1,3)- and β-(1,6)-glycosidic linkages. The formation of the protected cyclic dodecasaccharide was confirmed by the electrochemical one-pot dimerisation-cyclisation of the semi-circular hexasaccharide. The yield of the protected cyclic dodecasaccharide was improved by using a stepwise synthesis via the linear dodecasaccharide.


Solution Structures of Engineered Vault Particles.
Prior crystal structures of the vault have provided clues of its structural variability but are non-conclusive due to crystal packing. Here, we obtained vaults by engineering at the N terminus of rat major vault protein (MVP) an HIV-1 Gag protein segment and determined their near-atomic resolution (∼4.8 Å) structures in a solution/non-crystalline environment. The barrel-shaped vaults in solution adopt two conformations, 1 and 2, both with D39 symmetry. From the N to C termini, each MVP monomer has three regions: body, shoulder, and cap. While conformation 1 is identical to one of the crystal structures, the shoulder in conformation 2 is translocated longitudinally up to 10 Å, resulting in an outward-projected cap. Our structures clarify the structural discrepancies in the body region in the prior crystallography models. The vault's drug-delivery potential is highlighted by the internal disposition and structural flexibility of its Gag-loaded N-terminal extension at the barrel waist of the engineered vault.


Study on the role of gastric Helicobacter infection in gross pathological and histological lesions of the stomach in finishing pigs.
The prevalence of gastric Helicobacter infection in finishing pigs and the influence of this infection on gastric lesions was studied. Stomachs of 89 finishing pigs from 27 randomly selected herds were sampled at the slaughterhouse. Forty cases (Group A) were selected based upon the presence of gross pathological lesions in the pars oesophagea, and further 49 cases were obtained at random (Group B). Three samples of gastric tissue (junction of pars oesophagea and pars cardiaca, fundic area, and pyloric area) were collected from each stomach for histological and immunohistochemical examination. Helicobacter antigen was detected in 76 cases (85.4%). No association was found between the presence of Helicobacter in the stomach and the occurrence of gross pathological lesions in the pars oesophagea or gastritis detected on histological examination. However, a significant association was found between the occurrence of Helicobacter in the pyloric area and the presence of erosions/ulcers in the pars oesophagea (OR: 7.01, p = 0.022) in Group B. A significant association was also evident between the presence of Helicobacter and glandular lesions (dilatation of the glands + glandular abscess + degeneration of glandular epithelial cells). In conclusion, Helicobacter infection seems to be a contributing factor to pathological changes in the stomach of finishing pigs.


Allograft Augmentation of Hamstring Autograft for Younger Patients Undergoing Anterior Cruciate Ligament Reconstruction.
Younger patients and those with smaller hamstring autograft diameters have been shown to be at significantly greater risk of graft failure after anterior cruciate ligament (ACL) reconstruction. To date, there is no information in the literature about the clinical success and/or cost-effectiveness of increasing graft diameter by augmenting with semitendinosus allograft tissue for younger patients. Hybrid hamstring grafts are a cost-effective treatment option because of a reduced rate of graft failure. Cohort study (economic and decision analysis); Level of evidence, 3. We retrospectively identified patients younger than 18 years who had undergone ACL reconstruction by a single surgeon between 2010 and 2015. During this period, the operating surgeon's graft selection algorithm included the use of bone-patellar tendon-bone (BTB) autografts for the majority of patients younger than 18 years. However, hamstring autografts (hamstring) or hybrid hamstring autografts with allograft augment (hybrid) were used in skeletally immature patients and in those whom the surgeon felt might have greater difficulty with postoperative rehabilitation after BTB graft harvest. Patient demographics, graft type, graft diameter, the time the patient was cleared to return to activity, and the need for secondary surgical procedures were compared between the hamstring and hybrid groups. The clinical results were then used to assess the potential cost-effectiveness of hybrid grafts in this select group of young patients with an ACL injury or reconstruction. This study comprised 88 patients (hamstring group, n = 46; hybrid group, n = 42). The 2 groups did not differ in terms of age, sex, timing of return to activity, or prevalence of skeletally immature patients. Graft diameters were significantly smaller in the hamstring group (7.8 vs 9.9 mm; P < .001), which corresponded with a significantly greater rate of graft failure (13 of 46 [28.3%] vs 5 of 42 [11.9%]; P = .049). As a result of the reduced revision rate, the hybrid graft demonstrated incremental cost savings of US$2765 compared with the hamstring graft, and the hybrid graft was the preferred strategy in 89% of cases. Driven by increased graft diameters and the reduced risk of revision, hybrid grafts appear to be a more cost-effective treatment option in a subset of younger patients with an ACL injury.


The origins of Freud's concept of object representation ('Objektvorstellung') in his monograph 'On Aphasia': its theoretical and technical importance.
In 'On aphasia' Freud finds it necessary to ask a question: 'In what manner is the body reproduced in the cerebral cortex?' His answer to this question would provide the foundation for the essential concepts of psychoanalytic theory and technique. In this paper I present in detail Freud's conception of the process of representing the body in the cortex. I also attend to the vocabulary he selected to present his ideas. Finally, I describe the consequences of both for his later theorizing. Freud was the first to oppose Meynert's notion that 'a representation is localized in the nerve cell'. Freud suggests that representations are processes without any localization. The process, once formed, has the potential to reappear under proper stimulation, to bring forth, as mnemic images, something psychical (das Psychische). These psychical representations are the sole possessors of the proper stimuli that motivate human beings to talk spontaneously and voluntarily.


Musculoskeletal Spect-Ct: A Pictorial Review.
SPECT-CT being a hybrid imaging scanner provides molecular and anatomical imaging in one go as a one stop shop. The addition of correlative CT scan to the planar skeletal scintigraphy gives better localization of the lesion, its characterization and attenuation correction as well. We present a brief overview of our institutional experience with hybrid SPECT-CT, as an adjunct to planar skeletal scintigraphy. SPECT-CT imaging improves the diagnostic yield and specificity of planar skeletal scintigraphy.


Effect of sialoadenectomy on medroxyprogesterone-acetate-induced mammary carcinogenesis in BALB/c mice. Correlation between histology and epidermal-growth-factor receptor content.
To evaluate the possible involvement of the salivary glands in the modulation of medroxyprogesterone (MPA)-induced mammary tumorigenesis, 48 sialoadenectomized virgin BALB/c female mice and 47 controls were treated with 40mg MPA depot s.c. every 3 months for 1 year. Mammary tumors developed in 11 sialoadenectomized and in 34 control mice with similar latencies. In both groups, 75% of the tumors were ductal and progestin-dependent (PD) while the remainder were lobular and progestin-independent (PI). Epidermal growth factor (EGF) levels were measured in salivary glands (SG-EGF) and serum (S-EGF) in both groups. MPA induced a significant increase in SG-EGF and in S-EGF that became evident only after 1 month of MPA treatment. No increase in S-EGF was detected in MPA-treated sialoadenectomized mice, indicating that salivary glands are the major source of S-EGF. The presence of EGF receptors (EGF-R) was investigated in ductal PD and PI tumor lines and compared with 8 PI tumor lines of lobular origin. A significant difference in EGF-R content was found between lobular and ductal tumors. No increase in EGF-R was noted when ductal tumors became autonomous. EGF-R did not correlate with tumor growth rate and there was an inverse correlation between EGF-R and steroid receptors. When the effect of sialoadenectomy on tumor growth was tested in vivo in syngeneic transplants of 2 ductal PD, 1 ductal PI and 2 lobular PI mammary adenocarcinomas, it was not found to be significant when compared with the controls. It may be concluded that SG-EGF plays an important role in the induction of mammary adenocarcinomas by MPA, while it has no significant effect on the growth of established tumors.


Influence of antibody on the structure of glucans.
Glucosyltransferase (GTF) plays an essential role in the formation of the biofilm known as dental plaque and in the pathogenesis of dental caries. Mutans streptococci produce at least three distinct GTFs (GtfB, C and D), each of which forms a glucan polymer from sucrose. Glucan is a major constituent of plaque biofilm. GTF adsorbed to a surface forms glucans that differ in structure from those formed by the same enzyme in solution. In the present study, activities of GtfB and GtfC in solution or adsorbed on a surface were inhibited in the presence of a polyclonal antiserum (DS-1) to a mixture of GTFs and by immunoglobulin G (IgG) prepared from DS-1; in contrast, enzyme activity was enhanced by normal rabbit serum (NRS) and IgG from NRS. GtfD activity on a surface was enhanced by both antiserum DS-1 and NRS, and IgG prepared from either serum; GtfD activity in solution was slightly inhibited by each of the sera. The structure of GtfB and GtfC glucans formed in the presence of antiserum differed from that of controls based on linkage analyses, and on their susceptibilities to the glucanohydrolases mutanase (alpha-1,3 hydrolase) and dextranase (alpha-1,6 hydrolase); soluble products from the enzymatic digestion also differed. The results show that the effects of antibody on enzyme activity are more complex than simple inhibition or enhancement and that the presence of antibody may influence glucan structure, which clearly could impact plaque formation. The results have implications for the formation and properties of biofilms formed in other environments.


Neorickettsia sp. in coatis (Nasua nasua) in Brazil.
The genus Neorickettsia comprises trematode-associated bacteria that can cause diseases in animals and humans. Despite detection of Neorickettsia antigens in the intestine of coatis kept in captivity in southern Brazil through immunohistochemistry, the molecular identity of the bacteria in South American procyonids remains elusive. The aim of the present study was to investigate the occurrence of Neorickettsia sp. in blood samples from coatis in central-western Brazil. Between March 2018 and January 2019, animals were captured and recaptured in two areas of the Cerrado (Parque Estadual do Prosa, PEP; and Vila da Base Aérea, VBA) located in the city of Campo Grande, state of Mato Grosso do Sul, central-western Brazil. All captures were performed according to convenience. DNA from 97 blood samples was subjected to nested PCR (nPCR) targeting a fragment of the 16S rRNA gene of Neorickettsia sp. Six samples (3.6%; five from VBA and one from PEP) from different coatis were positive in nPCR based on the 16S rRNA. The sequences obtained (~500 bp) showed ˃ 99% similarity to N. risticii. Phylogenetic analysis clustered the sequences detected in the present study in a clade with N. risticii. This is the first molecular detection of Neorickettsia sp. in coatis in Brazil.


Co-infection with Legionella and SARS-CoV-2: a case report.
We report a case of COVID-19 with Legionella co-infection that was treated successfully. A 73-year-old man presented to the hospital with symptoms of fatigue that continued for the next 5 days. The patient was receiving docetaxel and prednisolone chemotherapy for prostate cancer. Laboratory findings on admission showed positive urine Legionella antigen test and SARS-CoV-2 test. He was administered antiviral and antibacterial agents, and a corticosteroid. Pneumonia exacerbated on day 2 of hospitalization. The patient underwent tracheal intubation and began receiving multidisciplinary care. On day 8 of hospitalization, his oxygenation improved, and the patient was extubated. He discharged on day 27 of hospitalization. The patient had a favorable outcome with early diagnosis and early treatment of both diseases. Patients with severe COVID-19 disease need to be evaluated for co-infection. Further, early diagnosis and early treatment of the microbial bacteria causing the co-infection are important.


Regeneration of the testicular interstitial compartment after ethane dimethane sulfonate treatment in the hypophysectomized frog Rana esculenta: independence of pituitary control.
The effects of ethane dimethane sulfonate (EDS) on the testes of hypophysectomized frogs (Rana esculenta) were investigated by light and electron microscopy. Initial signs of interstitial cell damage were observed in EDS- and EDS plus pituitary homogenate (PH)-treated animals 5 days after a single injection of EDS (100 mg/Kg body weight). The germinal compartment in these two groups appeared disorganized adjacent to the damaged interstitial tissue only in the EDS-treated animals, and by Day 8, spermatogenesis seemed to be affected in the EDS + PH-treated frogs in which Leydig cells had disappeared in some areas. On Day 28, regeneration of the interstitial tissue was complete and spermatogenesis was restored to normal. These data suggest that, in hypophysectomized frogs, the regeneration of the interstitial compartment is independent of pituitary activity and that the lack of interstitial cells activates the production of local factors responsible for the differentiation and proliferation of new Leydig cells. It is concluded that in addition to gonadotropins, the intratesticular environment is fundamental in the maintenance and regulation of testicular structure and function.


Reactions of C(1D) with H2 and its deuterated isotopomers, a wave packet study.
Using a Chebyshev wave packet method, total and state-resolved reaction probabilities (J=0) were calculated for the reactions of C(1D) with various hydrogen isotopomers (H2, D2, and HD, nu i=0, j i=0) on a recent ab initio potential energy surface. For all the isotopic variants, it was found that the initial state specified reaction probabilities have no energy threshold and are strongly oscillatory, indicative of the involvement of long-lived resonances in this barrierless reaction. The J=0 product vibrational and rotational distributions for all three isotopic reactions, and the CH/CD branching ratio for the C+HD reaction, show strong dependence on the collision energy, further underscoring the important role played by the resonances. The generally decaying vibrational distributions and highly excited rotational distributions, which corroborate an insertion mechanism, and the dominance of the CD+H channel in the C+HD reaction are consistent with existing experimental observations. Initial state specified integral cross sections and rate constants were estimated using a capture model. The estimated rate constants were found to be close and in the order kHD>kH2>kD2. Finally, a method to calculate branching ratio in the C+HD reaction is proposed.


[Elements for an analysis of psychosocial indicators and psychological intervention in heart transplantation].
It is now accepted that cardiac transplantation is a viable therapeutic alternative for patients with end-stage heart disease. The most recent data offer a favourable short and medium term prognosis. Retrospective studies suggest that transplantation is associated with a good quality of life and tolerance of the side effects of the medication. Even if cardiac transplantation does not appear to be associated with serious psychological morbidity, it is important to assess the recipient's anxiety, depression, body image and his subjective quality of life, including satisfaction with his family and marital life, to prevent postoperative psychologic distress and enhance the patient's coping abilities. The family is the patient's chief buffer against stress but it is also under stress and needs to be aided through this process. The psychosocial themes that appear prominently at the different stages of the transplant process are somewhat predictable. These can be used to help the patient and family anticipate stress and deal with these issues in a way that enhances mastery of a difficult situation. The heart transplant team faces difficult ethical issues regarding patient selection and informed consent. Public input on these issues is needed, especially since more patients elect to receive heart transplants and the donor supply is likely to remain the same, thereby making donor hearts less available to those who could derive benefit from them.


In vitro selection of Escherichia coli mutants with decreased susceptibility to norfloxacin.
In 10 clinical isolates of Escherichia coli the frequency of spontaneous mutation to high levels of resistance to nalidixic acid was greater than 300-fold higher than that to norfloxacin. Norfloxacin resistant mutants could not be detected (mutation frequency: less than 10(-12). However, nalidixic acid resistant mutants of E. coli developed decreased susceptibility to norfloxacin at a rate of approximately 10(-9). Mutants with decreased susceptibility to norfloxacin could also be obtained when the same clinical isolates of E. coli were exposed to norfloxacin in 2 steps. However, mutants with MIC values greater than 8 micrograms/ml for norfloxacin were never obtained even after repeated exposure. Widespread use of cinoxacin or nalidixic acid may select resistant strains and reduce the efficacy of norfloxacin and other 4-quinolones.


Evaluation of Arthrospira platensis extracellular polymeric substances production in photoautotrophic, heterotrophic and mixotrophic conditions.
The kinetic study of Arthrospira platensis extracellular polymeric substances (EPS) production under different trophic modes-photoautotrophy (100 μmol photons m(-2) s(-1)), heterotrophy (1.5 g/L glucose), and mixotrophy (100 μmol photons m(-2) s(-1) and 1.5 g/L glucose)-was investigated. Under photoautotrophic and heterotrophic conditions, the maximum EPS production 219.61 ± 4.73 and 30.30 ± 1.97 mg/L, respectively, occurred during the stationary phase. Under a mixotrophic condition, the maximum EPS production (290.50 ± 2.21 mg/L) was observed during the early stationary phase. The highest specific EPS productivity (433.62 mg/g per day) was obtained under a photoautotrophic culture. The lowest specific EPS productivity (38.33 mg/g per day) was observed for the heterotrophic culture. The effects of glucose concentration, light intensity, and their interaction in mixotrophic culture on A. platensis EPS production were evaluated by means of 32 factorial design and response surface methodology. This design was carried out with a glucose concentration of 0.5, 1.5, and 2.5 g/L and at light levels of 50, 100, and 150 μmol photons m(-2) s(-1). Statistical analysis of the model demonstrated that EPS concentration and EPS yield were mainly influenced by glucose concentration and that conditions optimizing EPS concentration were dissimilar from those optimizing EPS yield. The highest maximum predicted EPS concentration (369.3 mg/L) was found at 150 μmol photons m(-2) s(-1) light intensity and 2.4 g/L glucose concentration, while the highest maximum predicted EPS yield (364.3 mg/g) was recorded at 115 μmol photons m(-2) s(-1) light intensity and 1.8 g/L glucose concentration.


Preoperative ultrasound-guided carbon nanoparticles localization for metastatic lymph nodes in papillary thyroid carcinoma during reoperation: A retrospective cohort study.
Due to the damaged anatomical structure and a large amount of fibrous and scar tissues in the surgical field, reoperation of papillary thyroid carcinoma is difficult. This study introduces a new method of locating metastatic lymph nodes during reoperation and evaluates the effectiveness and safety of the preoperative ultrasound-guided carbon nanoparticles (CNs) localization. This retrospective cohort study enrolled 52 patients who were diagnosed with lymph node metastasis by histopathology and underwent reoperation from October 2015 to February 2016. The modified radical neck dissection or selective neck node dissection was performed. A total of 26 patients underwent preoperative ultrasound-guided CNs injection, and other 26 patients did not. Tolerance, the result of injection, the number of resected metastatic lymph nodes, and postoperative complications were recorded and analyzed. In CNs group, 102 suspicious nonpalpable lesions in 26 patients were injected with CNs, and 99 of the 102 lesions were successfully identified by surgeon in the reoperation. The positive rate of resected lymph nodes in total, in the central compartment, and in the lateral compartment were 31.6%, 31.2%, and 32.8%, respectively, which was significantly higher than that in the control group (P < 0.001, P < 0.001, and P = 0.041). In addition, the positive rates of levels III, IV, and V in the CNs group were 35.6%, 21.9%, and 30.5%, respectively, which was significantly higher than that in the control group (P < 0.001, P = 0.005, and P = 0.01). In additional, in the CNs group, the rate of temporary hypoparathyroidism was significantly lower compared with the control group (0% vs 26.9%, P = 0.021). Preoperative ultrasound-guided CNs injection is a safe and effective method for localization of the metastatic lymph nodes during reoperation.


Ethics and acceptance of smart homes for older adults.
Societal challenges associated with caring for the physical and mental health of older adults worldwide have grown at an unprecedented pace, increasing demand for health-care services and technologies Despite the development of several assistive systems tailored to older adults, the rate of adoption of health technologies is low. This review discusses the ethical and acceptability challenges resulting in low adoption of health technologies specifically focused on smart homes for older adults. The findings have been structured in two categories: Ethical Considerations (Privacy, Social Support, and Autonomy) and Technology Aspects (User Context, Usability, and Training). The findings conclude that older adults community is more likely to adopt assistive systems when four key criteria are met. The technology should: be personalized toward their needs, protect their dignity and independence, provide user control, and not be isolating. Finally, we recommend researchers and developers working on assistive systems to: (1) provide interfaces via smart devices to control and configure the monitoring system with feedback for the user, (2) include various sensors/devices to architect a smart home solution in a way that is easy to integrate in daily life, and (3) define policies about data ownership.