Recognition and treatment of acute alcohol withdrawal syndromes.
The alcohol withdrawal syndromes are generally self-limited processes from which spontaneous recovery can be anticipated. To achieve this outcome, the various types of withdrawal must be managed in such a way as to prevent the occurrence of life-threatening situations. This begins with a good initial evaluation, followed by the appropriate pharmacologic and behavioral steps to control the severity of withdrawal symptoms and to manage complications. Once the withdrawal process is completed, the patient can then be entered into a long-term treatment program.


Sarcoma and the spinal column.
Primary sarcomas are rare in the spine. Common primary sarcomas include osteosarcoma, Ewing's sarcoma, chondrosarcomas, and retroperitoneal soft-tissue sarcomas. These tumors tend to occur in adolescents and young adults. Surgery remains the mainstay of treatment, although the anatomy of spine and spinal cord often limits complete surgical resection with a wide margin. Chemotherapy and radiation therapy have variable effects on these tumors. With recent advances in surgical techniques and development of new chemotherapy protocols, survival and local control are both improving.


A Zinc Oxide Nanowire-Modified Mineralized Collagen Scaffold Promotes Infectious Bone Regeneration.
Bone infection poses a major clinical challenge that can hinder patient recovery and exacerbate postoperative complications. This study has developed a bioactive composite scaffold through the co-assembly and intrafibrillar mineralization of collagen fibrils and zinc oxide (ZnO) nanowires (IMC/ZnO). The IMC/ZnO exhibits bone-like hierarchical structures and enhances capabilities for osteogenesis, antibacterial activity, and bacteria-infected bone healing. During co-cultivation with human bone marrow mesenchymal stem cells (BMMSCs), the IMC/ZnO improves BMMSC adhesion, proliferation, and osteogenic differentiation even under inflammatory conditions. Moreover, it suppresses the activity of Gram-negative Porphyromonas gingivalis and Gram-positive Streptococcus mutans by releasing zinc ions within the acidic infectious microenvironment. In vivo, the IMC/ZnO enables near-complete healing of infected bone defects within the intricate oral bacterial milieu, which is attributed to IMC/ZnO orchestrating M2 macrophage polarization, and fostering an osteogenic and anti-inflammatory microenvironment. Overall, these findings demonstrate the promise of the bioactive scaffold IMC/ZnO for treating bacteria-infected bone defects.


Altered and Agitated due to Hypertension: A Case of Posterior Reversible Encephalopathy Syndrome.
The authors present a case of posterior reversible encephalopathy syndrome in a patient on nutritional supplements. The presentation and emergency management are discussed.


Feeding and body temperature in the rat: diencephalic localization of changes produced by excess calcium ions.
In the unanesthetized rat, Ca++ ions in solutions ranging from 2.6 to 112.0 mM in excess of the normal level in CSF were applied at different sites in the brain and by three separate procedures, Colonic temperature was monitored and in certain experiments, the amount of food pellets and water consumed was measured simultaneously following the administration of excess Ca++ ions. An infusion into the lateral cerebral ventricle of excess calcium in a volume of 5.0 mul produced a concentration-dependent hypothermia, This fall in temperature was not attenuated by a prior intraventricular infusion of mecamylamine and often enhanced by atropine. Depending on the site, a microinjection of excess Ca++ ions in a volume of 0.5 to 1.0 mul directly into the hypothalamus produced hypothermia or feeding. The sites of maximum sensitivity at which excess calcium caused a decline in temperature were clustered in the caudal hypothalamus, whereas those at which calcium elicited feeding were distributed widely in caudo-lateral, medial and rostral hypothalamic areas. Push-pull perfusions at a rate of 20 to 25 mul per min for 10 to 20 min at homologous sites caused similar responses but the cation concentration required to evoke feeding or hypothermia was significantly less than that of either microinjection or intraventricular infusion. These findings demonstrate species continuity in the rat concerning anatomical localization of the postulated set-point mechanism for body temperature. Several different pathways in the feeding system are affected by an alteration in the hypothalamic level of calcium.


Economy- and Social-Based Strategies for Anticoagulation of Patients with Atrial Fibrillation.
Atrial fibrillation is a public health problem associated with a fivefold increased risk of stroke or death. Analyzing costs is important when introducing new therapies and must be reconsidered in special situations, such as the novel coronavirus pandemic of 2020. This study aimed to evaluate the costs related to anticoagulant therapy in a one-year period, and the quality of life of atrial fibrillation patients treated in a public university hospital. Patient costs were those related to the anticoagulation and calculated by the average monthly costs of warfarin or direct oral anticoagulants (DOACs). Patient non-medical costs (eg., food and transportation) were calculated from data obtained by questionnaires. The Brazilian SF-6D was used to measure the quality of life. P-values < 0.05 were considered statistically significant. The study population consisted of 90 patients, 45 in each arm (warfarin vs direct oral anticoagulants). Costs were 20% higher in the DOAC group ($55,532.62 vs $46,385.88), and mainly related to drug price ($23,497.16 vs $1,903.27). Hospital costs were higher in the warfarin group ($31,088.41 vs $24,604.74) and related to outpatient visits. Additionally, non-medical costs were almost twice higher in the warfarin group ($13,394.20 vs $7,430.72). Equivalence of price between the two drugs could be achieved by a 39% reduction in the price of DOACs. There were no significant group differences regarding quality of life. Total costs were higher in the group of patients taking DOACs than those taking warfarin. However, a nearly 40% reduction in the price of DOACs could make it feasible to incorporate these drugs into the Brazilian public health system.


Analysis of the effect of recent reformulation strategies on the crystallization behaviour of cocoa butter and the structural properties of chocolate.
Chocolate is a complex soft material characterized by solid particles (cocoa powder, milk solid particles and sugar crystals) dispersed in a crystallized fat matrix mostly composed of cocoa butter (CB). Important chocolate properties such as snap, and visual appearance are strongly dependent on the internal molecular arrangement (polymorph), size and shape, as well as the spatial distribution of CB crystals within the chocolate mix. In recent years confectionary companies have put increasing effort in developing novel chocolate recipes to improve the nutritional profile of chocolate products (e.g., by reducing the amount of high saturated fat and sugar content) and to counteract the increasing price of cocoa butter as well as sustainability issues related to some chocolate ingredients. Different reformulation strategies can dramatically affect the crystallization thermodynamic and kinetic behaviour of cocoa butter; therefore, affecting the structural and sensorial properties of chocolate. In this review we analyse how different reformulation strategies affect the crystallization behaviour of cocoa butter and, hence, the structural and sensorial properties of chocolate. In particular, this work discusses the effect of: (1) CB replacement with emulsions, hydrogels, oleogels and oleofoams; (2) CB dilution with limonene or cocoa butter equivalents; (3) replacement or reduction of the amount of sugar and milk in chocolate. We found that there is certainly potential for successful novel alternative chocolate products with controlled crystalline properties; however, further research is still needed to ensure sensory acceptance and reasonable shelf-life of these novel products.


Not screens but their context of use impact cognitive development: a commentary on Yang et al. (2023).
There have been extensive debates about the impact of the digital transformation on human development. A recent study by Yang and colleagues highlights the importance of considering context of use, beyond amount of use. In their study, children from parents who reported having TV-on during family meals when they were 2 years old showed poorer cognitive development at age 3.5 as compared to those with TV-off during family meals. This highlights the importance of considering the context of use when studying effect of screen use. While Yang et al. discuss the distracting effects of TV-on sensory processing, we propose an alternative - and not mutually exclusive - interpretation based on TV induced deprivation of family interactions. On a more practical note, this should encourage to preserve screen-free time, especially during structured time such as family meals, in order to maintain family interactions known to be critical to development.


NMR structure of Plasmodium falciparum malaria peptide correlates with protective immunity.
Apical membrane antigen-1 is an integral Plasmodium falciparum malaria parasite membrane protein. High activity binding peptides (HABPs) to human red blood cells (RBCs) have been identified in this protein. One of them (peptide 4313), for which critical binding residues have already been defined, is conserved and nonimmunogenic. Its critical binding residues were changed for amino acids having similar mass but different charge to change such immunological properties; these changes generated peptide analogues. Some of these peptide analogues became immunogenic and protective in Aotus monkeys.Three-dimensional models of peptide 4313 and three analogues having different immune characteristics, were calculated from nuclear magnetic resonance (NMR) experiments with distance geometry and restrained molecular dynamic methods. All peptides contained a beta-turn structure spanning amino acids 7 to 10, except randomly structured 4313. When analysing dihedral angle phi and psi values, distorted type III or III' turns were identified in the protective and/or immunogenic peptides, whilst classical type III turns were found for the nonimmunogenic nonprotective peptides. This data shows that some structural modifications may lead to induction of immunogenicity and/or protection, suggesting a new way to develop multicomponent, subunit-based malarial vaccines.


Relation between laxative use and risk of major bleeding in patients with atrial fibrillation and heart failure.
Constipation has been reported to increase the risk of cardiovascular mortality. Patients with atrial fibrillation (AF) and heart failure (HF) have more comorbidities and an increased bleeding risk. However, it remains unclear whether constipation is associated with an increased risk of incident bleeding complications in AF with HF. Here, we investigated the association between constipation requiring laxatives and major bleeding in AF and HF. We retrospectively analyzed the medical records of 370 consecutive patients hospitalized for AF and congestive HF. Constipation was defined as regularly taking laxatives or having at least two prescriptions for a ≥ 30-day supply of laxatives. Sixty patients experienced major bleeding events during a median follow-up of 318 days. The most common sites of bleeding were lower gastrointestinal (28%, 17/60), upper gastrointestinal (27%, 16/60), and intracranial (20%, 12/60). There were 33 (55%) patients with constipation in the bleeding group and 107 (35%) in the non-bleeding group (P = 0.004). Multivariate Cox regression analysis adjusted for HAS-BLED score, hemoglobin, and direct oral anticoagulant use showed that constipation (hazard ratio [HR] 1.85, 95% confidence interval [CI] 1.11-3.08; p = 0.019) was a significant risk factor for major bleeding. We found a significant association between constipation requiring laxatives and major bleeding in patients with AF and HF. These findings indicate the need for constipation prevention in these patients to avoid reliance on invasive defecation management, including laxatives.


Ectopic overexpression of swine PPARγ2 upregulated adipocyte genes expression and triacylglycerol in skeletal muscle of mice.
Peroxisome proliferator-activated receptor γ2 (PPARγ2) is a key regulator of adipocyte differentiation, fatty acid uptake and storage in mammals. The primary goal of the present study was to investigate the consequences of PPARγ2 overexpression in the muscle. A swine muscle creatine kinase promoter was used to drive swine PPARγ2 (sPPARγ2) overexpression in the muscle of a transgenic mice model. The results showed that the mRNA of multiple adipocyte genes was increased in the skeletal muscle, as evidenced by the up-regulation of fatty acid synthase (2.11-fold, P < 0.05), lipoprotein lipase (2.08-fold, P < 0.01), fatty acid-binding protein 4 (14.30-fold, P < 0.01), and CD36 antigen (5.50-fold, P < 0.01). Meanwhile, skeletal muscle triacylglycerol was increased (P < 0.01) and the fatty acid profile of muscle fat was changed in that more polyunsaturated fats acid were augmented. The present study may further serve to develop transgenic pigs with higher intramuscular fat content and improved pork quality.


Permissive effect of glucose on the glucagon-induced accumulation of cAMP in isolated rat pancreatic islets.
Glucose stimulation increased the cAMP content of collagenase-isolated rat pancreatic islets fourfold above baseline values. The elevation was transient, lasting about 5 min, and was dose-dependent. Insulin release continued at a constant rate throughout the incubation. Glucagon, in the absence of glucose, increased cAMP for about 1 min but only slightly, and had no effect on insulin release. In the presence of glucose, however, glucagon enhanced islet cAMP content 15-fold and increased the release of insulin. Glucagon was most effective at high glucose concentrations (16.6 and 25 mM). This indicates that glucagon is critically dependent on the presence of glucose in order to increase the islet cAMP content and to stimulate insulin release. The inability of glucagon to generate sufficient cAMP in the absence of glucose might be one of the reasons why the hormone is a potentiator rather than an initiator of insulin release.


The impact of measures for secondary individual prevention of work-related skin diseases in health care workers: 1-year follow-up study.
Specific instruction courses as a tool for secondary prevention of occupational skin disease (secondary individual prevention, SIP courses) affecting individuals have been introduced in Germany. Little is yet known about the outcome of occupational disease and related behavioural patterns following these courses. To investigate the outcome of occupational skin disease in health care workers (HCW) 1 year after attendance of a SIP course. Two hundred and fifty-three HCW participated in SIP courses and were contacted by telephone 1 year after attendance. Patients were interviewed about skin lesions, medical treatment, sick leave, change of occupation, skin protection, skin care and skin cleansing, and the impact of skin disease. The follow-up rate was 81%. The proportion of participants reporting skin lesions decreased significantly (68% at follow-up compared with 77% at baseline; P = 0.02). Seventy-two per cent reported that their skin lesions had improved. Nine per cent reported having left their occupation due to their skin disease. Skin care and skin protection had improved, while the frequency of reported hand washing was reduced. Twenty-seven per cent said their quality of life was impaired due to the skin disease, compared with 54% at baseline (P < 0.001). Outcome parameters, including behavioural parameters, indicate a positive impact of courses for SIP on skin health of HCW 1 year after attendance.


Design and synthesis of Grp94 selective inhibitors based on Phe199 induced fit mechanism and their anti-inflammatory effects.
Glucose-regulated protein 94 (Grp94), a member of the Heat shock protein 90 (Hsp90) family, is implicated in many human diseases, including cancer, neurodegeneration, inflammatory, and infectious diseases. Here, we describe our effort to design and develop a new series of Grp94 inhibitors based on Phe199 induced fit mechanism. Using an alkynyl-containing inhibitor as a starting point, we developed compound 4, which showed potent inhibitory activity toward Grp94 in a fluorescence polarization-based assay. With improved physicochemical properties and suitable pharmacokinetic properties, compound 4 was advanced into in vivo bioactivity evaluation. In a dextran sulfate sodium (DSS)-induced mouse model of ulcerative colitis (UC), compound 4 showed anti-inflammatory property and reduced the levels of pro-inflammatory cytokines (TNF-α and IL-6). Together, these findings provide evidence that this approach may be promising for further Grp94 drug development efforts.


ChIP-seq: using high-throughput sequencing to discover protein-DNA interactions.
Chromatin immunoprecipitation (ChIP) allows specific protein-DNA interactions to be isolated. Combining ChIP with high-throughput sequencing reveals the DNA sequence involved in these interactions. Here, we describe how to perform ChIP-seq starting with whole tissues or cell lines, and ending with millions of short sequencing tags that can be aligned to the reference genome of the species under investigation. We also outline additional procedures to recover ChIP-chip libraries for ChIP-seq and discuss contemporary issues in data analysis.


Multisensory enhancement of attentional capture in visual search.
Multisensory integration increases the salience of sensory events and, therefore, possibly also their ability to capture attention in visual search. This was investigated in two experiments where spatially uninformative color change cues preceded visual search arrays with color-defined targets. Tones were presented synchronously with these cues on half of all trials. Spatial-cuing effects indicative of cue-triggered capture of attention were larger on tone-present than on tone-absent trials, demonstrating multisensory enhancements of attentional capture. Larger capture effects for audiovisual events were found when cues were color singletons, and also when they appeared among heterogeneous color distractors. Tone-induced increases of attentional capture were independent of color-specific top-down task sets, suggesting that this multisensory effect is a stimulus-driven bottom-up phenomenon.


Vestibular Organ and Cochlear Implantation-A Synchrotron and Micro-CT Study.
Background: Reports vary on the incidence of vestibular dysfunction and dizziness in patients following cochlear implantation (CI). Disequilibrium may be caused by surgery at the cochlear base, leading to functional disturbances of the vestibular receptors and endolymphatic duct system (EDS) which are located nearby. Here, we analyzed the three-dimensional (3D) anatomy of this region, aiming to optimize surgical approaches to limit damage to the vestibular organ. Material and Methods: A total of 22 fresh-frozen human temporal bones underwent synchrotron radiation phase-contrast imaging (SR-PCI). One temporal bone underwent micro-computed tomography (micro-CT) after fixation and staining with Lugol's iodine solution (I2KI) to increase tissue contrast. We used volume-rendering software to create 3D reconstructions and tissue segmentation that allowed precise assessment of anatomical relationships and topography. Macerated human ears belonging to the Uppsala collection were also used. Drilling and insertion of CI electrodes was performed with metric analyses of different trajectories. Results and Conclusions: SR-PCI and micro-CT imaging demonstrated the complex 3D anatomy of the basal region of the human cochlea, vestibular apparatus, and EDS. Drilling of a cochleostomy may disturb vestibular organ function by injuring the endolymphatic space and disrupting fluid barriers. The saccule is at particular risk due to its proximity to the surgical area and may explain immediate and long-term post-operative vertigo. Round window insertion may be less traumatic to the inner ear, however it may affect the vestibular receptors.


Influence of calcium channel blockers in patients with gastrointestinal disease in Japanese community pharmacies.
Calcium channel blockers (CCBs), which have been widely used for the treatment of hypertension and angina pectoris, decrease lower oesophageal sphincter pressure and, as a result, can exacerbate gastrointestinal disease. In a previous study, increased risk of exacerbation of gastrointestinal disease among elderly patients following treatment with CCBs was identified. The prevalence of gastrointestinal diseases has increased in elderly patients, and it is possible that treatment with CCBs may have undesirably influenced this increase. The change in risk of gastrointestinal disease can be estimated by analysing changes in the prescription of antisecretory drugs as an outcome of exacerbation of gastrointestinal disease caused by CCBs. It was hypothesized that patients who were prescribed CCBs would also change their use of antisecretory drugs. From September 2005 to August 2009, a dynamic retrospective cohort study was performed at five community pharmacies in Nagasaki, Japan, to assess alteration of antisecretory drug therapy following treatment with CCBs. Correlations with alterations of antisecretory drug therapy were determined by the Cox proportional hazards model. The proposed study included 260 patients who were prescribed CCBs and 155 controls. During the study period, 53 patients were prescribed CCBs and 13 controls altered their antisecretory drug therapy; the hazard ratio was 2·22 (95% CI 1·25-4·26). Calcium channel blocker treatment of patients with gastrointestinal disease was associated with alteration in frequency of prescription and an increase in dosage of antisecretory drugs. For clinical management of hypertension, alternative antihypertensive drugs may be considered for patients with gastrointestinal diseases. Further studies are required to determine the influence of CCB therapy on gastroesophageal diseases, suggested by the increase in use of antisecretory drugs.


Update on Charcot-Marie-Tooth disease.
Charcot-Marie-Tooth disease (CMT) disease encompasses a genetically heterogeneous group of inherited neuropathies, also known as hereditary motor and sensory neuropathies. CMT results from mutations in more than 40 genes expressed in Schwann cells and neurons causing overlapping phenotypes. The classic CMT phenotype reflects length-dependent axonal degeneration characterized by distal sensory loss and weakness, deep tendon reflex abnormalities, and skeletal deformities. Recent articles have provided insight into the molecular pathogenesis of CMT, which, for the first time, suggest potential therapeutic targets. Although there are currently no effective medications for CMT, multiple clinical trials are ongoing or being planned. This review will focus on the underlying pathomechanisms and diagnostic approaches of CMT and discuss the emerging therapeutic strategies.


Progressive vocal cord dysfunction subsequent to a chlorine gas exposure.
Chlorine gas inhalation, similar to other toxic gas exposures, can impart a variety of effects to the entire airway ranging from mucous membrane irritation to acute respiratory distress syndrome. The extent and location of damage is determined by numerous situational factors such as the duration of exposure, quantity of gas released, environmental factors, and instituted chemical defense measures. Reactive airways dysfunction and nonspecific bronchial hyperresponsiveness are commonly reported as sequelae to chlorine exposure. This article constitutes the first case of a single antecedent chlorine exposure inducing progressive vocal cord dysfunction.


Preliminary genome wide screening identifies new variants associated with coronary artery disease in Indian population.
Coronary artery disease (CAD) is a major health problem in developed and developing nations. Development of CAD involves a complex interaction between genetics and lifestyle factors. Individuals with high-risk genetic predisposition along with poor lifestyle are more inclined to the development of CAD. Advancement in genotyping technologies and increase in genome wide studies has provided a platform to identify new risk factors associated with CAD and associated complexities. In this study we performed genome wide screening in 76 well-defined CAD cases and 77 control samples in Indian population. Interestingly, new variants are identified in three genes viz, VLDLR, IFITM2 and C2CD4C. The odds ratios observed for variant rs1869592 (VLDLR), rs1059091 (IFITMI) and rs7247159 (C2CD4C) were 2.6 (1.4-4.8 95% CI), 1.9 (95% CI 1.2-3.1) and 2.1 (1.2-3.7 95% CI), respectively with significant P value <0.01. These variants that are associated with pathogenesis of CAD were not previously reported in literature. Moreover, we anticipate that these variants will be further validated using a larger sample size.


Combined Coronary Orbital Atherectomy and Intravascular Lithotripsy for the Treatment of Severely Calcified Coronary Stenoses: The First Case Series.
Severely calcified coronary stenoses remain a significant challenge during contemporary percutaneous coronary intervention (PCI), often requiring advanced therapies to circumvent suboptimal lesion preparation and major adverse cardiac events (MACEs). Recent reports suggest combined coronary atherectomy and intravascular lithotripsy (IVL) may achieve superior preparation of severely calcified coronary stenoses during PCI. We sought to evaluate the safety and utility of combined orbital atherectomy (OA) and IVL for the modification of coronary artery calcification (CAC) prior to drug-eluting stent (DES) implantation in PCI. We performed a retrospective review of all patients who underwent coronary OA and IVL within a single PCI procedure at our institution. The primary outcome was procedural success, defined as successful DES implantation with a residual percent diameter stenosis of <30% and Thrombolysis in Myocardial Infarction (TIMI) 3 flow following PCI without occurrence of in-hospital MACE (cardiac death, myocardial infarction, or target-vessel revascularization). MACE was additionally assessed at 30 days post intervention. Eight patients underwent combined coronary OA and IVL within a single PCI procedure. The mean percent diameter stenosis prior to intervention was 80.5 ± 8.3%, with a mean calcific arc of 338 ± 42°. Procedural success was achieved in 7 of 8 cases (87.5%). Both in-hospital and 30-day MACE rates were 0%. We report the safe and effective use of combined coronary OA and IVL for the preparation of severely calcified coronary stenoses during PCI. Through their distinct yet complementary mechanisms of action, the combined use of these therapies may achieve superior preparation of severely calcified coronary stenoses during PCI.


A model of blebbing in mitotic tissue culture cells.
A preliminary study of blebbing in tissue cultures has been made. The tubal epithelium of fetal mouse oviduct was cultured at 37 degrees C in Rose chambers. A cinematographic record was obtained of phase microscope observations of mitotic cells. Measurements of the size of both cells and blebs were made on the film using a "traveling" microscope. The duration and the rise and decay times of blebs were determined simply by counting frames on the film. Detailed observations are reported on blebbing in four cells undergoing mitosis. The results indicate that the frequency of blebbing as well as the duration of individual blebs exhibits a maximum during telophase. A model is proposed to account for blebbing in mitotic cells. The model attributes to local regions of the cell membrane the property of constant tension independent of stretch over some restricted range of stretch. This property implies that the cell membrane is locally unstable. Further assumptions stated explicitly in the model are that (i) cell division occurs at constant volume, (ii) the cell membrane stretches during cleavage, (iii) there is a positive pressure drop across the cell membrane. Evidence is cited in support of these assumptions as well as independent evidence that the cell membrane may be locally unstable. A physical model is described which would be expected to exhibit blebbing given the above assumptions.


Alterations in vascular endothelial cell-related plasma proteins in thalassaemic patients and their correlation with clinical symptoms.
An increased level of plasma thrombomodulin (TM) in alpha- and beta-thalassaemia was demonstrated using an enzyme-linked immunosorbent assay (ELISA). Nonsplenectomized patients with beta-thalassaemia/haemoglobin E (BE) had higher levels of TM than splenectomized cases (BE-S). Patients with leg ulcers (BE-LU) were found to have the highest increase in TM level. Appearance of larger platelets in all types of thalassaemic blood was observed indicating an increase in the number of younger platelets. These data indicate that injury of vascular endothelial cells is present in thalassaemic patients.


Leptin secretory burst mass correlates with body mass index and insulin in normal women but not in women with polycystic ovary syndrome.
Leptin secretion exhibits a pulsatile, circadian pattern and may play a role in reproduction. No previous studies have compared leptin secretory burst characteristics in normal eumenorrheic women and women with polycystic ovary syndrome (PCOS) who are appropriately matched for body mass index (BMI). To determine if leptin secretory burst characteristics and/or the relationships of BMI, insulin, or testosterone to these characteristics differ between PCOS and normal women, we studied 9 normal eumenorrheic women and 9 women with PCOS. Each woman underwent blood sampling every 10 minutes for 24 hours to measure leptin and insulin under controlled conditions. Leptin secretory bursts were identified and characterized using multiparameter deconvolution procedures (Deconv), and the 24-hour periodicity of leptin was characterized with cosinor analysis. Relationships between BMI, area under the curve (AUC) insulin, and testosterone and leptin secretory burst characteristics in PCOS and normal women were sought using linear regression. There were no significant differences in mean serum leptin concentrations or in secretory burst characteristics between PCOS and normal women. Although the 24-hour serum leptin concentration correlated with BMI in both normal and PCOS women, leptin secretory burst mass correlated with BMI only in normal women. Similarly, the 24-hour serum leptin concentration correlated with serum insulin AUC in both normal and PCOS women; but insulin AUC correlated with leptin burst mass only in normal women. Although there was a strong trend toward a correlation between both mean 24-hour serum leptin concentration and leptin secretory burst mass with the serum testosterone concentration in normal women, such trends were not seen in PCOS women. Both normal and PCOS women exhibited a diurnal rhythm of leptin secretion with the peak occurring at night. However, neither the peak amplitude nor the timing of the peak amplitude differed between normal and PCOS women. The presence of strong relationships between BMI and insulin with both mean serum leptin and leptin secretory burst mass in normal women as opposed to PCOS women suggests that the mechanisms subserving leptin secretion differ in these 2 groups.


It is about time. The advantage of transabdominal cervical length screening.
Sonographic cervical length (CL) measurement has become a standard practice for identifying women at increased risk for preterm birth. We aimed to assess the time needed for CL measurement during fetal anatomy scan using either transabdominal or transvaginal ultrasound, and to provide a predictive value of the transabdominal CL measurements for reassuring transvaginal CL measurements of more than 25 mm. In a prospective study we measured CL transabdominally, and transvaginally in all the anatomy scans performed at 18-25 weeks' gestation, from January 2017 until January 2018. CL and the duration of the examination were compared between the two approaches. Adjustments were made for, body mass index, previous cesarean sections and parity. Four hundred sixty-eight patients participated in the study. The time needed for the transabdominal CL measurement was significantly lower compare with the transvaginal CL measurement (0.46 ± 0.3 min versus 6.9 ± 1.38 min, p < 0.001). The CL measured transabdominally was significantly shorter than the CL measured transvaginally (36.7 ± 6.7 mm versus 41.9 ± 7.3 mm, respectively p < 0.001). All women with transabdominal CL measurements above 36 mm (64.2% of patients) had a transvaginal CL of more than 25 mm. Transvaginal measurement of CL is a time-consuming procedure that prolong fetal anomaly scan by 25%. Transabdominal CL measurement of 36 mm is reassuring CL above 25 mm. Transabdominal ultrasound should be used as an initial tool for CL screening. Transvaginal measurements of CL should be reserved for high-risk women, for women with difficulties in demonstrating the cervix abdominally, and for women with transabdominal measurements of less than 36 mm.


[Study on purification of polysaccharides in root of Salvia miltiorrhiza by macroporous adsorption resin and ion-exchange resin methods].
To study the purification and isolation of polysaccharides from Salvia miltiorrhiza. The root was extracted by water purified preliminarily by alcohol precipitation, and then four different types macroporous adsorption resin and one ion-exchange resin were comparatively investigated in the purification and isolation of Salvia polysaccharides. The total polysaccharides of crude extracts was 40.35%, and protein content amounted to 8.96%. Compared with the traditional methods, AB-8, DB-301 type of resin used in purification of polysaccharides could simplify the working process and obtain better effect. Then the obtained crude polysaccharides through AB-8 resin were purified by ion-exchange resin DEAE-52. Three portions of powder were obtained through lyophilization and named as SMP1, SMP2, SMP3. Purification of Salvia polysaccharides can be conducted by adoping AB-8, DB-301 type of resin and DEAE-52 ion-exchange resin.


Loss of control as a transdiagnostic feature in obesity-related eating behaviours: A systematic review.
Emerging evidence suggests that loss of control (LOC) may present as a common feature across disordered eating behaviours. However, there has been limited research on the transdiagnostic nature of LOC in this area. The primary aim of this study was to systematically review disordered eating behaviours and measures of LOC in clinical and non-clinical populations. Electronic searches of the relevant databases were conducted. Selected articles were screened for eligibility and assessed for methodological quality. Thirty-four studies met inclusion criteria. Findings demonstrated that LOC was associated with disordered eating behaviours across bariatric populations, eating disorder populations, and community populations. Specifically, LOC was associated with binge eating (subjective and objective episodes), grazing, night eating, and emotional or stress eating. Findings also revealed that LOC was inconsistently operationalised across studies, with varied approaches to measuring the construct. Overall, the findings from this review provide support for LOC as a transdiagnostic feature of disordered eating behaviours. Future studies should utilise robust multi-method assessments to measure the severity of LOC, which may provide greater insight into how LOC manifests across different eating disorder presentations.


Weight gain and maturity in fetuses exposed to low levels of lead.
The relationship between prenatal low-level lead exposure and fetal growth was evaluated in a sample of 4354 pregnancies in which the mean umbilical cord blood lead level was 7.0 micrograms/dl (SD = 3.3; 10th percentile, 3.4 micrograms/dl, 90th percentile, 10.9 micrograms/dl). Higher cord blood lead levels were significantly associated with gestations of slightly longer duration. Comparing infants with cord blood lead levels greater than or equal to 15 micrograms/dl to those with levels less than 5 micrograms/dl, adjusted risk ratios of 1.5 to 2.5 were observed for low birth weight (less than 2500 g) and for fetal growth indices that express birth weight as a function of length of gestation (e.g., small-for-gestational age, intrauterine growth retardation). The 95% confidence intervals of these risk ratios included 1, however, precluding rejection of the null hypothesis of no association. We conclude that the risk of adverse fetal growth is not increased at cord blood lead levels less than 15 micrograms/dl but that modest increases in risk may be associated with levels greater than or equal to 15 micrograms/dl.


Modes of podocyte death in diabetic kidney disease: an update.
Diabetic kidney disease (DKD) accounts for a large proportion of end-stage renal diseases that require renal replacement therapies including dialysis and transplantation. Therefore, it is critical to understand the occurrence and development of DKD. Podocytes are mainly injured during the development of DKD, ultimately leading to their extensive death and loss. In turn, the injury and death of glomerular podocytes are also the main culprits of DKD. This review introduces the characteristics of podocytes and summarizes the modes of their death in DKD, including apoptosis, autophagy, mitotic catastrophe (MC), anoikis, necroptosis, and pyroptosis. Apoptosis is characterized by nuclear condensation and the formation of apoptotic bodies, and it exerts a different effect from autophagy in mediating DKD-induced podocyte loss. MC mediates a faulty mitotic process while anoikis separates podocytes from the basement membrane. Moreover, pyroptosis activates inflammatory factors to aggravate podocyte injuries whilst necroptosis drives signaling cascades, such as receptor-interacting protein kinases 1 and 3 and mixed lineage kinase domain-like, ultimately promoting the death of podocytes. In conclusion, a thorough knowledge of the modes of podocyte death in DKD can help us understand the development of DKD and lay the foundation for strategies in DKD disease therapy.


Age at diagnosis and the surgical management of small renal carcinomas: findings from a cross-sectional population-based study.
To describe the use of partial nephrectomy (PN) for patients with stage T1a renal cell carcinoma (RCC) by age group (<65 and ≥65 years) in two Australian states. All adults diagnosed with RCC in 2012 and 2013 were identified through population-based cancer registries in the Australian states of Queensland and Victoria. For each patient, research assistants extracted patient, tumour and treatment data from medical records. Percentages of patients treated by PN were determined for the two age groups. Multivariable logistic regression analyses examined factors associated with PN. Clinicians treating RCC were sent surveys to assess attitudes towards PN. Data were collected on 956 patients (Victoria: n = 548; Queensland: n = 404) with stage T1a RCC. Of those undergoing surgery (n = 865), PN was more common for those aged <65 years (61%) than for those aged ≥65 years (44%), with this difference significant after adjusting for patient, tumour (odds ratio 0.50, 95% confidence interval 0.36-0.70). There were significant interactions between age and treatment centre volume (P < 0.05) and residential state (P < 0.05). PN was less likely for younger patients treated at lower-volume hospitals (<24 patients a year) but hospital volume was not associated with PN for older patients. PN was less likely for older patients in Queensland than Victoria. In multivariable analyses, age was not related to laparoscopic surgery. Queensland clinicians were less likely than those from Victoria to agree that PN was the treatment of choice for most T1aN0M0 tumours (P < 0.001). In Australia, patients aged > 65 years with small renal cancers were less likely to be treated by PN than younger patients. The variation in the surgical procedure used to treat older T1a RCC patients by state and hospital volume indicates that better evidence is needed to direct practice in this area.


Patient Attitudes and Participation in Hand Co-Washing in an Outpatient Clinic Before and After a Prompt.
Despite recent national emphasis, outpatient hand washing can be less than optimal. We tested a new approach involving both patient and physician hand washing. The study consisted of 384 questionnaires, 184 from phase 1 and 200 from phase 2. Patients stated doctors washed their hands 96.6% before examining them pre-intervention and 99.5% of the time post-intervention. Patients endorsed the importance of hand washing 98.7% of the time. "Co-washing" may offer a process to increase the practice of hand washing and decrease infection risk.


Obstructive sleep apnoea due to a dermoid cyst of the floor of the mouth.
A case of obstructive sleep apnoea is reported that was caused by a dermoid cyst of the floor of the mouth and cured by surgery.


Arthrofibrosis Associated With Total Knee Arthroplasty.
Arthrofibrosis is a debilitating postoperative complication of total knee arthroplasty (TKA). It is one of the leading causes of hospital readmission and a predominant reason for TKA failure. The prevalence of arthrofibrosis will increase as the annual incidence of TKA in the United States rises into the millions. In a narrative review of the literature, the etiology, economic burden, treatment strategies, and future research directions of arthrofibrosis after TKA are examined. Characterized by excessive proliferation of scar tissue during an impaired wound healing response, arthrofibrotic stiffness causes functional deficits in activities of daily living. Postoperative, supervised physiotherapy remains the first line of defense against the development of arthrofibrosis. Also, adjuncts to traditional physiotherapy such as splinting and augmented soft tissue mobilization can be beneficial. The effectiveness of rehabilitation on functional outcomes depends on the appropriate timing, intensity, and progression of the program, accounting for the patient's ability and level of pain. Invasive treatments such as manipulation under anesthesia, debridement, and revision arthroplasty improve range of motion, but can be traumatic and costly. Future studies investigating novel treatments, early diagnosis, and potential preoperative screening for risk of arthrofibrosis will help target those patients who will need additional attention and tailored rehabilitation to improve TKA outcomes. Arthrofibrosis is a multi-faceted complication of TKA, and is difficult to treat without an early, tailored, comprehensive rehabilitation program. Understanding the risk factors for its development and the benefits and shortcomings of various interventions are essential to best restore mobility and function.


Biochemical composition of human internal mammary artery and saphenous vein.
The long-term patency of the internal mammary artery graft is better than that of the saphenous vein graft in coronary bypass surgery because of a low incidence of atherosclerosis in the internal mammary artery. In search of a possible biochemical explanation of the low degree of atherosclerosis in the internal mammary artery we compared the chemical compositions of human internal mammary artery and saphenous vein obtained from 37 patients undergoing coronary bypass surgery. The levels of esterified cholesterol and free cholesterol were higher in the internal mammary artery than in the saphenous vein (p less than 0.001 and p less than 0.01, respectively), but lower than the levels reported in previous studies for coronary arteries. The amount of collagen was higher in the saphenous vein (p less than 0.001). Heparan sulfate was the major glycosaminoglycan fraction in the internal mammary artery, probably reflecting the higher cellularity and thicker media in the arterial rather than in the venous tissue. The level of dermatan sulfate was higher (p less than 0.001) in the saphenous vein than in the internal mammary artery. This difference is in a direction that could favor atherogenesis in the saphenous vein graft.


Time trends in birth incidence of cystic fibrosis in two European areas: data from newborn screening programs.
To determine the incidence of cystic fibrosis (CF) and its time trends over a 16-year period (1990 to 2005) in 2 European regions with a long history of newborn screening (NBS) for CF, and to investigate the impact of some external factors. This study focused on data from NBS and prenatal diagnosis (PD) in Brittany (western France) and Veneto/Trentino Alto-Adige (northeastern Italy). Similar birth incidences of CF were observed in the 2 regions (1/3153 vs 1/3540; P = .245). Time trend analysis using Poisson regression revealed that the birth incidence decreased significantly in the Italian area only (average annual percent change [AAPC] = -4.7%; 95% confidence interval [CI] = -7.3 to -2; P = .0008). The use of PD appeared more common in Brittany, and considering the terminations of CF-affected fetuses, the adjusted incidence was 1/2191 in Brittany and 1/3116 in Veneto/Trentino, corresponding to variations of 30.5% (highly significant; P = .0002) and 12% (not significant; P = .16), respectively. Recording the reason for each PD allowed ready assessment of the affect of various public health policies on incidence. The affect of population mixing also appeared to be relevant in the Italian area. This study highlights how the incidence of CF has evolved in 2 European regions that have different attitudes toward PD and immigration policy.


Voice Acoustics and Vocal Effort in Mask-Wearing Healthcare Professionals: A Comparison Pre- and Post-Workday.
We evaluated voice acoustics and self-perceptual ratings in healthcare workers required to wear face masks throughout their workday. Eighteen subjects (11 cisgender female, 7 cisgender male; M = 33.72 years, SD = 8.30) completed self-perceptual ratings and acoustic recordings before and after a typical workday. Chosen measures were specific to vocal effort, dysphonia, and laryngeal tension. Mixed effects models were calculated to determine the impact of session, mask type, sex, and their interactions on the set of perceptual and acoustic measures. The subjects self-reported a significant increase in vocal effort following the workday. These perceptual changes coincided with an increase in vocal intensity and harmonics-to-noise ratio, but decrease in relative fundamental frequency offset 10. As expected, men and women differed in measures related to fundamental frequency and vocal tract length. Healthcare professionals wearing masks reported greater vocal symptoms post-workday compared to pre-workday. These symptoms coincided with acoustic changes previously related to vocal effort; however, the degree of change was considered mild. Further research is needed to determine whether vocal hygiene strategies may reduce vocal symptoms in mask-wearing workers.


Application of machine learning to understand child marriage in India.
Prior research documents that India has the greatest number of girls married as minors of any nation in the world, increasing social and health risks for both these young wives and their children. While the prevalence of child marriage has declined in the nation, more work is needed to accelerate this decline and the negative consequences of the practice. Expanded targets for intervention require greater identification of these targets. Machine learning can offer insight into identification of novel factors associated with child marriage that can serve as targets for intervention. We applied machine learning methods to retrospective cross-sectional survey data from India on demographics and health, the nationally-representative National Family Health Survey, conducted in 2015-16. We analyzed data using a traditional regression model, with child marriage as the dependent variable, and 4000+ variables from the survey as the independent variables. We also used three commonly used machine learning algorithms- Least Absolute Shrinkage and Selection Operator (lasso) or L-1 regularized logistic regression models; L2 regularized logistic regression or ridge models; and neural network models. Finally, we developed and applied a novel and rigorous approach involving expert qualitative review and coding of variables generated from an iterative series of regularized models to assess thematically key variable groupings associated with child marriage. Analyses revealed that regularized logistic and neural network applications demonstrated better accuracy and lower error rates than traditional logistic regression, with a greater number of features and variables generated. Regularized models highlight higher fertility and contraception, longer duration of marriage, geographic, and socioeconomic vulnerabilities as key correlates; findings shown in prior research. However, our novel method involving expert qualitative coding of variables generated from iterative regularized models and resultant thematic generation offered clarity on variables not focused upon in prior research, specifically non-utilization of health system benefits related to nutrition for mothers and infants. Machine learning appears to be a valid means of identifying key correlates of child marriage in India and, via our innovative iterative thematic approach, can be useful to identify novel variables associated with this outcome. Findings related to low nutritional service uptake also demonstrate the need for more focus on public health outreach for nutritional programs tailored to this population.


Helical intermediate formation and its role in amyloids of an amphibian antimicrobial peptide.
Helical intermediates appear to be crucial in the amyloid formation of several amyloidogenic peptides, including Aβ, that are implicated in different neurodegenerative diseases. Intermediate species of amyloid formation have been reported to be more toxic than mature amyloid fibrils. Hence, the current work focuses on understanding the mechanistic roles of the helical intermediates in the early stages of amyloid self-assembly in amyloidogenic peptides. Molecular dynamics (MD) simulations and the adaptive biasing force (ABF) method were utilized to investigate structural changes that lead to amyloid formation in amphibian peptide uperin-3.5 (U3.5), an antimicrobial and amyloidogenic peptide. Microsecond time-scale MD simulations revealed that peptide aggregation, into β-sheet dominated aggregates, is centred on two important factors; evolution of α-helical intermediates and the critical role of local peptide concentration inside these aggregates. Electrostatic attraction between the oppositely charged aspartate (D) and arginine (R) residues located near the N-terminus induced hydrogen bonding resulting in the formation of precursor 310-helices close to the N-terminus. The 310-helices transitioned into α-helices, thereby imparting partial helical conformations to the peptides. In the initial stages of aggregation, U3.5 peptides with amphipathic, partial helices were driven closer by hydrophobic interactions to form small clusters of helical intermediates. These helices imparted stability to the helical intermediates, which promoted the growth of clusters by further addition of peptides. This led to an increase in the local peptide concentration, which enabled stronger peptide-peptide interactions and triggered a β-sheet transition in these aggregates. Thus, this study emphasized that the helical intermediates may be crucial to the evolution of β-sheet-rich amyloid structures.


Differential Trends in Disability Among Rich and Poor Adults in the United States and England From 2002 to 2016.
Disability in the United States has not improved in recent decades. Comparing temporal trends in disability prevalence across different income groups, both within and between the United States and England, would inform public policy aimed at reducing disparities in disability. Using the Health and Retirement Study and the English Longitudinal Study of Ageing, we estimated annual percent change from 2002 to 2016 in disability among community-dwelling adults (197,021 person-years of observations). Disability was defined based on self-report of limitations with 5 instrumental activities of daily living and 6 activities of daily living. We examined the trends by age and income quintile and adjusted for individual-level sociodemographic status and survey design. The adjusted annual percent change (AAPC) in disability prevalence declined significantly in both countries for ages 75 and older during 2002-2016. For ages 55-64 and 65-74, disability prevalence was unchanged in the United States but declined in England. Both countries experienced a widening gap in disability between low- and high-income adults among the younger age groups. For example, for those ages 55-64 in each country, there was no significant improvement in disability for the low-income group but a significant improvement for the high-income group (AAPC = -3.60; 95% confidence interval [CI; -6.57, -0.63] for the United States; AAPC = -6.06; 95% CI [-8.77, -3.35] for England). Improvements in disability were more widespread in England than in the United States between 2002 and 2016. In both countries, the disparity in disability between low- and high-income adults widened for middle-aged adults. Policies targeted at preventing disability among low-income adults should be a priority in both countries.


Controlled release recombinant human interferon-α2b for treating patients with chronic hepatitis C genotype 1: a phase 2a clinical trial.
Better convenience and tolerability and sustained therapeutic concentrations might improve interferon (IFN) treatment for chronic hepatitis C virus (HCV) infection. In an open-label, randomized study, controlled release free (chemically unmodified) recombinant human IFN-α(2b) in poly(ether-ester) microspheres (CR-rhIFN-α(2b)), was injected at doses of 160, 320, 480 or 640 μg every 2 weeks for 12 weeks with concomitant weight-based oral ribavirin in 32 treatment-naïve patients with chronic HCV genotype 1. Treatment was well tolerated, with 31 patients (97%) successfully completing the study. Full doses of CR-rhIFN-α(2b) were administered on 96% of scheduled occasions. Flu-like symptoms were generally mild and brief. Injection site reactions developed in 13 patients (41%), and neutropenia occurred in six of eight patients receiving 640 μg. In the 320, 480 and 640 μg groups, 62-75% of patients achieved a ≥2 log(10) HCV RNA reduction by 4 weeks and 88-100% by 12 weeks. For those groups, the pooled median time to ≥2 log(10) reduction was 11 days (95% confidence interval, 7-35 days). In those groups, viral reduction below the limit of detection was accomplished in 25% of patients by 4 weeks and in 62% by 12 weeks. The 160-μg dose was less potent. After CR-rhIFN-α(2b) injection, stable plateau levels of serum IFN-α(2b) were generally reached within 72 h. Treatment-emergent neutralizing antibodies to IFN-α(2b) were observed in one patient. No antibodies to host plant proteins were detected. CR-rhIFN-α(2b) with ribavirin cotherapy was well tolerated and displayed potent early antiviral activity in patients with chronic HCV genotype 1.


Huperzine A regulates amyloid precursor protein processing via protein kinase C and mitogen-activated protein kinase pathways in neuroblastoma SK-N-SH cells over-expressing wild type human amyloid precursor protein 695.
Alpha-secretase (alpha-secretase), cleaves the amyloid precursor protein (APP) within the amyloid-beta (Abeta) sequence, resulting in the release of a secreted fragment of APP (alphaAPPs) and precluding Abeta generation. We investigated the effects of the acetylcholinesterase inhibitor, huperzine A (Hup A), on APP processing and Abeta generation in human neuroblastoma SK-N-SH cells overexpressing wild-type human APP695. Hup A dose-dependently (0-10 microM) increased alphaAPPs release. Therefore, we evaluated two alpha-secretase candidates, a disintegrin and metalloprotease (ADAM) 10 and ADAM17 in Hup A-induced non-amyloidogenic APP metabolism. Hup A enhanced the level of ADAM10, and the inhibitor of tumor necrosis factor-alpha converting enzyme (TACE)/ADAM17 inhibited the Hup A-induced rise in alphaAPPs levels, further suggesting Hup A directed APP metabolism toward the non-amyloidogenic alpha-secretase pathway. Hup A had no effect on Abeta generation in this cell line. The steady-state levels of full-length APP and cell viability were unaffected by Hup A. Alpha-APPs release induced by Hup A treatment was significantly reduced by muscarinic acetylcholine receptor antagonists (particularly by an M1 antagonist), protein kinase C (PKC) inhibitors, GF109203X and calphostin C, and the mitogen-activated kinase kinase (MEK) inhibitors, U0126 and PD98059. Furthermore, Hup A markedly increased the phosphorylation of p44/p42 mitogen-activated protein (MAP) kinase, which was blocked by treatment with U0126 and PD98059. In addition, Hup A inhibited acetylcholinesterase activity by 20% in neuroblastoma cells. Our results indicate that the activation of muscarinic acetylcholine receptors, PKC and MAP kinase may be involved in Hup A-induced alphaAPPs secretion in neuroblastoma cells and suggest multiple pharmacological mechanisms of Hup A regarding the treatment of Alzheimer's disease (AD).


QA of dynamic MLC based on EPID portal dosimetry.
Dynamic delivery of intensity modulated beams (dIMRT) requires not only accurate verification of leaf positioning but also a control on the speed of motion. The latter is a parameter that has a major impact on the dose delivered to the patient. Time consumed in quality assurance (QA) procedures is an issue of relevance in any radiotherapy department. Electronic portal imaging dosimetry (EPID) can be very efficient for routine tests. The purpose of this work is to investigate the ability of our EPID for detecting small errors in leaf positioning, and to present our daily QA procedures for dIMRT based on EPID. A Varian 2100 CD Clinac equipped with an 80 leaf Millennium MLC and with amorphous silicon based EPID (aS500, Varian) is used. The daily QA program consists in performing: Stability check of the EPID signal, Garden fence test, Sweeping slit test, and Leaf speed test. The EPID system exhibits good long term reproducibility. The mean portal dose at the centre of a 10 × 10 cm(2) static field was 1.002 ± 0.004 (range 1.013-0.995) for the period evaluated of 47 weeks. Garden fence test shows that leaf position errors of up to 0.2 mm can be detected. With the Sweeping slit test we are able to detect small deviations on the gap width and errors of individual leaves of 0.5 and 0.2 mm. With the Leaf speed test problems due to motor fatigue or friction between leaves can be detected. This set of tests takes no longer than 5 min in the linac treatment room. With EPID dosimetry, a consistent daily QA program can be applied, giving complete information about positioning/speed MLC.


The lipid intermediates arising during glycoprotein biosynthesis in liver microsomes.
Incubation of liver microsomes with GDP [14C] mannose leads to the formation of lipid-linked derivatives of [14C] mannose, a dolichol phosphate monosaccharide and dolichol pyrophosphate oligosaccharides. Standard procedures for separating these two types of compounds from each other were found to be deficient in that fractions thought to contain only dolichol pyrophosphate oligosaccharides are contaminated with dolichol phosphate mannose. This paper presents a column chromatographic procedure which conveniently separates the products of an 8 min labeling experiment into two components; dolichol phosphate [14C]mannose and a [14C]-mannose containing oligosaccharide which is also lipid bound. When this oligosaccharide is released from the lipid by hydrolysis and chromatographed on Sephadex G-50 or G-15 it gives a single peak with an indicated molecular weight of 1100. However, when this released oligosaccharide is chromatographed on concanavalin A Sepharose it is resolved into two peaks suggesting that there may be 2 oligosaccharide of approximately the same size but different structures. After brief periods of labeling with GDP [14C]mannose (5 s) an additional oligosaccharide of 3 to 4 sugar residues can be found in the dolichol pyrophosphate oligosaccharides fraction. Incubation of liver microsomes with UDP [14C]glucose or UDP[14C]galactose produces oligosaccharide components containing 7--8 sugar residues. Labeling of microsomes with UDP[14C]acetylglucosamine gives rise to three different components, including a lipid bound oligosaccharide containing 3- 5 sugar residues.


CRF antagonist reverses the "anxiogenic" response to ethanol withdrawal in the rat.
The role of the neuropeptide corticotropin-releasing factor (CRF) in mediating the behavioral effects of ethanol withdrawal in the rat was examined using the elevated plus-maze test. In Experiment 1, CRF (0.5 microgram ICV) reduced the percentage of time spent on the open arms of the elevated plus-maze, consistent with an "anxiogenic-like" effect. CRF also reduced the total number of arm entries, indicating a reduction in general activity. Low doses (5 and 25 micrograms ICV) of the CRF antagonist, alpha-helical CRF produced no behavioral effects in the elevated plus-maze, while a higher dose (50 micrograms ICV) elicited CRF-like activity. In experiment 2, rats were maintained for 2-3 weeks on a liquid diet containing ethanol (8.5-11.5% v/v) or sucrose. Eight hours after withdrawal from the ethanol diet rats displayed "anxiogenic-like" responses as well as a reduction in general activity in the elevated plus-maze compared with rats withdrawn from control diet. Alpha-helical CRF significantly antagonized the "anxiogenic-like" effects of ethanol withdrawal in the plus-maze. General activity and physical signs of ethanol withdrawal such as tail stiffness, body tremor and ventromedial distal flexion were unaffected by alpha-helical CRF. Blood Alcohol Levels (BALs) determined immediately after removal of the ethanol diet showed no group differences in ethanol consumption. These results suggest that increased activity of central CRF systems may mediate the anxiogenic effects of ethanol withdrawal.


[Formation of the dysentery epidemic process in three small towns].
Data are presented concerning the epidemiological analysis of Sonnei dysentery outbreaks in three towns connected by common nutrition and water supply. The epidemic processes in these populated localites were strongly interrelated. Possibilities of the effect of the water factor on the extent of Sonnei dysentery incidence were studied as well. The results of studies led to the conclusion on the presence of numerous action forms of the water factor which should be taken into consideration in carrying out prophylactic and antiepidemic measures in Sonnei dysentery.


Toward high-performance nanofibrillated cellulose/aramid fibrid paper-based composites via polyethyleneimine-assisted decoration of silica nanoparticle onto aramid fibrid.
Flexible paper-based nanocomposites dielectrics are of crucial importance in electrical insulation and advanced electrical power systems. In this work, a novel nanofibrillated cellulose/aramid fibrid (NFC/AF) composite was fabricated by vacuum-assisted filtration process. In order to improve the dielectric property of the composites, carboxylated nano-SiO2 was chemically coated onto aramid fibrid via molecular self-assembly with the aid of phosphoric acid (PA) pretreatment and subsequent polyethyleneimine (PEI) functionalization. It was found that composites prepared by NFC and (PEI/SiO2)-modified AF (after crosslinking) ((PEI/SiO2)-AF) showed dense structure, which was mainly due to enhanced interfacial interaction between AF and NFC. Consequently, NFC/(PEI/SiO2)-AF paper-based composites showed better tensile toughness (∼6 % elongation at break) and mechanical strength (∼36.28 MPa), in comparison with NFC/AF. More importantly, the electrical insulation performance and thermal stability of the composites were significantly improved. Accordingly, this work provides a facile approach to fabricate high-performance dielectric composites especially for high-temperature electrical insulation applications.


(-)-Brunneusine, a new phenolic compound with antibacterial properties in aqueous medium from the leaves of Agelanthus brunneus (Engl.) Tiegh (LORANTHACEAE).
Agelanthus brunneus (Loranthaceae) is a hemiparasitic plant growing on Senna siamea (Fabaceae). The chemical investigation of its leaves and flowers led to the isolation of one new phenolic compound namely (-)-brunneusine (1), together with 13 known compounds. The crude leaves and flowers extracts (CLE and CFLE) with their ethyl acetate fractions (EAFL and EAFFL) and some isolated compounds (1-3; 8-9 and 11-14) have been tested on four bacterial species of sanitary importance isolated in an aquatic environment. All the samples except compound 3 showed antibacterial activity with MICs ranging from 0.43 to 8.88.103 µg/mL and MBCs from 0.43 to 3.55.103 µg/mL. Compounds 9 and 14 showed better activity on all bacterial species tested with MICs ranging from 0.43 to 27.77 µg/mL. Only CLE, EAFL and compounds 14, 2, 8 and 9 showed bactericidal effects on all bacterial species tested.


Therapeutic drug monitoring of high-dose gentamicin in an elderly patient: a case report.
To report the pharmacokinetics of gentamicin using traditional multiple daily doses and a high-dose regimen in an elderly patient. An 80-year-old male who presented with mild renal failure received two different gentamicin dosing regimens, 60 mg every 8 h for septicemia and a high dose of 400 mg with extended interval for suspected endocarditis. Based on population parameters of k(e) (0.1030 h(-1)) and Vd (18.1 liters), the initial gentamicin dosage regimen was calculated to be 80 mg every 12 h. The measured peak and trough concentrations were used to calculate the individual parameters of k(e) (0.0749 h(-1)) and Vd (30.9 liters). After a 5-mg.kg(-1) gentamicin dose, the Hartford nomogram was used to estimate the extended dosage interval. The Hartford nomogram may be a valid tool for estimating the dosage interval after a 5-mg.kg(-1) single dose of gentamicin.


[RELATIONSHIP BETWEEN SMOKING AND INDICATORS OF SYSTEMIC INFLAMMATION IN PATIENTS WITH CORONARY HEART DISEASE].
To estimate the severity of systemic inflammation in subjects with coronary artery disease (CAD) without bronchopulmonary system comorbidity depending on smoking factor. The subjects were divided into groups depending on smoking factor. We estimated the following laboratory markers of nonspecific inflammation: interleukine (IL)-12, -1β, tumour necrosis factor-α, matrix metalloproteinase-9, C-reactive protein. The examination of lungs respiratory function included spirometry, body plethysmography and assessment of diffusing lung capacity. 29.9% of the subjects with CAD smoked, 40% reported discontinuation of smoking in their histories. Smoking in CAD subjects without the history of bronchopulmonary system comorbidity was associated with a higher level of inflammatory markers (IL-12, IL-1β, TNF-α, ММР-9 and CRP) than in subjects who ceased to smoke and those who have never smoked. No differences in the levels of inflammatory markers were revealed in subjects who had smoked before and never smoked. Smoking is widespread among CAD subjects. It is associated with a higher level of markers of nonspecific inflammation as compared to subjects who have never smoked before or ceased smoking.


Lewis acid mediated reactions of cyclopropyl aryl ketones with alpha-ketoesters: facile preparation of 5,6-dihydropyran-2-ones.
[reaction: see text] A new general method for the synthesis of 5,6-dihydropyran-2-ones from cyclopropyl aryl ketones (monoactivated cyclopropanes) and alpha-ketoesters in good to excellent yields has been developed. The process involves a cascade of reactions, including a nucleophilic ring-opening reaction of monoactivated cyclopropane by H2O, Lewis acid mediated transesterification, and an aldol type reaction.


Kinetic differences in the effect of calcium on quantal and non-quantal acetylcholine release at the murine diaphragm.
The effects of Ca2+ withdrawal on non-quantal, evoked quantal and spontaneous quantal release of acetylcholine (ACh) from the motor nerve terminals were studied with standard intracellular recording techniques. Anticholinesterase-treated mouse diaphragms were used. In a Ca2(+)-free solution all forms of ACh release decreased, but with different kinetics. As expected, evoked quantal release declined to zero within a few minutes. Spontaneous quantal release, i.e. the frequency of the miniature end-plate potentials (MEPPs), decreased to 15% of the control within 20 min after calcium withdrawal. The slowest decay was that of non-quantal release which declined very slowly and reached zero after 45-50 min. Following Ca2+ re-admission, both quantal types of ACh release were rapidly restored (evoked in 10 min, spontaneous in 20 min). However, recovery of non-quantal release did not occur until after 50 to 60 min.


Comparison of resection site of standardized laparoscopic hepatic tumor resection.
The degree of difficulty in laparoscopic hepatic resection (LHR) was higher in tumors involving the suprahepatic segments than other sites. However, thanks to surgical instruments and procedures being improved and standardized, LHR can be performed safely in all regions. We report our standardized surgical techniques and outcomes in a series of patients undergoing LHR in our hospital and analyze the surgical outcomes, particularly with regard to the site of resection. We retrospectively analyzed data from 238 patients who underwent standardized laparoscopic partial hepatic resection between 2010 and 2017. In standardized LHR, the operator formed a triangle with the laparoscope in the center, maintaining a co-axial position by changing the port where the laparoscope was inserted. Operative time for the resection of tumors of the right hepatic lobe was 202 ±92 min and 140 ±104 min for tumors of the left hepatic lobe (p = 0.0024); intraoperative blood loss was 80 ±170 ml and 19 ±127 ml, respectively (p = 0.0016). No differences were found in the surgical outcomes between the various segments of the right hepatic lobe. In the left hepatic lobe, operative time was significantly shorter with laparoscopic tumor resection in segment III (p = 0.0023). During standardized LHR, a better field of vision with the greater ease can be established during resection of the left hepatic lobe compared to that of the right hepatic lobe. Nonetheless, LHR of the right lobe can be performed safely using various surgical instruments and techniques.


Comparison of different cytomegalovirus diseases following haploidentical hematopoietic stem cell transplantation.
Cytomegalovirus (CMV) can cause end-organ diseases including pneumonia, gastroenteritis, retinitis, and encephalitis in hematopoietic stem cell transplantation recipients. Potential differences among different CMV diseases remain uncertain. This study aimed to compare the clinical characteristics, risk factors, and mortality among different CMV diseases. A retrospective nested case-control study was performed based on a cohort of 3862 patients who underwent haploidentical hematopoietic stem cell transplantation at a single-center. CMV diseases occurred in 113 (2.92%) of 3862 haplo-HSCT recipients, including probable CMV pneumonia (CMVP, n = 34), proven CMV gastroenteritis (CMVG, n = 34), CMV retinitis (CMVR, n = 31), probable CMV encephalitis (CMVE, n = 7), and disseminated CMV disease (Di-CMVD, n = 7). Most (91.2%) cases of CMVG developed within 100 days, while most (90.3%) cases of CMVR were late onset. Refractory CMV infection and CMV viral load at different levels were associated with an increased risk of CMVP, CMVG, and CMVR. Compared with patients without CMV diseases, significantly higher non-relapse mortality at 1 year after transplantation was observed in patients with CMVP and CMVR, rather than CMVG. Patients with CMVP, Di-CMVD, and CMVE had higher overall mortality after diagnosis than that of patients with CMVG and CMVR (61.7%, 57.1%, 40.0% vs 27.7%, 18.6%, P = 0.001). In conclusion, the onset time, viral dynamics, and mortality differ among different CMV diseases. The mortality of CMV diseases remains high, especially for CMVP, Di-CMVD, and CMVE.


Brain natriuretic peptide levels in middle aged subjects with normal left ventricular function in relation to mild-moderate COPD.
Levels of plasma brain natriuretic peptide (BNP) have been shown to be elevated in chronic obstructive pulmonary disease (COPD) especially in connection with cor pulmonale (CP) and the late stages of the disease. BNP is also raised in left sided heart failure which sometimes coincides with COPD. Whether BNP is elevated in subjects with mild-moderate stable COPD and normal left ventricular function is not clear. To investigate BNP levels in subjects with mild-moderate COPD and normal left ventricular function. This was a cross sectional study of 450 subjects from a population-based respiratory questionnaire survey. All subjects were examined with echocardiography and spirometry and blood samples were drawn for BNP measurements. Subjects with left sided heart disease (n = 26) or echocardiographic signs of elevated filling pressure (n = 75), COPD stages III and IV (n = 5) or missing data (n = 13) were excluded. In the final study population (n = 331) spirometry identified 86 subjects with COPD (GOLD stage I, n = 65 and GOLD stage II, n = 21). In comparison with the rest of the study population subjects with COPD were significantly older, longer and with a male predominance. In a multivariate linear regression analysis with log-normalized (lnBNP) as the dependent variable a significant correlation was found with age, left atrial volume, body surface area and haemoglobin, but not with any pulmonary variables. Even when comparing groups no significant difference could be found between the plasma levels of lnBNP in normal subjects (1.8 ± 0.7 mean ± SD, pmol/L) subjects and in COPD subjects (1.9 ± 0.7, P = 0.47). In a population with normal left ventricular function no significant differences in BNP levels between stable mild-moderate COPD subjects and normal individuals could be found.


Management of intrahepatic recurrence after curative treatment of colorectal liver metastases.
Management of intrahepatic recurrence after complete surgical treatment for colorectal liver metastases is not well defined. The aim of this study was to analyse the survival results of patients who had repeat liver resection for intrahepatic recurrence and to evaluate prognostic indicators for survival. Between 1991 and 2005, 55 patients had repeat liver resection for isolated intrahepatic recurrence. The long-term survival results were assessed. Univariable and multivariable analyses were used to identify prognostic indicators for survival after repeat hepatectomy. The median survival was 53 (range 2-97) months and the 5-year survival rate was 49 per cent. In univariable analysis, size of largest initial liver metastasis, margin of initial liver surgery, carcinoembryonic antigen (CEA) level before and after initial liver surgery, liver disease-free survival, margin of repeat liver surgery, operation type of repeat surgery and CEA level before and after repeat surgery were significant prognostic factors. In multivariable analysis, largest initial liver metastasis 4 cm or less and CEA level 5 ng/ml or less after repeat liver surgery were independently associated with improved survival. Repeat hepatectomy can achieve an acceptable survival in selected patients with isolated intrahepatic recurrence.


Primary Total Knee Arthroplasty Performed Using High-Viscosity Cement is Associated With Higher Odds of Revision for Aseptic Loosening.
Aseptic loosening (AL) is the most common reason for revision total knee arthroplasty (TKA). An association between high-viscosity cement (HVC) and AL has been suggested by small, uncontrolled, case series. This study sought to determine whether HVC use during primary TKA is independently associated with AL requiring revision. We retrospectively analyzed a prospectively collected institutional knee registry to identify all primary TKAs from January 2007 to December 2016. Patients with less than 2 years of follow-up were excluded. Cement type was divided into 2 groups: HVC and low-viscosity cement. Potential confounders including age, body mass index, preoperative diagnosis, antibiotics in the cement, and implant type were recorded. Multivariable logistic regression analysis was used to determine whether HVC is independently associated with revision for AL. In total, 10,014 patients were included. Revision for AL was significantly higher in the HVC cohort (91/4790; 1.9%) vs the low-viscosity cement cohort (48/5224; 0.92%) (P < .001). Logistic regression demonstrated HVC to be independently associated with higher odds of revision for AL (odds ratio 2.26, 95% confidence interval 1.58-3.22, P < .001). Younger age was also associated with higher odds of revision for AL (odds ratio 0.96, 95% confidence interval 0.94-0.98, P < .001). Body mass index, gender, laterality, preoperative diagnosis, and antibiotics in the cement were not associated with revision for AL. Implant manufacturer, implant design, and cement brand all impacted the odds of undergoing revision for AL. Although HVC is an attractive option for use in primary TKA, this appropriately controlled study demonstrates higher odds of revision for AL when using HVC with multiple different implant types.


Function, occurrence and inhibition of different forms of BAFF.
B cell activating factor (BAFF or BLyS), an important cytokine for B cell survival and humoral immune responses, is targeted in the clinic for the treatment of systemic lupus erythematosus. This review focuses on the structure, function and inhibition profiles of membrane-bound BAFF, soluble BAFF 3-mer and soluble BAFF 60-mer, all of which have distinct properties. BAFF contains a loop region not required for receptor binding but essential for receptor activation via promotion of BAFF-to-BAFF contacts. This loop region additionally allows formation of BAFF 60-mer, in which epitopes of the BAFF inhibitor belimumab are inaccessible. If 60-mer forms in humans, it is predicted to be short-lived and to act locally because adult serum contains a BAFF 60-mer dissociating activity. Cord blood contains elevated levels of BAFF, part of which displays attributes of 60-mer, suggesting a role for this form of BAFF in the development of foetal or neonate B cells.


Adsorption kinetics, thermodynamics, and isotherm studies for functionalized lanthanide-chelating resins.
Conventional ion exchange resins are widely utilized to remove metals from aqueous solutions, but their limited selectivity precludes dilute ion extraction. This research investigated the adsorption performance of ligand-functionalized resins towards rare earth elements (REE). Functionalized resin particles were synthesized by grafting different ligands (diethylenetriaminepentaacetic dianhydride (DTPADA), phosphonoacetic acid (PAA), or N,N-bis(phosphonomethyl)glycine (BPG)) onto pre-aminated polymeric adsorbents (diameter ∼ 0.6 mm). Lanthanide uptake trends were evaluated for the functionalized resins using batch adsorption experiments with a mixture of three REEs (Nd, Gd, and Ho at 0.1-1000 mg/L each). Resin physical-chemical properties were determined by measuring their surface area, ligand concentrations, and acidity constants. The aminated supports contained 4.0 mmol/g primary amines, and ligand densities for the functionalized resins were 0.33 mmol/g (PAA), 0.22 mmol/g (BPG), and 0.42 mmol/g (DTPADA). Kinetic studies revealed that the functionalized resins followed pseudo-second order binding kinetics with rates limited by intraparticle diffusion. Capacity estimates for total REE adsorption based on Langmuir qMax were 0.12 mg/g (amine; ≈ 0.77 µmol/g), 5.0 mg/g (PAA; ≈ 32.16 µmol/g), 3.0 mg/g (BPG; ≈ 19.30 µmol/g), and 2.9 mg/g (DTPADA; ≈ 18.65 µmol/g). Attaching ligands to the aminated resins greatly improved their REE binding strength and adsorption efficiency.


Reliability of aneuploidy estimates in human sperm: results of fluorescence in situ hybridization studies using two different scoring criteria.
Aneuploidy estimates for chromosomes 1, 12, X, and Y were obtained in human sperm from five donors using multicolor fluorescence in situ hybridization (FISH) analysis. Disomy frequencies were obtained by scoring a minimum of 10,000 sperm for each chromosome probe per donor. This analysis was replicated for two scoring criteria: one used one half of a signal domain as the minimum distance between two signals to be counted as two and thus disomic; the other set one signal domain as the minimum distance between two signals. A total of 120,870 sperm were assessed using one half of a domain as the criterion, and 113,478 were scored using one domain as the criterion. The percentage of disomy for chromosomes 1, 12, X, Y, and XY was 0.18, 0.16, 0.15, 0.19, and 0.25, respectively, using the one-half-domain criterion, and 0.08, 0.17, 0.07, 0.12, and 0.16, respectively, using the one-domain criterion. The percentage of disomy decreased significantly with use of one domain as the minimum distance for signal separation for all chromosomes except for chromosome number 12. These lower disomy frequencies correlated well with frequencies derived from human sperm karyotypes analyzed in our laboratory. This suggests that the fluorescent signals for chromosomes 1, X, and Y split into more than one domain in decondensed interphase sperm, and that the use of the one-half-domain criterion would lead to an overestimate of aneuploidy frequencies. The factors known to affect aneuploidy estimates derived from FISH studies are discussed, and recommendations for stringent scoring criteria are proposed.


Widespread post-traumatic acute spinal subdural haematoma: case report and review of the literature.
A case report of acute post-traumatic spinal subdural haematoma (ASSH). To report a rare post-traumatic problem. Dicle University Hospital, Diyarbakir, Turkey. A 3-year-old boy was admitted to our clinic with paraplegia 24 h after falling from a height of about 5 meters. Investigation revealed an acute spinal subdural haematoma. Following surgery there was marked improvement. The rehabilitation of the patient continues. MRI is the most valuable diagnostic method. In each case diagnosed as ASSH, prompt evacuation should be performed before irreversible neurological damage occurs.


For children admitted to hospital, what interventions improve medication safety on ward rounds? A systematic review.
Every year, medication errors harm children in hospitals. Ward rounds are a unique opportunity to bring information together and plan management. There is a need to understand what strategies can improve medication safety on ward rounds. We systematically reviewed published interventions to improve prescribing and safety of medicines on ward rounds. Systematic review of randomised controlled trials and observational studies. Studies examining inpatient ward rounds. Children and young people aged between 0 and 18 years old. Any intervention or combination of interventions implemented that alters how paediatric ward rounds review inpatient medications. Primary outcome was improvement in medication safety on paediatric ward rounds. This included reduction in prescribing error rates, healthcare professionals' opinions on prescribing and improvement in documentation on ward rounds. Three studies were eligible for review. One examined the use of an acrostic, one the use of a checklist, and the other a use of a specific prescribing ward round involving a clinical pharmacist and doctor. None of the papers considered weight-based errors or demonstrated reductions in clinical harm. Reductions in prescribing errors were noted by the different interventions. There are limited data on interventions to improve medication safety in paediatric ward rounds, with all published data being small scale, either quality improvement or audits, and locally derived/delivered. Good-quality interventional or robust quality improvement studies are required to improve medication safety on ward rounds. CRD42022340201.


Diagnostic accuracy and adequacy of treatment of depressive and anxiety disorders: A comparison of primary care and specialized care patients.
Clinical diagnosis of depressive and anxiety disorders has poor sensitivity, and treatment is often not guideline-concordant. This longitudinal study aims to compare diagnostic validity and treatment adequacy in primary care (PC) and specialized care (SC), to assess associated risk factors, and to evaluate their impact on clinical outcome at one-month and three-month follow-ups. Two hundred twelve patients with depressive and anxious symptoms were recruited from 3 PC and 1 SC centers in Barcelona, Spain. Sensitivity and specificity were calculated comparing medical records׳ diagnoses with a reference (MINI interview). Adequate treatment was defined according to clinical guidelines. Logistic regression was used to estimate associations with risk factors. Impact on outcome was assessed with MANOVA models. Valid diagnosis of depression was more frequent in patients attending SC. Sensitivity for depression was 0.75 in SC and 0.49 in PC (adjusted OR=17.34, 95% CI=4.73-63.61). Detection of anxious comorbidity in depressed patients was low (50%) in SC. Treatment adequacy of depressive disorders was higher in SC than in PC (94.4% vs. 80.6%, adjusted OR=8.11, 95% CI=1.39-47.34). Depression severity was associated with valid diagnosis. Only four disorders (major depression, dysthymia, panic disorder and generalized anxiety disorder) were evaluated with the MINI interview in a convenience clinical sample. Treatment dosage was unavailable. Our results suggest that GPs need tools to improve detection of depression and its severity. Psychiatrists should enhance recognition of anxious comorbidity. Evaluation of the impact on outcome deserves further research.


Metal hyperaccumulation and hypertolerance: a model for plant evolutionary genomics.
In the course of evolution, plants adapted to widely differing metal availabilities in soils and therefore represent an important source of natural variation of metal homeostasis networks. Research on plant metal homeostasis can thus provide insights into the functioning, regulation and adaptation of biological networks. Here, we describe major recent breakthroughs in the understanding of the genetic and molecular basis of metal hyperaccumulation and associated hypertolerance, a naturally selected complex trait which represents an extreme adaptation of the metal homeostasis network. Investigations in this field reveal further the molecular alterations underlying the evolution of natural phenotypic diversity and provide a highly relevant framework for comparative genomics.


Corneal densitometry in patients with keratoconus undergoing intrastromal Ferrara ring implantation.
Evaluation of central corneal densitometry changes following Ferrara corneal ring segment implantation in patients with keratoconus, especially the correlation between corneal densitometry and keratometry. Retrospective, non-comparative, interventional study based on the review of medical records of patients diagnosed with keratoconus who underwent Ferrara corneal ring segment implantation. Pre and post-operative corneal densitometry measurements obtained with Pentacam HR (Oculus, Wetzlar, Germany) were analyzed. The follow-up time was 3 months, and data comparison was made, using specific statistical analysis, with the data of 3 months postoperatively. The study sample consisted of 43 eyes of 36 patients. The mean corrected visual acuity improved from 0.82 LogMAR preoperatively (SD ± 0.33) to 0.19 LogMAR (SD ± 0.13) postoperatively. The mean spherical equivalent varied from -4.63 (SD ± 3.94) preoperatively to -2.16 (SD ± 2.63) postoperatively. Asphericity varied from -0.69 (SD ± 0.32) preoperatively to -0.27 (SD ± 0.31) postoperatively. The mean maximum K was 54.01D (SD ± 3.38) preoperatively and 51.50D (SD ± 2.90) postoperatively. The mean anterior densitometric value was 18.26 (SD ± 2.03) preoperatively and 17.66 (SD ± 1.84) postoperatively. Corneal densitometry is an interesting technology that should be studied in keratoconus patients. Our results suggest that the corneal densitometry in the cornea's anterior layer reduces after ICRS implantation and correlates with corneal keratometry. Further studies should be performed to increase the knowledge in this field.


Use of a smartphone for visual detection of melamine in milk based on Au@Carbon quantum dots nanocomposites.
Gold nanoparticles@Carbon quantum dots nanocomposites (Au@CQDs) were designed for analyzing melamine in milk visually. Fluorescent emission of Au@CQDs enhanced with the increase of melamine concentration. A calibration curve (R2 = 0.9856) and fluorescence standard array were established for detection of melamine in the range of 1 μM-10 μM. Limit of quantification and limit of detection were 12 nM and 3.6 nM, respectively. The approximate concentration of melamine adulterated in milk samples were detected visually by the fluorescence standard array and smartphone. The accurate concentration was obtained by the calibration curve and portable fluorescence spectrometer with recoveries of 105.64%-102.75% and less than 2% of coefficient of variation (CV) (n = 18). This performance was consistent with that of the high-performance liquid chromatography (HPLC) method (recoveries of 105.56%-107.95% with 2.24%-3.56% of CVs). The Au@CQDs-based fluorescent method for visual and accurate detection of melamine in milk was presented and showed strong application potential.


Anisotropy of hyperfine interactions as a tool for interpretation of NMR spectra in magnetic materials.
Approach for interpretation of nuclear magnetic resonance (NMR) spectra in magnetic materials is presented, consisting in employing the anisotropy of hyperfine interaction. The anisotropic parts of hyperfine magnetic fields on (57)Fe nuclei are calculated ab initio for a model example of lithium ferrite and utilized to assign the experimental NMR spectral lines to iron sites in the crystal structure.


Comparative ultrastructure of cerebrospinal fluid-contacting neurons and pinealocytes.
The pinealocytes of fishes, amphibians, reptiles, birds and mammals have been compared with cerebrospinal fluid (CSF) contacting neurons. We found that the intraventricular dendrite terminal of the latter resembles the pinealocytic inner segment and that the atypical cilium (9x2+0 tubules) of the CSF contacting neurons is analogous with the outer segment of the pinealocytes, even though the outer segment bears photoreceptor lamellae in lower vertebrates. Regular, but small-sized photoreceptor outer segments were also found on pinealocytes of the chicken. In mammals, too, primitive outer segments are present in the form of 9x2 to cilia similar to those of CSF contacting dendritic terminals. In the Golgi areas of the perikarya of both cell types there are granulated vesicles which may contain transmitter substances and/or neurohormones. The synaptic junctions of the pinealocytes differ from those in the CSF contacting neurons. Many synapses occur on the latter, but they appear only rarely on pinealocytes. The axons of the CSF contacting neurons form synaptic connections with other cells, or terminate as neurohormonal synaptic hemidesmosomes on the basal lamina of the brain surface. The pinealocyte axons give rise to terminals containing synaptic ribbons. Such ribbons do not occur in CSF contacting neurons. In Lacertilians, we found pinealocytic terminals without ribbons on dendrite-like profiles. On the basis of the ultrastructural comparisons, we consider the CSF contacting neurons and pinealocytes to be very similar, but not to represent precisely the same cell type.


Synthesis and photophysical properties of ditrifluoroacetoxyboron complexes with curcumin analogues.
A new class of ditrifluoroacetoxyboron complexes were designed and synthesized by chelation reaction of curcumins with boron trifluoroacetate. Their photophysical behaviors were studied in different solvents, powder state and PMMA polymer films. The results indicated that these complexes revealed a green to yellow emission at 486-595 nm in solution or PMMA films and an orange to red emission at 598-710 nm in powder state. Especially, complex 2c displayed the strongest emission intensity, the highest quantum yield in solution and the longest fluorescence lifetime in powder state in these complexes. In addtion, the emission bathochromic shifts of these complexes as a function of the solvent polarity parameter ET(30) were investigated by Lippert-Mataga approximation. It was observed that these complexes exhibited the higher values of the dipole moment difference (Δμ) between the ground and excited states, which implied an intense intramolecular charge transfer characteristics and a noticeable emission solvatochromic effect.


Flexible ureteroscopy and lasertripsy (FURSL) for paediatric renal calculi: results from a systematic review.
To understand the role, safety and efficacy of flexible ureterorenoscopy and lasertripsy (FURSL) for paediatric renal stones. A systematic review was conducted using studies identified by a literature search between January 1990 and March 2014. All English language articles reporting on a minimum of five patients≤18-years old, treated with flexible ureteroscopy and lasertripsy for stone disease were included. A total of six studies (282 patients) were reported, with a mean age of 7.3 years (range 0.25-17 years). The stone sizes ranged from 1 to 30 mm. The mean stone-free rate across the three studies was 85.5% (range 58.0-93.0%) after initial ureteroscopy, with a postoperative stent inserted in 81.8% (range 66.7-98.0%). There were a total of 35 complications (12.4%), with the most severe complication being a Clavien class III (five ureteral injuries, one urinoma). There were no deaths in any of the studies. The present review shows that FURSL for management of renal calculi in the paediatric population is an effective and safe procedure. To ensure that outcomes keep on improving, these procedures should be undertaken by experienced surgeons who are familiar with the difficulties encountered in the paediatric population.


Plant-wide process monitoring based on mutual information-multiblock principal component analysis.
Multiblock principal component analysis (MBPCA) methods are gaining increasing attentions in monitoring plant-wide processes. Generally, MBPCA assumes that some process knowledge is incorporated for block division; however, process knowledge is not always available. A new totally data-driven MBPCA method, which employs mutual information (MI) to divide the blocks automatically, has been proposed. By constructing sub-blocks using MI, the division not only considers linear correlations between variables, but also takes into account non-linear relations thereby involving more statistical information. The PCA models in sub-blocks reflect more local behaviors of process, and the results in all blocks are combined together by support vector data description. The proposed method is implemented on a numerical process and the Tennessee Eastman process. Monitoring results demonstrate the feasibility and efficiency.


[Alteration of telomere length of the peripheral white blood cells in patients with obstructive sleep apnea syndrome].
To study the alteration of telomere length of the peripheral white blood cells in patients with obstructive sleep apnea syndrome (OSAS) and explore its significance. The DNA was extracted from the peripheral white blood cells of 11 patients with OSAS and 10 normal subjects matched for age and gender, and the T/S ratio was measured by fluorescence quantitative PCR. The T/S ratio in the peripheral white blood cells of patients with OSAS was obviously lower than that of the normal subjects (P<0.05). The reduction in the telomere length in the peripheral blood cells suggests a possible relationship between OSAS pathogenesis and telomere length, and hypoxemia and hypercapnia make accelerate telomere shortening and promote cell apoptosis.


[Strain-specific antigens detected on murine tumour cells by means of rabbit heteroantisera (author's transl)].
The rabbit heteroantisera anti-Meth A sarcoma (H-2d) (RAMA) and rabbit anti-RBL-5 leukemia (H-2b) (RAR-5) have been used to study the presence of normal strain antigens on the surface of different murine tumour cells. RAR-5 detected H-2-like structures on TLX9 (H-bb) lymphoma, however RAMA did not on LSTRA leukemia (H-2d) mastocytoma. Neither RAR-5 nor RAMA contained antibodies against non-H-2 and differentiation antigens.