Evidence that platelet buoyant density, but not size, correlates with platelet age in man.
Following infusion of 51Cr-labeled autologous platelets into normal subjects, high-density (HD) and low-density (LD) platelet cohorts were isolated by prolonged centrifugation in isosmotic arabino-galactan (Stractan). Specific radio-activity of LD platelets declined rapidly post-infusion (T1/2 = 1.5 days), but specific radioactivity of HD platelets remained constant or increased over a 3--4-day period and gradually declined for 6--7 days thereafter. These differences were exaggerated when platelet cohorts enriched in LD or HD cells by slow centrifugation in high-density albumin were labeled and transfused. Mean survival of a platelet cohort enriched with HD cells was significantly (P less than 0.02) shorter (7.73 days) than that of a cohort enriched with LD cells (9.33) days). In normal subjects treated with aspirin, capacity for thromboxane synthesis was regained more rapidly (P less than 0.05) in LD than in HD platelets. HD and LD platelets differed only slightly in mean volume (HD platelets = 7.57 mu3, LD platelets = 6.87 mu3, 0.05 less than P less than 0.01). We believe the most logical interpretation of these findings is that under normal conditions in man, newly formed platelets are less dense on the average than total platelets and become more dense as they age in the circulation. Thus, specific radioactivity of LD platelets declines rapidly as these platelets move into a more dense compartment and are replaced by newly formed, unlabelled cells; specific radioactivity of HD platelets remains constant or increases as labelled platelets enter this compartment in numbers equal to or greater than the number leaving it at the end of their life span. The similarity in mean volumes of LD and HD platelets suggests that platelet size is unrelated to platelet age under normal conditions.


Comparison of electrophysiological characteristics of right- and left-sided Mahaim-type accessory pathways.
Mahaim-type accessory pathways (MAPs) are generally right-sided due to the embryological differentiation, but left-sided localization is also possible. This study aims to compare the clinical and electrophysiological characteristics of right- and left-sided MAPs. Of 251 patients diagnosed with AP by electrophysiological study between November 2015 and February 2020, 12 patients with MAP were included (right sided n = 8, left sided n = 4). MAP was diagnosed if; (1) no retrograde conduction; (2) anterograde decremental conduction; (3) adenosine sensitivity; and (4) Mahaim potential at successful ablation site were present. Ten of twelve MAPs were clustered on the lateral walls of the mitral (n = 3, 75%) and tricuspid annuli (n = 7, 87.5%). Right-sided MAPs were mostly long pathways extending toward the conduction system whereas left-sided MAPs were short extending toward the neighboring myocardium. For right- and left-sided APs, the median QRS times were 129 and 156 ms (p = .042), the median VAbl -RVApex intervals were -12 and 64 ms (p = .007), the median QRS-V(His) intervals were 16 and 86 ms (p = .120), and the median VAbl -QRS interval was -8 and 12 ms (p = .017), respectively. Coexistence of dual atrioventricular node physiology was observed only in right-sided APs (n = 3, 37.5%). MAPs are more typically located on the right but may rarely be seen on the left. Catheter ablation was associated with high success without complications.


Use of eltrombopag for secondary immune thrombocytopenia in clinical practice.
Eltrombopag is a second-line treatment in primary immune thrombocytopenia (ITP). However, its role in secondary ITP is unknown. We evaluated the efficacy and safety of eltrombopag in secondary ITP in daily clinical practice. Eighty-seven secondary ITP patients (46 with ITP secondary to autoimmune syndromes, 23 with ITP secondary to a neoplastic disease subtype: lymphoproliferative disorders [LPDs] and 18 with ITP secondary to viral infections) who had been treated with eltrombopag were retrospectively evaluated. Forty-four patients (38%) had a platelet response, including 40 (35%) with complete responses. Median time to platelet response was 15 days (95% confidence interval, 7-28 days), and was longer in the LPD-ITP group. Platelet response rate was significantly lower in the LPD-ITP than in other groups. However, having achieved response, there were no significant differences between the durable response of the groups. Forty-three patients (49·4%) experienced adverse events (mainly grade 1-2), the commonest being hepatobiliary laboratory abnormalities. There were 10 deaths in this case series, all of which were related to pre-existing medical conditions. In routine clinical practice, eltrombopag is effective and well-tolerated in unselected patients with ITP secondary to both immune and infectious disorders. However, the response rate in LPD-ITP is low.


Examination of resident characteristics associated with interest in primary care and identification of barriers to cross-cultural care.
There is an increasing shortage of primary care physicians in the U.S. The difficult task of addressing patients' sociocultural needs is one reason residents do not pursue primary care. However, associations between residents' perceived barriers to cross-cultural care provision and career interest in primary care have not been investigated. We examined residents' career interest in primary care and associations with resident characteristics and their perceived barriers in providing cross-cultural care. We conducted a cross-sectional analysis of a resident survey from the 2018-2019 academic year. We first described residents' sociodemographic characteristics based on their career interest in primary care (Chi-square test). Our primary outcome was high career interest in primary care. We further examined associations between residents' characteristics and perceived barriers to cross-cultural care. The study included 155 family medicine, pediatrics, and internal medicine residents (response rate 68.2%), with 17 expressing high career interest in primary care. There were significant differences in high career interest by race/ethnicity, as Non-White race was associated with high career interest in primary care (p < 0.01). Resident characteristics associated with identifying multiple barriers to cross-cultural care included disadvantaged background, multilingualism, and foreign-born parents (all p-values< 0.05). There were no significant associations between high career interest in primary care and barriers to cross-cultural care. Residents from diverse racial/ethnic and socioeconomic backgrounds demonstrated higher career interest in primary care and perceived more barriers to cross-cultural care, underscoring the importance of increasing physician workforce diversity to address the primary care shortage and to improve cross-cultural care.


Remnant preserving ACL reconstruction with a functional remnant is related to improved laxity but not to improved clinical outcomes in comparison to a nonfunctional remnant.
The Anterior cruciate ligament (ACL) remnant has been pointed out as a ligamentization enhancer. Nonetheless, the remaining tissue can be functional if it still provides some stability or nonfunctional. This study intends to compare the clinical results and knee stability of functional vs. nonfunctional remnant preservation ACL reconstruction (ACLR). One hundred and seventy-five patients with ACL injuries were included and underwent remnant preservation ACLR. They were divided into two groups accordingly to remnant tissue functionality: functional (Group F) and nonfunctional (Group NF). Primary outcome was defined as patient reported outcomes measured with Lysholm, IKDC and Tegner continuous scales and improvements. Secondary outcomes comprised of Lachman test, anterior drawer test, pivot shift test, extension and flexion deficit, graft coverage by remnant preserved tissue and failure rate (persistent instability or new ACL lesion). Menisci lesions, cartilage lesions and time to surgery were also recorded for each group. One hundred and forty-four patients were available at a mean of 30.2 ± 10.1 months: 69 Functional and 75 Nonfunctional. Lysholm, IKDC and Tegner functional outcomes demonstrated no difference between the groups, Functional compared to Nonfunctional: 88.4 ± 10.5 vs. 92.2 ± 4.9, n.s. and 83.2 ± 11.3 vs. 87 ± 5.3, n.s. and 6 (5-10) vs. 6 (5-9), n.s., respectively. Lysholm and IKDC functional outcomes improvements demonstrated differences between the groups: Functional compared to Nonfunctional (39.3 ± 9.4 vs. 42.3 ± 7.4, p = 0.014 and 37.7 ± 10 vs. 41.0 ± 6.6, p = 0.032); however, they were not clinically significant. Functional group showed more stability on physical examination pre- and post-operatively (p < 0.001, p < 0.001). There was no difference regarding extension deficit (n.s.); however, functional group had more flexion deficit (p = 0.02). Nonfunctional group had better graft coverage (p = 0.001). There was no difference regarding failure rate: 4% vs. 9%, (n.s.). Both remnant preservation ACLR techniques were able to achieve satisfactory functional outcomes. A functional remnant was not related to improved functional outcomes in comparison to a nonfunctional remnant; however, it was related to less laxity pre and postoperatively and inferior graft coverage. II.


Graphene quantum dots-hybrid hydrogel as an avant-garde biomimetic scaffold for diabetic wound healing.
In the age of fathoming biomedical predicaments, ardently emerged the field of materiobiology to effectively counter the archetypal and outdated therapies. Correspondingly, the subpar activity of the over-the-counter wound dressing pharmaceuticals have been dominated with the implementation of biocompatible, water-retaining exotic hydrogels to facilitate accelerated diabetic wound healing. Considering a strategy to develop a pragmatic biomimetic scaffold having the ability of dynamic wound healing with diminutive inflammation, we investigated the creation of graphene quantum dot (GQD)-polyacrylic acid (PAA) hybrid hydrogel. We observe appropriate percentage of GQD incorporation in PAA to demonstrate lower pro-inflammatory cytokines, interleukin (IL-6), and tumour necrosis factor (TNF-α) along with higher anti-inflammatory (IL-10) expressions in contrast to natural and standard controls. Likewise, histological examinations corresponding to the in-vitro and in-vivo toxicological analysis of GQD-PAA manifested to be a non-toxic, biocompatible saviour of diabetic wounds. This hybrid hydrogel reports the quickest diabetic wound healing of 13 days. Additionally, the hybrid hydrogel also demonstrates salient antibacterial activity against E. coli. We explore a multifaceted mechanistic approach attributed by the hybrid framework as an avant-garde solution in materiobiology and diabetic wound healing nexus. We believe the GQD-hybrid hydrogel reveals an advancement that could portray a new horizon against diabetic wounds.


Utilization of sterol carrier protein-2 by phytanoyl-CoA 2-hydroxylase in the peroxisomal alpha oxidation of phytanic acid.
Since it possesses a 3-methyl group, phytanic acid is degraded by a peroxisomal alpha-oxidation pathway, the first step of which is catalyzed by phytanoyl-CoA 2-hydroxylase (PAHX). Mutations in human PAHX cause phytanic acid accumulations leading to Adult Refsum's Disease (ARD), which is also observed in a sterol carrier protein 2 (SCP-2)-deficient mouse model. Phytanoyl-CoA is efficiently 2-hydroxylated by PAHX in vitro in the presence of mature SCP-2. Other straight-chain fatty acyl-CoA esters were also 2-hydroxylated and the products isolated and characterized. Use of SCP-2 increases discrimination between straight-chain (e.g., hexadecanoyl-CoA) and branched-chain (e.g., phytanoyl-CoA) substrates by PAHX. The results explain the phytanic acid accumulation in the SCP-2-deficient mouse model and suggest that some of the common symptoms of ARD and other peroxisomal diseases may arise in part due to defects in SCP-2 function caused by increased phytanic acid levels.


A new sandwich enzyme-linked immunosorbent assay (ELISA) for transforming growth factor alpha (TGF alpha) based upon conformational modification by antibody binding.
A sandwich-type enzyme-linked immunosorbent assay (ELISA) for human TGF alpha was established utilizing monoclonal and polyclonal anti-synthetic human TGF alpha antibodies with defined epitopes. A polyclonal antibody which was raised in a rabbit and affinity purified by C terminal peptide (hTGF alpha (34-50)) recognized both intact and denatured human TGF alpha. Murine monoclonal antibodies isolated bound only to the denatured form of TGF alpha at the second loop (hTGF alpha (16-33)). However, the rabbit antibody was found to induce a conformation change of intact TGF alpha and the resultant immunocomplex was recognized by monoclonal antibodies. By virtue of this property, the ELISA could detect both native and denatured TGF alpha with the same efficiency with a detection limit of 0.1 ng/ml. Human EGF did not interfere with the ELISA. Production of TGF alpha in several transformed human cell lines was quantitatively examined. Some cell lines were found to secrete TGF alpha, but the production rate was very low, except one melanoma, suggesting that TGF alpha may function only locally in a very limited area in vivo.


Atomically efficient synthesis of self-assembled monodisperse and ultrathin lanthanide oxychloride nanoplates.
Monodisperse and ultrathin LaOCl nanoplates were synthesized via the thermolysis of La(CCl(3)COO)(3) in long chain amine and 1-octadecene. This single source precursor approach is simple but atomically efficient. The uniform amine-capped LaOCl nanoplates can be aligned into nanowire-like and nanorod-like superstructures, as a result of the different strengths of the interchain molecular interactions of the capping molecules during the self-assembly process of the nanoplates.


Emergence of linezolid-resistant Staphylococcus epidermidis in the tertiary children's hospital in Cracow, Poland.
Coagulase-negative staphylococci, ubiquitous commensals of human skin, and mucous membranes represent important pathogens for immunocompromised patients and neonates. The increasing antibiotic resistance among Staphylococcus epidermidis is an emerging problem worldwide. In particular, the linezolid-resistant S. epidermidis (LRSE) strains are observed in Europe since 2014. The aim of our study was to genetically characterize 11 LRSE isolates, recovered mostly from blood in the University Children's Hospital in Krakow, Poland, between 2015 and 2017. For identification of the isolates at the species level, we used 16S rRNA sequencing and RFLP of the saoC gene. Isolates were characterized phenotypically by determining their antimicrobial resistance patterns and using molecular methods such as PFGE, MLST, SCCmec typing, detection of the ica operon, and analysis of antimicrobial resistance determinants. All isolates were multidrug-resistant, including resistance to methicillin, and exhibited so-called PhLOPSA phenotype. In PFGE, all isolates (excluding one from a catheter) represented identical patterns, were identified as ST2, and harbored the ica operon, responsible for biofilm formation. Linezolid resistance was associated with acquisition of A157R mutation in the ribosomal protein L3 and the presence of cfr gene. All isolates revealed new SCCmec cassette element composition. Recently, pediatric patients with serious staphylococcal infections are often treated with linezolid. The increasing linezolid resistance in bacterial strains becomes a real threat for patients, and monitoring such infections combined with surveillance and infection prevention programs is very important to decrease number of linezolid-resistant staphylococcal strains.


Psychoneuroimmunology in pregnancy: immune pathways linking stress with maternal health, adverse birth outcomes, and fetal development.
It is well-established that psychological stress promotes immune dysregulation in nonpregnant humans and animals. Stress promotes inflammation, impairs antibody responses to vaccination, slows wound healing, and suppresses cell-mediated immune function. Importantly, the immune system changes substantially to support healthy pregnancy, with attenuation of inflammatory responses and impairment of cell-mediated immunity. This adaptation is postulated to protect the fetus from rejection by the maternal immune system. Thus, stress-induced immune dysregulation during pregnancy has unique implications for both maternal and fetal health, particularly preterm birth. However, very limited research has examined stress-immune relationships in pregnancy. The application of psychoneuroimmunology research models to the perinatal period holds great promise for elucidating biological pathways by which stress may affect adverse pregnancy outcomes, maternal health, and fetal development.


Surgical complications related to hematopoietic stem cell transplantation.
Surgical complications in recipients of hematopoietic stem cell transplantation (HSCT) are common. However, this issue is infrequently reported in the literature. The records of 165 patients who underwent hematopoietic stem cell transplantation at King Hussein Cancer Center between January 2007 and December 2008 were retrospectively reviewed. All surgical complications were included and were classified into gastrointestinal (GI), catheter-related, ear, nose and throat (ENT), peri anal, musculoskeletal, neurological and urological complications. There were 279 surgical complications in the studied patients. Gastrointestinal (n = 122) and catheter-related (n = 78) complications were the most frequent. The frequency and the percentage of patients needing surgical intervention for the 5 most common complications were as follows: Gastrointestinal (n = 122, 4.5% needed surgical intervention), catheter-related (n = 78, 46.2%), ear, nose and throat (n = 31, 9.7%), perianal disease (n = 21, 19%) and urinary complications (n = 17, 5.9%). Surgical consultation was sought for 116 surgical complications. Surgical interventions were necessary for 55 patients. All the patients who underwent surgery did not have an intervention-related mortality except for one patient who died from surgical intervention post-gastrointestinal complication. The majority of surgical complications after HSCT do not require surgical intervention. However, these conditions may overlap with the more common reasons for surgical consultation and must be identifiable by the surgeon. Extra vigilance is necessary when dealing with both GI and catheter-related complications as they are the most frequent. The early involvement of surgeons and proper timing of surgical management may circumvent detrimental outcomes.


Antilymphocyte autoantibody in lethal mouse malaria and its suppression by non-lethal malaria.
Mice infected with lethal P. berghei or P. yoelii malaria develop anti-lymphocyte autoantibodies less than a week after infection. The autoantibodies are IgM, T-dependent and cytotoxic to a subpopulation of non-T lymphocytes at 37 degrees C in the presence of mouse or guinea-pig complement. Non-lethal P. yoelii and P. chabaudi do not induce these autoantibodies. X-irradiated P. berghei parasites induce autoantibodies in normal mice but not in mice infected with non-lethal P. yoelii suggesting an active suppressor mechanism in the non-lethal infection.


[Review of interventional radiology techniques in breast disease].
Breast imaging plays a significant role in treatment. Ultrasonography to drain fluid collections, vacuum-assisted biopsy to excise papillomas and fibroadenomas, and stereotactic excisional biopsy are a few examples of interventional procedures performed by radiologists in patients with breast disease. Moreover, there is a growing interest in the minimally invasive treatment of invasive tumors, which aims to achieve the same efficacy while minimizing morbidity and improving the esthetic outcome. Especially noteworthy are thermal ablation techniques, which involve destroying tumors with heat or cold. The most widely studied thermal ablation techniques are radiofrequency, high intensity focused ultrasound, laser therapy, microwaves, and cryoablation. After a review of the literature, we conclude that the development of these treatment approaches will depend largely on the capacity of imaging techniques to plan the destruction of the tumor. Ultrasonography and magnetic resonance imaging are the current techniques of choice for this purpose. The evidence suggests that small invasive carcinomas can be efficaciously treated with thermal ablation, especially by radiofrequency ablation; however, before this technique can be validated, phase III clinical trials must compare it with conservative surgery in terms of local progression and overall survival.


α-Lipoic acid has anti-inflammatory and anti-oxidative properties: an experimental study in rats with carrageenan-induced acute and cotton pellet-induced chronic inflammations.
α-Lipoic acid (ALA) has been termed the 'ideal' antioxidant, a readily absorbed and bioavailable compound capable of scavenging a number of free radicals, and it has been used for treating diseases in which oxidative stress plays a major role. The present study was designed to gain a better understanding for the positive effects of ALA on the models of acute and chronic inflammation in rats, and also determine its anti-oxidative potency. In an acute model, three doses of ALA (50, 100 and 200 mg/kg) and one dose of indomethacin (25 mg/kg) or diclofenac (25 mg/kg) were administered to rats by oral administration. The paw volumes of the animals were calculated plethysmometrically, and 0·1 ml of 1 % carrageenan (CAR) was injected into the hind paw of each animal 1 h after oral drug administration. The change in paw volume was detected as five replicates every 60 min by plethysmometry. In particular, we investigated the activities of catalase, superoxide dismutase (SOD), glutathione S-transferase (GST), glutathione peroxidase (GPx), glutathione reductase (GR), inducible NO synthase (iNOS) and myeloperoxidase (MPx), and the amounts of lipid peroxidation (LPO) or total GSH in the paw tissues of CAR-injected rats. We showed that ALA exhibited anti-inflammatory effects on both acute and chronic inflammations, and a strongly anti-oxidative potency on linoleic acid oxidation. Moreover, the administration of CAR induced oedema in the paws. ALA significantly inhibited the ability of CAR to induce: (1) the degree of acute inflammation, (2) the rise in MPx activity, (3) the increases of GST and iNOS activities and the amount of LPO and (4) the decreases of GPx, GR and SOD activities and the amount of GSH. In conclusion, these results suggest that the anti-inflammatory properties of ALA, which has a strong anti-oxidative potency, could be related to its positive effects on the antioxidant system in a variety of tissues in rats.


Interpersonal evaluation bias in borderline personality disorder.
The cognitive theory of personality disorders hypothesizes that the emotional dysregulation and interpersonal problems in individuals with borderline personality disorder (BPD) are, at least partially, caused by dysfunctional cognitive schemas. These schemas lead to biased evaluation of environmental and interpersonal stimuli. This study examined the interpersonal evaluations of individuals with BPD, depressive and healthy control participants with the thin-slice judgments paradigm. Participants were asked to evaluate six persons in six film clips, which showed these persons for 10s, during which these persons entered a room and took a seat. Interpersonal style of the BPD group was investigated with the Inventory of Interpersonal Problems (IIP-C) questionnaire. Individuals with BPD judged the persons as being more negative and aggressive and less positive than the healthy participants, and more aggressive than the depressive individuals. In addition, individuals with BPD reported more extreme interpersonal behavior relative to the controls. The findings indicate an aggressivistic evaluation bias and elevated levels of interpersonal problems in individuals with BPD as suggested in the cognitive theory.


G117C MelB, a mutant melibiose permease with a changed conformational equilibrium.
Replacement of the glycine at position 117 by a cysteine in the melibiose permease creates an interesting phenotype: while the mutant transporter shows still transport activity comparable to the wild type its pre steady-state kinetic properties are drastically altered. The transient charge displacements after substrate concentration jumps are strongly reduced and the fluorescence changes disappear. Together with its maintained transport activity this indicates that substrate translocation in G117C melibiose permease is not impaired but that the initial conformation of the mutant transporter differs from that of the wild type permease. A kinetic model for the G117C melibiose permease based on a rapid dynamic equilibrium of the substrate free transporter is proposed. Implications of the kinetic model for the transport mechanism of the wild type permease are discussed.


Temporary biventricular support with extracorporeal membrane oxygenation: a feasible therapeutic approach for cardiogenic shock with multiple organ failure.
Various strategies using a ventricular assist device (VAD) are applied to rescue Interagency Registry for Mechanically Assisted Circulatory Support profile 1 (Profile-1) patients. However, the optimal use of VAD in Profile-1 patients has not been completely elucidated. We retrospectively reviewed 23 Profile-1 patients [mean age 36.9 ± 16.6 years, 14 males; 11 with non-ischemic cardiomyopathy (NICM), 9 with fulminant myocarditis (FM), 2 with ischemic cardiomyopathy (ICM), and 1 with peripartum cardiomyopathy (PPCM); 18 with pre-operative percutaneous extracorporeal membrane oxygenation (p-ECMO) support] who underwent VAD implantation from 2011 to 2015 at our institution. Nine initially received left VAD (LVAD) alone (NICM in 9, ICM in 2 with ICM, and FM in 1), one with NICM received biventricular VAD (BiVAD; n = 1), and 10 received LVAD combined with right ventricular support using an ECMO circuit (BiVAD-ECMO) (FM in 8, NICM in 1, and PPCM in 1). Paracorporeal VAD was used in all patients. ECMO was used for the patients with severe pulmonary edema, inflammation, anemia, and thrombopenia. The BiVAD patient died 1.4 months after VAD implantation. The overall survival was comparable between patients with BiVAD-ECMO and LVAD (2-year survival, 80.0 and 75.0%, respectively). Three VAD strategies were initially applied in Profile-1 patients. Among them, the BiVAD-ECMO strategy is a promising therapeutic option to rescue Profile-1 patients with multiple organ failure.


Increase of infectious syphilis among heterosexuals in Amsterdam: its relationship to drug use and prostitution.
Since 1986, an increase in heterosexually acquired syphilis cases has been seen in Amsterdam. The proportion of syphilis patients who reported using hard drugs, increased from 7% in 1985 to 23% in 1988, which was mainly due to increased numbers of addicted prostitute women with syphilis.


An assessment of surgical education.
A review of the dramatic changes in society, science and medicine that have affected the time we have available for education of students and residents. Reference is made to distance learning, educational efficiency and mental practice as concepts that may aid educators in the quest to provide the public with well trained surgeons. Surgical educators are urged to look outside of traditional models of teaching and evaluating for tools that have been successfully used by industry or business.


Correction to: Combination of graphene oxide and platelet-rich plasma improves tendon-bone healing in a rabbit model of supraspinatus tendon reconstruction.
[This corrects the article DOI: 10.1093/rb/rbab045.].


Experimental study of the anticonvulsant plants used for treatment of infantile convulsion in Nigeria.
In Nigeria, convulsion, especially in children, is managed by traditional healers employing plant decoctions. A number of herbs are used for this purpose. We have carried out some preliminary studies on some of these traditional anticonvulsant plants. The experimental models were pentylenetetrazole- and electroshock-induced convulsions in mice. The acute toxicity (LD50) and the median effective (ED50) doses of the extracts of these plants were determined. Most of these plants exhibited potent anticonvulsant activity. The average onset of convulsion was delayed, while the average duration of convulsion was significantly reduced. Most of the animals showed signs of central nervous system depression. The results indicate that these plants possess anticonvulsant property, and this activity may be linked to their ability to depress the central nervous system.


Conversion after laparoscopic cholecystectomy in England.
Laparoscopic cholecystectomy is the procedure of choice for the treatment of symptomatic gallstones. Conversion to open surgery is reported to be necessary in 5-10% of cases. This study aimed to define those factors associated in English hospitals with the need to convert a laparoscopic cholecystectomy to an open procedure. These included patient-related and particularly nonpatient-related factors. Using data derived from a national administrative database, Hospital Episode Statistics, patients undergoing cholecystectomy in acute National Health Service (NHS) hospitals in England during the financial years 2004-2006 were studied. The individual surgeon caseload and the hospital conversion rate were calculated using data from the first (baseline) year. Factors affecting the need for conversion were analyzed using data from the second (index) year. The study included 43,821 laparoscopic cholecystectomies undertaken from 2005 to 2006 in English hospitals. The overall conversion rate was 5.2%: 4.6% for elective procedures and 9.4% for emergency procedures. Patient-related factors that were good predictors of conversion included male sex, emergency admission, old age, and complicated gallstone disease (p < 0.001). Nonpatient-related factors that were good predictors of conversion included the laparoscopic cholecystectomy caseload of individual consultant surgeons and the overall hospital conversion rate in the previous year (all p < 0.001). Conversion after laparoscopic cholecystectomy is less common as consultant caseload increases. This suggests that operation should be undertaken only by surgeons with an adequate caseload. There is a wide variation in conversion rates among hospitals. This has important implications for training as well as for the organization and accreditation of cholecystectomy services on a national basis.


Laser bronchoscopy with transglottic/supraglottic ventilation to relieve dysphonia and subglottic obstruction.
Dysphonia after endotracheal intubation usually indicates a glottic lesion but it can also herald an obstructing subglottic airway mass. Outpatient strobovideolaryngoscopy may be anatomically extended by transglottic videotracheobronchoscopy to achieve a thorough examination of the proximal bronchi, trachea, subglottis, glottis, and supraglottis in selected cases. Combining these techniques with lateral soft tissue x-ray studies of the neck in two patients with dysphonia and stridor, nearly identical postendotracheal intubation subglottic severely obstructing granulation "tumors" were diagnosed. Operative subglottic resection with a rigid ventilating laser bronchoscope combined with transglottic/supraglottic anesthetic ventilation techniques and contact-tip Nd-YAG laser phototherapy relieved the dysphonia and airway obstruction simultaneously. Normal vocal quality and full anatomical airway patency were achieved in both cases. Follow-up postoperative vocal rehabilitation and medical therapy sustained the surgical results.


Extended Gate Field-Effect Transistor Biosensors for Point-Of-Care Testing of Uric Acid.
An enzyme-free redox potential sensor using off-chip extended-gate field effect transistor (EGFET) with a ferrocenyl-alkanethiol modified gold electrode has been used to quantify uric acid concentration in human serum and urine. Hexacyanoferrate (II) and (III) ions are used as redox reagent. The potentiometric sensor measures the interface potential on the ferrocene immobilized gold electrode, which is modulated by the redox reaction between uric acid and hexacyanoferrate ions. The device shows a near Nernstian response to uric acid and is highly specific to uric acid in human serum and urine. The interference that comes from glucose, bilirubin, ascorbic acid, and hemoglobin is negligible in the normal concentration range of these interferents. The sensor also exhibits excellent long term reliability and is regenerative. This extended gate field effect transistor based sensor is promising for point-of-care detection of uric acid due to the small size, low cost, and low sample volume consumption.


Association between diabetes and food insecurity in an urban setting in Angola: a case-control study.
Diabetes is common in urban settings in Sub-Saharan Africa. Household food insecurity has been suggested to increase the chance of developing diabetes among adults. The relationship between diabetes and food insecurity has not been explored in Angolan urban settings so far. This case-control (1:2) study investigated the association between diabetes and food insecurity among adults attending six healthcare facilities in Luanda (Angola) between April 2019 and September 2019. All subjects with fasting blood glucose (FBG) levels ≥ 126 mg/dl were included as cases. For each case, the next two subjects with FBG levels < 110 mg/dl were included as controls, to warrant the achievement of the set 1:2 ratio. Food insecurity was assessed using the Food Insecurity Experience Scale (FIES). A total of 663 participants (221 cases and 442 controls) were enrolled in the study. Median FIES raw score was 7 (IQR 1-8) in cases and 5 (IQR 2-8) in controls (p = 0.09). The distribution of FIES levels (0-3; 4-6; 7-8) was different between cases and controls (p < 0.0001), with highest FIES scores (7-8) recorded in 53.0% of cases and 38.2% of controls. Our findings revealed an association between diabetes and severe food insecurity among adults attending healthcare facilities in the capital city of Angola.


First-principles description of correlation effects in layered materials.
We present a first-principles description of anisotropic materials characterized by having both weak (dispersionlike) and strong covalent bonds, based on the adiabatic-connection fluctuation-dissipation theorem with density functional theory. For hexagonal boron nitride the in-plane and out-of-plane bonding as well as vibrational dynamics are well described both at equilibrium and when the layers are pulled apart. Bonding in covalent and ionic solids is also described. The formalism allows us to ping down the deficiencies of common exchange-correlation functionals and provides insight toward the inclusion of dispersion interactions into the correlation functional.


Relationship between dietary factors and recurrent aphthous stomatitis in China: a cross-sectional study.
Recurrent aphthous stomatitis (RAS), a common oral mucosal disorder characterized by chronic, inflammatory, and ovoid ulcers, has a complex etiology. The purpose of the study was to investigate the specific dietary factors influencing the prevalence of RAS. A total of 754 participants aged 18 to 59 years were enrolled in this descriptive cross-sectional study. An anonymous questionnaire was adopted to investigate the distribution of RAS, dietary factors, self-reported trigger factors, and therapeutic methods. Among all participants, the prevalence rate of RAS was 21.4%. Univariable analysis showed that fruit, dairy products, vegetables, and water, but not fried foods, fermented foods, spicy foods, and eggs, were preventive factors against RAS. After adjusting for age and sex, multivariable regression analysis suggested that fruit (adjusted odds ratio [aOR] = 0.430, 95% confidence interval [CI] = 0.218-0.847) and water (aOR = 0.294, 95% CI = 0.119-0.726) were protective factors against RAS. This study found that the consumption of fruit and water was negatively associated with RAS. These results imply a potential adjunctive and complementary role of food in RAS treatment and some feasible means of RAS prevention.


[Peri-trapezial arthrotic lesions].
The usual concept of arthrosis of the base of the thumb as a carpometacarpal arthrosis has been replaced by the concept of its being a pantrapezial arthrosis involving all of the peritrapezial joint spaces. In the pathogenesis of pantrapezial arthrosis, the static role of the shaft of the thumb, and the strains from pinching movements between the thumb and fingers are of predominant importance. The lack of satisfactory radiographic technique up to now has made the evaluation of this joint difficult, but the possibility of trapezometacarpal dysplasias favoring arthrosis should be considered. The treatment of an arthrosis of the basal joint of the thumb is surgical when medical treatment has not been successful. The various techniques, which currently are numerous, are given in detail. Carpo-metacarpal arthrodesis has still some precise indications. Arthroplasties have superseded the usual trapezectomy which, nevertheless, seemed to give satisfactory results. The various techniques of arthroplasty and their respective indications according to individual patients, and the anatomic type of the arthrosis of the base of the thumb are discussed.


Correction: Bitsi et al. Supramolecular Triblock Copolymers through the Formation of Hydrogen Bonds: Synthesis, Characterization, Association Effects in Solvents of Different Polarity. Polymers 2020, 12, 468.
The authors wish to make the following corrections to the published paper [...].


Associations between pattern separation and hippocampal subfield structure and function vary along the lifespan: A 7 T imaging study.
Pattern separation (PS) describes the process by which the brain discriminates similar stimuli from previously encoded stimuli. This fundamental process requires the intact processing by specific subfields in the hippocampus and can be examined using mnemonic discrimination tasks. Previous studies reported different patterns for younger and older individuals between mnemonic discrimination performance and hippocampal subfield activation. Here, we investigated the relationship between the lure discrimination index (LDI) and hippocampal subfield volume and activity across the adult lifespan (20-70 years old). Using ultra-high field functional and structural magnetic resonance imaging at 7 T, we found that lower DG volume and higher CA3 activation was associated with worse LDI performance in individuals (>60 years), suggesting that this higher activation may be an indication of aberrant neurodegenerative-related processes. In fact, higher activation in the CA1 and DG was associated with lower volumes in these subfields. For individuals around 40-50 years old, we observed that greater left and right DG volume, and greater activity in the CA3 was associated with lower LDI performance. Taken together, these results suggest that the relationship between memory and hippocampal subfield structure or function varies nonlinearly and possibly reciprocally with age, with midlife being a critically vulnerable period in life.


Clinical Results of Revision TKA in Patients With Presumed Metal and Cement Allergy.
Metal and cement allergy affects a small subset of patients, causing severe pain and often systemic reaction after total knee arthroplasty (TKA). Revision with ceramic-surfaced femoral components has been reported to resolve these symptoms of metal allergy, but no solution currently is available for patients with allergies to metal and bone cement. Five patients (5 knees) with documented metal allergy were revised with custom porous-coated ceramic femoral components (Magnesia-stabilized Zirconia) from January 2007 to January 2013. An additional 23 patients (23 knees) met inclusion criteria from 2007 to 2015, but because the ceramic implant was unavailable, they underwent different treatment based on their underlying allergy to metal, cement, or both. Inclusion criteria included the history of clinically documented severe metal allergy, severe pain, swelling, and effusion >1 year after TKA, negative workup for infection, loosening, and ligament imbalance. Knee Society scores were compared for each cohort. Mean Knee Society scores for all 5 patients revised with custom cementless ceramic femoral components improved significantly for objective score (preoperative, 39 ± 5; most recent visit, 90 ± 2) and function score (preoperative, 33 ± 8; most recent visit 93 ± 4) (P < .0001). The 12 knees revised with off-the-shelf cemented ceramic-coated femoral components had similar results. The 7 unrevised knees (including 4 knees with allergy to metal and bone cement) and the 4 knees revised with standard CoCr femoral components did not improve and worsened over time. Symptoms resolved in the 5 patients revised with custom ceramic implants and in the 12 patients revised with ceramic-coated components, but did not improve in the patients unrevised or revised with CoCr femoral components. Symptoms presumed to be associated with metal or cement allergy improve with the use of ceramic femoral surfaces, but patients who are allergic both to metals and bone cement would be candidates only for porous-coated ceramic implants fixed without bone cement.


Establishment of Vespa bicolor in Taiwan (Hymenoptera: Vespidae).
The establishment of a hornet, Vespa bicolor F., in Taiwan was confirmed based on successful field collection of adults of both sexes and two subterranean colonies. Information on nesting habitat, nest measurement, and colony composition of this species are provided in this article. V. bicolor is the ninth hornet species ever recorded from Taiwan. Possible pathway for the introduction of this alien species is also discussed.


Modeling of Retinal Degeneration.
We developed a model of retinal degeneration in rabbits based on exposure to light with a wavelength of 405 nm. This model allows reproducing structural and functional disorders in the central parts of the retina, including primarily degeneration of the outer layers of the retina (retinal pigment epithelium and layer of photoreceptor cells), and is designed to study the mechanisms of formation, progression and effectiveness of new drugs and methods of treatment of degenerative diseases of the retina.


[Traumatic hematoma of the adrenal gland simulating pheochromocytoma. A case report].
A young man with Weber B fracture had adrenalectomy under the suspicion of pheochromocytoma on the right side. Surprisingly hematoma of the right adrenal gland was found. This case is presented to point out the mechanism of trauma and diagnostic possibilities of the injury.


Identification of a sex pheromone component for the blueberry leafminer, Caloptilia porphyretica.
Coupled gas chromatographic-electroantennographic detection (GC-EAD) of both gland extracts and effluvial collections from female blueberry leafminer, Caloptilia porphyretica Braun (Lepidoptera: Gracillariidae), showed that females produced a single EAD-active compound. The amount of the compound collected from virgin female C. porphyretica was below GC and mass spectrometry (MS) detection thresholds, even with highly concentrated gland extracts (approximately 150 female equivalent). (E)-11-Hexadecenal (E11-16:Ald) was determined to be a sex pheromone component mainly by comparison of retention times with authentic standards on both polar and nonpolar capillary columns, microreaction-GC-EAD analyses, and field trapping tests. GC-EAD experiments showed that synthetic E11-16:Ald exhibited extraordinarily high electrophysiological activity, stimulating significant male antennal responses at as low as 10 fg. Traps baited with E11-16:Ald alone were attractive to males. Addition of 1 or 3% of its geometric isomer, Z11-16:Ald, to E11-16:Ald did not significantly increase trap captures, but an inhibitory effect was observed at the 10% level. The influence of two kinds of rubber septa on attraction was also evaluated. Male moth captures were higher in traps baited with red rubber septa than with gray rubber septa at 30-300-microg doses. Monitoring of adult flight activity with 3-microg doses of E11-16:Ald indicated at least three distinct flight periods throughout the 2003 season.


Advances in our understanding of the molecular basis of disorders of platelet function.
Genetic defects of platelet function give rise to mucocutaneous bleeding of varying severity because platelets fail to fulfil their haemostatic role after vessel injury. Abnormalities of pathways involving glycoprotein (GP) mediators of adhesion (Bernard-Soulier syndrome, platelet-type von Willebrand disease) and aggregation (Glanzmann thrombasthenia) are the most studied and affect the GPIb-IX-V complex and integrin αIIbβ3, respectively. Leukocyte adhesion deficiency-III combines Glanzmann thrombasthenia with infections and defects of kindlin-3, a mediator of integrin activation. Agonist-specific deficiencies in platelet aggregation relate to mutations of primary receptors for ADP (P2Y(12)), thromboxane A(2) (TXA2R) and collagen (GPVI); however, selective abnormalities of intracellular signalling pathways remain better understood in mouse models. Defects of secretion from δ-granules are accompanied by pigment defects in the Hermansky-Pudlak and Chediak-Higashi syndromes; they concern multiple genes and protein complexes involved in secretory organelle biogenesis and function. Quebec syndrome is linked to a tandem duplication of the urokinase plasminogen activator (PLAU) gene while locus assignment to chromosome 3p has advanced the search for the gene(s) responsible for α-granule deficiency in the gray platelet syndrome. Defects of α-granule biosynthesis also involve germline VPS33B mutations in the ARC (arthrogryposis, renal dysfunction and cholestasis) syndrome. A mutation in transmembrane protein 16F (TMEM16F) has been linked to a defective procoagulant activity and phosphatidylserine expression in the Scott syndrome. Cytoskeletal dysfunction (with platelet anisotrophy) occurs not only in the Wiskott-Aldrich syndrome but also in filamin A deficiency or MYH9-related disease while GATA1 mutations or RUNX1 haploinsufficiency can affect expression of multiple platelet proteins.


A rice DEAD-box RNA helicase protein, OsRH17, suppresses 16S ribosomal RNA maturation in Escherichia coli.
DEAD-box proteins comprise a large protein family. These proteins function in all types of processes in RNA metabolism and are highly conserved among eukaryotes. However, the precise functions of DEAD-box proteins in rice physiology and development remain unclear. In this study, we identified a rice DEAD-box protein, OsRH17, that contains a DEAD domain and all of the common conserved motifs of DEAD-box RNA helicases. OsRH17 was specifically expressed in pollen and differentiated callus and upregulated by application of the plant hormones naphthyl acetic acid (NAA) and abscisic acid (ABA). The OsRH17:GFP fusion protein was localized to the nucleus. Tiny amounts of OsRH17 and partial fragments (N-427 and C-167) were detected when they were expressed in Escherichia coli, a prokaryote. Growth of the host cells was suppressed in E. coli by OsRH17, N-427 or C-167, and this suppression was independent of the concentration of the NaCl in the medium. Expression analysis of rRNAs in E. coli revealed that the 16S rRNA precursor accumulated in transgenic E. coli cells, and the relative growth rate was inversely proportional to the levels of pre-16S rRNA accumulation. Results suggested that OsRH17 may play a role in ribosomal biogenesis and suppress 16S rRNA maturation in E. coli. No visible phenotype was observed in transgenic yeast and rice (overexpressing OsRH17, N-427, and C-167, as well as OsRH17 knockdown), and even in some abiotic and biotic stresses, which could be due to the redundancy in rice under normal conditions.


Development and validation of a kit formulation of [68Ga]Ga-P15-041 as a bone imaging agent.
One of the commonly performed studies in nuclear medicine are bone scans with [99mTc]Tc-methylene diphosphonate (MDP) for detecting various bone lesions, including cancer metastasis. The recent emergence of commercially available 68Ge/68Ga radionuclide generators makes it possible to provide 68Ga-labelled bisphosphonates as positron emission tomography (PET) tracers for bone imaging. Preliminary human studies suggested that [68Ga]Ga-HBED-CC-BP ([68Ga]Ga-P15-041) in conjunction with PET/computed tomography (CT) showed accumulation in known bone lesions, fast clearance from blood and soft tissue, and an ability to provide high contrast images. A simple and efficient lyophilized P15-041 kit formulation for the rapid production of [68Ga]Ga-P15-041 with excellent radiochemical purity (RCP) under ambient temperature without the need for purification is described. It is demonstrated that clinical doses of [68Ga]Ga-P15-041 can be prepared manually within minutes with an excellent purity (> 90%) and readily meet the dose release criteria. When [68Ga]Ga-P15-041 was evaluated in a patient with cancer, the imaging agent clearly showed accumulations in multiple lesions. In conclusion, [68Ga]Ga-P15-041, prepared by a lyophilized kit, might be an excellent bone imaging agent for widespread clinical application.


Intermolecular Non-Covalent Carbon-Bonding Interactions with Methyl Groups: A CSD, PDB and DFT Study.
A systematic evaluation of the CSD and the PDB in conjunction with DFT calculations reveal that non-covalent Carbon-bonding interactions with X-CH3 can be weakly directional in the solid state (P ≤ 1.5) when X = N or O. This is comparable to very weak CH hydrogen bonding interactions and is in line with the weak interaction energies calculated (≤ -1.5 kcal·mol-1) of typical charge neutral adducts such as [Me3N-CH3···OH2] (2a). The interaction energy is enhanced to ≤-5 kcal·mol-1 when X is more electron withdrawing such as in [O2N-CH3··O=Cdme] (20b) and to ≤18 kcal·mol-1 in cationic species like [Me3O+-CH3···OH2]+ (8a).


[Carbon monoxide poisoning: the importance of computed and magnetic resonance tomographic cranial findings for the clinical picture and follow-up].
Clinical, CT and MR imaging findings of 5 patients are presented who suffered from sudden coma due to carbon monoxide intoxication. Follow-up investigations were done for up to three years. 4 patients recovered with only minor deficits, while one patient survived with a severe choreatic syndrome. Cranial computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated typical lesions in the globus pallidus, the cerebral white matter and the cortex. Initial lesions of the cerebral white matter rather than of the globus pallidus seem to indicate a doubtful clinical prognosis. In the CT of the severe case progressive white matter atrophy was visible still after half a year. In contrast, in two cases with good outcome repeated MRI showed no progressive white matter changes.


N, P, O co-doped carbon filling into carbon nitride microtubes to promote photocatalytic hydrogen production.
Carbon nitride (CN) as the photocatalytic hydrogen production catalyst has attracted great attentions but suffering from a poor performance due to the unsatisfied energy band gap and the low separation efficiency of photogenerated carriers. Herein, we create a simple method to construct a novel CN-based photocatalyst, i.e., the N, P, O co-doped carbon filled CN microtube, which presents a narrow band gap, a high separation efficiency of photogenerated carriers, and a good stability. In this novel structure, the tubular morphology of CN ensures a narrow band gap, and the N, P, O co-doped carbon facilitates the transfer of photogenerated electrons. Coupling these two further reduces the energy band gap and improves the separation efficiency. For the photocatalytic hydrogen evolution under the visible light, the optimal sample presents an ultrahigh hydrogen evolution rate of 1149.71 μmol g-1 h-1 ranking at the top level, which is 112.60 times that of traditional bulk CN. In addition, it also has a high reusability and good stability after four cycle experiments. This study has provided a new viewpoint to design or develop the high-efficient photocatalysts for hydrogen production.


Whole-bowel irrigation should not be used routinely in poisoned patients.
Whole-bowel irrigation is a method of gastric decontamination in the poisoned patient involving administration of large volumes of osmotically balanced polyethylene glycol-electrolyte solution to empty the gastrointestinal tract of ingested toxins before absorption, limiting systemic toxicity. While this approach may seem intuitive, and observational studies confirm it can lead to expulsion of tablets or packets in the rectal effluent, there is a lack of evidence correlating this with improved patient outcomes. Administration of whole-bowel irrigation is also challenging to the inexperienced physician and associated with adverse effects, which may be serious. Recommendations for whole-bowel irrigation are therefore limited to patients who have ingested modified-release preparations, those who have ingested pharmaceuticals not adsorbed by activated charcoal and for the removal of packages in "body packers". Until more robust evidence is available from high-quality prospective studies demonstrating efficacy, the use of whole-bowel irrigation should not be used routinely in poisoned patients.


Assessing the Uniformity in Australian Animal Protection Law: A Statutory Comparison.
Animal welfare is not included in the Australian Constitution, rendering it a residual power of the states and territories. Commentators have suggested that inconsistencies exist between the state and territory statutes, and that a uniform approach would be beneficial. However, there has been no comprehensive assessment of the nature or extent of these purported inconsistencies. This review addresses this gap by providing a state-by-state comparison of animal protection statutes based on key provisions. Utilizing systematic review methodology, every current Australian statute with an enforceable protection provision relating to animal welfare was identified. A total of 436 statutes were examined, with 42 statutes being included in the detailed analysis. The comparison showed that animal protection laws are generally consistent between each Australian jurisdiction and were found to have similar shortcomings, notably including lack of a consistent definition of 'animal' and reliance on forms of legal punishment to promote animal welfare which have questionable effectiveness. It is argued that there is a need for attention to definitions of key terms and future consideration of alternative forms of penalties, but that a uniform federal approach may not be necessary to address these shortcomings.


Strategies to improve indigenous access for urban and regional populations to health services.
Lack of appropriate health service provision for Aboriginal and Torres Strait people still remains and important social determinant of ill health. Historically, health services have been absent or inappropriate. Cultural factors, financial factors and distance from health services have been important barriers limiting Indigenous access to mainstream health services. The Inala Indigenous Health Service, a mainstream health service has been able to improve Indigenous access from 12 Aboriginal and Torres Strait Islander patients in 1995 to 4000 patients in 2009, and approximately 1200 doctor consultations each month. Community consultation and participation were the main ingredients to improving indigenous access to the service. With improved access the Inala Indigenous Health Service has been able to analyse 413 Adult Health Checks aged 15-54 years. The Adult Health Checks provide an opportunity to evaluate health status, identifying chronic disease risk factors and for implementing preventive care. The Inala Indigenous Health Service has access to the Healthy for Life Program, a Commonwealth funded quality improvement program that has improved health outcomes for patients over the past three years. All primary health care services working in Aboriginal and Torres Strait Islander health settings should have access to funded continuous quality improvement activities.


Floor dust bacteria and fungi and their coexistence with PAHs in Jordanian indoor environments.
Floor dust samples were collected from Jordanian indoor environments (eight dwellings and an educational building) in Amman. Quantitative PCR (qPCR) analyses of selected fungal and bacterial groups were performed. The bacterial and fungal concentrations were also correlated with PAHs concentrations, which were previously measured in the same samples by using GC-MS. The bacterial and fungal concentrations varied significantly among and within the tested indoor environments. Based on the collected samples in the entrance area of the dwellings, the largest variation was found in Gram-negative bacteria and total fungi concentration. The lowest bacterial and fungal concentrations were found in the dwelling that was least occupied and the most recently built. At the educational building, the Gram-positive bacteria concentrations were lower than those observed in the dwellings. Unlike for bacteria, we observed significant negative correlation with some polycyclic aromatic hydrocarbons (PAHs). This calls for further studies investigating biodegradation of PAHs in house dust and presence of potentially health hazardous PAH metabolites. Since biocontamination in floor dust has been given relatively little to no attention in the MENA region we recommend that more extensive measurements be conducted in the future with chemical and biological analysis of floor dust contaminants and their exposure indoors.


Drought, hunger and coping mechanisms among rural household in Southeast Ethiopia.
Protracted and prolonged droughts lead to famine and substantial decline in agricultural productivity that contribute to food insecurity and hunger in sub-Saharan Africa which needs to explore the risk coping strategies to better target risk mitigation. The main research question of this paper was to analyze ex-post coping strategies and their determinants in rural Ethiopia. We use a cross-section data collected in 2013 from vulnerable rural households in Rayitu district, Bale Zone of Oromia Regional State. Using population-proportionate to size (PPS) sampling technique, a total number of 1,402 households in the district participated in this study. The data were analyzed using a three-stage least squares (3SLS) method. Our analysis confirms that rural households in Rayitu district experience drought and are vulnerable to the consequences of shocks. As a response, rural households adopt interdependent risk coping strategies. This supports the notion of addressing the problem of risk through integrated rural development strategies (and policies) to help the poor to improve the vulnerability to shock and help to escape out of poverty. In addition, we found that the risk coping strategies that households adopt are influenced by the resource holdings and income levels of the rural households, their access to product and financial market, and their socio-demographic characteristics. Hence, we argue that strategies and interventions to improve the livelihood of the poor and to support the vulnerable ones should be targeted to fit to the needs and priorities of households.


Congenital duplication of lower extremity--a case report and review of the literature.
Congenital duplication of the lower extremity is quite rare. Only 26 cases have been reported so far. A female infant with incomplete duplication of lower limb and with hypothyroidism was reported. Her mother's pregnancy and delivery was uneventful. A tube-like skin tissue was found on the posterior aspect of the infant's left thigh. Her left foot presented equinovarus deformity. There were three extra toes on the plantar side of her foot. A band of skin with a thin horny layer, similar to the dorsal surface, could be seen on the sole. The skin tube on the thigh was simply resected. A neuro-vascular-islanded toe was made from the plantar toes and rotated to restore five toes on the foot. The transferred toe thrived in accordance with the surrounding toes. The patient could run without difficulty at the age of 3. Previous reports about this case are summarised and reviewed here.


Spontaneous remyelination following prolonged inhibition of alpha4 integrin in chronic EAE.
Inhibition of alpha(4)beta(1) integrin blocks immune cell influx into the CNS providing benefit to patients with multiple sclerosis and in animal model systems. We have used this mechanism to examine whether the presence of inflammatory cells suppresses spontaneous myelin repair in experimental autoimmune encephalomyelitis. We observed (1) 87% of plaques showed remyelination after 40 days of treatment; (2) myelin repair occurred in half of the total lesion area; (3) half of the animals regained motor function. There was no significant repair or gain of motor function in vehicle-treated animals. Therefore, prolonged inhibition of CNS inflammation, in the absence of targeted myelin repair, facilitates mechanisms of spontaneous remyelination.


11-oxygenated androgens and their relation to hypothalamus-pituitary-gonadal-axis disturbances in adults with congenital adrenal hyperplasia.
Hypothalamus-pituitary-gonadal (HPG)-axis disturbances are a common phenomenon in patients with classic congenital adrenal hyperplasia (CAH). 11-oxygenated androgens have been suggested to play a role in this context. Cross-sectional single center study including 89 patients (N = 42 men, N = 55 women) with classic CAH. Differences in steroid markers in men with hypogonadism and women with secondary amenorrhea with a special focus on 11-ketotestosterone (11KT) and 11β-hydroxyandrostenedione (11OHA4). Hypogonadotropic hypogonadism was present in 23 % of men and 61 % of those women currently not on contraceptives suffered from irregular menstrual cycles or amenorrhea. Testicular adrenal rest tumor (TART) was documented in 28 % of men. 11KT (3.5x) and 11OHA4 (5.7x) among other adrenal steroids were significantly elevated in men with hypogonadism and in women with amenorrhea in comparison to those with a regular cycle (11KT: 5.2x; 11OHA4: 3.7x). 11-oxygenated androgens were not higher in men with TART than in those without. There was a negative association of 11KT and 11OHA4 with FSH but not with LH in men. As expected, all steroids were strongly correlated with each other and cases of disproportionally elevated 11-oxygenated androgens that could explain for HPG-disturbances or TART in otherwise controlled patients were rare and also found in eugonadal individuals. In CAH, 11-oxygenated androgens are elevated in women with menstrual disturbances and in men with hypogonadotropic hypogonadism. Due to the close correlation of 11-oxygenated androgens with other adrenal steroids it remains to be shown if their measurement is superior to conventional markers of androgen control.


Mechanical interactions of invasive cancer cells through their substrate evolve from additive to synergistic.
Non-contacting, adjacent cancer cells can mechanically interact through their substrate to increase their invasive and migratory capacities that underly metastases-formation. Such mechanical interactions may induce additive or synergistic enhancement of invasiveness, potentially indicating different underlying force-mechanisms. To identify cell-cell-gel interactions, we monitor the time-evolution of three-dimensional traction strains induced by MDA-MB-231 breast cancer cells adhering on physiological-stiffness (1.8 kPa) collagen gels and compare to simulations. Single metastatic cells apply strain energies of 0.2-2 pJ (average 0.51 ± 0.06 pJ) at all observation times (30-174 min) inducing a mechanical volume-of-effect in the collagen gel that is initially (<60 min from seeding) on the cell-volume scale (∼3000 µm3) and on average increases with time from cell seeding. When cells adhere closely adjacent, at short times (<60 min) we distinguish the additive contributions of neighboring cells to the strains, while at longer times strain fields are synergistically amplified and may facilitate increased cooperative/collective cancer-cell-invasiveness. The results of well-spaced and closely adjacent cells at short times match our simulations of additive deformations induced by radially applied strains with experimentally based inverse-distance decay. We thus reveal a time-dependent evolution from additive to synergistic interactions of adjacently adhering cells that may facilitate metastatic invasion.


Risperidone attenuates brain damage after focal cerebral ischemia in vivo.
Since their introduction, atypical neuroleptic agents have been discovered to have some beneficial effects beyond their effectiveness as neuroleptic drugs. Among these initially unexpected effects are their potential effects as mood stabilizers in bipolar disorder and their efficacy in improving long-term outcome in schizophrenia. These effects recently raised the question whether these drugs may also have some neuroprotective effect in the brain. To examine this matter, in this study we evaluated the neuroprotective effect of risperidone after permanent focal cerebral ischemia. Anaesthetized male C57BL/6j mice were submitted to permanent thread occlusion of the middle cerebral artery (MCA). Risperidone (0.1, 1 or 10 mg/kg) or vehicle was applied intraperitoneally just after permanent ischemia. Twenty-four hours after permanent ischemia, brain injury was evaluated by triphenyltetrazolium chloride staining (TTC). Risperidone (0.1, 1 and 10 mg/kg) showed significant neuroprotection after permanent focal cerebral ischemia.


Isotachophoretic determination of mobility and pKa by means of computer simulation. IV. Evaluation of m0 and pKa of twenty-six amino acids and assessment of the separability.
Isotachophoretic qualitative indices, RE, of twenty-six amino acids were measured at several pHL values in the range of 8.6-9.6. The absolute mobility, m0, and pKa values were evaluated by the use of a least-squares method utilizing a simulation of the isotachophoretic steady state. The pKa values were in good agreement with values cited in the literature. The RE values simulated using the evaluated constants were in good agreement with RE values converted from step heights observed previously. By comparing the previously observed separation behaviour of amino acids with their simulated effective mobilities, it is concluded that when the effective mobility of samples differs by ca. 1 X 10(-5) cm2 V-1 s-1 at the steady state, ca. 10-nmol samples can be separated by the use of a 80 cm X 0.5 mm I.D. tube. The simulated effective mobilities of twenty-two amino acids were tabulated to assess the separability under some typical electrolyte conditions.


Drug screens of NGLY1 deficiency in worm and fly models reveal catecholamine, NRF2 and anti-inflammatory-pathway activation as potential clinical approaches.
N-glycanase 1 (NGLY1) deficiency is an ultra-rare and complex monogenic glycosylation disorder that affects fewer than 40 patients globally. NGLY1 deficiency has been studied in model organisms such as yeast, worms, flies and mice. Proteasomal and mitochondrial homeostasis gene networks are controlled by the evolutionarily conserved transcriptional regulator NRF1, whose activity requires deglycosylation by NGLY1. Hypersensitivity to the proteasome inhibitor bortezomib is a common phenotype observed in whole-animal and cellular models of NGLY1 deficiency. Here, we describe unbiased phenotypic drug screens to identify FDA-approved drugs that are generally recognized as safe natural products, and novel chemical entities, that rescue growth and development of NGLY1-deficient worm and fly larvae treated with a toxic dose of bortezomib. We used image-based larval size and number assays for use in screens of a 2560-member drug-repurposing library and a 20,240-member lead-discovery library. A total of 91 validated hit compounds from primary invertebrate screens were tested in a human cell line in an NRF2 activity assay. NRF2 is a transcriptional regulator that regulates cellular redox homeostasis, and it can compensate for loss of NRF1. Plant-based polyphenols make up the largest class of hit compounds and NRF2 inducers. Catecholamines and catecholamine receptor activators make up the second largest class of hits. Steroidal and non-steroidal anti-inflammatory drugs make up the third largest class. Only one compound was active in all assays and species: the atypical antipsychotic and dopamine receptor agonist aripiprazole. Worm and fly models of NGLY1 deficiency validate therapeutic rationales for activation of NRF2 and anti-inflammatory pathways based on results in mice and human cell models, and suggest a novel therapeutic rationale for boosting catecholamine levels and/or signaling in the brain.


Senior BSN students' confidence, comfort, and perception of readiness for clinical practice: the impacts of COVID-19.
The Coronavirus Disease 2019 (COVID-19) has impacted overall nursing education program requirements, classroom delivery of theory hours, as well as clinical and laboratory learning opportunities for students. The aims of this study were to explore the impacts of COVID 19 on the students' perceptions of readiness for practice and their preparation for the NCLEX exam and initial clinical practice. A cross-sectional descriptive design was used to investigate the impact of COVID-19 on senior BSN students' preparation for NCLEX and future careers. The Casey-Fink Readiness for Practice Survey was used to investigate the perceptions of the BSN students' clinical confidence and readiness for practice. Students reported substantial impacts of COVID-19 on their clinical experiences, their ability to practice skills and procedures, their preparations for NCLEX exam, and their nursing career. The most significant confidence concerns noted from this study seemed to center on handling multiple patient assignments, calling the physician, responding to a change in patient condition, and treating a dying patient. Healthcare experts expect that the impact of COVID-19 may last until 2022. More research is needed to understand the impact of COVID-19 on nursing education and transition to nursing practice. While clinical confidence and readiness for practice are essential topics, more research is needed to investigate the psychological and physiological impacts of COVID-19 on nurses, nursing students, nursing preceptors, and faculty members.


The 3-deoxysappanchalcone induces ROS-mediated apoptosis and cell cycle arrest via JNK/p38 MAPKs signaling pathway in human esophageal cancer cells.
The 3-deoxysappanchalcone (3-DSC), a chemical separated from Caesalpinia sappan L, has been substantiated to display anti-inflammatory, anti-influenza, and anti-allergy activities according to previous studies. However, the underlying mechanisms of action on esophageal cancer remain unknown. The present research aims to survey the action mechanisms of 3-DSC in esophageal squamous cell carcinoma (ESCC) cells in vitro. Evaluation of cytotoxicity was determined by MTT tetrazolium salt assay and soft agar assay. Cell cycle distribution, apoptosis induction, reactive oxygen species (ROS) generation, mitochondrial membrane potential (MMP), and multi-caspases activity were appreciated by Muse™ Cell Analyzer. The expressions of cell cycle- and apoptosis-related proteins were presented using Western blotting. 3-DSC blocked cell growth and colony formation ability in a concentration-dependent manner and invoked apoptosis, G2/M cell cycle arrest, ROS production, MMP depolarization, and multi-caspase activity. Furthermore, Western blotting results demonstrated that 3-DSC upregulated the expression of phospho (p)-c-jun NH2-terminal kinases (JNK), p-p38, cell cycle regulators, pro-apoptotic proteins, and endoplasmic reticulum (ER) stress-related proteins whereas downregulated the levels of anti-apoptotic proteins and cell cycle promoters. The effects of 3-DSC on ROS induction were counteracted by pretreatment with N-acetyl-L-cysteine (NAC). Also, our results indicated that p38 (SB203580) and JNK (SP600125) inhibitor slightly inhibited 3-DSC-induced apoptosis. These results showed that 3-DSC-related G2/M phase cell cycle arrest and apoptosis by JNK/p38 MAPK signaling pathway in ESCC cells were mediated by ROS. ROS generation by 3-DSC in cancer cells could be an attractive strategy for apoptosis of cancer cells by inducing cell cycle arrest, ER stress, MMP loss, multi-caspase activity, and JNK/p38 MAPK pathway. Our findings suggest that 3-DSC is a promising novel therapeutic candidate for both prevention and treatment of esophageal cancer.


Orthokeratology in adults and factors affecting success: Study design and preliminary results.
To report the study design and one month's preliminary results of a randomized, single-masked, one-year prospective study of orthokeratology (ortho-k) in adults wearing lenses of different compression factors. Adults aged 18-38 years, with myopia of -0.75 to -5.00 D and astigmatism < 1.50 D, were recruited and randomly assigned into two groups: a conventional compression factor or Jessen Factor (CCF) group (compression factor = 0.75 D) and an increased (extra 1.00D) compression factor (ICF) group. Clinical outcomes, including spherical equivalent refraction (SER) reduction, visual acuity, corneal hysteresis (CH) and corneal resistance factor (CRF), and signs and symptoms were collected at the one-month follow-up visit. Indicators of the level of satisfaction and quality of life after commencing treatment were determined via a satisfaction questionnaire and the NEI-RQL-42 questionnaire. Baseline data from 26 CCF and 24 ICF participants were analysed and no significant differences were observed between the two groups (p > 0.05). The first fit success rates were 90 % for CCF group and 83 % for the ICF group, SER reductions were 97 % and 95 % for the CCF and ICF group, respectively, with uncorrected high-contrast visual acuity of -0.06 (-0.18 to 0.42) and 0.00 (-0.16 to 0.52), respectively (p > 0.05) at the 1-month visit. Overall, the incidence of corneal staining was 77 % in the CCF and 79 % in ICF group; central corneal staining was 15 % and 33 %, respectively. However, the differences of corneal staining between the groups did not reach significance in any visit (p > 0.05). The main complaint from participants was glare (both groups). No significant differences in CRF and CH were found in the first month (p > 0.05). Both groups recorded high scores in the level of satisfaction questionnaire, with no significant differences between groups (p > 0.05). Compared with baseline scores, 1-month NEI-RQL-42 subscales of dependence on correction, appearance, and satisfaction with correction significantly increased, and the glare score significantly decreased in both groups (all p < 0.05). The majority of participants were satisfied with the treatment and no serious corneal adverse effects were observed. These results demonstrate that ortho-k lenses of default and increased compression factor (1D) demonstrated similar clinical performance and ortho-k can be a safe and well-accepted option for myopia correction in adults, but long-term observation is warranted.


A sensitive bioluminescence assay for myo-inositol.
A specific, sensitive bioluminescence assay for myo-inositol is described employing myo-inositol dehydrogenase linked to a commercial NADH bioluminescence kit. Optimum conditions providing a linear response over 4 orders of magnitude are presented with reproducibility of 6% CV and a sensitivity of 1 pmol. The assay is suitable for the measurement of inositol at low concentrations or in small volumes.


Strategies for shotgun identification of post-translational modifications by mass spectrometry.
The global identification of post-translationally modified proteins is a difficult challenge that is currently being addressed by many researchers in the field of mass spectrometry (MS)-based proteomics. The ability to identify thousands of proteins by shotgun-based strategies has made the mere idea of a global analysis of a particular protein modification seem reasonable. There has been much progress in the development of methods that make use of shotgun-based protein identification in the analysis of a wide variety of protein modifications, some of which will be discussed here.


Tick paralysis caused by Dermacentor andersoni (Acari: Ixodidae) is a heritable trait.
The heritability of the ability to cause paralysis was examined in crosses of virulent and avirulent Dermacentor andersoni (Stiles) (Acari: Ixodidae). Virulence was assessed using hamster bioassay. Paralysis was caused by the virulent parental strain but not by the avirulent parental strain. Four crosses were made: Avirulent female x Avirulent male (AA cross), Virulent female x Virulent male (VV cross), Avirulent female x Virulent male (AV cross), and Virulent female x Avirulent male (VA cross). The proportion of females that produced fertile egg masses was similar among the crosses; however, VV females produced fewer fertile eggs. This was attributed to the long-term laboratory colonization of the virulent strain. All crosses had similar levels of larval and nymphal engorgement and adult eclosion. The ability to cause paralysis was detected in progeny of all crosses except the AA cross. Both heterogeneous crosses caused paralysis, but the virulence was slightly less than for the VV cross. Virulence was similar among the AV and VA crosses, indicating that virulent males were as likely as females to pass the trait to progeny. Time to paralysis was faster for the VV cross compared with the heterogeneous crosses.


Ergosterol Attenuates Isoproterenol-Induced Myocardial Cardiotoxicity.
Phytomedicine has shown a promising potential for the prevention of cardiovascular system diseases and disorders. This study aimed to evaluate protective effect of ergosterol (ER) on isoproterenol (ISO)-induced myocardial cardiotoxicity. We found that pretreatment with ER significantly decreased levels of myocardial CK-MB and LDH, and alleviated myocardial damage induced by ISO in rat model. In addition, ER restored Nrf2 and HO-1 expression and inhibited apoptosis through upregulating Bcl-2 and downregulating Bax, cytochrome c, cleaved caspase-3, caspase-9, and PARP in rat hearts. Hypoxia-reoxygenation model in H9C2 cells confirmed the cardioprotective effects of ER. In conclusion, we provide both in vitro and in vivo evidence that ER significantly enhances Nrf2-mediated anti-oxidative activities, and exerts a protective effect on cardiomyocyte apoptosis. ER could be considered as a potential therapeutic agent to prevent myocardial injury.


Alcohol, smoking, and caffeine use among headache patients.
We reviewed the charts of 151 headache patients, seen initially in a specialty headache center between 1988 and 1994, to collect information regarding reported alcohol consumption, smoking, daily number of caffeinated beverages, and medications. Charts of 50 patients in a general medicine clinic were reviewed for the same information. No significant differences between headache patients and general medicine patients were found in consumption of alcohol, smoking, or caffeinated beverages. Thirty headache patients (20%) used caffeine-containing medications more frequently than recommended; 24 of these patients used the products daily; 18 of those had a greater caffeine intake from medications than from beverages. Over-the-counter caffeine-containing analgesics were overused by 12 of the patients compared to 21 patients who overused prescription caffeine-containing preparations. Headache patients consume minimal amounts of alcohol, tobacco, and caffeinated beverages. However, headache patients often use caffeine-containing analgesics more frequently than recommended, which may lead to rebound and withdrawal headache.


Hymenolepis diminuta-based helminth therapy in C3(1)-TAg mice does not alter breast tumor onset or progression.
An individual's risk of breast cancer is profoundly affected by evolutionary mismatch. Mismatches in Western society known to increase the risk of breast cancer include a sedentary lifestyle and reproductive factors. Biota alteration, characterized by a loss of biodiversity from the ecosystem of the human body as a result of Western society, is a mismatch known to increase the risk of a variety of inflammation-related diseases, including colitis-associated colon cancer. However, the effect of biota alteration on breast cancer has not been evaluated. In this study, we utilized the C3(1)-TAg mouse model of breast cancer to evaluate the role of biota alteration in the development of breast cancer. This model has been used to recapitulate the role of exercise and pregnancy in reducing the risk of breast cancer. C3(1)-TAg mice were treated with Hymenolepis diminuta, a benign helminth that has been shown to reverse the effects of biota alteration in animal models. No effect of the helminth H. diminuta was observed. Neither the latency nor tumor growth was affected by the therapy, and no significant effects on tumor transcriptome were observed based on RNAseq analysis. These findings suggest that biota alteration, although known to affect a variety of Western-associated diseases, might not be a significant factor in the high rate of breast cancer observed in Western societies. An almost complete loss of intestinal worms in high-income countries has led to increases in allergic disorders, autoimmune conditions, and perhaps colon cancer. However, in this study, results using laboratory mice suggest that loss of intestinal worms might not be associated with breast cancer.


Pretreatment of moso bamboo with p-toluenesulfonic acid for the recovery and depolymerization of hemicellulose.
Bamboo and its mechanical processing residues have broad prospects for high value-added utilization. In this research, p-toluenesulfonic acid was used for the pretreatment of bamboo to investigate the effects of extraction and depolymerization of hemicellulose. The response and behavior of changes of cell-wall chemical components were investigated after different solvent concentration, time, and temperature pretreatment. Results indicated that the maximum extraction yield of hemicellulose was 95.16 % with 5 % p-toluenesulfonic acid at 140 °C for 30 min. The depolymerized components of hemicellulose in the filtrate were mainly xylose and xylooligosaccharide, with xylobiose accounting for 30.77 %. The extraction of xylose from the filtrate reached a maximum of 90.16 % with 5 % p-toluenesulfonic acid at 150 °C for 30 min pretreatment. This research provided a potential strategy for the industrial production of xylose and xylooligosaccharide from bamboo and for the future conversion and utilization.


Rapp-Hodgkin ectodermal dysplasia.
A rare case of ectodermal dysplasia--the Rapp-Hodgkin syndrome--is presented. Its diagnosis is discussed and the importance of a multidisciplinary management and genetic counselling outlined.


An assessment of the safety of rapidly changing magnetic fields in the rabbit: implications for NMR imaging.
The effects of rapidly changing magnetic fields on the cardiac and respiratory functions of anaesthetised rabbits have been investigated. No changes were observed using pulsed fields with peak rates of change of 60 T/sec. The implications of these experiments for the safety of NMR imaging are discussed.


Nuclease hypersensitive regions with adjacent positioned nucleosomes mark the gene boundaries of the PHO5/PHO3 locus in yeast.
The chromatin structure of two tandemly linked acid phosphatase genes (PHO5 and PHO3) from Saccharomyces cerevisiae was analyzed under conditions at which the strongly regulated PHO5 gene is repressed. Digestion experiments with DNase I, DNase II, micrococcal nuclease and restriction nucleases reveal the presence of five hypersensitive sites at the PHO5/PHO3 locus, two of them upstream of PHO5 at distances of 920 and 370 bp, one in between the two genes and two downstream of PHO3. Specifically positioned nucleosomes are located next to these hypersensitive sites as shown by indirect end-labeling experiments. The positions deduced from these experiments could be verified by monitoring the accessibility of various restriction sites to the respective nucleases. Sites within putative linker regions were about 50-60% susceptible, whereas sites located within nucleosome cores were resistant. Hybridizing micrococcal nuclease digests to a probe from in between the two upstream hypersensitive sites leads to an interruption of an otherwise regular nucleosomal DNA pattern. This shows directly that these hypersensitive sites represent gaps within ordered nucleosomal arrays.


Plasmonic meniscus lenses.
Controlling and manipulating the propagation of surface plasmons has become a field of intense research given their potential in a wide range of applications, such as plasmonic circuits, optical trapping, sensors, and lensing. In this communication, we exploit classical optics techniques to design and evaluate the performance of plasmonic lenses with meniscus-like geometries. To do this, we use an adapted lens maker equation that incorporates the effective medium concepts of surface plasmons polaritons travelling in dielectric-metal and dielectric-dielectric-metal configurations. The design process for such plasmonic meniscus lenses is detailed and two different plasmonic focusing structures are evaluated: a plasmonic lens with a quasi-planar output surface and a plasmonic meniscus lens having a convex-concave input-output surface, respectively. The structures are designed to have an effective focal length of 2λ0 at the visible wavelength of 633 nm. A performance comparison of the two plasmonic lenses is shown, demonstrating improvements to the power enhancement, with a 22% and 16.5% increase when using 2D (ideal) or 3D (realistic plasmonic) meniscus designs, respectively, compared to the power enhancement obtained with convex-planar lenses. It is also shown that the depth of focus of the focal spot presents a 19.8% decrease when using meniscus lenses in 2D and a 34.3% decrease when using the proposed 3D plasmonic meniscus designs. The broadband response of a plasmonic meniscus lens (550-750 nm wavelength range) is also studied along with the influence of potential fabrication errors on the generated effective focal length. The proposed plasmonic lenses could be exploited as alternative focusing devices for surface plasmons polaritons in applications such as sensing.


Serum c-reactive protein in patients with serious trauma.
Daily serum c-reactive protein (CRP) concentration was monitored in 98 patients (26 female) admitted to the Major Injuries Unit (MIU) at Birmingham Accident Hospital following serious trauma. The mean (SD) increase in CRP concentration for 79 survivors and 19 non-survivors between days 1 and 2 after trauma were 69.5 (74.6) and 111.8 (59.0) mg/l/24 h, respectively (P = < 0.001). By day 4 after trauma the mean serum CRP concentrations for survivors and non-survivors were 150.9 (76.9) and 233.4 (100.8) mg/l (P < 0.001), respectively. Injury severity data were available for 50 patients. The mean (range) injury severity score was 25.2 (4-50), Glasgow coma scale 10.4 (3-15), revised trauma score 6.5 (3.39-7.8) and predicted survival 0.78 (0.02-0.99). Univariate regression analysis of serum CRP on days 1-5 after injury against revised trauma score and injury severity score, revealed an inverse correlation between day 1 serum CRP and Glasgow Coma Score (r = -0.306, P < 0.05), but no correlation with injury severity score or predicted survival on any of the study days. The lack of correlation between serum CRP and injury severity or predicted survival, and the strong association with actual survival, suggests that the acute inflammatory response to serious trauma and subsequent complications, is an important determinant of outcome.


The influence of scaffold architecture on chondrocyte distribution and behavior in matrix-associated chondrocyte transplantation grafts.
Scaffold architecture and composition are important parameters in cartilage tissue engineering. In this in vitro study, we compared the morphology of four different cell-graft systems applied in clinical cartilage regeneration and analyzed the cell distribution (DAPI nuclei staining) and cell-scaffold interaction (SEM, TEM). Our investigations revealed major differences in cell distribution related to scaffold density, pore size and architecture. Material composition influenced the quantity of autogenous matrix used for cellular adhesion. Cell bonding was further influenced by the geometry of the scaffold subunits. On scaffolds with widely spaced fibers and a thickness less than the cell diameter, chondrocytes surrounded the scaffold fibers with cell extensions. On those fibers, chondrocytes were spherical, suggesting a differentiated phenotype. Fiber sizes smaller than chondrocyte size, and widely spaced, are therefore beneficial in terms of improved adhesion by cell shape adaptation. They also support the differentiated stage of chondrocytes by preventing the fibroblast-like and polygonal cell shape, at least briefly.


Progesterone, brain-derived neurotrophic factor and neuroprotection.
While the effects of progesterone in the CNS, like those of estrogen, have generally been considered within the context of reproductive function, growing evidence supports its importance in regulating non-reproductive functions including cognition and affect. In addition, progesterone has well-described protective effects against numerous insults in a variety of cell models, animal models and in humans. While ongoing research in several laboratories continues to shed light on the mechanism(s) by which progesterone and its related progestins exert their effects in the CNS, our understanding is still incomplete. Among the key mediators of progesterone's beneficial effects is the family of growth factors called neurotrophins. Here, we review the mechanisms by which progesterone regulates one important member of the neurotrophin family, brain-derived neurotrophic factor (BDNF), and provides support for its pivotal role in the protective program elicited by progesterone in the brain.


Esophagus tissue engineering: hybrid approach with esophageal epithelium and unidirectional smooth muscle tissue component generation in vitro.
The aim of this study was to engineer the two main components of the esophagus in vitro: (a) esophageal epithelium and (b) smooth muscle tissue. Furthermore, (a) survivability of esophageal epithelial cells (EEC) on basement membrane matrix (BMM)-coated scaffolds and (b) oriented smooth muscle tissue formation on unidirectional BMM-coated collagen scaffolds was investigated. Both EEC and smooth muscle cells (SMC) were sourced from Sprague-Dawley rats. The EEC were maintained in vitro and seeded onto BMM-coated 2-D collagen scaffolds. Similarly, smooth muscle cells were obtained using an explants technique and seeded on unidirectional 3-D BMM-coated collagen scaffolds. Cell-polymer constructs for EEC and SMC were maintained in vitro for 8 weeks. Protocols to obtain higher yield of EEC were established. EEC formed a layer of differentiated epithelium after 14 days. EEC survivability on polymers was observed up to 8 weeks. Unidirectional smooth muscle tissue strands were successfully engineered. Esophageal epithelium generation, survivability of EEC on BMM-coated scaffolds, and engineering of unidirectional smooth muscle strands were successful in vitro. The hybrid approach of assembling individual tissue components in vitro using BMM-coated scaffolds and later amalgamating them to form composite tissue holds promises in the tissue engineering of complex organ systems.


Atmospheric insight into the reaction mechanism and kinetics of isopropenyl methyl ether (i-PME) initiated by OH radicals and subsequent oxidation of product radicals.
Studies on primary gas-phase reactions of emitted saturated and unsaturated ethers with oxidants and subsequent secondary reactions of product radicals with O2 in the presence of NO are important in their atmospheric chemical processes. To accomplish these findings, we have examined the chemistry of OH-initiated oxidation of isopropenyl methyl ether (i-PME) CH3C(CH2)OCH3 by electronic structure ca using density functional theory. Our energetic calculations show that OH additions to carbon-carbon double bonds of i-PME are more favorable reaction pathways than H-abstraction reactions from the various CH sites of the titled molecule. The rate constant values which are obtained from the transition state theory also signify that OH-addition reactions have faster reaction rates than H-abstraction reactions. Our calculated total rate constant of the reaction is found 9.90 × 10-11 cm3 molecule-1 s-1. The percentage branching ratio calculations imply that OH-addition reactions have 98.09% contribution in the total rate constant. The atmospheric lifetime of i-PME is found to be 2.8 h. Further, we have identified 2-hydroxy-2-methoxypropanol, methyl acetate, methy-1,2-hydroxyacetate and 1-hydroxypropane-2-one, 1,2-dihydroxypropan-2-yl format, 2-hydroxyacetic acid, acetic acid, and formaldehyde from the secondary oxidation of product radicals.


[Preventing transmission of infection in endoscopy: hygienic maintainance of flexible endoscopes and measures for personal protection].
For prevention of transfer of infective agents by the contaminated endoscope the importance of thorough mechanical cleaning of the endoscope and adequate disinfection is stressed. Mode of action and side effects of liquid disinfectants as well as resistance of microorganisms (spores and some mycobacteria) to germicidal chemicals are mentioned. The different steps of disinfection procedures and potential causes of failure are discussed. Automatic disinfection systems are required for a higher degree of security of both patient and staff of the endoscopic unit. A regular control of the efficacy of the disinfection process is recommended and models for implementation are discussed. For prevention of occupationally acquired infection general precaution guidelines (use of gloves, prevention of needle-stick injuries) and vaccination programs are stressed.


An improved in situ DNA hybridization protocol for detection of human papillomavirus (HPV) DNA sequences in paraffin-embedded biopsies.
In situ DNA hybridization is becoming rapidly an important technique for detection and typing of human papillomaviruses (HPV) in epithelial lesions, some of which (those due to HPV 16, 18 and 31) seem to possess an increased risk for progression into an invasive squamous cell carcinoma. An improved in situ DNA hybridization technique (Technique II) was described, and the results obtained in a series of cervical and penile HPV lesions were compared with those given by the in situ hybridization technique (Technique I) previously used in our laboratory. Special emphasis was made to increase the sensitivity with three basic alterations of the hybridization protocol; omission of the 0.2 N HCl wash, use of increased proteinase K concentration (from 50 micrograms/ml to 1 mg/ml), and elevated denaturation temperature (obtained by a heating block instead of an incubator). Poly-D-lysine as a slide-coating medium was replaced by Kodak Photo-Flo 200 to improve the attachment of the tissue sections on the slides. Identical HPV DNA types were discovered by the two hybridization techniques. The attachment of the tissue sections was equal on the slides coated with either poly-D-lysine or Kodak Photo-Flo 200, and the latter did not interfere with the sensitivity of in situ hybridization. The hybridization signals for HPV DNA were weak or moderate in 15/16 lesions with Technique I, but intense in 10/16 lesions with Technique II (P less than 0.001). Furthermore, the resolution of Technique II seemed to be superior to that of Technique I, while being capable of disclosing HPV DNA in the intermediate cell layers (P less than 0.001) and in basal/parabasal cell layers (P less than 0.025) of both the cervical and penile lesions. The discovery of HPV DNA in the parabasal cells provides important clues to the understanding of the biology of HPV infection in the squamous epithelium, and makes this improved in situ DNA hybridization technique invaluable in assessing the lesions, where low copy numbers of HPV are to be expected.


Inhibition of diacylglycerol:CDPcholine cholinephosphotransferase activity by dimethylaminoethyl p-chlorophenoxyacetate.
Cholinephosphotransferase [EC 184.108.40.206] activity of rat liver microsomes, with 1,2-di-0-[3H]acyl glycerol or 1-0-hexadecanoyl [U-14C]ethanediol as substrate, was inhibited by N,N-dimethylaminoethyl p-chlorophenoxyacetate (centrophenoxine). Inhibition progressed in a linear fashion with increasing drug levels and was complete at 30 mM concentration. It appears that the microsomal enzyme was largely affected by the drug itself because the hydrolysis products of centrophenoxine, viz., N,N-dimethylaminoethanol and p-chlorophenoxyacetic acid, were less inhibitory.


Transcriptomic analysis of Raphidocelis subcapitata exposed to erythromycin: The role of DNA replication in hormesis and growth inhibition.
The occurrence of hormesis in the algal growth inhibition test is a major challenge in the dose-response characterization, whereas the molecular mechanism remains unraveled. The aim of this study is therefore to investigate the changes in the molecular pathways in a model green alga Raphidocelis subcapitata treated with erythromycin (ERY; 4, 80, 120 μg L-1) by transcriptomic analysis. After 7 day exposure, ERY at 4 μg L-1 caused hormetic effects (21.9 %) on cell density, whereas 52.0 % and 65.4 % were inhibited in two higher exposures. By using adj p < 0.05 and absolute log2 fold change> 1 as a cutoff, we identified 218, 950, and 2896 differentially expressed genes in 4, 80, 120 μg L-1 treatment groups, respectively. In two higher ERY treated groups, genes involved in phases I, II & III metabolism processes and porphyrin and chlorophyll metabolism pathway were consistently suppressed. Interestingly, genes (e.g., pri2, mcm2, and mcm6) enriched in DNA replication process were up-regulated in 4 μg L-1 group, whereas these genes were all repressed in 120 μg L-1 group. Alteration trend in gene expression was consistent with algal growth. Taken together, our results unveiled the molecular mechanism of action in ERY- stimulated/ inhibited growth in green alga.